RNCEN

EM Basic is a good one to get started with. I enjoyed it as a new nurse because it looked at CC's and the things you would be concerned for. ER Nurse Pro, SMACC, EMCrit, Dirt Medicine are others I've listened to.

I loved our old Nexiva's. I learned with them and was a fantastic stick with them (alos used them for U/S placements). We also had Jelco's with the "via valve" blood control, which were nice too. Now we have a terribly inferior product (IMO), and are using the BD Insyte Autogard. They are junk compared to what we were using.

IMO, you'll get more from the course after you've spent some time in the trauma environment.

Alaris has apparently had some serious issues with pumps doing this exact thing. We've had several where I work. Seems it wasn't through any fault of your own.

Unless I missed it, Nicardipine is not on that list. Easily titratable, and wonderful for htn management especially in stroke/head injured patients.

Never, EVER give a med that you did not draw up yourself. That's MY personal rule. If the person that drew it up is present, THEY can administer the med.

Is that a typical day? How many visits/year?

I don't think there is a lot of time wasted in our department transporting patients to hard tele areas. We do have medics available much of the time for those transports. An RN must accompany a patient receiving blood products, or any patient going to an ICU (not step-down). We do wait for standard transport frequently, and for a variety of reasons (staffing, volume, etc). This can delay the patient leaving the department by 60+ minutes at times.

I should have been more clear. I know what TAT is...I just don't know our values.

We have in house consultants on the project. I do not know exactly what the TAT is, but am hoping to find out tomorrow at our meeting.

I'm working with a multi-disciplinary committee that includes both department members and several other hospital-wide members to identify barriers to efficient patient care and flow both within the ED and transitioning to the inpatient side. Constraints--- add no FTE's, and we will not be considering any major construction. This project will be several months in duration and is only in the beginning stages. I'm reaching out to this forum because I think you may have valuable ideas and experiences. I'm curious as to what issues you've encountered in your departments in terms of flow, and what has been done to resolve them. We are identifying time wasting activities/processes in order to better serve our patients. We are a large ED, appx 90 beds, seeing 100K patients/year. We use a bedside triage model when possible, and have 3 acute "pods" a fast track/minor acute area, all with their own providers/PAC's. 2 radiology areas, 3 CT scanners, and several US techs on at any given time. We are also a trauma center, with a large population of elderly falls with anticoagulants. What time wasters do you have your department...and has anything been done about it? Thanks for your input!!

-What length of orientation did you have? 16 weeks -Were there specific ER classroom time or general nursing classes? How many hours would you estimate? Cardiac dysrhythmia class x 2 days, ACLS, PALS -What is your experience? (10 years med-surg or new grad) I was a new grad with experience as an ER tech while in nursing school - How long ago was your orientation period? (like was it 33 years ago or just last year?) 2012 Then here are some questions about your ER: -What is your current patient to nurse ratio? 1:3 or 1:4 in acute areas, we don't have assignments in minor acute, just pick up...usually 1:5 to 1:8 - What type of ancillary help do you have if any? ED techs (EKG's, straight sticks-no lines, transport to tests, assist with traumas) and Paramedics (lines, US lines, help with traumas, transport to tele floors) - What tasks do they do? See above - Can you send squads to triage? No - Do you have protocols? We get pt's started without orders, line, labs, EKG's if needed, urine, basic meds-zofran etc.

Forgot to mention, I passed easily. Many of my experienced (many years) coworkers did not pass, for what it's worth. They are very good nurses.

I took it as a new grad, and with only 7 (4 on orientation) months experience as an ER nurse. I was an ER tech for 2 years while in school...so I did have a little more experience. It's just a test, it doesn't make you an expert, although it would seem that is the intention of the BCEN. So, yes, it's possible. Does it REALLY mean anything...probably not.

We bedside triage nearly all our patients, and ultimately it is the primary RN's responsibility. That said, we typically have a team leader in each area (85 bed + hallways ER) to help, although they are frequently not available to triage. We work closely as a team, so help is never far away. Our ER operates with a triage team leader out front who directs patients to the 3 different acute areas and to minor acute based on a pre-designed grid system. Pt. assignment/placement may also depend upon what is going on in a specific area (IE, that area may get skipped if they have high acuity-such as concurrent MI/CVA/Cardiac arrest, etc.). We have 3-4 bed slots, and if you have an open room, you can bet you'll be getting a pt soon. It can be overwhelming, but it's what we do...our door to Doc times are very low.