Ryan RN

out of curiousity, how many years have you been in "the hole?" everything that you said, sounds just like me. after 9 years of being I the ER, im finally getting out to go to endoscopy. based on my experience, employers don't really care about ER experience if you are applying to a completely different unit. im very lucky to even land that endoscopy position, mostly due to me charming the director and staff on my interview. good luck on your journey into a completely different unit

so heres my input on your situation youre a medic, your colleagues will know youre not an idiot and familiar with the emergency setting. here are the differences between being a medic and being a er rn 1- you will now have x patients at the same time instead of your usual 1 at a time 2- you will now be with the patient for hours instead of your usual 15 minutes 3- you will now get dumped on instead of being the dumper (haha) 4- you will now be serving turkey sandwiches to your patients and figuring out how they will be going home hopefully, you get a good preceptor. somebody who most importantly can train you in a fun way. I would rather have an ok but fun preceptor than a very smart/educated but strict one. you can practice safely and still have fun doing it good luck!

is it just me, or is the tubing absorbing some insulin not really affecting the patient at that time. if the tubing does absorb some insulin, the patient will still get checked every hour, and adjustments made. at the end of the day, does it hurt the patient in any way? let the ICU nurses figure that one out

if you can pass the CEN exam even without the years in the ER, you get my respect its a test that cannot be passed simply by being in the ER for 50 years. it shows that you have the knowledge. Lets be real, certain topics on that test you will most likely never see in your practice, depending on where you live (snake bites in suburban hospitals)

i remember when i first started in the ER, i wanted the senior staff to take me serious and not as a new nurse i passed my CEN in the first year and they congratulated me. i passed by CCRN in the 2nd year and they looked up to me i act like a idiot at work but everybody knows i know what im doing

it might take a little while, but you definitely need to develop a relationship with your doc to show that they can trust your judgement

If that was me, i would put it down as abd pain, esi 3. A quick ekg would most likely get ordered anyway so a normal ekg would just further back up an abd pain. Romi would probably get ordered anyway just to make sure, but hell most likely get treated with the gi cocktail instead of cardiac You need to be able to anticipate exactly what will get ordered, and document your symptom findings to accompany your nursing "diagnosis" Imo, if you can backup your triage decisions then you should be fine.

Been in like 5 ERs but i always had one home ER I also did ground critical care transport for several months, one of the best er jobs nobody talks about Flight is hard to get into

Im a 29 year old male whos been working in the ER for 9 years. During my career in the ER, i obtained CEN and CCRN status. Im arguably the least "serious" RN in the unit, but youll live with me Anyways, after 9 years of pushing dilaudid, giving out "free" turkey sandwiches, and handing out taxi vouchers, im getting a "promotion" to endoscopy I am sure it is nothing like the ER, but im hoping to enjoy my job again. Now, im not sure if im completely leaving ER, i still have thoughts of possibly doing it as a PRN but well see Anybody else jumpshipped and never looked back?

ive been a ER nurse for 9 years. I needed a change so I recently accepted a endo position over going to the OR. ill be replacing somebody who retired from endo after 30 years. the rest of the team have been there for forever basically, I just want some insight on a typical day of an endo nurse. it is hospital endo so im assuming ill be getting everything endo related among other things.

Once you leave medsurg, you get into a specialty.Why do you want to leave dialysis?

I guess it depends on the person. One unit might fit one better than another. I cant see how a dialysis unit is more crazy than the ER which is where im coming from. With that said, ill crap my pants in a pediatric or maternity unit.

I have a friend who works as a dialysis tech... If he can do it anybody can... I dont see how the RN role is that much more difficult.. SeriouslyYears of experience means nothing... The quality of those years is a different story...With that said... As long as you havent killed anybody, youre doing something right

I currently work in the ED with almost 6 years of experience. I have my CEN and CCRN certifications, with CPEN coming along the way. However, i have zero dialysis experience.Im thinking about getting into dialysis while staying in the ED as per diem. I have an interview comin up with a fresenius clinic. How much less pay am i looking at by going to dialysis? Will i need to start back at the bottom of the pay ladder even with my current exp?

I work in the ER and in am CEN certified. I have never worked a shift in the ICU, but i am also CCRN certified. I found the "pass ccrn" book useful.If you know your patho, then you should be fine, as the ccrn is basically a detailed pathophysiology test.

Yeah i used the pass ccrn bookTo give an idea on what the difference between cen and ccrn is...Ccrn fills in the gaps on the cen test.To put it another way, the nclex is like the test to how NOT to kill a patient. The CEN/CCRN is how to actually help save the patient.

I took the cen course by jeff solheim. It is a good course, ill give it to him, but dont expect to pass the test just by taking the course.If your hospital will pay for it, then take it. Youll learn something

Im from the ED so its kinda of like ED vs the rest of the hospital. Anyways, one day i felt that an ICU nurse talked down on me. Im not sure why but it happened. It didnt bother me at all. Ive never worked a single shift in icu but i got my CCRN anyway. Now nobody in the icu can feel like theyre "superior" compared to me.I guess its like the more you know, the more you expect from people. I do not talk down on people but when their ego gets too much of themselves, i just ignore them.

Use a pump for vanco or youll have a very red patientUse a pump for potassium or you can kill themWhen a patient tells you their pain is a 10 while eating a sandwich and talking on the phone with a smile on their face, and theyre asking you for dilaudid, it must be true... Jk

I believe triage is one of the more challenging section of the ED. Do it properly and everybody moves smoothly, in and out. Do it poorly and you risk putting bs patients into the main while leaving the real patients waiting in the waiting room. I understand that triage is supposed to be a quick process, but that extra minute or 2 can save a patient an hr or 2 wait when in the wrong dept.

One of my coworkers only does fast track. Been in the ER about the same amount of time i have been. He cannot handle the main ER but handles fast track just fine.If you can do the main without any problems, fast track is a piece of cake. Dont think it works the same the other way around. Maybe its just me.I just think that everybody should be rotated. Its all one big unit. I can kind of understand somebody whos been doing it for like 100 years but if youre one of the youngest in the ER and all you do is fast track, there isnsomething wrong

Dilaudid is about 5-10x stronger than morphine, depending on the source of that infoDilute your dilaudid with the frequent flier patients so they still get the analgesic effect without that instant high when pushed in rapidlyPotassium iv burns like hell. Put ice in a specimen bag and place on the iv site to numb it someNitroglycerin is notorious for headaches. Be careful about giving a beta blocker iv and calcium channel blocker iv. Can cause a rapid decrease in bp.I know a bunch more tips but im tired haha

As far as that hydralazine goes with the tachycardia...Wont it only cause tachycardia if it causes the bp to drop a bit too much? If im not mistaken, its a direct vasodilator with no chronotropic effect. I just cant see why hydralazine will cause a 230/130 to drop enough to actually stimulate the baroreceptors..... Just a thought.....

My best advice is to use your current knowledge from medsurge as stepping stones into the ER... Nothing worse than having a new ER nurse act like they know everything in a completely new environment. Im not saying act like a dummy, but show your new coworkers you are willing to take in what they teach you without "correcting" them. Certain things are done differently in the ER as you will soon find out. Also, getting your CEN will help show your new dept that you know what the heck you are talking about. Even if you dont have the "years of experience", getting that cert alone will help you gain knowledge that would otherwise take you years to figure out.