wyosamRN

wyosamRN

ED, OR, Oncology

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All Content by wyosamRN

  1. Being blamed for fall after shift

    wyosamRN replied to notyetnurse's topic in General Nursing

    In every department I've worked in since I became a nurse, all patients are considered, and labeled, as high risk for falls (2 EDs, 2 ORs). Let me guess, all your patients in that ICU have a colored...

  2. Advice for a OR nurse wanting to make move to the ED

    wyosamRN replied to optimistic92's topic in Emergency

    I made that switch- it is easy to make that wrong assessment about what life in the OR is like, even after shadowing. At first, surgery is exciting, you feel like you're part of it, but after a while,...

  3. For nurses in WA or CO

    wyosamRN replied to MNNICU, RN's topic in General Nursing

    No one is saying it should be OK to be impaired while working. The problem is that the drug test commonly used (aside from what is currently evolving to enforce drugged driving in states where pot has...

  4. ED Ethics In Self Harm

    wyosamRN replied to ReadyToListen's topic in Emergency

    Not sure how it works in other places, but in one of the facilities I work in, any mention towards a suicidal ideation starts the 72 hour hold, court hearing, etc process. I think it is way over used,...

  5. med surg to ED

    wyosamRN replied to wayemika's topic in Emergency

    I think ED would be better experience- while you do see the trauma and critical patients, you also see all those people with fairly benign complaints that wont get them admitted. You have that solid...

  6. Medications in the Modern ED

    wyosamRN replied to jep395's topic in Emergency

    I would add that drugs used for intubation, including RSI, as well as drugs/drips used for maintenance should be included in drugs that you know like the back of your hand. Until you've done a bunch...

  7. IV Cather kinking when advancing

    wyosamRN replied to sreynolds's topic in Emergency

    Most of the time when this happens, the entire beveled tip of the catheter isn't all the way through the wall of the vein before

  8. Insurance & Weight Loss Meds

    wyosamRN replied to OrganizedChaos's topic in Activism, Healthcare

    And honestly, you cant necessarily fault the employer either. There are things that can legally be excluded from coverage by insurance, and things that cant. It is all a balance of dollars- the more...

  9. Fingerprinting patients?

    wyosamRN replied to sharkbacon's topic in Activism, Healthcare

    Don't confuse not wanting to pay nursing staff with not having an enormous budget to buy useless gadgets- hospitals cant seem to get enough of that

  10. Why is medicare going to be nonexistent?

    wyosamRN replied to Vtachy1's topic in Activism, Healthcare

    There is a very important piece of this puzzle missing. Why was she at the doctor? How long since she last had lab work done? If you go to the doctor and say "I don't feel well", or grandma doesn't...

  11. Adenosine administration

    wyosamRN replied to sreynolds's topic in Emergency

    I think whats really different about this is the lead up- if the patient presented with a rate in the 170's, most of the things you asked if the physician wanted prior to administration would normally...

  12. Are ER Patients Getting More Ridiculous?

    wyosamRN replied to us2uk4u's topic in Emergency

    Absolutely- with the ratios we typically run, I am quite thankful that a good majority of the people in my rooms are not particularly sick. Prioritization is much easier that way. I'm not afraid to...

  13. Fall risk score for Peds?

    wyosamRN replied to amandagbrink's topic in Emergency

    That drives me crazy- we are supposed to do a fall risk assessment on everyone that walks through the door, including peds. Then every single one of them gets the same fall risk band because by...

  14. First PICC insertion!

    wyosamRN replied to francoml's topic in Infusion, Intravenous

    A single should be fine- you know exactly where you're going, so numbing a small area should be

  15. I don't know if I can do it...encouragement needed

    wyosamRN replied to PERSEPHONE01's topic in Emergency

    How many years as an RN? I would think that being very comfortable in your work role would make it easier to focus on being a student when not at

  16. Feeling Discouraged- Heparin Drip

    wyosamRN replied to FloatFNP-C's topic in Patient Medications

    Sounds like bridging prior to a procedure to me. Heparinize the patient, then reverse the coumadin. The reason you do this, is it is much faster and more predicable/controllable to "dehaparinize" the...

  17. job is getting to me today

    wyosamRN replied to joe007's topic in Emergency

    I bet that shooting up succs to get high is a bit

  18. job is getting to me today

    wyosamRN replied to joe007's topic in Emergency

    I think we are all missing the bigger picture here- the real problem here, is that as emergency nurses, we spend a ridiculous amount of time each day wasting (or witnessing the waste of others) 1 mg...

  19. patient re-assignment question

    wyosamRN replied to NurseCallus's topic in Emergency

    While not always possible, we try to avoid this, especially on sicker patients, patients transferring/being admitted/go to the OR. If it is going to happen reasonably soon, it make more sense for the...

  20. IV catheter changes..

    wyosamRN replied to RNnewbie2014's topic in General Nursing

    IV abx for weeks should probably be considering a PICC

  21. Best ER Tricks what it meant is like putting two tourniquet to get the IV

    wyosamRN replied to Wantoknow-rn's topic in Emergency

    This is a good trick- the monitors on the anesthesia machines at the facility where I work have a setting for this- just hit the veni-puncture button, it inflates the cuff and holds it. Can also...

  22. I/O in ER

    wyosamRN replied to kool-aide, RN's topic in Emergency

    We all save lives in the manner appropriate to our setting. If having every drop of urine counted is the method you employ, then quit stalling, take report, and start measuring urine so I can fill...

  23. shotgun knowledge from emergency geniuses

    wyosamRN replied to tarotale's topic in Emergency

    We always draw lactic without a tourniquet, if we cant get the line that way, then we draw everything else and lab will come draw the

  24. CNA vs. PCT (ER)

    wyosamRN replied to EricD's topic in Emergency

    We use EMT's in our ED (titled as ED techs), more useful than CNA's, since their scope of practice is bigger. If you can go that route, you'll get to do more (line & lab, splints, EKG's,

  25. Rules for Triage

    wyosamRN replied to Anna Flaxis's topic in Emergency

    I had a twofer a while back that while the original two were BS, one of the many children that were brought along ended up being admitted. I was bringing another warm blanket or some such into the...