nolabarkeep

I've had a similar experience as you. One thing that you have to accept is that computer charting will slow you down. I can't tell you how many times I felt my BP rise while standing in front of a monitor waiting for the program to respond. I now use those extra minutes to focus and prioritize. Unfortunately, your employer has spent millions of dollars to convert to this system, so it is not going to change. Our unit had a log to record problems/concerns with the program. You should right down all of your issues and present them to your NM. Be patient, and good luck.

I'm fairly certain that you need to consult the ED physicians on this. It is not within my scope of practice to remove a pt from a spine board.

It's offensive to many on this board because of the sheer hell we all had to go through to become a RN. Don't take it personally. Obviously, if you new any better, you would not have asked this question. If you were posting on any other professional board, you would get the same response. Yes, there are various Nursing degrees attained online. The major difference is that these degrees are available to those that are already practicing RN's.

Just what the medical field needs, another person who doesn't like to put forth an effort to achieve. I believe you can get an online degree in laziness in two semesters. Good luck!

While I agree with every thing you wrote, they all boil down to the money. Unless your spouse is wealthy, it's unrealistic to take that much of a pay cut. Kudos to anyone who can.

It has always been about the money. Pay not just nurses, but all educators more. This will lead more intelligent individuals to pursue teaching as a second job and/or a career. I can't imagine having to support a family on a teachers salary. It is sad.

Seasoned ER doctor: Option 1. New ER doctor: CYA protocol. It's amazing how much money and resources are wasted just to avoid that one in a million missed diagnosis. I've seen people have the super deluxe work-up only to request a specific amount of days off of work once they get the negative results.

I think a simpler scale would suffice. Maybe have a slimmed down rating system such as severe, moderate, minimal, and no pain. We have to reassess on all interventions. Pain is different because it is completely subjective. A pt can't exaggerate changes in HR or BP. It's not going to go away, so try to make it more efficient.

Leslie, thank you for your comment, it was ever so insightful. The Dr. is notified, of course. I am a RN, I don't make medical decisions without consulting the Dr. I assumed this was obvious. I will be more clear in the future. Medications such as Benzos and/or Benadryl can alleviate the side effects of Compazine. However, it doesn't always work. Hence the bolting out of the ER. Some humans are overly sensitive to medication and adding the side effects of a Benzo and/or Benadryl on top of that sometimes freaks them out even more. Medication is not always the answer, sometimes you can actually comfort your patient without pushing a medication into their veins. Do you work in the ER? It is not terribly uncommon for pt's to leave if things are not going their way. Hence the "WHAT CAN YOU DO?"

We give this for migraines a lot in my ER. I've seen more people freak out on Compazine than any other drug I administer. I just stay with them and give constant reassurance that the feeling will pass. Some pt's have run out of the unit at full speed, never to be found. What can you do? I'd run to.

Eventually, you will have to take report from this guy and be responsible for a pt. that he has cared for.

Pt. enters triage, pt. has bleeding laceration, oozing abscess, etc. Pt. feels the need to jam finger in said spot to show you where the wound is because obviously you don't notice the 4 inch laceration the is bleeding down their face.

I would report it to the CEO. You were a pt. at the time. They had no right to look up your medical records. What if you had a pregnancy test that was positive? They would know before your family. This is actually very disturbing. People get sued and/or lose their license for this kind of behavior.

So what you are asking for is that your job as a RN comes with certain stipulations, made by yourself, on who you will and will not care for. While I respect your pro-life stance, I would not want to work on the same unit as you. I guess your coworkers are screwed if a lady partsl bleed s/p abortion comes into the ER. Do you just step aside while your TEAM tries to save this woman from bleeding to death? This career is about caring for others regardless of sex, race, religious denomination, planetary alliance, past medical history, etc. Please, stick with teaching instead.

Happened twice the other day. The same company called report to another ED and then showed up at our ED. Neither crew bothered to pay attention to the name of the initial facility they called. Yes, they were reported.

The fact is, we deal with a lot of unkept/dirty humans in the ER. I can't tell you how many times I have to tell patients to stop touching their laceration that is oozing blood or their abscess that is draining MRSA all over the bed. You never know what you are touching. Unlike a visit to the doctors office, most people don't jump in the shower before coming to the ER. They have been sweating and vomiting for twelve hours or they've seized and soiled themselves, or they are 90 years old and live by themselves and have not bathed since last week. The point is, I'm not worried about offending people by wearing gloves. I'm here to protect the patients as well as myself.

As a male RN, I will perform any task I am ordered to do on any patient regardless of sex. I do, however, work together with my female coworkers to make the patients as comfortable as possible. I can't give you exact numbers, but I would imagine that a female patient would prefer a female RN performing/assisting in a pelvic exam and/or urinary catheter. Another problem is that it is unsafe for a male RN to be in a room alone with a female patient when performing these skills. It is easier in the ED where I work for a coworker to do it themselves instead of just standing in as a chaperone. I return the favor to my female employees without hesitation.

This is a good idea. I would assume that once FF's find out that said hospital is implementing this system, they will scratch that hospital off of their list. Having a driver present in the room is a good idea as well, but what about a homeless person? Our ER provides cab rides to some patients, but the monthly bill on this is outrages. This system has also been abused just like patients calling 911 to catch an ambulance to the ED to get their prescriptions refilled. Happened twice in one hour the other day. Pain management is a tough issue to debate since it is subjective, but ED's certainly should take advantage of resources to catch and discourage abuse. Physicians should also refuse to prescribe narcotics to these same patients. They should refer them to pain management clinics. This is an ED, not a doctors office.

The mom who brought her two teens to the ED for vague cold like symptoms and became irate when we explained to her that she had to stop eating her boiled crabs in the room.

You should not become a nurse unless you are somewhat of a masochist.

We have a tech in our ED who does all of the splinting of limbs. He actually knows as much, if not more than the physicians regarding orthopedics. I guess its possible to thoroughly train staff to suture wounds. I can't imagine a hospital spending that amount of time and money to do this. I also have never known a physician that would trust a tech to suture a patient. I believe this person(s) were making this up. What if there is a lac to the lip? This is a delicate procedure that needs a professional trained hand.

With all due respect, your school must not teach the art of properly placed punctuation.!? Report it! Would you want someone who could not pass the required curriculum taking care of you or your family.

You are going to drive yourself crazy. Go with your gut. If it turns out you don't like the decision you made, then change it. Do all that you can with your life. You could die tomorrow. Good luck!

I would refuse to collect the money. You are a RN, not a cashier. We are responsible for doing patient charges and I don't feel like RN's should be responsible for this. I could potentially be sued for fraud if the charges I enter are inaccurate. To make matters worse, the template we are presented with to base the charges is extremely confusing. Look, RN's are jack's of all trades. We are intelligent, inventive creatures that have the ability to do much. And we do MUCH without whining about it. This is why we are so easily taken advantage of. Be careful.

It is definitely a psychological issue maybe stemming from something from childhood. I had a 460 lb. pt who for the life of her could not swallow a tylenol. Strange. In a related story, I did learn a valuable lesson. If a nine year old can not swallow pills, don't put the pill in pudding in the hopes that he/she will be able to swallow it. Chocolate pudding art work all over the entire room. Pill still not swallowed!