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musherdeb

musherdeb

ER, peds.,nursery.
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musherdeb has 19 years experience and specializes in ER, peds.,nursery..

I am an ER nurse currently traveling again. My first love is trauma.

musherdeb's Latest Activity

  1. musherdeb

    Do you know any "good ER experiences"??

    I am currently in Minot, ND and this ER is a VERY traveler friendly place. Level 2 with lots of variety and you will be busy. Only downside is housing. This place got flooded really bad last year and the town is still suffering for it. But this ER is awesome to work at. Really good folks.
  2. musherdeb

    Do you know any "good ER experiences"??

    Lake havasu City, Az Silver city, NM Bangor, maine. really depends on what kind of ER experience you are looking for and what experience you have already
  3. musherdeb

    Agency pay dropped ?

    just remember that if you go independent you are responsible for all your taxes and keeping up with all the paperwork. a lot of hospitals wont deal with you because they have no idea who you are. there are good and bad to all things. i have done both. yeah it really feels like we are getting raped out here with pay and the companies are really raking it in now. i really dont want to work full time with a hospital so i put up with it. i am moving to Maine and hoping to find enough work out there to keep me very busy. anyone work in maine out there?
  4. musherdeb

    Travel Assignment on Reservation

    Again email me and I can give you a heads up. You need to be prepared for a very different kind of nursing. It really depends on which one you are going to. Two of the ones I have been in in SD and MT are going thru major turmoil and there are some situations you really need to know about before you sign. I was not told about this until I got to the facilities. Be very careful. Email me
  5. musherdeb

    Travel Assignment on Reservation

    sorry musherdeb@yahoo.com
  6. musherdeb

    Travel Assignment on Reservation

    email me privately and i will tell you a few things.
  7. musherdeb

    Traveling Opportunities

    i have to agree about the pay. but i was only making around $22 an hour as a staff ER nurse in NM. i used to travel a few years ago and the pay was better. now the rates seem to be the same as base rates in most hospitals. but i really don't want to be trapped in the politics anymore. It is harder to find the jobs and it does seem that the ER's are requiring a lot more certs. one wanted me to be NRP and Fetal monitor certified. well that was interesting but i think it is cause the smaller hospitals are going to an all around nurse that can do everything in the hospital. while i do like smaller ER's i really love ER and want to stay in that. I am willing to take a different assignment if i have to wait for an ER to open. i really wish i could get more Peds ER experience. i guess it really does matter what you are looking for and what you are willing to do. you have to be flexible to be able to get some of the assignments and i don't think it is better yet. i think it might get better but i really think our pay will not get better. i don't want to commit to one hospital and then not like the place. so it is a hard decision a lot of the time. there is still attitude out there against travelers and i really don't understand why these nurses get so mean towards the travelers. we are trying to help them out. do they really want to go back to no travelers and they have to take the load and work massive hours? good grief. oh well. i am careful now. i wont take an assignment if i think it is going to be dangerous to my license. i worked way to hard to get it. i have been in facilities that frankly scared me to death. what i recommend is that you sit down and really look at what you want. what you are willing to sacrifice to get that. where you are willing to go. then decide if traveling is right for you. by the way. there is no such thing as free housing. you will pay for it somewhere. so keep in mind all of this and think about the bills at home and the bills on the road. good luck
  8. musherdeb

    Travel nurse workload vs. staff nurse

    I ink it really depends on where you are. I am in a place right now where the travelers take all the rooms and the staff does ... Well what ever is left to do.this unit has only 7 beds and they are staffed with 4 nurses. So if you do the math it still does not add up. Yeah frustrating at best.
  9. musherdeb

