murphyle BSN, RN

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 that kind of throughput?

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 or a PA/NP), three RNs, one tech, one secretary an...

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 warm our lido beforehand, except in the context of ...

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 or so to develop their IV competencies. We do res...

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 anything, it might err on the side of overkill (it calls ...

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 with routine Foleys for pelvic ultrasound, we certain...

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 & Vascular Services (one always stationed at Triage, th...

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 Warning A, and now you're slacking at work, complain...

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 limits, as well as anything else with a waveform - art ...

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 occlusion).

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 stays in, the patient has to stay in bed, which m...

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, and already had my CEN and CCRN when I applied. :-)...

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, "Pockets."

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 penlight. Left chest: Surgical site marker, misc personals...

"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." "He's had three liters bolus, six units of PRBCs, fou...

Love it! We call our department's "breakfast club" the Atheists' Bible Study. :cheers:

It's funny that you ask this question, as I just had this conversation the other night with an SN who was shadowing me through the usual twelve hours of mayhem that constitutes an emergency shift. I come from a family of medical professionals, in pa...

I think I've done pretty much all of the things people have mentioned here, and they all work pretty well. I'm also quite fortunate to have a family full of people "on the job," so I frequently try to debrief when I get home, good night or bad. Usua...

Major community hospital in a major metropolitan area, working the midnight shift... Giving nebs: No, Respiratory does this. Drawing own labs: Yes. Starting your own IVs: Yes. If you have a tech to help you (see #2), that's bonus. Otherwise you do it...

I have a pair of Miltex 8.5" utility shears that were recommended elsewhere on this site. Might be a little on the pricey side for shears, especially as compared to EMS and drug-rep freebies, but they cut through anything and they're practically inde...

I'd agree with Altra's assessment: we're always busy, but things go in cycles. * Winter sees lots of falls (and their ugly siblings, falls on anticoagulants), respiratory crud of all descriptions, infectious disease (two big subgroups there: flu, RS...

Definitely ask your manager. According to AORN*, surgical personnel should wear hospital-provided, professionally laundered scrubs that are made of low-linting fabric and fit in a loose and comfortable fashion. Tight-fitting scrubs increase skin fric...

Love these! ...If you've ever straight-facedly said "Okay, you'll feel a little pinch" while putting in a 14ga EJ. ...If you've had to crash sedate a seizing, febrile infant, with the parents standing there saying "Of course we didn't give any Tyleno...

The first time I had a "stable" patient go down the drain came about eight months into my nursing career. I'd been on scads of resuscitation teams, dealt with everything from chest pain to respiratory failure to massive trauma, but I'd never had one ...

Echoing what others have said: in our system, a PSQI (Patient Safety/Quality Improvement report) can be written by anyone, at anytime, on any subject. That report automatically goes to the involved departments' managers/directors, and by policy must ...