AznMattRN

the trick to prevent hemolysis is not to draw with too much negative pressure. If its not drawing with a 10cc syringe, step it down to a 5, and if that doesnt work go down to the 3cc syringe... i rarely have problems drawing off existing lines.

theres no contamination if 5ml are wasted from PIV lines... I always draw from existing lines...

Its not just the amount of fluids required that should determine what size IV to use, but what exactly the treatment is also. If large amounts of fluids need to be placed into a pt and a short amount of time, the larger IV's are safer for the pt. The smaller lines equate to fluids being placed through the veins at a higher velocity, which can cause the vein to blow, leading to BAD phlebitis. It really does come down to doing a correct assessment of the pt. and his/ her needs in choosing the correct IV size.

If its an elderly person, try starting the IV w/o a turnoquet if you can already see it... the veins are usually more frail and too much backpressure may be building up causing the vein to blow. Also, be sure to a good job stabilizing the vein before you poke.

I had one of my ER docs tell me that the other week...

if anyone "looks sick" vs "not sick" I always think having a lg. bore access is good... The way I see it is we work in an EMERGENCY room, and we must always be prepared for things to go downhill very quickly.

i learned how to access mediports in nursing school, and I will access them at work if needed... with a physician's okay to access it that is.

i dont neccesarily start AC IVs because its the quickest access.... I start AC IV's because the vein is usually bigger there in case I need to do a quick resuscitation, or I need to adminsiter blood, or I need a CTA Pulmonary... I don't do things just because "it's easier." I do things for a reason... and if its easier, its a plus.

what state are you guys in where you can carry concealed in a hospital??? It is illegal here in Texas for a CHL holder to carry in the hospital... I must be in the wrong state lol

I concur that it seems like bed assignments are finally made at the wrong time all the time... What kills me is when people do not want to take report at shift change... it comes down to "Do you want report from the person that knows the patient the best, or do you want report from the oncoming nurse that knows only whats been told to him/ her." I feel bad for the floor nurses when bed assignments are made @ 0530 because they have to do all their admit stuff, plus whatever AM orders that doc has placed, but down in the ED we don't have much of a say. We get our butts reemed for not moving pts. upstairs quick enough, and we get hell from the nurses upstairs for waiting so long to admit a pt. when in all actuality, we may have just gotten the bed assignment at a god awful hour.

yeah I was surprised to hear that myself. She told me that the earliest she could even get in would be next year... and thats if any slots opened up.

Navy Reserve Bonus is actually only $10K... my buddy is thinking about doing it herself. She was trying to go active duty, but there aren't any slots open for nurses in the Navy.

Just remember, even if you go to DO school, you have to do a residency after your 4 years of schooling... then possibly a fellowship. Timewise, you are really looking at 4-12 years depending on what specialty you choose. Other then that, if time is not that big of a problem to you, I would choose DO school.

I got in the ER under an internship... I am having to deal with alot of BS with the internship other then working and learning on the floor, but it was a step into an area I was really interested in so I just had to bite the bullet

I just graduated from nursing school in December and went straight into ED. The biggest encouragement I've received from other nurses is this: "You will mess up, make some mistakes, and probably some big ones at that, but always remember from those mistakes and learn what you did right and what you did wrong." I keep getting encouraged to ask questions, and nobody really ever looks down on me for not knowing something. Good luck! ER nursing was the biggest stress I have had the last 4 months of my life, but things are starting to get better. Just go into work each day and try to learn something new.