ERRN324

Thank you very much for that response. It is somewhat strange because I started out with this EMS company as an Explorer doing ride alongs on their ground ambulances, then worked side by side with them for 10 years as a volunteer firefighter, then worked contract work on their fixed wing and now I will be an employee on their rotor aircraft. I know all the crew quite well so it is exciting but there are some little things that I feel awkward asking but was curious about. Thanks.

I really do appreciate your response. I have spoken to two separate people at the insurance office and have personally reviewed my policy. My agent literally laughed when I told him this. He said he has never heard of ANYONE losing their life insurance for anything other than not paying premiums. However, your seeming knowledge on the subject allowed me to break out the actual policy and re-read all 52 pages. Not a single word in it about losing the policy due to jobs. Lots of stuff about criminal acts, suicide, and falsifying the application but that is about it. Without sarcasm, I appreciate you pushing me to review the policy as this was a very important aspect of taking the job.

While I appreciate the negative response, that's a common thing said about life insurance and safety. I'll say several things. First, like any smart adult, I've had life insurance for years. I contacted my life insurance company at the suggestion of another nay sayer. They laughed and said once you have life insurance, it's yours. You can smoke crack, shoot a human, rob a bank, become a lawyer, move to Antarctica; basically do what you want and it is yours. You can't lose it or have it revoked or have your premiums change. You can not lose it. Second,as far as safety goes, air medical is obviously an inherently dangerous job. However, this company flies duel pilot IFR in twin engine aircraft with ZERO accidents in their five rotor and one fixed wing aircraft. Considering it is obvious you have never flown, I am not sure if that means anything to you, but it is decent in HEMS. I appreciate your input but you did not address a single question or issue I posed. Now I will ask one moreqyestion. Tell me about YOUR experience in the flight world. I'll take positive or negative discussion as long as it is your personal experience and not some negative talk because you are butt hurt about never having done it. Thanks.

Newbie question. Really just bored and want to hear people's stories and thoughts. Just landed my first rotor wing job. I had sort of given up the dream and went and got a Masters degree and then was contacted by the company that I always thought I would work with for a job offer. They have always only staffed a paramedic and never a nurse. I worked with them on their fixed wing operation as they typically fly RN/NREMT-P. For various reasons, they're converting to that configuration in their rotor aircraft. Anyway, I've have read enough and been around enough to know the long road ahead, but I'm curious about something rarely discussed; station life. I have always worked ER and 12 hour shifts so I really don't know what it's like at a station for 24 hours at a time (they work 24/48). For instance, do you show up in flight jumpsuits and stay in it for 24 hours? Do you typically shower and change mid shift? You ever leave for food or always bring something? What kinds of things are often done in a typical shift other than run calls, check inventory, review previous cases? Any thoughts or stories would be appreciated.

Long story short. The only HEMS company in my area only uses a paramedic and never a nurse. They have been the sole provider for years. I have dreamed of HEMS work since I was a kid. Finally, after nearly giving up hope, an Air Evac base opened about 5 miles from my home. Previously, the closest company to use nurses was about 3 hours away. My friends who work for "the other company" have put the fear of God in me about flying single engine. They are stating they would rather quit their profession than fly in single engine. Can anyone provide objective informatoin regarding single engine aircraft. Also, can anyone provide any information on what it is like to fly with Air Evac? Thanks.

What exactly is Registry? Is it the same as agency? How often in advance is the work booked? More importantly, what can an ER nurse with 5 years experience expect doing registry in northern California? I am from Louisiana and cannot do a contract due to school and family. I am considering flying in and out of California about 7 days on and 7 days off. Could I schedule 5 days of work in a row while in California? Any help is appreciated.

I was told that Air Evac works 24 on 24 off x 5 and then off 6. Is that on 24 off 24 x 5 days or five shifts?

I got two e-mails 7 days ago. One from the Base Clinical Lead and one from the Program Director. Both stated they wanted to interview me for a new Fixed Wing base that they were opening. It would be a phone interview. &nbsp;The last e-mail stated that they would contact me soon to set up a phone interview. New Years Eve and New years day were in this time frame. My question is, when should I follow up? I do not want to pester them but I do want to show my interest. Should I call or should I e-mail?<br><br><br>My other question is, has anyone done a phone interview? Any suggestions?<br><br>Thanks.

