murphyle BSN, RN

murphyle has 4 years experience as a BSN, RN and specializes in Emergency, Critical Care (CEN, CCRN).

Latest Activity

1. 

   What is your ER like.....need advice?

   murphyle replied to Theocbean's topic in Emergency

   370/day in a 39-bed shop?! That's not just efficiency, that's magic. You must have amazingly fast inpatient admissions, or be seeing a lot of fast-track traffic, to make that work. How do you keep up...
2. 

   What is your ER like.....need advice?

   murphyle replied to Theocbean's topic in Emergency

   45-bed adult acute care/10-bed adult minor care/10-bed pediatric acute care, seeing 280-330 patients/day: An acute care team, of which we run four, consists of one physician (plus or minus a resident...
3. 

   Warmed lidocaine

   murphyle replied to ADeks's topic in Emergency

   Anecdotal evidence suggests that warming lidocaine decreases burning and stinging associated with local infiltration. I have not seen any papers proving this one way or another. We typically do not...
4. 

   ED techs to start IVs?

   murphyle replied to montecarlo64's topic in Emergency

   IV starts are a "delegatable task" in our shop, and many of our EC techs are frankly brilliant at it. Indeed, we typically assign our orienting nurses to work with an experienced tech for half a shift...
5. 

   Ebola... What'cha Gonna Do When It Comes to You

   murphyle replied to Music in My Heart's topic in Disaster Preparation

   We do have a quite robust plan for viral hemorrhagic fevers in place in my department, covering identification at Triage, a chain of notification, rooming requirements and visitor policies. If...
6. 

   OB ultrasound...foley or no?

   murphyle replied to Kalipso's topic in Emergency

   We've been waging this battle in my shop for the last 4.5 years that I've been in practice, and likely for a lot longer before that. Our physicians have repeatedly stated that they no longer agree...
7. 

   ER Workflow

   murphyle replied to junejames's topic in Emergency

   45-bed department, midsize community hospital: An acute care team consists of one MD, three RNs, one tech and one secretary for up to 15 patients. ECGs are done by dedicated staff from Heart &...
8. 

   how to deal with management?

   murphyle replied to takeiteasynyc's topic in Emergency

   So let me make sure I understand this: you got into it with a charge nurse, then made an error and didn't document it, for which you've already had a verbal counseling and are being threatened with...
9. 

   Documentation in the ICU

   murphyle replied to *LadyNurse*'s topic in MICU, SICU

   Head-to-toe assessment, LDA (Line/Drain/Airway) documentation, SIRS screen, Braden and safety assessment are all done q shift, plus any changes. Strips (at a minimum two ECG leads and your alarm...
10. 

    Are swans going "out of style?"

    murphyle replied to TemperStripe's topic in MICU, SICU

    You do? Interesting. Policy here is that any Swanned patient has to stay on SBR, due to concerns about accidental migration of the catheter (either RV whip or PA
11. 

    Are swans going "out of style?"

    murphyle replied to TemperStripe's topic in MICU, SICU

    I'm in a cardiovascular surgical ICU, so every post-op heart comes back with a Swan. We have rather a love/hate relationship with them; they're great for accurate hemodynamics, but as long as the Swan...
12. 

    ER transitioning to ICU

    murphyle replied to felineRN's topic in MICU, SICU

    Feline, your resume looks an awful lot like mine! I am also a 3-year emergency veteran, who just transferred to CV-SICU a few weeks ago. The only differences were that I came from a Level II center,...
13. 

    What's in your pocket - ER Style

    murphyle replied to Frizbeeboy's topic in Emergency

    Reply to Airwayguru: Neither. I wear Aviator Scrubs - Classic shirt, ER pants. They're comfy, last forever, and are the source of one of my two department nicknames,
14. 

    What's in your pocket - ER Style

    murphyle replied to Frizbeeboy's topic in Emergency

    For me, this question should read "What's in your pockets", plural, as I'm quite well known for the plethora of them on my scrubs. That said, on to the tally... Left sleeve #1 and 2: Pen and...
15. 

    Best one sentence handoff report

    murphyle replied to emtb2rn's topic in Emergency

    "303's EtOH is only 378 this time, which for them is practically stone cold sober." "Your Resus coverage is the med student, the resident and (slow-moving attending). I'll light a candle for you."...