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wildlaurel specializes in Emergency.

wildlaurel's Latest Activity

  1. wildlaurel

    At the end of my rope...hate nursing.

    You don't say you hate nursing or caring for patients...you hate the hours, the place, the people...You will most likely not find your dream job right out of school, but you might find one that is a little more compatible with your lifestyle in terms of hours and working conditions. As long as you don't "hate" caring for patients - I think it's the environment/situation more than the career. The other thing to keep in mind, many people feel depressed and tired when they first work night shift - especially when they're trying to balance a day life as well. This might be part of what you're experiencing right now. Good luck with everything!
  2. I agree with several of the other posts, call RT - get them to assess the patient. If the patient had a hx of COPD - you have to be careful about over oxygenating. Go to the EDP and say, "I'm really concerned about this patient and need you to come assess her again." A central line would have been called for if she was septic or had poor vascular access. I'm not so sure you could have gotten anything beyond a 22 in someone like that - she was probably vasoconstricted if her H&H was that low...so don't beat yourself up about that. Nursing - all nursing, but especially ED nursing - is a team sport! You're not a marathon runner out there by yourself. You could also call your charge nurse and tell them you need help. I've been an ED nurse for 4 years now and I sometimes still call someone more experienced than me and say, "I need a nurse who's been doing this longer than me." Ativan would have calmed the pt some - she was probably oxygen starved and that is a scary feeling.
  3. I had a lady take an ambulance to our ED at 2 am once because she didn't get her piece of fruit before bedtime...because nobody was home to give her "care and comfort." I wanted to give her a fruit cup and send her home - the EDP wanted to work her up for a CVA!
  4. wildlaurel

    Pharmacy Techs in ED

    Hello, We're getting ready to implement the use of pharmacy techs in our ED with ALL patients. We already have techs who come in and verify meds on patients being admitted, but we'll soon have techs doing all patient meds. We're having conversations about the best way to have this flow...do the techs come to triage and do it, does the nurse do triage, then tell the tech...We'll only have 2 techs in a 60 bed ED... So, do any of y'all use pharmacy techs or people to do med recs separate from triage? If so, what is your flow?
  5. wildlaurel

    Violent psych patients - how do you handle them in your ED?

    Yeah - there was no reasoning with this patient - they were completely psychotic. Those people just scare me - I can take a mean drunk or a manipulative personality disorder - but psychotic people just cannot be reasoned with.
  6. wildlaurel

    The Patient That Helped My Patience

    Wow! So well written and engaging Loque! It is a good reminder that something that is small and annoying to us can be huge to someone else. I had a little old lady patient who came into the ED one day with constipation and I really felt for her - my mom has that problem too - and I talked to her about what we could do to get her immediate relief and then changes in diet, etc...When she left she cried and hugged me, saying, "I know it's just constipation, but you're the only one who really seemed to care how miserable I am."
  7. wildlaurel

    Calling Code Blue in ED

    In my ED we don't call Code Blues when we have a pt arrest or a CPR in progress come in. ED staff handles all codes in our department. If there is a Code Blue called anywhere else in the hospital, one of our docs responds with one of our EMT's and the rapid response team also responds - but none of those are ED nurses. The ED charge nurse does respond with the EDP if a code blue is called in a off-unit area (e.g., lobby or CT scan). The RRT also responds in that situation as well.
  8. wildlaurel

    Normal SQBS, critically low venous BS?

    Sometimes "milking" the patients finger - squeezing really hard, can elevate the blood glucose reading. I'm not sure it would do it by that much though.
  9. wildlaurel

    "You cannot have BSN or MSN on your nametag?"