    pediatric crash carts

    i am really curious on the different types of pediatric crash carts you are all using. I believe we have the worst where i am right not. we are using "braslow bags." they are suppose to have everything you need except the meds, for each level of the braslow. yeah right. all of the IO's are the same size. you have to open a "kit" with the right color and just hope all the supplies are there. we have had several really bad codes and we had nothing in a TRAUMA room to support the code. so darn frustrating. we are a large enough unit to be able to have the right stuff. SO. what are you all using out there? we are a 15 bed with 2 trauma beds. the adult crash carts are loaded. i find myself hiding supplies just to make sure that at 2 am when i get my usual pediatric rush that i am ready. the other night we had 3 pediatric cases at one time. two intubated. it was so darn challenging cause we just did not have to right stuff. also.. are there cheat sheets out there for the pediatric sedation drugs.? we have a great binder of drips for the adults but nothing for the kids. i want to put one together. i have been researching and cant seem to find any at all. thanks guys. really appreciate your input.
  10. musherdeb

    Good Personalities for ER Nursing?

    way cool. i am gonna go to the class. no one around here has the cd.s oh well. that would have been cheaper LOL.. but i look forward to the class. i do well with hands on and that is why i love trauma. i am glad i dont work in one of the bigger hospitals cause the RN s dont get to do the stuff. i like my hands in it. i will do the practice exam as well. thanks so much.
  11. musherdeb

    Good Personalities for ER Nursing?

    yeah i love TNCC great course. ENPC as well. sad that a lot of ER units dont require ENPC. oh well. how long is the test for CEN? and did you go to a class before? i am thinking of a class cause i hate taking tests LOL and i like to get as much info in my brain so that hopefully it just falls out on the tests pages. LOL. I have heard many times that the test is not as bad as it is hyped to be. we shall see.
  12. musherdeb

    Good Personalities for ER Nursing?

    yeah but i love it. call me crazy. so now i am getting ready to study for CEN and PCEN. do you know of any kind of Trauma certification out there for us as well? did you take the CEN. i have seen your posts in that thread.
  13. musherdeb

    anyone come to the ER with peds experience?

    i have had a variety of experience over the last 18 years that now really helps me out in the ED. i worked NICU, lots of med/surg/peds and i also worked as a second ob. once i got to the ED i was happy to be able to use a lot of this in the unit as we see everything. i am really good at peds iv starts and that is a bonus to the unit. i am also good at a lot of the iv's so that helps the unit also. i am comfortable with delivering a 17 weeker in the ed and with working the pediatric code. my advice would be to hone in on specific skills. things are really laid back on the peds floor. but in the ED they can be life threatening in an instant. be comfortable with so many aspects of children oh and their parents. get strong in your pediatric code setting. IE take ENPC. awesome course. most units only require PALS but i think you gain a much better resource from the ENPC course. i have both. I love the kids. it is great to see one come in barely breathing and to see him sitting up and laughing later that shift. it is hard to lose them though and you really have to have a thick skin cause we lose babies all the time. most of the time they come to us in full arrest and we cant save them. it is very emotional for some nurses. Kids are the worst for that cause it tugs at everyones heart strings. remember... it takes time to get good at ER and just as long to get good at PEDS ER. learn all you can and be willing to learn. dont go to the unit with the attitude that "i am a great pediatric nurse and you cant teach me anything" cause believe me the ER nurses can teach. but they also dont know everything and they need to be just as open to new ideas. That is hard for a lot of hard core ER nurses to do.
  14. musherdeb

    Good Personalities for ER Nursing?