I got two e-mails 7 days ago. One from the Base Clinical Lead and one from the Program Director. Both stated they wanted to interview me for a new Fixed Wing base that they were opening. It would be a phone interview. The last e-mail stated that they would contact me soon to set up a phone interview. New Years Eve and New years day were in this time frame. My question is, when should I follow up? I do not want to pester them but I do want to show my interest. Should I call or should I e-mail? My other question is, has anyone done a phone interview? Any suggestions? Thanks.

I kick patients out of triage ALL the time. There are other people who are waiting and I will triage them and come back to the talker later.

South Louisiana $23.97/hr base pay ER RN BSN with ACLS, PALS, ENPC, TNCC, BLS 4 years Full Time 36 hours per week No shift diff for me (7a-7p), weekends gets me $3 an hour Charge nurse (this gets me $1 per hour)

Well, thats the first thing, it is 24 hour shifts so its only twice per week that I would have to commute. The other thing that I am hoping for is to be able to work back to back shifts and that would make it worth my while. Think of it this way, if I have to go back and forth for one shift (48 hours), thats two shifts a week. That's six hours a week driving. If it was an hour away, and it was three 12 s a week thats still six hours a week. I am trying to convince myself that this will be ok. Thanks for all of your help.

How far would you commute for your dream job? I am interviewing for a job that would work two 24 hour shifts per week (its a fixed wing flight job). My commute would be 219 miles or about 3 hours into Houston. Anyone do anything like this? Think this is doable?

Thats really a great point. If Neurology should be consulted but some how a consult for nephrology should have been done, any nurse should know that. It does not take report. If the wrong nephrologist was called on the other hand, how do you expect the ED nurse to know that?

This is now the standard. Hand off is not some magical thing that happens between two people. It is an exchange of information. Reading report on the computer is a hand off as long as the nurse has the chance to ask questions if needed. Presumably this would be at the bedside when the patient arrives but ER staff can never find a nurse to meet us at the bedside. We have been faxing report for years and only calling ICU or cath lab. Surgery comes get their own patients so they get a really nice bedside report. The floor patients are stable and everything is in the chart. No need for me to read it to them, if I know the information, I chart it.

I imagine the patient with a CBG of 27 was acting funny? Does it matter if 1 unit of insulin or 100 units was given? Given the man d50, call your rapid response, or do what you have to do to treat the patient. We should be assessing our patients when they get to our units and thats how we catch these things. It didn't matter if they told you how many units they got, the patient still would have had the same outcome. And as far as no one knowing a patient was on the floor, again has nothing to do with report. The transferring nurse should have notified the primary or charge nurse, that is not excusable. Again, report would not have solved this problem, this is a problem with a nurse dropping a patient and running.

Absolutely none. It takes me that long to print out the information, go to the fax machine, fax it, and then call and ensure it made it up. At least half of the nurses upstairs were always great and made it a point to come to the phone when we called report. It is the few bad apples that would have us wait 5 minutes to come to the phone to say they had to call back. Then never would for an hour or so. It is one of those age old arguements that the good nurses are getting punished for the bad nurses but it is the best thing to get the patient to the floor. Just like the floor, the ER has bad nurses that will abuse this system too, we should try to work together and realize that we are all part of the solution and part of the problem.

From triage? Absolutely not! NEVER! From EMS, if I am the nurse lucky enough to triage my own patient then yes. From the off going shift? No, we read our reports on the computer and then get with the nurse if needed to ensure we do not have nay questions.

The important thing to remember is the patients the floor gets has all necessary workup (at least the emergent part) complete. When I get a new patient, even a lower acuity belly pain, they need an IV, blood work, meds, a vomit bag, a blanket, vitals, an assessment, and to go to Xray or CT. No one gives me any report on these people and at the time I meet this patient I do not know if she is having a triple A or a bad menstral cycle. Thats just something to keep in mind and it shows that we should all do a shift in each others units to see what the other does.