    At my hospital we have RN, BSN or ADN or MSN on our name tags - the highest degree is the only one listed. So if you have your MSN it just says, Jane Doe, RN, MSN. I have my BSN and patients or families sometimes ask what it means and I tell them...and they'll ask, "so that is better than an ADN?" and I say, well, we all have to pass the same boards and the pass rates for ADN programs and BSN programs are pretty much identical! So, I'm proud of my BSN, but in the end, we're all RN's!
  10. wildlaurel

    Fluid restrictions vs Patient rights

    I think the big thing here is that, unlike with prisoners of war, you aren't depriving the pt of water to punish them. It isn't a form of torture - you're trying to help the patient - that is the concept of beneficence - if you can't do good, at least do no harm. Plus, it isn't as though you are depriving them of hydration of any kind or forever.
  11. wildlaurel

    What's the difference between medicine and nursing?

    Doctors, PAC's, NP's, etc., treat the disease - nurses treat the patient's response to the disease. That is the nursing school answer. I do believe that, but you also have to be able to anticipate what the doctor is going to order based on the patient. I work in an ER and when we have somebody come in with chest pain, respiratory distress, potential sepsis - whatever it may be, it is my job to anticipate the labs, other diagnostics and treatment the doctor might order. At the same time, you're reassuring the patient and their family and trying to keep them educated as to why you're doing what you're doing.
  12. wildlaurel

    More than half of ER nurses have been assaulted on job

    I am a new graduate ER nurse and I've gotta say that thus far when I've seen a patient becoming abusive, our charge nurses let them know pretty quick that they can leave if they are going to act that way and if they choose to continue being verbally/physically abusive, we'll call the police to help them find the door! However, when I worked as a CNA on a med-surg floor, I was verbally assaulted, punched and pinched a couple of times by patients - most of whom were elderly and confused. I really do believe they can't help it, but it doesn't make it any easier to handle. In both of the physical assault situations though, I was caught unaware because the nurse and the CNA I relieved hadn't mentioned this person's propensity to strike out. When I told my nurse about it, she said, "oh yeah, they mentioned that in report." Well, why didn't you tell ME?? I was angrier at the nurse than I was the patient.
  13. wildlaurel

    Pearsonvue "Trick". Is this TRUE? Does it Work Every Time?

    I was very skeptical about the "trick" because you hear from so many people that they got the pop-up and passed, but what about the people who don't post that they failed? I got the pop-up after taking the NCLEX and found out via quick results 2 days later that I had indeed passed. I had told a friend of mine about the "trick" and when she took the NCLEX the following week she tried the trick...and got the CC page and found out 2 days later that she had really failed. So, it validated the trick for me, but not in the happiest of ways.
  14. wildlaurel

    100% cotton scrubs

    Thank you so much for the website address, I'll check it out!
  15. wildlaurel

    100% cotton scrubs

    Where do you find 100% cotton scrubs! I just passed the NCLEX and start nursing next week, but can't find cotton uniforms anywhere and I'm allergic to polyester. My nursing school and CNA uniforms are 100% cotton...so I know they make them.
  16. wildlaurel

    Where is money wasted in healthcare?

    I am a new nurse, but I am now working in an ER and I totally agree with the abuse of ER services for everyday problems. My first day in the ED we had 2 people with tooth aches and a couple of ear aches! Having worked as a CNA I also agree with the palliative care comments. I encourage everyone I know to have a living will and make decisions about that kind of thing in advance so their children and family aren't left with the guilt of deciding to opt of ICU and extraordinary treatments. I also think we waste a lot of money in small things...I don't know how other healthcare systems do it, but where I work if someone comes in for surgery, KNOWING they're going to stay overnight in the hospital, we still provide them with everything they need for grooming. And if a patient does happen to bring their own things, most of the time the CNA's have already brought a basin full of stuff into the room and left it there - so it can't go back into supply. That is also a problem with nursing staff and their supplies. I can't tell you how many extra bottles of sterile saline or Kerlex (sp?) and 4X4's are left and thrown out in a room because the nurse didn't see what was there before she went in to do a dressing change. Or laundry costs - we had a patient leave after several weeks in the hospital and when housekeeping went to clean the room, they found 3 linen bags worth of clean laundry stored in the cabinets because it was brought in and never used and the patient stored it. Not only was it a pain for the housekeeper, but what a waste in laundry costs.