    one word.... FLEXIBILTY.. got to have it cause if you are in a 15 bed er, all rooms are filled, 3 are critical, 3 can get there really fast, 3 are psych pt that have no evaluations done, 1 room is on hold for EMS, 2 rooms are trauma beds, prepped and ready to go. oh and the waiting room is full of headaches and flu symptoms. of course... of the 3 criticals, one is waiting for flight team, one is waiting for ambulance team, and as you are getting started, one comes stumbling into the waiting area with severe shortness of breath. ie: sats are 78 and dropping and he is clutching his throat. yeah the last bed is the EMS bed. so now you have no room for ems.. ha ha.. and of course between this new one and one of the other critical pts., no one can get the iv's , one of those is a cardiac pt the other is the guy that cant breathe. in the middle of starting the very difficult iv on the cardiac patient, you get the phone call from H....L GSW to the head code 3 be there now. So you run to the trauma room, call the crew, did i mention you are not in a teaching hospital. so your crew is the doc another nurse the rt and the xray. and most of the time the crew bringing the nightmare with them. so much fun.. of course he ends up on the ventilator so that takes one nurse off the floor cause he is unstable and is awaiting transport. oh yeah the flight crew is stranded in another city and there are no other teams available. this guy is not stable enough to go ground. so.. 2 nurses handle the rest which now consists of a guy that has done a great amount of cocaine and is having an MI. a gal with a bp of 225/118, and you still have the other critical pts one of which is waiting for his ambulance still. they arrive and starts to crash. yeah.. so you finally get the trauma pt out and you immediatly go back to the front and you take 4 pts asap. one has to have a "fast" pelvic, one is a small kid with an earache that needs meds, one is the MI that needs Retevase plus a few thousand other things and one is a psych pt still in your unit. oh and it is finally 5 am. 7am is getting close. ha ha the tone out goes for difficulty breathing and another call you dont even hear. finally the day shift shows up and so does the ambulance for the MI.. No flights available. you had 3 pts shipped out and 4 0r 5 admissions, you cant even remember anymore. finally at 7:30 you rush out the back door to your car and LEAVE..... but hey.. only one pt left AMA in the 12 hours and he was one of the psych pts that "escaped" during the trauma. oh.. the other pts have to wait cause there is ONLY 1 doctor in the ER.. yeah... FLEXIBILITY but i love it...... that is what we like to call things changing rapidly.
  15. musherdeb

    ATCN/ATLS

    has anyone taken this course? i am considering it but wanted to know if it actually helped you. i am an ER nurse and want to increase my knowledge base as i get ready to study and take CEN/PCEN please answer if you have taken this course. thanks so much
  16. musherdeb

    What is a good resource for learning Emergency Nursing?

    great that you are looking to the Emergency Dept. my best advice would be to make sure you have a solid skills base. It takes time to become a good ER nurse. None of us learned it overnight and neither will you. You have to be willing to learn. to be willing to understand you will make mistakes. no one is perfect. The ER is a great place to be challenged and to grow. but you have to be willing to learn. We work as a tight knit group and we have to because we have to trust the guy next to us is going to be able to do what is needed. it is so hard to work a code with someone that does not ever get in the codes to learn. i got into a situation one night with a baby code and i was almost alone in that room. the doc and I were the only ones "comfortable" enough with the code. I was scared to death since i had a lot of pressure to make sure everything went right. there were two new nurses there and one that was an er nurse but no peds. it was really tough. you need to make sure you are willing to jump into every situation you can to learn. sometimes you have to stand back and watch and you can gain alot of experience with that alone. but sometimes you need to jump in and just ask what you can do to help. Remember to always always be honest with your skill base and to let the others know your weaknesses and strengths. i promise you that you will grow and you will get good if you have this attitude. dont be afraid to ask. take a good year in Med/Surg to fine tune your basic skills. in the ED you need to be able to put in IV's really fast and you need to be able to put ng tubes in and foleys. sometimes these seem so darn easy but there are many times that it is not easy. dressings and wound care. and then you have to get comfortable with the drugs. I never leave anything to my memory. i am human. we have awesome props in our ED to help us when time is a serious matter. we have iv drip sheets and protocols in place so that we dont screw up. Never ever feel like you are weak if you have to ask someone to verify your meds. I do it all the time. i dont want to kill someone because of pride. decide what kind of ER you want to work in. there are so many. i wish you the best. i love the ER. i really like the trauma and the peds. i am currently studying the CEN and the PCEN . take TNCC, ENPC, ACLS, those are the backbones. yeah most of the er's only require ACLS and PAls but do yourself a favor and get the others too. NRP is also valuable . I have heard so many times. "we dont do babies" ha ha.. you never know what is going to walk into the ER and you have to be ready for anything and that includes delivering a baby or a preterm infant. good luck.
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