Heartattaq

Thanks so far. I have started looking up various things that I know are more of a problem in northern communities, like premature birth, drug, and alcohol addiction, suicide, knife and gunshot wound, Diabetes, Tuberculosis, among some other things. What I would really love to read about is some of the personal experiences. Like the coordinator I am dealing with said to bring warm clothes and food, but I would love to hear from some of the nurses about things to bring that they may not have mentioned that have made the differance. Or how the community accepted you, somme real life personal experiences from this type of nursing, I know there has to be some great experiences and some not so great. I think when I get there I may start my own blog, outlining what it is like in a day to day remote northern ontario reserve nursing job.

Hello, I am a 31 year old Male Nurse living in Central Ontario, I graduated in May 2003, have 2 years of emergency room service in a large Emergency room, as well as just over 1 1/2 years as a med/surg nurse. I have a contract to work February 18th - March 14th on a Remote Fly in Native reserve at the local Nursing Station. Since I am going in kind of blind to this type of nursing is there anyone at all that can give me any information on what to expect, what I should bring, what if anything i should brush up on. Any information you can provide would be great. I have been searching for blogs and whatnot of nurses who have done this particular type of work but am so far unsuccessful. Thank you in advance for any information you all can provide.

Speaking of shocks we had an amazing case over the weekend. Person came in with complaints of chest pain talking it up with the nurse then nose dive, started the pulseless VT/VF algorithm when all was said and done the pt was blasted 24 times and every ACLS drug known to man was given the patient did make it and was rushed to the cath lab for a pacer, it was unreal.

in our emerg dept critical care- 4-6 pt's (we are pushing for 3-4 max) decision making and admitted waiting for beds- 5 pts Trauma: 2-3 pts Resucitation- 2-3 Ped's Resus/special procedure/2 isolation rooms- 4 pts Sub Acute- 3-9 pts Fast Track anywhere from 1-10

ACLS- Advanced Cardiac Life Support PALS- Pediatric Advanced Life Support TNCC- Trauma Nursing Core Course ENPC- Emergency Nursing Pediatric Course. I know the first three can be obtained in a weekend I am unsire of ENPC. The ER I work in does not Mandate that you have them but they really push us to get them. We do however have to have Cardiac Arrest Response (a toned down ACLS) and Lead two interpretation

I graduate May 9th and start May 25th. I have been doing my final preceptor for the last 2 months, and have found my favorite spot to work. I love Emerg. I love going in the morning and hate leaving when it is over. The staff I have worked with have been amazing and so helpful it has been a great experience. And I think I have had one of the best preceptors ever made. She has been amazing and really helped my transition to Emerg nursing from floor nursing. coming to Emerg form regular clinicals was like starting school all over again but she helped me get through, and really pick up well. Anyhow, I am extremely psyched and can't wait to get started. Oh and it is a full time position which is :balloons: :biggringi

ETOH wipes. #16 gauge angiocath, 3 bottles of Lovenox, 1 bottle of humulin N, an empty bottle of Cefazolin, some 2x2's and 4x4s, a 4-0 silk suture, some Saline flush syringes. a couple of IV end caps, a NG tube stopper, a bottle of lidocaine, some EMLA patches.......................... Wow I think I will stop there. I could have a pretty nice First Aid kit.

good info to know as I was unsure what rate would start showing circulatory and conduction side effects. Although my drug guide says there is a possibility of renal side effects at 20 mics. Thank you for the site link looks like a good one. I am still curious as to what the ECG was reading pre and post dope drip though

What ethnicity were they, I find it odd that he was allergic to all pain meds. I am just curious if there was some sort of cultural bias against them or something. What kind of rhythm was he in when he arrived was there anything abnormal with the rhythm?, and did you notice a change to the rhythm after increasing the Dopamine to 30 mics? The reason I ask is I wonder if dopamine can start causing arrythmias are conduction abnormalities at 30 mics as that is a side effect

Out of curiosity what were his baseline vitals enroute to ambulance, and the set you took before starting nitro? Was there any indication BP was dropping. Also what was the nitro started at?

First things first. So you are saying the pain is in his leg where they introduce the catheter right, and not in his chest area where the stent was placed? If it is in his leg is the pain right at the site of insertion or farther down? Does it occur at rest at anytime as well. Are there any other triggers other than walking. Does he notice it only at certain times of the day? Or if he has been on his feet long? Did it just occur or has it been occuring since he had the surgery?

Take it directly to human resources and demand something be done. alot of great advice has been handed on this thread I suggest very strongly that you take some of it, and go to them ASAP. he may be putting his hands around your waist right now, but please do not let it get past that point. You may think that he would never take it further, but just when you atrt to think that is when it happens. Take care of yourself and your well being, you do not deserve that treament nor asked for it. And ifall else fails and noone will listen to you, next time he tries to touch you kick him in the junk. (please take the last comment tongue in cheek) but please follow this matter ASAP

I hope that on a professional level people are able to look past your scars and see the potential you have, and when you graduate the professional you are. On a people level I am not so optimistic. Like someone above said, humans are humans. and unfortunately sometimes human's ignorance clouds better judgement. All I can say is good luck in school, I am glad you have found other ways to deal with your problems, and I wish you all the best, nursing is definitely a profession that can leave you with a ton of self satisfaction. :) I don't know if I personally would take the direction of hiding what they were and tring to change the subject if asked about it, unfortunately that only allows people to form their own opinion of their origin and breeds suspicion. I would never bring the subject up as a form of attention seeking, but if were asked I think I would be open and honest, but also make it clear that it was a very different time in my life, and that I have grown and have learned to deal with things in other ways.

