bartender514

coffee, coffee and more coffee....

I love when ER's get picky about who they hire. Sure, I get that you don't want some moron working in your ER but 3 years experience is a year or two more than some people have in the ED I work at. We're also so short staffed that anybody with a pulse would be a welcomed addition to the team. It could be new grads are getting the slots instead of you because they can mold them from scratch since they have no prior experience. My ED takes about 7-8 new grads every year into it's year long ED RN intern program. It sounds like there's some heavy competition for ED nurses where you come from. Wish I could say the same...

I work in a level 1 trauma center as well. To touch upon the ICU nurse thing. We used to have a position for what we called a TEDI nurse. We no longer have this but this is how it worked....out trauma bay has 7 rooms. 2 designated trauma rooms and the rest are for ICU/really sick people. The TEDI nurse was someone who was hired to only work in the trauma bay with the idea being that the ED trauma nurses would take the trauma patients that came in while the TEDI nurse took the ICU/CCU pts that came in. Granted, actual level 1 and level 2 traumas aren't always streaming through the door so you just divide the patients amongst yourselves or everyone just kind of works as a team. Typical staffing in our trauma bay is 1 nurse from mid-noon and hopefully 2-3 for the noon-midnight business. Charge is always available to help and is good to pull other nurses in if it hits the fan. During an actual level 1 or 2 trauma we typically have 1 bedside nurse while the other documents. If the other is busy someone from peds ED is usually available to chart.

A woman that was having abd pain came in and while she was there two of here family members asked me if the doctor could order her some anti-anxiety meds....eluding to valium, ativan etc... the reasoning being that her brother had died the day before and they hadn't told her yet and they were hoping we could pre-medicate her for the news. Long story short....the doc refused, they told her, she freaked out in a textbook case of status hispanicus and received haldol and versed....

A fake nail that came off and wanted it replaced with dermabond or one of our other sticky substances...

we have multiple "regulars" who visit us d/t sickle cell "crisis." Several of them have their own specific protocols. Most of them hospital hop. They are by far some of the most annoying pts to frequent the ED. Most get Dilaudid. Some have ports because they have no veins left. blah blah blah

I've known a few nurses to migrate out of ED to OR or cath lab strictly due to better hours. I guess it would also depend on whether or not you got to choose what service you were with. Trauma, ortho, cardiac etc...

Not only do you have to factor in dosage you also have to consider duration of time given. I'm sure it's standard in most facilities to give 10mEq of IV K through a peripheral line over 1.5 hrs. Giving a pt 50mEq of K over multiple hours wouldn't be nearly as bad as giving 50mEq IVP in less than a minute.....