RNin92

Amber, I have 2 pieces of advice for you... If you find all of this "disgusting" stop reading it. And... Sign back on about 5 years after you are working as a real RN... We'll talk then. Walk a mile in my shoes, babygirl...

You know you are an ER nurse when... A trauma patient comes in with his foot facing backwards and all you can think of is..."COOL!". You can code a patient and order lunch...all at the same time. You have the phone numbers for Poison Control, Crisis Line and the Coroner;s office memorized. Just once, you want to be able to say to the yahoo that calls to ask if you think his tail bone is broken...well put the phone right up to your a$$... You have just worked a 12 hour shift, never got a chance to pee let alone take a break...and a Level 1 Trauma comes flying in your doors and you think...just for a minute...I could stay...

Just a question to pose... In my hospital we have a new policy on Site Verification. You know..."lop off THIS necrotic leg not the good one" New JCAHO safety goals and all... But most places that we recently polled do things a bit differently than we do. We have to site mark everyone who has an invasive procedure unless it is an emergent case (this being the ER and all??!!??). So tension pneumo-no marking needed Your run-of-the-mill pneumo that is stable...mark the site But here's the deal... LPs??? Exactly how many lumbar spines does a person have? And... Who does the marking? Most places the physician explains the procedure, consents the patient and together the site is marked Not us...the RNs do it all...including the site marking. How do you do it in your ER?

This comes up a lot in my ER as well. What happens when an intoxicated person refuses transport to the ED by rescue? What happens when a well intentioned friend brings them in drunk and they refuse treatment? Our "legal people" don't have clear cut rules either but we try to use the right terms and document until the cows come home... If they are drunk but "decisional" they can sign out AMA. Decisional is the ability to understand the consequences of your actions. Some of our FF drunks are decisional no matter what the BAL says. "Competent" is a legal term, as another poster stated. We try to avoid that term because competence is decided in a court of law not an ER. As far as people who are given narcs and then try to drive home... Direct line to the PD...thank you very much! Gotta love those boys/girls in blue!

We ER nurses... We are a superstitious bunch!!! Just like the "Q" word... hee hee hee

shock-shock-shock period follow acls protocols don't debate while the pt is dying shock-shock-shock

In Illinois it has to do with services offered. Level 1 must have OR in house and available 24 hours They have to in house Trauma surgeons 24 hours Level 2s can have up to 30 minutes to get a Trauma surgeon and a surgical crew in house. There's more but it all has to do with availability of services

I understand what you are saying but I think a little humor will go along way in easing the anxiety of new nurses and those considering the scary world of the ER. I personally think that ER nurses are some of the most caring I have ever had the privillege to work with. We step into people's lives at their worst moments, in the most chaotic of circumstances, under the most stressful uncontrolled times...and shine. Day after day after day... If it takea a little humor to make it through...so be it. Those who would sterotype us have no understanding... And I choose not to live my life by their closed-minded rules. End of soap box! Sorry

Thanks. I sent a PM with my e-mail address

That is sooooo true! It's because we practice medicine now according to litigation rules. Everything is way messed up.

Love these!!! Thanks... Keep 'em coming! :rotfl:

Can I say ouch! I'm female and I still want to cross my legs and say ouch!

Ok... So I am a part of a committee putting together a "seminar" targeting New Grads, Recent Grads and students. We are tentatively calling it "REAL Life in the ER". We are planning it from a humorous perspective. I have the task of ED "Definitions" You know... "DDK"=Dead Doesn't Know it "Code Brown"=No explanation needed...I hope! Got it??!!?? So if anyone has some funny ones...please post them so I can include them in my "lecture" Thanks! :rotfl: Also, any funny "Nurse Calls"

I've posted my father and son tag-team pruners before...with the lawn mower!! (So...did ya WANT those fingers?!?) And, I've posted my 20 something year old who thought 3 titanium cock rings were better than one...or two! (Yowie!) Those are my 2 personal favorites... But there are so many others... The lady who had staples in the right side of her head...just didn't fell like getting them out...came in 2 months later with c/o of "Headache, but only when she laid on her right side"...no kidding! And ya gotta love the pregnant girls who have never had sex..(so are ya STICKING with that story missy??!!?) I do love the girl who came in with etoh poisoning...she was a volunteer at a local department...trying to help show the effects of etoh on your judgement...and they had her drink a quart of tequilla in 45 minutes...ooooh...was their chief ticked off when we called him...seems that he told them to use the glasses with the lenses that "simulate" etoh...oops. Ahhhhh...so many people so few neurons! :rotfl:

