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Geriatrics, Emergency Nursing
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rhkenji has 4 years experience and specializes in Geriatrics, Emergency Nursing.

rhkenji's Latest Activity

  1. rhkenji

    Get Linked: 6 Reasons Nurses Need a LinkedIn Profile

    Linkedin is not free. You may not be paying for it, but companies do, and they also have paid membership for professionals that has needs for the site.
  2. rhkenji

    Was I out of place?

    I love my ER, 9/10 people in our ER treats ourselves as one family and is always ready to lend a hand even if you dont ask for it. They're just there when you need help and we strive to have a great shift every time. There's 1 or 2 nurses that REQUIRES help with everything that they do, even the simplest thing. As our work culture sees that the team is only as strong as it's weakest member, we try out best to help them out whenever we can. As my charge nurse always say, "She may only work 70% of what we are able to do, they are still part of the team and we should appreciate their presence especially when we are short" Well, this morning, I was helping out a registry nurse try to chemically restrain a female belligerent drunk patient. The problem was the other RN and I are male, and 3 of our EMTs are also male. I advocated that for the patient's safety and everyone's safety, a female nurse should be present when we go into the room to medicate her. This nurse was the only female nurse in the area, and the situation is starting to get out of hand, we needed to restrain this patient as soon as possible. This will take approximately 30sec to 1 minute to get everything done. I asked this nurse nicely and explained the situation. Her answer was "Well, I need to chart, so you guys need to find someone else". She even stated that she need one of the EMTs right there and then to help her do an inventory list. Frustrated, and after 11.5hrs of the shift behind me, I blurted out. "Well, I do hope that when it's your time to need someone to help you with a psychiatric patient that you get all the help that you need". The EMTs and other auxillary staff started chuckling and she became really defensive while I ran off to the other side of the ER to find another female nurse to help us out. After the shift was over, I thought about it and I felt like I was out of place. I just feel like, we are always there for everybody, but she cant be a team player even once in a setting such as our busy ER. I know I could have handled it properly.
  3. rhkenji

    Propofol Dosing in ER

    This could be it as well, I agree. Analgesic was followed through afterwards. She was losing her airway and only medication included in our intubaton box are succ, etomidate and roc.
  4. rhkenji

    Propofol Dosing in ER

    she was placed on propofol immediately after RSI. given that additional meds will take 5-10 minutes to get from pharmacy, she needed more sedation to control restlessness. immediate v/o to max out propofol was given when it seemed like her high BP and having been intubated will support it. Maxed out on 50mcg, and being that she still restless, the V/O was to go beyond 50mcgs and both my CN and MD stated that it's ok as long as BP can take it.
  5. rhkenji

    Propofol Dosing in ER

    This was immediately after intubation while new med were being added.
  6. rhkenji

    Propofol Dosing in ER

    The BP was later addressed with nitro and cardene. The propofol scenario and verbal order was right after intubation. While waiting for nitro, versed and cardene from pharmacy.
  7. rhkenji

    Propofol Dosing in ER

    Versed. She was placed on versed afterwards. But I guess MD wanted the propofol for sedation and to lower her BP
  8. rhkenji

    Propofol Dosing in ER

    So, I had a AMS patient who was awake but non-verbal, not following direction and had to be intubated. Prior intubation, we couldnt get an accurate BP reading due to the PT being restless. After intubation, her BP was found to be in the 260s/150s, rechecked multiple times. After her paralysis wore off, doctor wanted her to be maxed on propofol per our unit policy (50mcg/kg/min), but that didnt help the restlessness.. she was still moving all extremities and the sedation is not working. Her BP at 50mcg/kg/min was 220s/130s. Doctor stated that we can go pass our guidelines of max 50mcg/kg/min. The MD and my charge nurse stated we can keep on increasing the propofol up to whatever is needed as long as the BP can support it and the patient is intubated. I cannot find any articles regarding about it. How far have you pushed your propofol dosaging? I usually request a secondary sedation after reaching 50mcgs.
  9. rhkenji

    I don't want to be a nurse!!

    Don't do it! Listen to these nurses. We wanted to be what we are but we still get burnt out by the profession. More for you that doesn't want to be one. Do yourself and future patients a favor and don't do it
  10. rhkenji


    I work in the emergency department in a hospital with a very small ICU. Most of the time, ICU level patients stay in the ER when there is no bed available for them to be admitted, so we function as an ICU nurse as well, on top of our other 3 sometimes unstable new patients. ER is busy, and can be overwhelming. ER nurses are expected to function as well as all other specialty unit nurses combined.
  11. I asked about that, she stated: "the law sees the nurse in the position of power every time, even in a situation where the nurse defended him or herself against a patient"
  12. thats what they said. let security handle the patient, they are allowed to: nurses then can put restraints (chemical, physical), but we cannot and not allowed to hold a patient down.
  13. We are a mix of med-surg, tele and ED nurses. I will be working in the ER
  14. I was on my new work orientation today and the topic of restraint and battery was discussed at the end of the day. I totally understand that we CANNOT touch a patient without permission and the a patient has the right to refuse to be touched or cared for or the nurse can be charged with battery. Now, I get that.. but I didn't know that in cases that we are getting battered ourselves, we are also not allowed to "push" a patient back or hold them to stop them from hitting us. How true is this? I know this is orientation, and this is probably hospital policy. But are we really not allowed to defend ourselves? I asked what I'm suppose to do, the instructor just said "run. call security. lock yourself somewhere.. even your co-nurses are not allowed to hold a patient to help you", "security, EMTs and MDs on the other hand, CAN by law" California, Los Angeles area
  15. Sadly, I work the AM shift when all things happen and the shift where they actually expect you to do everything. The other two shifts feels like they're are just there to watch the facility until the morning shift arrives which leaves me the lone person to manage my station's med cart I am expecting corporate survey to come in next week and I'm currently cleaning up my cart for old/unused medications. Please correct me if I am wrong. I have OCD when it comes to cart maintenance so sometimes I question myself 1). We are asked to date our opened bottles (like tylenol, vitamins, ibuprofen, etc, OTC stuffs) but we are not told when to throw em away (except when they're expired, duhh). So whats the guideline in this? 28 days / 38 days like insulins / pen insulins? 30 days? how long can they stay after opening them? 2). How about for liquid medications? OTCs and Prescriptions 3). Inhalants (1 month to 1 1/2 months?) 4). Nitroglycerin (as far as I know, 6 months?) 5). Eye drops (as far as I know, 6 months) 6). Nasal Sprays (6 months?) If you guys have a visual chart / web resources please link it. I've been looking for an hour but I can't find one. I always find "how to administer drug..." kind of resources. Thank you :)
  16. rhkenji

    Moving to Nursing Dept.

    First time being transferred to a different department in all of my professional life so I dont really know thats why Im asking. Thank you for the help.. I have told her verbally and she knows I'm leaving. I just thought that a 2 weeks letter is just standard way of cutting off professionally from a job.