murphyle BSN, RN

Emergency, Critical Care (CEN, CCRN)

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All Content by murphyle

  1. murphyle

    New to ER and getting CEN?

    Wow, nothing but CENs on the trauma service? That's quite unusual. I, too, would be curious to know where the OP works, as out here there simply aren't enough people with the credential to do...
  2. murphyle

    New to ER and getting CEN?

    I'm a new grad (ASD-BSN) who started straight in Emergency, and wrote the CEN exam at just shy of a year's experience chronological (I pick up a ton of OT, so it was more like 1.25 years FTE - still...
  3. murphyle

    Scheduling in the ED

    My department: 45 acute beds, not a Level II center yet (working on it!), and we see about 230-260 a day. We do a combination of self- and set scheduling; you have your assigned shift (they're all...
  4. murphyle

    All nursing students wear white scrubs?

    Oakland University mandates white uniforms for SNs; traditional BSN students wear a patch on the right sleeve, ASD-BSNs don't. They may be one of the only local schools that do put students in white....
  5. murphyle

    IV draw vs Lab draw?

    We go back and draw off PIV locks occasionally in the EC, based on a few criteria: 1) the patient has poor vascular access and/or won't tolerate an additional stick (peds and geri, I'm looking at...
  6. I don't think I'd be laughing either. I've been an RN for about a year and four months, which is approximately as long as it takes a flea to break wind in terms of a nursing career, and there have...
  7. murphyle

    CEN Exam Review/Preparation

    1) Newness to the profession. (I took my CEN at just less than a year's experience, chronologically; however, I pick up enough OT that my actual hours-worked number was closer to 1.25 years at...
  8. murphyle

    Tips For New Grad ER Jobs

    In my department, our new grads generally fall into one of two categories: previous emergency experience (as a EMT-B or EMT-P, as a department aide or tech, as a military medic, etc), or previous...
  9. murphyle

    asystole then DC

    I cannot for the life of me imagine sending the girl in this case home. In my department, that kind of incident would buy her an automatic night in CCU and a full cardio workup. Who only knows what...
  10. murphyle

    Trauma roon in your ED... who gets it?

    A bit about our department: We have 45 acute-care rooms, of which 3 are the Trauma/Resuscitation bays. The other 42 are split up into "teams" of 10-11 rooms staffed by three RNs, one tech (ECT) and...
  11. murphyle

    CEN Practice Questions

    ...which, as you so helpfully pointed out, is the aforementioned $18.50. :) I quoted the member price under the assumption that the OP would have at least considered ENA membership at some point,...
  12. murphyle

    CEN Practice Questions

    I agree with Legz: get the ENA's test book. For $62 and tax/shipping you get five full-length practice tests plus two full-length online tests, written by the people who design the test, and it's...
  13. murphyle

    So if all nurses are heroes.......

    ROFL, emtb2rn - reminds me of a recurring joke with a few of our staff, discussing the event that we ever lost our jobs and licenses and had to take up "exotic dance" to pay the bills. #1 stage name?...
  14. murphyle

    The Nursing Math Thread

    #1: This one's a three-step problem: you're given a solution (2 g/500 mL) and a dose (2 mg/min), and you need to figure out an infusion rate (note, NOT a drip rate - this med is going on pump!) So,...
  15. murphyle

    What was the lowest diastolic bp you have seen?

    ...Yes, I've seen zeroes over zeroes before, and I recall one or two of them that we actually got back. The 62/32 lady was the lowest that was still awake and oriented. She made it too, by the by....
  16. murphyle

    What was the lowest diastolic bp you have seen?

    1) In general, DBP shouldn't get below 35-40 mmHg - this is the filling pressure needed for the coronary arteries to perfuse. (Remember that the coronary sinuses fill during diastole.) No coronary...
  17. murphyle

    Funny Sign In Slips

    ...Funny thing is, she would've been completely right if she'd been in
  18. murphyle

    The Nursing Math Thread

    1. Calculate the drip rate for 500 cc of IV fluid to be given by microdrip over an 8 hour period. Wouldn't that be 63ml/hr? My answer key said 63gtt/min (I thought it would be ml/hr, not gtt/min). But...
  19. murphyle

    Pocket Guide

    Our new nurses all get a copy of "Fast Facts for the ER Nurse." People here are also big fans of "Detroit Receiving Hospital Emergency Medicine Handbook" and "ER Facts Made Incredibly Quick." For...
  20. murphyle

    ER nurses...I need your help!!!

    Welcome! I started in "the Pit" straight out of school, been there for a year and change, and loving every second. You may want to check the Emergency Nursing board for new-to-the-ED tips and tricks;...
  21. When I was in nursing school, the gift tradition went both ways. The instructor would buy us lunch or casual dinner on the last day of clinical, and in return we'd get them a thank-you card and a...
  22. murphyle

    Will I ever keep up the pace???

    Hi there! I remember you from your posting when you got hired into Emergency. Glad to hear you're still loving life in the wild world of the ED. Hitting a "plateau point" in your orientation phase is...
  23. murphyle

    How long until you were pretty good at IV starts?

    It probably took me a good six months, total, before I was confident starting lines on adults. My ED preceptors were very good about getting me lots of IV experience, since I told them upfront that I...
  24. murphyle

    ICE " in case of emergency " apps worth it ?

    *grin* I wear one of those routinely - I call it my "Paddington Bear Tag." (If found, please return this nurse to Community Hospital, postage paid. :) --Actually, it has my name, DOB, allergy status...
  25. murphyle

    CEN's and experienced ED nurses I need your help!

    I'm a big fan of the AMPLE rubric: Allergies, Meds, Past history, Last PO intake, Events leading to presentation. Simple, clear and covers just about everything I need to know in a Priority I/Resus...