murphyle BSN, RN

Emergency, Critical Care (CEN, CCRN)

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All Content by murphyle

  1. murphyle

    Is CEN really helpful for hunting a job as an emergency nurse?

    murphyle replied to sc531313's topic in Emergency

    Eligibility for the CEN doesn't require a set number of hours worked prior to examination as CCRN and CNOR do, but the ENA recommends that you don't attempt the exam until you've worked at least two...
  2. murphyle

    Critical thinking/scenario practice

    murphyle replied to elizabethgrad09's topic in General Nursing

    yes, it's complex, but it's also a common scenario - we see this kind of patient at least three times a night in emergency, and nearly all of them get admitted for observation and a neuro consult, so...
  3. murphyle

    Critical thinking/scenario practice

    murphyle replied to elizabethgrad09's topic in General Nursing

    Try working through case scenarios instead. You see these frequently in medical school review books and physicians' journals (usually in the format "Case of the Week" or something similar), and I...
  4. murphyle

    Please, please set me straight!

    murphyle replied to glovedgoddess's topic in Nursing Student Assistance

    Whether or not to stop the infusion for push medications depends on what's infusing. Many medications aren't compatible in solution, either premixed or at Y-sites. I keep a copy of Lexi-Comp's IV...
  5. murphyle

    What were you doing last year?

    murphyle replied to HeartsOpenWide's topic in First Year After Licensure

    Let's see, one year ago this week... *pulls up calendar for November 8-14, 2009* Community health, psych, nursing leadership and nursing research classes. Psych clinical and preceptorship in CV-SICU....
  6. murphyle

    Chest tube help

    murphyle replied to RNLola035's topic in General Nursing

    You were dealing with a dry suction system. As opposed to the old "wet suction" type of chest drain that used a water column to regulate the suction, dry systems use a pressure manifold that's...
  7. murphyle

    Signs, Triads, and Other Terms

    murphyle replied to midge121787's topic in Emergency

    Virchow's triad: venous stasis, hypercoagulability, and vessel wall damage/compromise. Predicts risk of vascular thrombosis. Fireman's sign: the appearance of ST-segment elevation on an ECG, so named...
  8. murphyle

    How To Become an Emergency Nurse

    murphyle replied to happy_bunny_101's topic in Emergency

    ...I think you've gotten a little out of step with yourself here. You go to nursing school to obtain a nursing degree, whether ADN or BSN, which then permits you to sit the NCLEX and obtain licensure...
  9. murphyle

    What do you use for conscious sedation in your ER ?

    murphyle replied to BunkyRN's topic in Emergency

    Depends on the case. For infants and toddlers, we typically use ketamine; on older kids we'll use morphine and Versed, and then etomidate as the induction agent. Likewise, adults usually get either...
  10. murphyle

    I really really need some help with this, PLEASE?

    murphyle replied to Soon2bnurs's topic in Emergency

    Email reply sent. Hope you find it helpful!
  11. murphyle

    Large bore IV

    murphyle replied to remf3's topic in Emergency

    In my department, 20-gauge is the "bread and butter" line - the vast majority of our patient population only requires maintenance fluids, maybe a liter bolus, and perhaps one or two infused...
  12. murphyle

    Milk and Molasses Enemas

    murphyle replied to trixie's topic in General Nursing

    We still do them on a fairly regular basis. They're effective, if rather messy. (I do admit to having a good laugh the first time I saw one ordered. I sat there for about thirty seconds going "What...
  13. murphyle

    The Nursing Math Thread

    murphyle replied to Tweety's topic in General Students

    Right idea, but you lost it when calculating the dose. Did you divide by 1.98, perhaps? :) So, our patient is 172.7 cm tall and weighs 81.8 kg. Using the Mosteller BSA formula, _ \/ (Ht x Wt) /...
  14. murphyle

    ER Prioritizing/communication help please!

    murphyle replied to cmarn's topic in Emergency

    Your mileage may vary based on how orders, admissions and other "paper" tasks are handled in your department, but here's a brief rundown on how we make it work. (Note that we use Epic oneChart as our...
  15. murphyle

    Appropriate gift for preceptor...thank you letter for charge nurse and other RN's?

    murphyle replied to BSNmwsu's topic in General Students

    The hospital where I served my nursing-school preceptorship had a program for recognition of exceptional staff (nominations go in the nominee's personnel file, and every month a selection of "winners"...
  16. murphyle

    Song lyrics that remind you of nursing...

    murphyle replied to grace90's topic in Nursing Humor

    "Mr. Ambulance Driver," The Flaming Lips. Probably a bit more geared to the EMS/prehospital provider, but still a great song for emergency care in general. Coincidentally, it also has a pretty good...
  17. murphyle

    Germ fatigue...

    murphyle replied to Florence NightinFAIL's topic in General Nursing

    That actually used to be a running joke with my old attending from my high school Senior Project. She did wear a clean lab coat every day, and had four coats in rotation - three new with her name and...
  18. murphyle

    which hospital has the best nurse grad. orientation?

    murphyle replied to smitty10's topic in Michigan Nursing

    If you're planning on continuing in emergency, WBH-Troy's EC orientation is outstanding. It's also a very GN-friendly department, which is a big plus if you're still gaining experience and confidence...
  19. murphyle

    Looking for the PERFECT ink pen ;)

    murphyle replied to nkochrn's topic in Scrubs, Uniforms, Gear

    Add another confirmed pen geek to the list! Out in the world, I normally carry fountain pens - a trick I learned in high school, as my writing tends to be a bit illegible and the fountain slows me...
  20. murphyle

    A funny and warped FACES pain scale

    murphyle replied to SlightlyMental_RN's topic in General Nursing

    Oh yes, I saw this little gem a while ago. Just as funny now as it was then. I did find a poster version of that scale and put it up at the Crossfit gym where I work out. "This is distressing, I...
  21. murphyle

    Air in the line!!! What am I doing wrong?

    murphyle replied to juliannaUT's topic in General Nursing

    For Alaris-type pumps (Medley, Alaris PC, etc - the large square "brain" with small rectangular modular "arms"), ensure that the tubing immediately below the flow control cassette is completely pushed...
  22. murphyle

    What do ED nurses need from volunteers?

    murphyle replied to medicinelover's topic in Emergency

    I was a volunteer at a large urban trauma center back in the days of my first undergrad, and got to the point where my only restriction was that I couldn't do vascular accesses (i.e. butterfly draws...
  23. murphyle

    Anyone get away with a "questionable" hair shade?

    murphyle replied to Little Miss Blue's topic in General Students

    Likewise with us. We allowed athletic-styled nursing shoes and professional clogs (i.e. Danskos-type) as long as they had a completely enclosed toe and back, were at least 80% white (you could get...
  24. murphyle

    Anyone get away with a "questionable" hair shade?

    murphyle replied to Little Miss Blue's topic in General Students

    My school not only required no unnatural hair colors or "faddish styles," but also a restriction on length: male students had to wear short hair (not longer than 2" when extended), and females' hair...
  25. murphyle

    School supplies other than books?

    murphyle replied to doublehelix's topic in General Students

    There's another good "school supplies" thread at Nursing School Must Haves?? - Nursing for Nurses. I recommended a few items in that thread, the revised version of which looks something like this: *...