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RedSox33RN

RedSox33RN

Emergency Dept, M/S
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RedSox33RN specializes in Emergency Dept, M/S.

Recently moved to a southern state from New England

RedSox33RN's Latest Activity

  1. RedSox33RN

    Frustrated and considering a career change

    This is SO true, and what I am struggling with right now. I really thought ER nursing would be for me, but find myself more "disenchanted" with it than ever (although it's only been 2 years for me). I'm looking now for a new area of nursing, hoping and praying that I will find my niche. I know I need to be able to spend more time with my patients and truly HELP them make lifestyle changes and follow their progess, which obviously not what the ER is about. Yes, helping people, of course, but after they're gone to the floor or out the door..........they're gone. I often wonder what happens to a lot of them, and this feeling and wanting to follow-up/follow-through, has become much more pronounced in the past few months.
  2. RedSox33RN

    What's The Meanest Thing A Dr. or Co-worker Ever Said To You?

    I got yelled at by a surgeon once because I couldn't understand him. I work in the ER, and I was taking telephone orders for him because he couldn't get in to see the patient before he was admitted to the floor. He spoke VERY broken English, and with the heavy accent (not sure from where, but I was told he had only been in the US a year or so), he was just impossible to understand. I DID, however, understand the gist of his yelling when I kept asking him to repeat what he said, and I would TRY and repeat it back (incorrectly, as it was)! lol I finally said he would need to come write orders or fax them over. I was not taking any chance of a missing or incorrect order! That p'd him off to no end.
  3. RedSox33RN

    Frustrated New Grad

    I feel your frustration! I lived in the Northeast all of my life, graduated NS in 2007, and probably sent out 150 applications in 2 states, and all I got was two PRN jobs in M/S and LTC, neither of which was the area I really wanted, ED. I had to relocate, leaving family and friends behind, which was tough. But I got into a great "ED school" in NC that was for new grads and RN's looking to get into the ED. It was 6 months long, combination of classroom and dept shifts the first 3 months, then with a preceptor for the last 3 months. It was very helpful and a great experience. I've since left that hospital and in a smaller ED (they had just opened a new ED the place I trained at, over 75 bed ED and not nearly enough RN's!) and as much as it pained me to move, I don't have any regrets. I hope you can figure out or find something soon!
  4. RedSox33RN

    EMS abuse: The Ride to get High

    Several of our docs are now documenting in their assessments and notes that they have educated the pt about use/abuse of the EMS system. I'm hoping that one day this will help fine or prosecute the ones that have demonstrated abuse of the system, showing that these people were informed of the correct use of EMS. One doc in particular recently got extremely irritated at a woman who came in via EMS with her 6m old r/t a diaper rash (if it could be called a rash. The area was slightly red, child interactive and smiling) x4 hours. The woman has a big hx of EMS abuse. I wish more of the docs would speak up, because coming from me ("You're JUST a nurse, not the DOCTOR!") doesn't seem to have much effect.
  5. Absolutely horrible.....I want to cry reading about that poor woman, and think about all the residents that witnessed this horror, who may believe that they will be treated with the same indignity and disrespect as this woman. That nurse should have more than her license revoked.
  6. RedSox33RN

    I'm having an interview for ED tomorrow

    I hope your interview went well! Good luck to you Sleepless! Let us know how your interview goes.
  7. Our Urgent Care is attached to our main ED also, and we regularly get those that must be transferred (just a w/c ride away) to us. I wish we could do the same thing, but unfortunately, no downgrading in triage. We get a LOT of pt's that say the magic words "chest pain" and when I assess them, it's "oh, I really don't have c/p, just am nauseated and have a sore throat, and oh yeah, I need a refill on my Percocet". It makes it so difficult on triage nurses. Just this week I've had 3 pt's that came in Level 4, who are usually quickly d/c'd, that ended up being admitted for something severe, and more than twice that in Level 2 that were in and d/c'd within 20 minutes. One was almost admitted with GI bleed because of black diarrhea, guiac was negative though. It wasn't until pt told me she had taken Pepto-Bismol the night before that we called off the CT and admitting doc. That was something the pt hadn't told the triage RN, and obviously the pt was unaware the s/e of bismuth. We hear that a lot also - that pt's went to Urgent Care or Fast Track because they didn't want to wait for the regular ED, but they really do belong in the main ED.
  8. RedSox33RN