This is one thing that drives ER nurses crazy. I call report all the time and am told, "The BP must be under 200 or I won't accept report." So we give them something and it goes to 180 and the patient goes up. I have never ever seen a patient have a CVA from an acute BP of 200, and nothing magical happens between 180 and 200. The ER MD's are usually aware of those BP's and do not like to treat them typically. The main reason is the therapy they choose and what the admitting doctor chooses may be different and changing meds for BP like that on a patient is unsafe. Likewise, a patient with a sugar that is high, likely lives that way and does not need emergent insulin (remember that is what emergency rooms are for, stablize emergent patients, not fix them. If we fix them then we do not need the floor.) unless of course they are being admitted for DKA. If they are being admitted for DKA, then there is NO reason they would not have been placed on a drip or been given a push.

I have only worked with a few EDM systems but I work with a pretty terrible one now and I can look up all the information I need (assuming the nurse charted properly which is a huge caveat) in less than two minutes. When our ER nurses arrive, we read our reports on the computer, then meet with the ongoing nurse to clarify any issues and usually there is none. The charge nurse on the floor should be telling the nurse who is getting the patient as soon as they know it is coming so they can begin looking for report. Also, it is really the best policy for the ED staff to alert the floor that they have arrived. Then, someone should come to the bedside and this is really the best way to ensure that report is given. I like everyone else hate change, I actually even hate that I do not call report anymore, but it is all part of where healthcare is going and in order to see the amount of patients in our ER, we must move patients quickly. Otherwise, people will keep dieing in our lobbies and I hate that more than anything.

At my facility, the nurse can absolutely call down and ask for report. However, we are under strict orders for our clinical supervisor to not answer any questions that are already charted. Meaning, "what kind history do they have?" Will get a, "I am sorry, that is in the faxed report you got, please see that." Now, if it something that we have not charted, that obviously should be answered. It actually creates better charting from the ER because we do not want to have to stop and answer 20 questions, just like I am sure you do not want to have to ask 20 questions.

We went to this years ago, well sort of like this. We fax up report which is just a computer generated report of what was done, labs, that sort of thing. We are then REQUIRED to call and ensure someone has the report. This is typically the Charge nurse or unit clerk who will hand it to the nurse. We then give 15 minutes for the nurse to review then information and then we go up. The receiving nurse has the responsibility to call and ask questions. The main reason for this change was that we were having 15-20 patients sitting in the lobby waiting to be seen (some of which were quite sick) and we were having nurses say, "I am busy I cannot take report" or "That nurse is at lunch, try back later". This was unsafe for patients who were presenting to the ED and not getting to see a provider due to long admit to disposition times. Is it drastic? Maybe, but it is the only way to ensure patient flow. I realize you may think it is unsafe to not know anything about your patient but a doctor has completely worked that patient up, determined they are stable for your unit and handed them off to another doctor. If they were not stable they would go to ICU (which we call report to and not fax it). Think of the poor triage nurse whose license is riding on those 20 patients in the lobby who have not had a medical screening exam or any workup yet. That is unsafe. I truly see it from both sides and think there is likely a better fix but the most important thing is to get patients screened by doctors and the only way to do that is move patients out of beds. Hope this helps?

Thanks. I realize that the last post was almost two years ago but I have been working and obtaining more certifications and I was wondering if your still doing RW? If so, what company is it with that is in Houston? I now have four years of experience, ACLS, PALS, TNCC, ENPC and I am actually in NP school. How far would you drive for a shift? I am about 3.5 hours from Houston. Is it worth it? Are the people who are getting jobs having 10+ years experience or is it more like 5 years? Any help would be appreciated. Feel free to e-mail me at [email protected] Thanks so much.

Hello All, I have been an ER nurse for over three years and have done one assignment in St Croix. My wife and I had a baby 4 months ago. She is a certified teacher but has been doing substituting since the baby was born with plans to go back to work in August. I would like to do another assignment this summer before she starts working full time again. The wife, baby, and small dog would all need to come to make this happen. Anyone have advice on travelling with wife and baby? Would you suggest driving vs flying? We would like to do something in California. My biggest two concerns will be insurance and safe/secure housing. I feel like I can handle a crummy ER for 13 weeks as long as their housing will be safe and in a place where we can get out and do and see some things. Any advice is appreciated. P.S. My wife is super excited about travelling again. She loved St. Croix and our expereince travelling. I just do not know how many people have travelled with a baby.