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EmergencyNrse

EmergencyNrse

Emergency Medicine
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EmergencyNrse has 17 years experience and specializes in Emergency Medicine.

EmergencyNrse's Latest Activity

  1. EmergencyNrse

    Triage-How is it done in your ER?

    Triage as a system is dead. Everyone has bowed down to the 5-level ESI system to "maximize reimbursement". Now you get to charge for every little detail of a person's visit. Ooooh, you're a one. You're a two. There's not chit wrong with you but we have deemed you labor-intensive so we can stick it to you and your insurance. Way to go ENA. Way to go... Triage? There's no such thing in a civilian system. Only in the military do they sort based on severity any more. But, Love hearing about the way others nickel and dime patients in their facilities. Keep 'em coming.
  2. EmergencyNrse

    Is anyone using Cerner in their ER?

    Cerner and Epic... NOT very good programs for our purposes but they are the leading platforms that integrate well with hospital systems. T-system is the Cadillac of ER charting but they (programmers) were short-sighted in not being able to integrate into existing hospital software programs so it's on the outs... Sad really but that's our government at work. Thanks Unce Sam for all the headache
  3. EmergencyNrse

    Burnout tips?

    1.5 years you say? You need a change of venue. Good luck.
  4. EmergencyNrse

    Best Drug Seeker Stories

    There is no such thing as a "seeker". Just ask the ENA.
  5. EmergencyNrse

    New Graduates who don't welcome feedback

    I know the mentality. I know the personality type. Go ahead and let them fall. Let them "feel" their way. Just make sure YOUR name isn't on any of their patients charts...
  6. EmergencyNrse

    Cooler weather and homeless "patients"

    Treat 'em and street 'em... Nothing you can do to change their arrival. Doesn't change your paycheck either. Try not to be too concerned about the things you cannot control. It will burn you out.
  7. EmergencyNrse

    What is the best stethescope for an ER nurse?

    I have a Littmann Master Cardiology and am pretty good with high frequency/low frequency auscultation. Truth be known, the vast majority of physical exams in the ER can be eval-ed with the 2.00/disposable stethoscopes... Don't go out of your way to spend lots of dollars. You don't need one to get the job done. Just my 0.02
  8. EmergencyNrse

    General Travel Nursing Questions...

    double post
  9. EmergencyNrse

    General Travel Nursing Questions...

    Although you are "traveling" I don't believe it's travel nursing you will be interested in... Travelers usually are flexible in going all over for short periods. I'm guessing you want to be together not apart? Registry! You will want to work in the community your husband is stationed. Registry is a sure-fire way to work locally in one or many facilities around base/post. Look around where he is stationed for companies that staff hospitals/clinics in the community. This way YOU stay in charge of yourself. (Usually pays more than part-time or per-diem too)
  10. EmergencyNrse

    New ED Program: Charting vs. Patient Care

    Patient care always comes first. I'm a traveler and see a new computer system every 13 weeks. I admit that I don't get everything in the system sometimes but I have never left a patient hanging. Charting of IV starts, port access, foley insertion.... sometimes it's charted, sometimes it's not. Meds are the exception. They get done but the chart auditors will have to assume that IV meds/fluids were given through an IV that was there somewhere. It's a compromise. Getting the job done or apeasing the iChart Gods. You can only hope that as you become more familiar with the system that you will become more efficinet with the charting. Good luck.
  11. EmergencyNrse

    burnout in ER

    This.... (Don't let the idiots get you down. Shrug them off. They'll be back next week...)
  12. EmergencyNrse

    Have been in the ER for 3 hrs now....

    I'll just bet you were able to leave the ER alive... Sounds like a good visit to me. Better if you were actually discharged. Did you really need to be there or did the staff manage to snatch you from the jaws of death? Good luck in your future endeavors with unreasonable expectations... Life must surely be a series of constant letdowns.
  13. EmergencyNrse

    Sometimes you just can't bite your tongue.....

    As good as it feels to "inform" patients and their families of their rudeness and inconsideration of everyone around them I caution you to refrain from doing so. It never helps the situation and can only open you up for scrutiny. Administration doesn't care how slow things are. They only see you being unprofessional to the "clients". One of the 1st stages to ER burnout...
  14. EmergencyNrse

    What is the best experience to transfer into ER?

    Ranger School.... Maybe Navy Seal BUDS. Learn to tolerate pain and suffering. Lack of sleep. Stress... Forced starvation and denying yourself basic elimination needs. Probably the best way to get a feel for life in the ER
  15. EmergencyNrse

    Critical Care Experience

    The answer can be found in another question: How well do you work independently and make critical decisions on your own? It's not just "experience". I know a bunch of people that are really good in the unit but put them out on their own without someone to ask, check their dose, mix their gtts... they're LOST! There is no code button. There is no rapid response team. There is no doctor to turn to when your patient "tanks". You might get to make cell phone call but what's going on with that patent while you're on the phone? You're on your own. I know the appeal to getting out there. It seems like it's really cool but at what cost? You absolutely MUST be solid in your ACLS algorithms. You MUST be able to adjust to micro-drip concentrations that aren't standard for your floor/hospital. (They vary) You have to be comfortable to recognize when it's appropriate to give a bolus or start "pressors" on your own. Know how to mix your solutions, give medicines, and take appropriate actions by yourself. Intubation? Running a code by yourself? One more thing to consider. Motion sickness. I have worked with people with far greater skills than my own. I can only aspire to equal their skills and knowledge but they can't be in an aircraft blowing around. They can't be in the back of an ambulance riding backwards writing/charting... They blow chunks. All-in-all transport really is a fantastic job. My suggestion is not to be too eager. It might bite yo in the end. Work on skills. You CAN do it. Good luck.
  16. EmergencyNrse

    New to Travel Nursing...need advice!

    First you should start out asking/talking to a recruiter. You are never just sent out to work somewhere you don't want to be. You decide when/where you will go. The recruiter will show you the job offerings in the states you want to work and you can pick and choose the place. There is still an interview process (usually telephone) that takes place before you're hired and can sometimes be competitive with all the nurses seeking similar "choice" destinations. Licensure can be an issue with some states and can be as much as 6 months to wait on a temp or permanent license. Most nursing programs meet standards for all states but reciprocity is not guarranteed. You must go to the Board of Nursing in each state you are interested in working to ensure you meet all their requirements. Lastly, this is a word-of-mouth driven industry. Get with some other travelers that work in your same field. We discuss the best companies, the best destinations, and the hospitals to avoid. (There are some #ell-holes out there and you don't want to get stuck in a bad assignment) Traveling should be enjoyable. Don't stress about it but arm yourself with facts and intelligence BEFORE you contract anywhere. There's good information here and other websites.
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