BigheartRN

Hi! As a former trauma SICU nurse we would get numerous patients sent up from the ED or trauma bays without a central line in place and pressors usually infusing. The resident/fellow/attending or whoever was available would place the central line and readjust the pressors and we would continue to stabilize the patient from there. I have never ever heard of us refusing a patient due to the fact they don't have a line in place, they are not intubated, etc... Usually the ED stabilizes them as much as they can and transfers them to us so we can continue the care at a more "intense and focused level".

Hi! I am a former critical care RN and just from reading your story the situation your describing sounds highly ridiculous and soo unsafe. I know that we don't have "mandated" nurse to pt. ratio but usually in the critical care area are max is 1:2, having a ratio of 1:3 is usually IMC criteria at least where I work. If any issues arise from you resigning to your job without notice you should contact your BON. Your license and the patients safety was at risk..you did the right thing and you hung in that nightmarish situation for 1 whole year so major kudos to you. Also usually fresh hearts ( less than 12 hours post op) are monitored 1:1 in the CVRR so it's so crazy you would have a 3:1 assignment with a fresh heart period. Best of luck to you! :)

Hello Allnurses!It's been awhile since I've posted but here's the rundown. I am a nurse with 2.5 years experience (medsurg/trauma/ortho/ transplant/ that was all in one unit) and then I transferred within the same hospital to the trauma SICU. I hail from a level I trauma center in the inner city. I recently accepted a nursing position in the ER at a community hospital much closer to my home. I am super excited since ER has always been something I've always wanted to do. I'm really nervous due to the fact I have zero ER experience but I have safely managed a 6-7 pt. load on the floors, I'm pretty good with time management and usually get my charting done in a timely manner, my reviews have been great in my previous job and I do feel confident in the nursing skill I have acquired. I just wanted any advice from any experienced ER nurses out there. I was told my orientation might be cut in half since I have nursing experience ( 6 weeks instead of 12) and we have classroom time as well. What I feel most nervous about is - charting ( I know the ER is a fast paced kinda place and I don't want to fall behind--the hospital I will be working at is all computerized charting)-Protocols ( I'm so use to having a DR's order for everything/ and I've read posts where the ED has protocols in place where you do not need a DR's order for everything like placing an IV, obtaining an EKG, etc.. ) -time management ( as I said before I manage time pretty well and have dealt with many situations where patients and family are diffcult) I just don't want to fall behind.I know I'm walking into a position that has high expectations of me since I'm coming from level I trauma center where all the sickest patients are sent to, I'm just nervous and don't want to disappoint myself and my future team of coworkers. I am going to add that the hospital I am going to does not take traumas ( if we do we stabilize and fly them out to my previous place of employment) and I will be in the adult ED not the PEDS division. I have been told that the ED I am going to is a super busy place and our ratios are usually 1:5. I will add I have been brushing up on my skills before starting I purchased an emergency nursing orientation book I've been Reading and taking notes paying close attention on how to care for pt's with chest pain and stroke care protocols. I also bought a small pocket sized notepad that I will use as my "brain sheet" once in the ED. Any advice would be greatly highly appreciated! I'm super excited but oh so nervous at the same time. Thank you all in advance!

Hello Everyone! I'm overjoyed to say that I've been accepted into the nursing program offered at my community college. I've been to orientation, and ready to begin classes in Fall 2008 :) However I'm nervous to begin, I must take and pass a medical math exam with a 97% to continue in clincal practices, I was wondering if any experinced nursing students and/or nurses have any helpful study tips? I also was looking for advice on on the ADN and BSN option, currently I'm in school for my ADN. I'm not sure if to continue for a BSN. Any advice? my dream is to be an ER nurse :) Thanks! -New nursing student