whykiki0103

Do you ever feel like you're a licensed narcotics pusher/IV starter for seekers?

I would say evenings. 11a-11p or 3-11p if u're not a morning person. I've done nights for 2.5 years and it really has affected my mood, energy level, sleep pattern and even social life! I am tired all the time during the day and it took me about 1.5 years to get used to night schedule. Sometimes you wake up at 3am on your day off and there's nothing to do. Yes, there are less supervision and people come together like family, but that largely depends on the culture of the floor. It's not like that where I work without a good leader. Right now, I am trying to get off nights because it's busier than the day with less staff and no support. The hospital doesn't acknowledge the night shift either (especially nurses' week)

Thanks for the input. I did not take this position.

I am down! :)

They're offering $15/hr (blended rate! ) and $20/hr including the stipend..... Free private housing, but will reduce hourly rate for a rental car.... Does this sound right? I really like the location, but $15/hr is such an abysmal number....

I think you need to be an ER nurse to find humor in this clip. :) Maybe we do need to slow down, make eye contact and let the patient know that we care about ingrown hair at 4am while the guy next to him is coding.

Hey, first of all, congratulations on landing a job in the ER as a new grad. :) You should be proud of yourself. *pat on the back* I started as a new grad in the ER myself and know exactly what you're going through. I know the school (or any tech/EMS courses for that matter) never prepared you to be an ER nurse as the courses are more geared towards Med/surg. Don't worry about what other people would think. You need to grow thick skin to work in the ER and you will eventually. :) I think the most important thing about being an ER nurse is PRIORITIZATION. For example, you have 2 patients who need to be discharged, another one needs pain med and screaming, the next one needs a bed pan, 1 person with fingerstick of 30 and paramedics just brought in a pt with chest pain. What would you do first? :) Know your resources, get acclimated so you can work fast, be flexible as your priority shifts constantly, and don't be too task oriented and forget about the assignment as a whole. Don't be afraid to jump in and learn as much as you can. For example, don't just watch a code, at least do compressions, hand out meds, get familiar with code carts, look for the pulse yourself, charge up the defibrillator, etc. It's quite different to be doing it than watching it. Write down diagnosis or drugs you've never heard of and look it up at home. You will do fine. Relax, have fun, learn lots and focus on prioritization! :) Good luck!

I'm having the same trouble where I work, but I made a mistake of handling things myself (i.e: confronted the tech myself) and now I have a "bad reputation" amongst the techs. Looking back, I took it too personally and was too prude & naive in thinking that everyone's a professional here and we can solve problems 1:1. I'm learning things the hard way, and I hope you don't make the same mistakes I did. There's bound to be some hazing especially when ancillary staffs have been there for years and you're just fresh out of school. They want you to acknowledge that they have more experience than you and want your respect. (plus a lot of times they're much older than you) So suck it up, do everything yourself and hopefully they will see that you mean business and start helping you out. When they teach you new things or correct you, (even if it's something you already know) either laugh it off or just say "Thank you." However, if they challenge you about something legal regarding patient care, don't back down. If you had a 200lb patient with stage III decub who needed repositioning and the all ancillary staffs ignored you, then talk to the charge nurse, but not in accusatory manner, but as a patient advocate. ex: "Hey, I have a pt who is 200lb with stage III decub who really needs to be repositioned, but I could not find any help at this moment. Can you help me out?" S/he will either come and help you him/herself or find someone to help you out. Always go through the AHN or whoever is in charge and don't take matters into your own hands! Use the system! I think it's a good idea to always explain why you're delegating as well. I once asked a tech to put a pt on a bed pan because I had to triage a pt who complained of chest pain, but she complained straight to the AHN that I was just talking to the pt and didn't put her on a bed pan. :angryfire Sometimes, you never win...... So yes, it sucks, but unfortunately, it's part of real life nursing as a new grad. Good luck!

A guy got stuck by a fish bone while removing a dead fish from the tank. couldn't even tell where this "puncture wound" was. Sent him home with a bandaid and tetnus shot. haha

I agree with CathyLew. It is ok to come to ER for non-emergencies, but don't complain when you have to wait hours to be seen because we prioritize ABCs first. I see more and more people coming to the ER as a clinic which is ok depending on their complaint. But things people can take care of through OTC drugs, home remedy or a visit to a nearby clinic shouldn't really come through the ER. For example, a lady c/o her knee pain in triage box, then she mentions burning on urination on assessment. After we collect urine sample, she suddenly wants her cholesterol level done and wants prescription for lipitor along with percocet b/c she knows her cholesterol is bad and she has chronic back pain. Then we have people coming in because they want refill on methadone and fentanyl or psych med. I mean... it's called EMERGENCY room for a reason. Emergency = life and death situations. Some people really abuse EMTLA and charity care... I can't stand people who c/o back pain for 3 months and expect to see the doctor right away so they screaming at the nurses. What were they doing all this time?! Why can't they wait 2 more hours if they were waiting on it for 3 months??? SOB and Altered mental status is a big red flag and should've been triaged as emergent. I don't know why they brushed it off. I would be really upset too!

It's been 2 months since I started working in the ER and I lost about 15lb!!!!!!!!!!!! Yes they are unintentional losses. I don't know if I should be happy about it or not. haha My coworkers told me they've all lost about 20~40lb their first year. How much did you lose if at all?

Thanks for all the helpful advices! I only use AC for people going for CT w/ contrast, people who need blood/ffp asap or just as a last resort. There definitely is a good day and a bad day for PIV.

I started working @ ER as a new grad this February and I am doing pretty well with everything EXCEPT starting a line!!! I know I am supposed to take my time, but I also need to draw labs before attaching the saline lock, so I need to do it pretty fast before blood hemolyzes. So far my score is 50/50 before I have to call my preceptor for help. Everyone is really anxious which does not help my own anxiety. I need help!! So please~~ share some techniques/advices/experiences. I've asked around and the majority of the answers are: just do a lot of them and you'll get it. Question1: I was taught to enter the skin at 20~30degrees, but I've seen a lot of people go about 15 degrees or lower. What do you guys do? Question2: When you get a valvy vein, what do you do? Someone told me to just push through with the needle, but I ended up hurting the pt and had to try the other arm. What's your strategy? Question 3: what is your favorite site for PIV? (besides ac) I don't like doing it on the hands b/c 1) it's painful and 2) i feel like it's going to blow easily.

Is ER considered critical care? Our ETD is lvl 2 trauma.

oh, plus isn't back massage contraindicated anyways for bed bound pt with redness? They found out that it is more likely to be damaging due to shearing force as Rn/Writer mentioned above and doesn't help circulation nor prevent pressure ulcers.