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bjaeram

bjaeram

OB, ER
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bjaeram has 12 years experience and specializes in OB, ER.

bjaeram's Latest Activity

  1. bjaeram

    ENA CEN review

    It looks like the ENA has a new online study guide for the CEN. It has many videos, practice tests etc. It looks great BUT its $200. I'm curious if anyone has used it and what your thoughts are. Was it worth it? I'm having trouble getting organized and motivated to study. I think this would be a great way but I don't want to spend that kind of money and have it be a waste.
  2. bjaeram

    IV forms of Zofran and Decadron given PO???

    We do IV decadron all the time in kids. We usually mix it with Tylenol. Makes it taste better and most of the kids have a fever or could use some Tylenol.
  3. bjaeram

    Black Friday, Code Blue

    I am a little confused....I don't read where your patient actually coded. From what I get they just had a seizure. Seizures in themselves aren't typically dangerous or run worthy. She was probably unresponsive after because most people take a bit to come out of seizures AND you gave her 4mg of Ativan. That's kind of a lot for a seizure. Calm quiet codes are the best codes. No one should be yelling or running. There should not be 20 people in the room. You need maybe 5 people...CPR person, Respiratory bagging, a medication nurse, a scribe, and a nurse directing the show calmly from the foot of the bed. A runner outside of the room is a good idea too in case you need something. If you can keep the adrenaline down it makes everything go much smoother. Fast and loud are caotic and counterproductive. Just a thought for the future. I have a very good friend that nearly coded in child birth a couple months ago....hemorraging, bp 50/20, ect. She was in and out of it. After when she retold the story she just kept saying how calm everyone was and how nice that was. She said I wasn't scared because no one else in the room seemed scared. She knew she was very sick and people were working quickly around her but she didn't feel stress in the room. Her story was a huge reminder of what I already knew. Your stress level definitely translates to everyone on the team, the patient, and the family.
  4. bjaeram

    Charcoal/NG tubes

    Are most of you still using charcoal and if so when? We rarely do anymore. They say if you don't get it in in the first hour it does no good and even then it has little effect.
  5. bjaeram

    LOC or ABC first?

    In reality you do it all at the same time in about 15 seconds. It's not a long process you think through and do in order. If you are choosing an order for BLS everyone saying ABC is not correct. The newest version of CPR is actually CAB CHEST COMPRESSIONS come before breathing! In bystander CPR they don't even recommend breathing anymore. I think it depends on what setting you are in and who your resources are. In the ER a tech does compressions and respiratory does airway and and the RN assesses. they happen at the same time. You have to establish nonresponsiveness before doing CPR or you will get punched in the face by an angry patient. To the person that says you would never do CPR until the monitor showed asystole is very incorrect. They are rarely on the monitor yet when CPR starts in the ER. You don't take the time to put a monitor on a look at the rhythm. No signs of life....go directly to CPR. Then you worry about the monitor and iv's and airways.
  6. bjaeram

    Vital Signs Taking at ER

    Some people are just complainers and nothing you can do will make them happy. The good news is they do this every visit so even if they complain the higher ups will see it for what it is. A grumpy person that likes to complain. Don't worry about it!
  7. bjaeram

    SCAPEGOAT NURSE SUSPENDED UNFAIRLY new job offer HELP!!!!

    Seems odd to be suspended for an IV infiltration. They happen and are often now anyone's fault. Every nurse has had it happen and I've never heard of anyone being suspended for it. The uneven patient load is ridiculous! You should not have been given the 6th patient if other nurses only had 2 or 3. If I were you I would take the job you were offered and run far away from your current job!
  8. bjaeram

    When patients discharge... transportation

    Now they just stay in the room until a ride arrives and a volunteer wheels them down to the car. However our hospital is above capacity so we are starting a new process shortly to empty rooms quicker. We will have a discharge lounge where patients can wait for rides. It will just be a room with a bunch of chairs. An RN will staff it.
  9. bjaeram

    Low blood sugar, juice or D50?

    The patient is a known diabetic so I can almost guarentee there were orders on the chart for this situation. Were they on sliding scale insulin? If so the scale also includes what to do for lows, at least at our hospital. If not specific patient orders the hospital would have a policy. I would have done what you did. Just make sure they follow with breakfast or whatever meal to keep the sugar up. A quick sugar fix = a quick sugar drop when it wears off. Definitly give them some longer lasting carbs. That is a problem with a dose of D50 too! I wouldn't give IV sugar if you have an alternative...it's so hard on the veins!
  10. bjaeram

    Just found out my partner's dad is a DNR

    Why don't you just talk to dad about it? It's his decision not someone out of state.
  11. bjaeram

    My first code-feedback appreciated!

    You saved his life! The nurse or others may not have found him in time to get him back! GREAT JOB!
  12. bjaeram

    Day of Codes

    Code Pink usually means a baby is missing not coding!
  13. bjaeram

    Just applied!

    I just applied for a school nurse position at my girls school. I'm very excited, but trying not to get too excited because who knows if I'll get chosen or not. I'm qualified. I'm a BSN with 12 years of ER experience so I should be good there. Now they just have to like me! I have so many questions. I know all the medical I'll need but it's the school system, laws, ect I need to learn. Where do you find the laws for a school nurse in each state? Do you do routine lice, vision, scoliosis screening? I remember that as a kid! How do you know what ages and how often to do those things? Do teachers and staff come to you a lot? Do you have to do newsletters, websites, teach health classes, ect. Those things I'm not confident with. What do you wear, teacher clothes or scrubs? If it's teacher clothes I'll have to go shopping! I would love any information, advice, websites, resources, ect you might have! Especially someplace I can review the laws so I know what I can and can't do! Keeping my fingers crossed! I'm sure I'll have tons of questions if I get the job!
  14. bjaeram

    Dietary policy- vent

    Our hospital has only healthy food on the patient menu. They order off a menu via phone and the person on the other end knows what diet they are on and they can only order to fit that diet. There is no fried food on the menu, only baked. They have pizza but it's whole wheat crust and healthy toppings. No bacon for breakfast, ect. I think it's a great idea. If there are not unhealthy choices on the menu then they have no choice but to eat healthy. Of course family and friends still bring in the McDonalds and such but hey it's a start!
  15. bjaeram

    ER Nurses: What did you do before the ER?

    You can do it for sure! I had one year of post partum then went to ER. I have no desire to ever do med surg. I did just fine. You will learn a lot on the job. We hire new grads even in our ER. Go for it! You will love it!
  16. bjaeram

    Ruptured Appendix

    We just had this last night and the surgeon did the same thing. Antibiotics, watch and surgery in a week or so when it isn't so risky. Your surgeon is not crazy!