MissERN

Hi! My question is this: Do you have a nurse manager that is dedicated solely to the ED, or is he/she also managing other departments? I feel that the ED is a department that needs a manager who can dedicate his or her time completely to the ever changing needs that arise in the department, however I work at a facility where my manager also oversees 2 other departments. We are a 22 bed ED with high acuity. Thanks in advance for your replies!

My grandmother had severe dementia prior to passing away, but she ALWAYS laughed about everything. Last week I had a patient that reminded me so much of her. She presented to the ED after a syncopal episode. She was not thrilled about my using a foley to obtain a urine sample, and did not hesitate to let me know about how she felt about me doing that. After I got her urine, I left her room for about 2 minutes and then immediately returned, and I was afraid she might still be upset with me. The moment I walked into her room her face lit up with a great big smile and this is how the conversation went: Patient: "There you are! I've been thinking about you!" Me: "Oh, really! Why's that?" Patient: "Because my oven's broken!" Me: "Well, we can't have that, now can we? We'll just have to get it fixed!" She then lamented again on how terribly she wanted a cup of coffee. It's not often I have the time to sit at a patient's stretcher and help them drink a cup of coffee, but that day I did. She drank 2 cups of coffee and I enjoyed every minute! I think I liked it better than she did. It's moments like that that make me love nursing! I'm quite certain that those 2 cups of coffee did her more good than the Rocephin she got for her UTI...the oven we are still working on!

Johnny1414, Your peers are sadly mistaken. You must realize that, generally speaking, in the ED you are starting from scratch. Your patients will arrive with nothing, and often they need many intervetions quickly, and more times than not you get multiple patients at a time. Your SOB patient that just walked through the door needs an iv started, EKG, and a whole workup, while you are trying to stabilize and get your other patient with an acute MI to cath lab...I'll stop there, but could go on and on about this. There is no "which is better" in the ED and ICU...they are just very DIFFERENT. Half the work? Not on your life!

First of all I want to congratulate you! Secondly, you will NEVER go wrong by bringing King Cake, just as long as you don't make the one who gets the baby actually bake the next one! :) (I'm kidding, of course :) I hope you love your job in the ER! I feel that the fact that you are on here asking how you can best do your job shows a great willingness to work hard, and I appreciate that. My piece of advice is simply: Don't lose that work ethic!

The number of nurses we have on a day to day basis is fixed, despite the number of patients we have in the department. From 1a-9a we have 4 nurses, and then another comes on at 0900. At 1000 we get another nurse for the main ED, and we also have a fast track nurse come in. We stay with this number until 2200 when we lose a nurse and then another nurse leaves at 0100. It's all about different patient trends in the department. While no two days are EVER the same, there are generally overall trends in the number of patients an ED will have at a given time and this is what is used to determine how many nurses are needed. Please forgive me if my post is difficult to understand...today was one of those days where I could have used about 5 more nurses...BUSY...and I'm exhausted! Good night! Hope this answers your question!

Hey Tweety, Would you please bring me some takeout Chinese when you get yours?!?! I couldn't find anything open when I got off, so I got frozen pizza from Walgreens...I think I'd have been better going to bed hungry!! :) Merry Christmas!

Congratulations to you! Have you signed your name with CEN behind it yet?!?!

Absolutely time for a rapid response! Sat dropping to 85% and heart rate of 180 on a post op femur fracture...I'm definitely thinking PE, and I'm definitely giving more oxygen! In a situation such as this by the time you get an order for more oxygen it may be to late. This patient needs high flow oxygen immediately! Sounds like a great learning experience!

I find it incredibly helpful to wear a soft scented lotion on my upper arms. It has saved me from wretching many times when cleaning someone. I am able to "sniff my arms" when I feel that I am about to gag. And it is definitely not as noticeable as if I tried to sniff my deodorant. :) Hope this helps!

I would also like to encourage you to continue on with your plan of working in the ED! Before I started nursing school I worked in a phycisicans office, and one day I almost passed out while watching an NP suture, and it just terrified me that I would not be able to be a nurse if I couldn't watch such a common procedure. Then there was the time I donated blood and nearly passed out as I was talking to the phlebotomist about sticking people. I noticed that every time I nearly passed out while watching procedures I was also worrying about upcoming nursing school and whether or not I could handle it. So, try to relax while watching, or doing, procedures! By the way, I have been in the ED for 3 years now, and I absolutely love it. I have a hunch that you will love it as well! Go for it!

There are so many days that I realize on my way home from work that the last thing I had to drink was 14 hours ago when I brushed my teeth that morning. Food? Who has time for that? Sad, isn't it?!? I feel your pain!

I work 6 day stretches (12 hrs) and then get 8 days off. However, it doesn't take me a day to get over it...it takes 2!!!! Love my days off though!

I work ER and was bitten a couple of months ago. The bite broke the skin...this guy would NOT let go despite multiple people attempting to restrain him. You better believe I pressed charges! He knew exactly what he was doing. I'm very fair skinned and the bite mark that is still on my wrist is the ONLY part of my arm that is tanning this summer...very cute! While this is not the only injury I've ever received from a patient, thankfully it is the worst. There have been numerous times I've been very afraid for my safety! We desperately need better security!

I agree with Batman! I appreciate what you do immensely! I can only imagine that the conditions in which you provide care are often less than desirable. Thank you for your thanks!! :)

Perhaps you also might be able to get some information from the manufacturer. I know that when we switched to new glucometers we had an inservice and they actually instructed us to place the test strip on the droplet of blood, and hold it on the finger for about a second. Good luck!