That is what I was thinking. As for the continuing in elevation of WBC's I would wonder if she is going septic, or if there is some peritonitis from a possible slow bile leak into the abdomen from somewhere. You did say they had a hard time getting the gallbladder out right? Hard for me to say without having all the papers in front of me to see what everything is and has been doing over time.

The Rn I am working with as my emerg preceptor is on that list. She worksin Emerg, has been a nurse for 18 years and works loads of hours. Pretty cool to know you can make that much if you work your butt off.

I worked full time for about a year straight. After about 4 weeks I was able to get off work at 7 am stay up until 3 or 4 pm, and then sleep from then until I had to go to work for the next night shift. So my body got quite used to it. But I am sure it is relative for everyone.

Nowadays where morals have gone to the wayside of the almighty dollar. I would bet the farm we are a long ways away. Medical and pharmaceutical businesses today are more concerned with treating than curing people IMO. There is just too many people with Diabetes and too much money being made from oral diabetic agents and insulin that I don't thinkn they are trying to hard to find a cure. Just my opinion though.

Sorry to hear he had to wait so long, but it pretty much goes like the others said. If the town is small enough, either a tech had to be called in and took their sweet butt time, or it is a possibility that a trauma or something else could have happened or a stroke that, (in my hospital anyway,) is automatically next on the CT table when it comes in. Because your husband heard 4 people at the nursing station talking does not necessarily mean that the only reason he didn't get into CT quickly was because they were doddling. As well another thing I have noticed now that I have been on both sides of the fence. Even if you are triaged and in a room and assessed by the nurse, it doesn't guarantee you are gonna have a fast turnaround time. Last night in the ambulatory section for instance, we had people triaged and assessed by nurses waiting in rooms. So we had all our beds filled and some people were going on a 3 hour wait to be seen by the doctor. Meanwhile there was no more we could do, so we waited at the nursing station for doctor's orders so we could get in gear again. As well during that 3 hours we were dealing with some very irate patient's wondeirng why they are in rooms waiting when we are just "sitting at the nursing station." They just don't understand that we can only go so far then we have to wait for others. Again it is unfortunate your husband had to wait and I won't speculate on the circumstances, but I strongly suggets he go back for the CT, considering the Dr. seemed concerned. And I sincerely hope all turns out well for him.

I am finishing placement in the ER in our regional health sciences centre. We see approx 240 patients a day. We have 4 Trauma rooms. 2 are designated for resusc and 2 for traumas. all 4 rooms have their own articulating arms that have our ambu bag 4 suction sources and 4 O2 sources on the arm. A vitals monitor, then it has various airways and instruments set up for intubation and opening airways. then our back tray carries various stuff, such as N95 masks, sterile gloves, gowns, closed chest drainage trays, central line insertion kits, suture kits, paracentesis trays, catheterization kits, along with numerous other kits and instruments. Each room has a crash cart that carries a large amount of drugs for resusc, ACLS and Trauma, as well as preloaded syringes, so we do not have to run for any drugs, and a biphasic defibrillator. Each room has a dual bag pressure infuser The 2 trauma rooms have an inhouse X-Ray machine and portable ultrasound as well. We also stock all the RT equipment the RT's would need, and Iv equipment in room. WHen a trauma comes in, we do not have to leave the room for anything, until either the patient hsa to go for a ct scan or is going to ICU or OR. Our pediatric resusc rooms are set up in the same manner but everything in the peds rooms works on the Braslow system.

Every floor other than surgical floors I have been on RN's do all their own vitals at all times. Personally I am more comfortabel doing them myself, I do them when I first walk in in the morning and am speaking with the patient and getting a mini assessment done.

If the lady is able to answer yes and no questions as you indicated when she was asked if she wanted a FDG. tube are you able to ask her yes and no questions that could help justify the use of the morphine? Some people do suffer emotional pain but some come to a peace with the position they are in (like my father did) and don't want anything that would alter their mental status. My father for instance wanted to be able to experience as much of his family as he could his last days, and knew what the Morphine did to him mentally so only agreed to Morphine when he was in considerable physical pain, and would only take Tylenol for when he spiked a fever. So I don't know what kind of mental state your pt. is now in but maybe some yes/No questions can be asked to find out.

Hi all I just started my Emergency placement last week and have to say I am kind of in awe of everything. I honestly feel like I am a first year not nurse and not graduating in May. there is such a different atmosphere and pace, that I feel my myriads of clinical placements on surgical and medical floors has not really prepared me for. It is certainly a different experience. Don't get me wrong I love it already and reallyt hope that if I can excel at it that I would love to make ER nursing my specialty. My question is do you all, as experienced professionals, have any ideas on literature I can read that will help with my ER experience? I haev picked up the ACLS manual from an ICU friend I have and have begun to read that, and it has certainly given me some insite. Do any of you have any other suggestions for things that I could look over, or things that you know now, that you wish you could have looked at as a student pertaining to ER nursing. Any help would be greatly appreciated as this is my last placement before I graduate in May, then I work here in Thunder Bay for a couple of months until all my tests are out of the way, then I move to California wher I have signed an offer of acceptance to Enloe Medical Centre. Thank you in advance for any help you can give

To work :chuckle

Hmm Enjoying our cold snap Lydia LOL. I am finishing up the Rn program here at Confederation College in Thunder Bay. I have an interview at a Hospital in New york, and one in California today. With weather like this I am leaning toward California lol. I am from Manitouwadge myself and I have relatives in Atikokan and yes it is beautiful country up here, the cold and snow suck when ya don't have a ski-doo though.

The only problem I have ever had with client's not wanting treatments from me was for bedbaths or catheterizations on females. Other than that there has been nothing but praise towards me from other nurses and client's because I am going to be a nurse