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obliviousRN's Latest Activity

  1. obliviousRN

    Joke..You know you are truly an ER nurse if...

    I just laughed so hard I snorted. This is the best thing I've heard in ages.
  2. obliviousRN

    Question for ER moms

    It's none of your bosses business until you decide to tell them. Definitely give them enough time to plan for your maternity leave though.
  3. obliviousRN

    Evidence collection on unconscious patient

    Number one - check your state regs on this. I'd ask your local DA to be sure you are in compliance with these. Maybe they can consult on your policy as you develop it. That's what we did. Number two - implied consent as stated above, covers this. Number three - I would collect it no matter what as evidence is time sensitive. You might not know how long they've already been down, etc. Our docs are also good about holding off on foley, etc. if medically possible until I can get my swabs at least. Good luck!
  4. obliviousRN

    what makes you a good ER nurse?

    What makes a good ER nurse? The realization that "some dude" will never be caught because he does not exist. For example: "I was just sitting there minding my own business when some dude walked up and shot me." Ok seriously - I like the one that someone said above about a sense of humor and a thick skin. ABSOLUTELY! Could not exist in the ER without it. And unfortunatly you have to very quickly rid yourself of the idea that you can "help" everyone that comes in. Some people you just plain cannot help. Period.
  5. obliviousRN

    Small ER Management

    We also have 1 nurse to staff our ER at night. They usually waste with the med/surg nurses since our hospital is small enough to run and get them (i.e. 100 feet down the hall to med/surg type of arrangement). I've been known to make the pharmacist waste with me also - but I work day shift so much easier. It's a challenge, that's for sure. Be very careful of what your own state regs are regarding this issue. You might want to check on that. Have your pharmacist print them out for you. I wouldn't wake a doc up to waste a med though. That seems so stupid and a waste of their time - especially if they are on 24 hours straight and their sleep time is limited anyway. good luck.
  6. obliviousRN

    Medical Screening Exam at triage by RN

    The radiologist reads the Xray. We wait for the dictated report. Doesn't take long at our facility as it is not a huge ER.
  7. obliviousRN

    Need Policy Help

    Make sure you are aware of your state law on the topic. Each state is different.
  8. obliviousRN

    Medical Screening Exam at triage by RN

    I'm in Oregon and we do MSE's at our facility. First and foremost we determine emergent vs. non emergent (MSE) - this may include some labs and/or Xrays. We then triage them into the order to be seen. It is 2 separate procedures, but you basically do them at the same time. You just chart it differently. Say for example, you do an MSE on someone with ankle pain. We deem them non-emergent so we discharge them from the ER and recommend follow up in clinic the next day. We may have ordered an Xray or not per our clinical guidelines depending on swelling, deformity, etc. Change that to MSE on someone with ankle pain with obvious deformity and open area in skin. Xray ordered per clinical guidelines shows fracture, possibly open so MSE = emergent. They are then triaged into the appropriate level and seen in the ED by the physician. It gets confusing at times, but you really are doing it all at once. It just matters how you document. Clearly define your MSE in your documentation and then assign them a triage level separately.
  9. obliviousRN

    ER the television show

    :roll :roll :roll :roll
  10. obliviousRN

    Applying for Charge Nurse

    We have to have the following: 1. demonstrated excellent time management skills 2. demonstrated excellent and appropriate delegation skills 3. ability to interact well with others, including in a high stress environment and with those who you may not always agree 4. mediation skills etc. I would stress your ability to perform these functions and the realization of how important they are. Good luck!
  11. obliviousRN

    Enraged (venting)

    Should add the above post was not meant to be snotty at all - serious talking about the issues. The apology was for previous posts, not a "sorry, but here I go.... " type thing
  12. obliviousRN

    Forensic nursing info.

    What are you doing now? Can it be taylored to forensics? Investigation of death from a medical standpoint (cause, manner, etc) is done by teh Medical Examiner's office or Coroner's office - not the police. Police are investigating the legal aspect not the medical aspect. Are you currently a pharmacist? Your experience could be invaluable in assisting on investigations related to drug assisted sexual assaults. If not in the medical field currently - what are you doing? Can it be shifted?
  13. obliviousRN

    Enraged (venting)

