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Ciale's Latest Activity

  1. Ciale

    Handoff to PACU

    New to OR. Still on orientation and it seems like there’s no standard of handoff/report. Sometimes my preceptor doesn’t say anything and let’s anesthesia do it. What do you all include in your report?
  2. Ciale

    OR Job Interview

    I've been an ED nurse for 10 years and am stepping out of my comfort zone and applied for an OR gig. I have an interview and all of a sudden am feeling very nervous! I have just a few questions: 1. How long did it take you to feel like you knew what you were doing? 2. How often do you code a patient? And how does that work exactly in a sterile enviornment? 3. Who exactly is in the room with you during the surgery? 4. What equipment will you be expected to operate? 5. Do you always feel like you have no idea what the surgeon is actually doing? 6. Despite my ED experience, but personality is very laid back and I dislike confrontation. Do you think thats a suitable personality for an OR?
  3. Ciale

    Elevated troponin with renal failure?

    Thank you! The oncoming nurse asked if I got one when the pt arrived, I said no, and she rolled her eyes and ran to get a trop cartridge. Psh...dummy!
  4. Ciale

    Elevated troponin with renal failure?

    So maybe that's why the doc didn't order a POC Trop on my unresponsive pt the other day...they had already shocked him 6 times in the field so seems like a POC trop would be irrelevant?
  5. Ciale

    Emergency Room Skills

    I have good bedside manner and have gotten pretty dang good with IV's but that's about it right now. I'm a brand new nurse. I'm still pretty clueless with the crash cart/life pack and thank gawd there are people to help me when I need it. I feel like if I could just get some confidence, I could be pretty awesome but that's hard to do when you feel like you suck each day. I have so much respect for the experienced nurses I work with.
  6. Ciale

    Happy er nurses week

    We get sandwiches. Oh and they put up a giant expensive looking sign in the department that says "HAPPY ER NURSES WEEK" I wish they'd just pay us a critical care differential instead. That would be nice. Really feel like I earned it today. But I'm not bitter. NOPE!!!! Ilovemyjobilovemyjobilovemyjob....
  7. Ciale

    emergency prepared

    Meh. I would have just assessed LOC and held c-spine while making small talk until medics showed up. That's IF I would have stopped. I know that sounds terrible, but I know of too many nurses that were injured or killed while tending to traffic accidents. Future reference: walking, drinking and taking aspirin would all be contraindicated in the event you just described. Why did he crash? I feel no compassion for this guy...only irritation that he could have hurt someone. Does that mean I'm already a jaded er nurse?
  8. Just my two cents on this...I think it's important to remember that nursing students aren't there to "work". Students know how to get a patient water and a blanket. I think if I was a preceptor, I'd try and find out what skills they need to work on and what they feel comfortable with before the shift starts. That way, you've laid the ground-work for when they NEED to be in the room with you and when they can take a few minutes to study at the nurse's station. I do not believe students should be stuck to you like glue. I've literally seen them almost follow nurses into the bathroom while at clinical. Good advice/observation on the while "pity vs. compassion". I saw this on adult med surg units too. You've GOT to have a positive outlook to make it in nursing or you'll be depressed.
  9. Ciale

    NG tube in an intubated patient

    Right?!?!? Thank you!
  10. Ciale

    Death of Spouse

    I could not have explained this better than Esme12. KimRN, I am so incredibly sorry you had to go through that. You were definitely there for him, fighting for him. Often our training flies out the window when it comes to caring for our loved ones but it sounds like you were able to maintain your composure in order to give your husband the best chance at surviving. That takes incredible courage and strength. I cannot speak to the actions of the medics on-scene because I was not there of course. I recently lost my father very suddenly and traumatically and was left with many questions for the paramedics, hospital and for my non-medical family that was there. I was able to speak to the supervisor of the ambulance crew and received a copy of their report, also contacted the M.E. for a full tox report and obtained the ER report from his recent visits to the ER. It took a lot of time and energy but I felt it was the only way I could get closure. It was/is very difficult to deal with but personally, I did take comfort in having my questions answered. I wish you could have been part of their resuscitation efforts. I have always been in support of family presence. Again, so very sorry for your loss. No words.
  11. Ciale

    IV insertion problems

    If I don't think you're going to be admitted or if I think you might need contrast, I'm sticking a 20 in your AC. Aint nobody got time to look for veins!!!!!!! -ER nurse
  12. Ciale

    New nurses in the ER

    Thank you, OP. Gave me the warm n fuzzies :)
  13. Just reading this makes my stomach turn a little bit. Did you run a troponin? I'm pretty sure we're all in "bad codes" at some point. I'm a brand new nurse and I've already been in a couple. The other day I infused LIFE SAVING drugs into an iv that wasn't even in a vein! I just trusted that the ambulance crew had a good IV in place (came in hot doing compressions/no encode) and didn't even check it's patency *cringe cringe cringe* I've worked in ER as a tech for a few years and I watched the smartest most experienced nurses forget to turn on oxygen flow to a bvm during a code, fumble with pulse ox and bp cuffs when the patient doesn't have a pulse and countless other ding-dong moves. Don't get me started on physician goofs. Long story short, I think it's the nature of the job. After my crap code (in my mind...no one ever said anything to me about it), I asked the doctor for feedback on what could have gone better fully expecting him to tell me I suck. He said "there was probably nothing we could have done that would have made a real difference and that's why they call it "PRACTICING medicine" because that's all we can do...practice" So cliché but time heals all wounds. If you weren't a compassionate nurse, you wouldn't be on here talking about this. It's ok.
  14. Ciale

    Soft spoken nurses

    Meh...if it's just one person that has a problem, I wouldn't pay any attention to her. She sounds like she's kind of hateful. I work in a busy ER and I'm pretty sure I'm the ONLY soft-spoken nurse there. What I've learned is 1. Patients appreciate it and it's calming to them. 2. It can deescalate a bad situation quickly 3. People are forced to pay close attention to you when you're speaking. I work with mostly loud motor-mouths (don't get me wrong, I love them) but it's not real therapeutic. Haters gonna hate. Forget em.
  15. Ciale

    ER Doc, "I need Succ!"

    No. I refuse to believe the nurse came back with socks. that makes me very sad inside
  16. Ciale


    Definitely ask if ORTHO can come down to teach you. They are the most scrupulous when you send a patient to them for follow-up and they will not hesitate to call and find out who did the splinting if it's all jacked up.