TlhRNED

We had this discussion in our ED tonight. If a patient is intoxicated, are they incompetent?

We are not a locked down unit- we have entrances and exits at both sides of the ED, there will not be any added staff, we are already fighting for staff, and we are not a grocery store.

Our facility is suggesting that we start collecting co-pays on insurances at the ED registration desk upon discharge. I am completely against this... Any feedback out there? To add clarification here... we do not have a locked ED. We are a small rural ED and this task is one they want to add to my registration/secretarial support staff, of which there is only one 24/7. We do not have a policy where patients go to a discharge desk or window. There are several different people who function in the registration and secretarial role and I have concerns for them.

I am a Nurse Manager in PA and we utilize ED techs. We follow the ENA EDT curriculum and guidelines for PA. It is up to the individual facility of what qualifications are preferred for the facility. I require EMT and CNA within one year of hire. The EMT certificatin gives a broader scope and knowledge base of Emergency Medicine.

I am interested in getting feedback on the JCAHO regulations for first dose medications and medication management from the ED perspective. Our pharmacy is telling us that we need to fax every non-stat order to them prior to administration to a patient in the ED. My arguemets are delays in patient care and hellooo... all ED orders are stat! :) Any thoughts?

We use the conscious sedation policy as well. There is not a thing you can do differently. Protect the airway. Go back to your basic ABC's. The unfortunate thing about Ketamine is that there is no reversal agent. The fortunate thing is the 1/2 life is short. More bad news... The lingering affects these kids can have are scarier than ****! They can have the hallucinations, nightmares, and sweating at home- good time for parent education! I would rather sit on a kid to hold him down any day! Ketamine is not my favorite...

Our pediatricians in my facility are pushing for our ED to start an initiative for patient/parent education on the effects of alternating or combining Tylenol and Ibuprofen in the Pediatric population. They do not want us treating all fevers and educate parents as to the reasoning- can you see the Press-Ganey scores now! :roll I am attempting to write a fever protocol- can you imagine the difficulty with so many differing opinions??? Any input out there?