    Again - I apologize for my snottiness - please understand it comes from a place of being in that nurse's position of having a drunk volatile pt physically assaulting me. so........................... Here is a direct quote from the OP: Yes he was holding the nurse's arm, but he had also just punched them in the chest and face. So I would like to remind everyone it wasn't as simple as just holding onto the nurse's arm. Yes at that point the pt was holding the nurse's arm, but was his other arm raised in a fist? Was he suggesting the hitting would continue? Was he moving toward the nurse? Was he trying to get off the scanner table and come toward the nurse? Was he........was he.....etc. There are so many unanswered questions in the scenario, but I still would give the nurse the benefit of the doubt. OK and onward - Point #4 - police were present in the immediate vicinity. That would be better wording from me. In our scanner, it is arranged so that the "window" that separates the pt from the staff or police or whoever is about 8 feet away and a few running steps. My point is that even with people close by, I would still respond with physical force if someone was (or had just been) punching me. Point # 6 - I think we will just have to disagree. I'm not sure I can assume all those things about how they were feeling. Yes, they expressed dismay that they "lost it", as I think any of us would. When I say I would physically respond to someone assaulting me, that doesn't mean I would brag about it later or be proud of myself (not saying that is what you are implying - just bringing my thoughts out here). I would definitely be upset that I had to resort to that point and feel sad. But I would still do it to protect myself. Point #7 - for my assault and my fighting back - my hospital fully supported me in my actions. The risk manager didn't have any concerns at all. My manager was more concerned about my safety than my actions. She was supportive. Point #10 - please realize that all hospitals are not the same. Staffing at a rural hospital is insane - especially at night. At a rural hospital I've worked at, noc shift staffing was 3 RN's for the entire hospital. 1 in ER, 2 on the floor, another for ICU if we had a pt. The ER had no other staff in it - just the nurse and the doctor (if the doctor was actually inhouse and didn't go home for the night). Police officers at night on duty usually ran about 2 or 3 for the entire county (Very rural, seriously - 10,000 square miles of pretty much nothing but sagebrush and a few people thrown in for good measure). So - using that scenario................. think of drunk pt in ER - to CT scanner with one nurse, maybe 2 officers (since the other one was probably on the other side of the county), doctor not present, CT tech running computer. Nurse next to pt with lead gown on, which weighs you down and makes it difficult to move anyway. Pt starts to fight- hits you in face, chest, grabs arm (probably took about 1-2 seconds). Police may be coming towards you to help.............. I would still fight back. Really, I would. It takes one punch to knock you out or to permanently damage you. It takes one punch to damage your airway. One punch can happen in the time it takes the police to take a few more steps toward you. Yes.............I would hit the pt to make them stop. The police could take over from there. NOw I know not everywhere is rural and more people may be present to help, but think about the situation from that viewpoint.
  14. obliviousRN

    Enraged (venting)

    Many excellent points DusktilDawn
  15. obliviousRN

    Enraged (venting)

    OK - you're right. Let's talk and not argue and I apologize if I came off as harsh and angry. This may all end up that we will have to agree to disagree, but here are my points: 1. the nurse was being hit by a patient 2. the hitting was going to continue unless they did something to stop it 3. the nurse's safety was endangered 4. police were present in the CT scanner 5. pt's are difficult to restrain in a CT scanner unless they are restrained chemically 6. initial gut reaction of nurse was to hit back to keep themselves safe (my interpretation of the situation) 7. I don't feel this was assault or battery as the nurse was responding to a violent patient 8. I don't feel it is wrong for a nurse to respond with physical force if they are being physically assaulted by a pt. 9. Would holding down someone's leg when they are kicking you constitute assault if we consider this in the overall scheme of things? 10. I don't feel that working in a dangerous area means that you should accept the fact that you will be assaulted or that you should think about working elsewhere if you don't want to be assaulted. This situation actually could have happened on the floor also - think pt with high ETOH admitted for traumatic injuries. Wakes up the next day and becomes angry and violent on the first nurse that walks in to assess him and starts grabbing them or hurting them. This pt punched her in the face. As a floor nurse, I would also try to get away from the pt and if that entailed hitting them to get them to release me or to quit hitting me, yes - I would do that. Yes, measures could have been taken to "hopefully" prevent the situation. But I'm looking at the angle of "it happened - what do I think now?". I don't think the OP assaulted the patient (my opinion). I think the OP protected themselves as they best knew how in that moment. That 1 to 2 second moment. That's such a quick, quick, moment. Boom - 1, 2 it's over. So while I agree with the whole idea that prevention would have gone a long way (as in almost any area of healtcare, life, etc), the face is that I believe a nurse has every right to respond with physicial force if they are being assaulted. Thoughts?
  16. obliviousRN

    Enraged (venting)

    Choosing to work in a dangerous field does not negate your right to protect yourself. My husband is also a police officer. If someone is trying to assault him, he certainly will protect himself and his other officers with physical force if need be. A dangerous job does not mean you throw your hands up in the air and take the mindset that it's OK for someone to hurt you because you "chose" that line of work.