    Discharge

    I would not like having such a policy, but would follow it if we did. It does seem very time consuming to have to escort ALL pt's to their car (and what if they are waiting for the bus? Do you have to wait with them until the bus comes??). I know our facility just does not have enough RN's or tech's to do that. I am one to use a w/c for all pt's that have had narcotics or are a fall risk of any sort, but to use a w/c for a pt that came in for a small lac repair or got an RX for a sore throat seems like a waste of time and resources.
  9. RedSox33RN

    ICU differential pay

    There were certain specialty units in my last hospital that got "specialty" pay. I worked ED, and got an extra $1.10 per hour.
  10. RedSox33RN

    new nurse in emergency nursing

    I just started in the ED in December, but had done some work in LTC and M/S, but only per diem. They had an extensive "new grad" program for new ED nurses too, which included classroom time and floor experience. My advice is to first be willing to admit you know nothing. I had nurses that started with me also, but had lots of M/S experience or whatever, and thought they knew it all. They didn't. I was used to doing full head-to-toe assessments on my pts. That wasn't what we were supposed to be doing in the ED, so it was hard to get out of that (not talking about the trauma pts now, just the ones coming in for a sprained finger or dislocated shoulder or cold sx, etc). But that being said, you have to be able to learn what are some good ways to do things and what are not. Just a "for instance", blood cultures x2 are something we do all the time. However, my instructor told us you'll see a LOT of nurses doing them wrong, and they KNOW they are, but are trying to "save time" or are just plain lazy. First, they aren't doing them 15 min apart - just labeling them as such, and a lot of time, are pulling them off an existing IV line, which is not going to culture the blood, but the line itself. They should be done on 2 separate sites 15 min apart, and unless the IV line is brand new and the blood drawn off it right away upon insertion, a butterfly stick should be done on 2 separate sites. I can't tell you how many nurses (and paramedics who work in our ED) would draw 20ml all at once off an existing IV line. I know we're all busy and it saves time, but it doesn't help the pt, and the results may be erroneous. So be open to learning - learning the right way, maybe learning some short cuts (eventually, but learn the right/textbook way first) and learning the wrong way so you know what NOT to do. Does that make sense?? lol (BTW, I'm not saying this to be flamed! I know I'm new to the ED and don't know much, but this was just an example of something we were told and I also saw). Take advantage of "down time". It very rarely gets slow, at least where I was, so I decided during those times I would learn a new rhythm strip, review a certain protocol, learn some new drugs, etc. I also always kept by IV drug book and Drug guide with me. I looked up drugs I had never given before, and would do that until I'd given the drug several times. I kept a notebook with me and would write down notes, then would review them later. Ask lots of questions. Practice all of the common skills needed in the ED until you can do them in your sleep. Part of our ED school was just doing skills for about 7 or 8 shifts. All we did was blood draws, IV's, catheters, 12-leads, NG tubes, etc. If there is one skill you need practice on, ask everyone to let you know if they have a pt that needs that. Don't shy away from what you don't do a lot or don't know. Well, I've written a novel, but congratulations! I'm still learning too, and don't be afraid to tell people that you've never done that before, and would they guide you through it or ask for help. Most of the nurses and techs and docs I've worked with are more than willing to help!
  11. RedSox33RN

    ER triage protocols for OB patients

    In our ED (well, my old one, since I just left and moved back to New England!), they would be seen for the chief complaint, but we would always assess fetal heart tones and chart them. If the pt was over 20 weeks, no matter what the chief complaint, they had to be transferred via w/c to the L&D floor after they were cleared/dc'd in the ED and be seen in L&D triage. The only change from this protocol was if we called L&D and the attending OB gave orders over the phone that the pt did not need to be seen, after we gave report. This happened a few times to me when L&D was over-flowing, and the OB pt was less than 36 weeks and only seen in the ED for a sprain, cold/flu sx, etc. I did have one though that I sent up anyway, even after the OB attending said she didn't need to go up. She was 36-37 weeks, presented with excessive vomiting and fever - some stomach virus that her young son had also had. Fetal heart tones were fine (couldn't assess ctxns since we didn't have a full fetal monitor, but pt denied any), cervix was closed and thick on exam, but she also had +leukocytes in urine. We got the vomiting and fever under control, but I was thinking she just was not right and I didn't want to send her home, even though she was d/c'd by our ED doc and OB with a script for Phenergan and abx for a UTI. I mentioned my concern to the ED doc, but he wasn't too concerned. I called L&D triage and said I was sending her up anyway. They said they'd put her on the monitor up there. So, she was having ctxn's she couldn't feel, probably from the UTI (I had the same thing happen to me in my first pregnancy, and it's hard to tell the ctxns from the bladder pain). Once she slept off the IV phenergan we had given her, she said she had kidney pain also, which maybe had been masked by the vomiting/abd pain. She had a kidney infection, and was contracting every 7-8 minutes pretty regularly. Ended up being admitted. I'd be interested in every one else's protocols also. I'm going to be starting at a new ED in a couple weeks (just deciding on whether to stay with adult ED or try Peds ED. I'm job shadowing this week in the Peds ED to see if I like it!) so will be getting used to alllll new protocols! I've already learned this new hospital is way different than what I'm used to.
  12. RedSox33RN

    Anyone else call 'em johnnies?

    I'm from New England, and always called 'em johnnies too. When I moved to the south last year and called 'em that, I got the WEIRDEST looks. They had no clue what I was referring to! I finally said "gown?" and they got it, but we ended up in a big discussion about what we all called different things. We in New England are known for saying "wicked" a lot, like something is "wicked cool!". They'd never heard of that either, but I know 65yo grandparents that say it! lol
  13. RedSox33RN

    Nursing, Smoking, and Kids

    Disagree all you'd like, but it's been proven. I would provide the link if I could find it, but it's been a while since I wrote the paper for nursing school. I never said it was an abundant amount, just that it is there. I'm not a scientist so I'm not going to get into how much transfers and how much is really poisonous, etc. But there IS toxin, whether someone smokes outside or inside. And these are toxins that are avoidable, just as the bad things in McD's cheeseburgers are. No one says anyone must eat them. Just as no one says people must smoke. Toxins that are in the air are much harder to avoid, obviously. I'm not stating this to place blame on anyone, just stating it as a fact that they are there. I'm not judging. I am an ex-smoker for over 19 years now, so yes, I do know the effects and how hard it is to quit, etc. People are just misinformed when they think not smoking around kids is the answer, because it's not, just as using Febreze and gum covers up the smell, because it doesn't. The OP was asking about smoking around children, that's all. I'm not turning this into a smoker vs. non-smoker conversation, which it obviously has turned into. I'm stepping out of this thread for good, since several smokers seem to not believe toxins exist after the the cigarette has been put out.
  14. RedSox33RN

    Nursing, Smoking, and Kids

    No, it most certainly is NOT a dead horse when children are exposed, especially if those children have other illnesses.
  15. RedSox33RN

    Nursing, Smoking, and Kids

    Would I say anything? No, not unless they were good friends. Like posted before, if those kids have ever seen a doctor, they have probably been advised. I also find it interesting how many smokers say that they don't smoke with the kids in the house or in the car. But be it outside or just not when the kids are around, the toxins from the smoke remain in clothing, furniture, the fruit in the bowl on the counter, towels hanging in the bathroom, etc. etc. I am looking for the studies I used for my paper in college, but just because a child in a smoking household may not be directly exposed to second-hand smoke, they are still exposed to all of the chemicals and are still very much at risk that way. It is very nasty and while not exposing non-smokers to the second-hand smoke helps, it is nowhere near the same as being in a non-smoking environment.
  16. RedSox33RN

    only in the er...had to share this

    Oh no!! I'm hoping they weren't going to try and re-attach it! Glad the patient didn't find it! That wouldn't have done much for her nausea and vomiting.