bjaeram

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.

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.

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.

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.

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!

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!

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.

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!

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

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

Code Pink usually means a baby is missing not coding!

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!

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!

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!

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!

Sickle cell patients aren't in chronic pain. They have a disease that can put them in crisis causing pain. Most days they are like anyone else. Some go into crisis more then others and some can go a long time between. Something else not mentioned is you can do simple blood work to determine if someone is in crisis or not. We have a couple of pain in the ass frequent flyers that seem to be drug seekers and we always do the blood work. If it comes back showing they are in crisis they get admitted and medicated. If it comes back normal they are asked to leave......and do so screaming and swearing. One in particular is such a problem security is notified the minute he checks in. I treat him with compassion and I medicate him when warrented. He can be nice some days but when he doesn't get what he wants he quickly turns into a jerk having to be escorted off of the property. He has been in jail for some time and I often wonder how his disease gets treated there. I'm sure not well. I do feel sorry for him and others and I will treat him with compassion HOWEVER he can be a jerk and we as nurses don't deserve to be treated like that for any reason. Other things like o2 and hydration are as important or more important then pain meds too. We can't forget that!

I'm glad it's over and no one was upset about the situation. I do want to add as others said though that getting informed consent is not supposed to be a nurses job. The MD is responsible for that. So really every time you are getting the consent you are in the wrong. I know a lot of places have nurses do it out of laziness of the doctor but it's not right. Clearly the patient was okay with the procedure happening and luckily it went well. Most patients would just happily sign the next time they were in and wouldn't think twice about it. You do have to be careful for the occasional ******* that will use it against you though!

I don't think you made a mistake at all. It is perfectly fine to take a forearm bp. If someone has a fat short upper arm it's almost impossible to get a good reading there and it does hurt like crazy. If the cuff is sized properly you will get the best result. I often find people grab a large cuff for a fat arm but the cuff covers the entire upper arm. That is also incorrect and will give an inaccurate reading. I often grab a long cuff not a large cuff!

You did nothing wrong! You could have given his reguards to your wife as well. It's not against HIPPA at all. The person gave you permission too. You can walk into any hospital and visit a friend and you are allowed to know anything they tell you. HIPPA protects their privacy and if they chose to tell you anything they certainly can. Going through a chart, talking to a doctor, getting info from the persons wife is all a HIPPA violation but talking to the patient is not.

Nurses have the best immune systems! The first 6 months you may be sick a lot but once your immunity builds you won't get sick often. My whole family had the puking, nasty stomach virus a couple of weeks ago...not even nausea for me! It's a great benefit to being a nurse. As far as the bugs....I work in the ER and I do see all of those on a regular basis. I would say scabies is the most common. You definitly don't have to be in a third world country they are everywhere. Its gross but we usually know right away and can take precautions against getting them. They aren't going to jump across the room at you. I have never gotten any of these things from people! We have had to call in exterminators after patients and you do get the phantom itches but you grow a tough skin eventually:) You are much more likely to catch stuff in public when you aren't looking for it. In the hospital you are vigilant and constantly washing your hands. In public you can be exposed and never have any idea. You can get lice from a movie theatre seat or a bus, bed bugs in a hotel, TB in an elevator, ect.

I think the LVN did an excellent job! She got the doctor, got the patients feet up, got an IV, got a bp and hr....she even wanted to call medics. It think this was all perfect emergency response. The MD on the other hand is an idiot. He refused medics....um if it's a true emergency this chick needed a hospital. He wanted to push atropine...ummm HR 50 in a young healthy doesn't indicate this, especially for a simple vagal. He assaulted the LVN. He fired her because she followed her scope of practice and now he is threatening her. Kudos to the nurse! I would love to hear how this turned out. Did you go to the meeting?

I don't think security is a lesser skill then a tech AT ALL! I would rather have a security officer in a room with me when I have a combative patient or an angry family member then a tech! A security officer may save my life by tackling a 300lb crazy man where a tech may save me a few minutes by doing my EKG for me. Don't get me wrong I think techs are invaluable and do a lot but I don't think it's a highly skilled job. I think you make great money for what you do! Hell $14.75 was my RN starting pay 10 years ago!

If the dilaudid makes him itch that badly I would have refused that and gotten an order for another pain med....problems solved! The patient is obviously a frequent flyer that knows the combination gives him a better high. I'm doubting he is allergic to all the other meds he says he is.. He is a manipulator trying to get the best high he can. Kudos to the nurse for recognizing that and not allowing it to happen!

GSW to the butt! The guy was more concerned that the police were going to take his shoes as evidence then the hole in his behind. At one point he got off the cart and put his shoes back on.....buck naked except for his Jordans!!!

Just one more piece of info that might be important. He is not on any meds, just diet controlled. He tried metformin and it made him angry and grumpy so he took himself off.