ThrowEdNurse

I worked my way through nursing school as a vet tech. We always did this for animals as a standard of practice.....cat and dogs do have stretchy skin and are so less dramatic than people. Which is why I think it would be an awesome technique for the elderly....behind biceps and to the chest wall....right?

If you don't want anyone to respond to your opinions, then don't give them. What makes you think that? Voice your opinion, just try not to let your obvious hostility show. It's slipping out for whatever reason. I haven't killed any 20 yoa CPs. Take a breath.

Oh, come on! The OP put chest pain in quotation marks! We all know what that means. Not sure how triage works in your house, but in mine, it demands that everyone is evaluated on a case by case basis. I thought this post was about IV size, not my person opinions about young people with CP that has no bearing on how I treat them professionally.

We don't work up every 20 yoa cp that comes in the ED, doesn't mean they don't get EKGs.....

Ridiculous! I would have come unglued. Despite his opinion about the size of IV needed, he shouldn't speak to you in a rude manner, which I assume he did by snapping at you. I would have also insisted he explain it to the pt. I also can't believe a 20 yoa cp gets worked up in your ED. He would've needed a hx in mine. Our requirement for contrast is a twenty. Also, if he was so concerned about this pt and thought he was so ill to require larger IV access, why d/c the existing, functioning 20? This just doesn't make sense to me. Sounds like he's going to be a challenge to break in.

Yeah, I was waaay to low. Forgot about the nipple line...:nuke:

I don't understand how these people can ask you to use nursing judgement to make important decisions. You don't have nursing judgement. It's ridiculous. To be safe, until you get this sorted, I would rush everyone back as an emergency. You can't go wrong with that. If they don't like it, they'll need to triage.

I broke a sternum in nursing school. Super gross.

I think we're all so used to suctioning, we don't think much of it. But I am thinking of the other kids. How many of them are bothered by it or freaked out? Are they able to understand with it and accept it? How does the pt feel about it? Does it embarass him to be suctioned in front of everyone or he is more embarassed by leaving class constantly. I think the decision should be his and the other students' opinion at least weighed.

Also, I have given a lot of thought to moving to one of those cushier, nicer hospitals...where the pts have insurance. But, I've heard there can be a lot of......pillow fluffing. I'm not sure I would be very good with the customer service as I am trying to focus on safe and good nursing. We don't even have pillows in my ER!

Sorry, Altra. I didn't intend for my response to come across so....charming. I have an injury and have been laid up for a month and a half on back and I've realized lately that I am losing my grip on reality and am having a problem keeping things in perspective as well as the ability to use basic reasoning skills. I am literally losing my mind from staring at four walls, watching tv, and reading. But, I don't think I was hurt at work. Well, probably was, but it's nothing I can prove. Plus, not everyone gets my sense of humor and it definitely doesn't read in text (flat) as I would say it in my head or outloud (jokingly.) Please forgive me!!!! Anyway, yes, someone gets assaulted that frequently in the urban hospital I work at. There is really no response by anyone. It sucks. I actually followed through on one guy who was on cocaine. I wound up going to court and making 3 separate trips downtown to court to follow through on the charges. The judge continually allowed him to postpone the trial as he alleged that he didn't know about the court date it, didn't have his judge, his judge didn't know, he was the ER for seizures (nope), and couldn't remember a thing. I just wanted to jump up and scream, "Liar, liar, pants on fire!!!! He was high and drunk and never once seized!!!" But apparently that is frowned on in court. So I gave up all this time, energy, money, missed days at work, left my coworkers short staffed, and repeatedly inconvenienced the cop who was working nights who filed the report, etc to make all these trips and get wound up and anxious about the court date for the case to eventually be dropped because his mommy (the man was 49 yoa) wanted to get him placed in a "long term care facility for drugs." After I informed the DA that those places didn't exist here and that even if he was placed somewhere that within the week he would be thrown out or leave andhe would be back living at the hourly rate motel down the street from my hospital and that he better not come back to my ER, I rolled out. I definitely learned my lesson. I suffered more during the process than he did and was taught a bigger lesson. I refuse to let the criminal get anymore of my time and the law protects them more than me. Sigh, my taxes at work....

Ummm? Well, clearly it's a cause for celebration. Usually I throw a big party and tell the story repeatedly over dinner? What do you mean???? File a report, press charges, see employee health as needed....and scrub down with cavi wipes head to toe.

Aside from the senile geriatrics and the pts with elevated ammonia who both spit, scratch, grab etc, I've been shoved across the room by a young healthy man who was 6' 4" who wanted to leave because it was time for his cocaine fix. I've been punched in the face and kicked multiple times in the head by a young girl in an acute psychotic state without warning because the clock said something ugly to her, I guess. She was talking to the clock and I guess the conversation didn't go well because she was mad! I've had full grown drunk man with extremely poor hygiene and the remaining teeth in his head were various shades of yellow and brown spit in my face when I told him to stop screaming racial slurrs down the hall in my hospital who's pt population is mainly black. Then of course the psych pt who doesn't take her meds, despite my taxes paying for them, come in and verbally abuse me for two hours as the resident refuses to chemically sedate her, eventually grab me by my hair and repeatedly scratch me in the face with her filthy, unwashed claw/hand. The only pt I don't mind having assault me are the confused geriatrics. The rest of them either choose to stop their meds, abuse alcohol, abuse drugs, etc and put themselves in the situation to have this illness that results in their assaulting me. The worst is when the family shows up and acts like they don't care that their family member assaults people with educations and jobs who are trying to help their behinds that have never done anything to contribute to society. I guarantee that if the people who make the rules regarding restraint usage and documentation got assaulted as much as we do, things would be different. It's ok to be injured as a health care worker but not to be restrained as a mentally unstable pt? They got it twisted. On average I have a major assault about every six months. Don't get paid enough!

I agree to go for all the easy ones first. They get you confident and used to how it should feel and how it should go. Als, this might sound horrible but try to get practice in on hard veins on people who aren't going to complain. The hard veins on a whiney pt who is puking or crying as you try to focus are a challenge for the most experienced nurse, oooh especially if they have an overbearing family standing over you and criticizing. Therefore, it may be good for you to practice on the dead, the near dead, the comatose, the sedated, the nonverbal, etc. I also recommend this for NG tubes. They are terribly difficult on someone who is awake and alert enough to cough, gag, grab, cry, etc. But you feel less pressure when you do it to someone who is intubated and sedated.

Please don't think this is a luxury. What this means is that we do everything in our power not to have to call. The doctor only gets called when we need intubation. Otherwise, we manage everything and keep the pt alive until the doctor pulls the chart. I think this is like ICU? I mean, you guys don't call the MD everytime the pt pukes or asks for the doctor or complains of the worse pain ever. I don't think we call for them anytime you wouldn't in ICU, just we have to manage their care until then without orders.