[quote= I did get a bit miffed at Rena's and RNin92's comments, to be honest, and they were what prompted my second post. The last thing we nurses need--no matter which unit we work--is to be disrespectful to one another. I hope I didn't offend anyone, either. That was not my intent. I agree...nursing MUST stick together to do what is best for the patient. That is what prompted my starting this thread in the first place. However, when you ask a question that clearly shows disrespect of the workload of another, you shouldn't be surprised if someone is offended. And asking "how would you ER nurses feel..." was offensive. But I appreciate that it was not your intent. I also totally agree that a pi$$ing contest is an excercise in futility.We all agree that we all work hard. But it is really not about us... It is about the patient. I worked Tele for 10 years. My unit was incredibly busy. We usually had four patients...sometimes 5...just many of the days they were not the same 4 or 5 I started with! I would drag my weary body home at the end of the shift and try to figure out which Mack truck hit me! I DO understand the busy pace of inpatient nursing. I also now understand the insanity of the ER. That's why I asked the question in the first place. But the fact remains, that it is NOT about us!!! It IS about taking care of a patient... The in-patient will receive optimal care from the nurses who are trained in their specialty area over the care they recveive in the ER. When it comes to ACUTE disease processes...get out of the way of the ER nurses. But when it comes to managing the disease process...hands down it is the nurses on the units. I was only trying to get to the best practice in getting the patient to definitive care. If the patient requires ICU...they need the ICU NURSES...not just the real estate. If the patient requires chemo...they need the NURSES who are trained in chemo. Etc...

I know my friend... Some people just have no clue!!! :rotfl:

So veetach my friend... Care to share that taser with a friend in illinois!!!?? Just sayin'

Jason, I think you have gotten great advise here...debriefing is the way to go. After forcing myself through the doors of my first debriefing (from a 16 y/o stabbing death) I know it is really the way. Our crisis team came out...EVERYONE involved was invited. EMS came, ED staff and docs, Med Imag people, Lab, many people. Everyone just came together... Some talked Some didn't It was good. I could finally sleep. Good luck my friend And remember we all have each other to get us through

And I still want to know how you "close beds" in your ED? You can't exactly send people away...

Amen my friend, Amen I would only add to that that at least at our hospital, administration also refuses to take on the physicians. We are a 200-bed community hospital. Our ED has 14 beds in our main ED and 6 in our fast track. We see about 38,000-40,000/year. The problem is so complex...it's not just a bed issue... Most of our docs close their offices at 4... Almost none are open on weekends No more "sick visits" held NO pediatrician in our ENTIRE COUNTY who accepts public aid patients One free clinic in the county...open once a month Guess where all those patients end up Attendings that refuse to discharge patients along nationally accepted LOS guidelines Attendings that inappropriately admit Attendings that "admit thru the ER" so they do not have to come in to see their patient Lab that is downsized so much that now we "send out" half our labs to our sister hospital...and wait for results...and delay dispositioning of patients Psych beds closed due to lack of funding I could go on forever...And I haven't even mentioned the nationwide Nursing shortage

When I "retire" I am coming to your hospital for that cushy little baby shift!!!!! I try to get all the nurses to lunch...most days I can... I am almost the last to go...I feel like I am in charge and one of my responsibilities is to get everyone to break...can't make myself go FIRST!!! Oh...and to the poster who left the ER because when they were covering someone for lunch they had "8 patients"...gimme a break my friend...and nice try...

Not sure if we have a state ratio limit (IL) but we are usually staffed for 4:1. Nights they go up to 5:1. Minor care they are 6:1.Assuming, of course, that there are no "holes" in our schedule. Managers do try pretty hard to cover those... But when we fill our beds, we start lining up the hallways...we even gave them "room numbers"...it just got too confusing! I try VERY hard not to use "hallway" beds unless forced to do so...crushing CP, etc...but the Gods are not always so kind! We, too, triage squads to the waiting room...just LOVE when people say" I called an ambulance so I could get treated quicker"...Yea...nice try Our managers and TC and RNs in for meetings, etc do come out to help during those times...but we are only 14 beds in our main ED...we get backed up fast. We do try to get the squads out right away, too...Nurses are at the bedside on arrival...either the primary or the charge nurse Some days, though, it sure does feel like a juggling act!!!

I have a different take on this... I think because we intervene at the MOST difficult times in a person's life that a caring relationship almost HAS to develop. People are trusting their very lives and the lives of the people they love to US... Talk about a bond... Just my view

Faster is ALWAYS better. We are going to try!

You know, why is it that we can't just call things as they are???!!?? Medical Records...no no..."Health Information Systems" guess what people ask for when they call or come in... Radiology...uh uh...Medical Imaging as opposed to some other type of imaging??!!?? Secretary...Certified Health Unit Clerks can you figure out their acronym??? Nursing Assistants...Nurse TECHNICIANS...Unlicensed Assitive Personnel don't even start me there!! Housekeeping...Environmental Engineers ????? The list goes on and on... And I haven't even begun on the administrative "titles"...but that would be a whole other post! :rotfl: