trsnurse

Ours go to OR, but how often do you do them? I hope we never do:uhoh21:.

Yeah I know all that about him. He is a great guy, and personal friend. I don't talk to him much anymore, he used to do PT hours at our hospital. I sent you a private message.

Do you know (and love) Dr. Mearns?

We have to do incident / occurrance reports on all LBT's (left before triage), LBTC's (left before treatment complete), LBT's (left before treatment/seen by MD) , and of course the AMA's. At our hospital we have an incident report for EVERYTHING!! We also if I might add, have an assistant nurse manager that we can't figure out what exactly she does other than micro-manage (just recently learned from other er staff that this is how she conducts her time which means to focus on how many ways the RN's screw up). She is also the receiver of all these reports, as a permanent charge RN in the dept. I want to delegate all this (much ado about nothing) paperwork to her!!! But we also have a new director, she has been in her position for 2 years (about) and this is her 2nd assistant nurse manager, she seems to think this person is GREAT-- but for the most part I think the staff feels as I do (she would make a good hood ornament for my truck)!! Okay back to your issue... We also have to check on patients triaged back to the lobby, at minimal every HOUR. But if they were in the lobby b/c we are full and can't get a bed for our patients who are sick and tirage is getting their teeth kicked in then how the He** can you begin to worry aobut those who have such complaints that they are triaged back to the lobby in the first place? We work on a 3 scale triage system-emergent, urgent, non-emergent, and if someone is non emergent then we place them back in the lobby-why would someone who sits in an office M-F 8-4:30 want to question why someone left to start with? well I do not have the answer to that; but maybe that is their "job security". We just get O.T. at the end of our shif doing all the darn paperwork associated with all the idiots who left and turn it in to all the idiots who require it!:angryfire Our tirage is already a 40 minute dissertation as it is, we also do a community health screen, and the floors initial assessment when checking in every patient, so one can only imagine, we don't have time to check on every patient triaged back to the lobby. But I do forward the paperwork back to the appropriate person. Now I don't know if any of this is an answer--I think I just vent bit*hed. I guess we all live in the same screwed up ER world! GOOD LUCK dealing with your new nurse manager and her new found power-we have been "enjoying" the same ride.

Welcome! Where in SC are you located? I am SC RN too-just curious where you are in SC.

Don't get discouraged, if ER is in your blood you will end up there eventually. But good luck

If you want "unstable patients" you can find them in ER's, as far as "the people we treat"...well they are at times disgusting, but they are also the patients we send to ICCU's. ER is frustrating- you have frequent flyers, drug seekers, (these are usually the same). BUT you get to do some exciting things, and you do meet some really great people-patients and staff. but nevertheless it is a challenging job. 9-years in ICU-might need a little ER now. You know treat em and street em aint all bad. Good luck in your decision making. I love what I do, frustration included.

I don't know of any in Illinois, or Indiana; BUT there is a great one on ER and Nursing Management in LAS VEGAS (I want to go:o ) but from my blue, sad face you can see I can't. But good luck on finding one closer to Illinois, or Indiana. Sorry I am no help.

I am with PetiteFlower- I am a firm believer in training prior to ER, Med-surg, Telemetry, Heck anything is better than nothing. Things happen quickly in ER's, and you will be more likely (at some point) in a situation that makes you uncomfortable; rather it be your skill level, or the acuity of your patient. No matter what you do, your preceptor is the key; make sure you have a good one, and don't get rushed out of orientation. I was an LPN prior to going to ER as a new grad. (ADN), I still found my self to be insecure. My preceptor was very bright, but hard on me and I found myself alone alot. Basically I had to learn by fire. I hated my orientation to the ER, I felt as though all my experience meant nothing, my education-gone. I even tried taking Zoloft to get through my orientation with this "strong" nurse (I mean that in every sense of the word). It didn't help. So like I said, I had to learn by fire. I think I did well, I am now one of the permanent charge nurses, I love the ER, and my best friend-well that would be my ER preceptor, some how we made it to being best of friends, of course not until my orientation was long over with. We practice very much the same, (she's still the better ER nurse). But there are things you learn, and one of the things I learned was that new grads don't belong in ER, of course that is not meant to offend or discourage, it is only my opinion. EXAMPLE: A 43 y/o white male checked into triage, c/o chest pain, I bring him into the triage chair, he begins to tell me about his chest pain, I am writing his history, and he quits talking to me, I look and he has appeared to have passed out, me and others get him to a stretcher, wheel him to the treatment area of the ER, put him on a monitor, he is in cardiac arrest, duke power times 3, brought him back (shock X3), but where was my preceptor? Not with me. I was scared to death, almost quit my job. wanted to give her He**. but instead cried for three days and decided, I can do this, with or without a preceptor, hence learn by fire. Be ready if this is the decision that you make. It is a tough road, dont know what I would have done had I had no experience at all. maybe I would have quit, or maybe I would have, thought my patient was okay, and not known that he was in cardiac arrest-who knows, I see new grads all the time in our ER, and they scare me. But good luck in your venture.:) and CONGRATS ON YOUR ACCOMPLISHMENTS OF BECOMING A NURSE.

I wanted to reply to the "foley" ending post ictal periods.. foley is also a cure all to some of the so-called "unresponsive" patients. like the drunks that just dont want to go to jail, and their only way out is for us to admit, so they fake "unresp." I have found that intubation of the meatus has a healing effect. HA HA HA :rotfl: (just good humor)

ditto AIRWAY!

OKAY-Again I swear you must work where I do-No answers for you but when you figure this one out, Please come run our dept.

ha ha ha- aint it the truth:rotfl: Triage is taking longer and longer. So much for the days of wanting to be in triage for the simplicity of only having one person to deal with at a time. Now you have so much to ask, and do in triage; of course I am one who happens to dislike triage, so I don't have pleasant things to say about it anyway, but your right about aging 5 years. :rotfl:

HA HA HA TOO FUNNY...:rotfl: POOR GUY:crying2:

I think JCAHO is now requiring it as part of assessment; our ED is having to initiate questions re: diet, abuse etc.

Our ED admission forms have just recently become the first part of the floor admission paperwork. We are also having to address such issues (that are not ER relavent). So you can only imagine the frustration of the floor nurses now when there is a direct admit to the floor, and they have to initiate the paperwork....in someways this is just more E.R. abuse.:angryfire

Not to me; my free meal ticket to the hospital cafeteria is still on my dresser, unused, and expired, and I dont eat pizza--but to those who were rewarded with something worth having -might would have been a loss.

We have one we tell people in our ER you might like as well..This came from the frustration of the 10/10 scale. A male pt come to the ER w/ c/o penile pain (and of course you know his mister had a cold) anyway he rated his pain a 20/10 on a very busy sunday night I looked at him slightly frustrated with the rating; and said are you sure it is a 20/10, pt said yes, I said well you know, around here we cut off anything that hurts worse than 10. The look on his face was priceless.

Like I said YaaaaY! We are educated people, we know someone was rewarded WELL; it just wasn't us. Heck our pictures didn't make the local paper either (that was someone else too), but we were the ones that had to kiss a** so to speak. ANYWAY we all had some good fun with it though-had a lot of laughs. And our rating fell the very next month- and we didn't change a thing. *POINT TO PONDER: do you suppose those who received more than pizza and a free meal ticket to the cafeteria had to give back their reward?$

okay this is a late response... we have a code team, just recently re-vamped by the higher powers that be... Us ER nurses used to respond in any common areas of the hospital such as the cafeteria, the lobby, etc. basically no in patient rooms-that was left up to the family practice resident MD's and the ICCU RN's, and the floor RN. They have since included the ER RN's to respond to these "in house" codes (meaning we have I guess graduated to be good enough) to respond to patient room codes. So with this new implementation, one may wonder what does an ER nurse do when she/he responds to a patient room for a CODE BLUE? Well this experienced RN will for one RUN to the said code (which is on the other side of the hospital and up the stairs to floors 2-6-where ever said code is called) then she/he enters the room and (all her experience is worthless) she is now at the hands of a floor nurse (who may have never read a monitor and wouldn't know v-tach from SR) and is to WRITE!!!! THE CODE. HOW'S THAT FOR STAMPING OUT DISEASE AND SAVING LIVES?!?!?!?!:uhoh21:

oh and we were only rewarded with a free meal ticket, good in the hospital cafeteria, and Pizza bought by the CNO. Yaaay--hows that for customer satisfaction.

I know this is a late response to your issue with customer satisfaction in the E.R., but...speaking from a hospital E.R. that recently scored 93.7% on customer satisfaction (one of the top 10 hospital er's in the nation) (yeah right) ANYWAY-- the nurses were all rewarded and there was a write up in the local paper regarding our accomplishment; who the hell knows why or how we got it, but we did. We too see about the same number of patients (more somedays and less on others) BUT our staffing is much different, we start out with 7 nurses at 7 am and at 11 am on Friday, Sat., Sun., and Monday we get 2 more nurses (on Tues., Wed., and Thurs. we only grow by 1 nurse), then at 1pm we get 2 more nurses (on Tues., Wed., and Thurs. we only grow by 1 nurse) these nurses also work 12 hours so they are there until 11pm and 1am. This helps the 7p's out as well as us during peak hours. Our 7p shift starts with 7 on F,S,S, and Mondays. Our MD's also had to bulk up their staff too. On F,S,S,and Monday their schedule is as follows MD at 8a-4p m-f--this MD stays till 6pm on Sat and Sun. MD at 12n-11p on Sat, and Sun. MD at 2p-12MN MD at 11p-8a and there is always a PA/NP (one or the other not both) on duty. this helps with waiting times. Now about Attitude.... a whole other story. We still piss and moan. Our patients still have to wait, typically not as long. It sounds to me like you guys need to look at the whole problem not just nursing, there is a way to keep patients happy. we still have unhappy patients, but you usually know them prior to D/C. I gues my point is your Management Staff / Doc's need to become proactive, if you guys are seeing that size patient load then put the nurses and doc's in there to care for them. we had a 33 y/o white male patient check in w/ chest pain at 05:33 am, dead in 14 minutes from check in...2 hour wait times can kill people. Good luck to you.