All Content by stretch thin
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Learning thread (ER medicine)
Ok, I've got a question. I had this 24yr old female come in last night. She is 5mths pregnant(>20weeks gestation) and she drank carbarator fluid. She has a know history of self mutilation, amphetamine abuse, huffing paint and drinking carbarator fluid in the past. Question is: Isn't this considered child abuse? Especially now she >20wk gestation. It's a viable pregnancy, correct? Any input on this would be great. We had a 2 1/2 mth old infant that we coded last night 2 to child abuse. I would like to prevent that from happening with this situation. Thanks
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Sleepless on the night shift
Need advise. I'm having trouble turning my nights and days around. Translation I work nights. Usually 3 in a row and we work 12 hour shifts. My problem is that I have teenagers and a husband that are day people.(NORMAL PEOPLE) When I get off my third shift, I'm dead. I work in the ER and many times you don't sit down for the whole shift. I want to beable to see my family, but I'm so use to my day sleeping and night working that I can't seem to switch. I can't afford to go to days and don't want to. So whats the answer? Any advise I would appreciate it. Thanks.
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customer satisfaction in the er
My question is, does anyone read the paper or watch the news. Everywhere in the united states the ER is used as a clinic, let alone an emergency room. We see the worst of people. One because their in pain, which would make anyone cranky. They give these surveys to these people on arrival. Common on, that's smart. I mean EMERGENCY doesn't mean FAST CARE. Where people get this idea, I have no clue. It takes time to find out why grandma , who is 90 years old and has extensive medical hx, has been constipated for a month. I have had people scream at me because I haven't gotten them back as soon as they check in. I had this guy scream at me one night because he had been waiting 2 hrs, because he hadn't seen a doctor.(He came in because of back pain, which he had and he was out of his Lortabs) He cursed at me till I had enough. I had given my same routine. Sir we are extremly busy, we are trying to move people has fast as we can. Still wouldn't stop. So I took him to the back to show him exactly what I had to deal with. All rooms full, halls full and 2 ambulance crews waiting in the hallway to place pts. You would think that would be an eye opener. Nope, he still continued to complain. I had a few chosen words for him. Face it, we do the best that we can! Surveys don't mean anything. Please feel free to print this and show this to your manager, because it's this way everywhere. And with so many people out of work, the ER is these people primary care. Wheather it's right or wrong, it is.:)
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8:1 ratios in the ER???
Acquity? Does the management really look at that? I know at my hospital, it's a body with a degree. They don't care how many they pile on one nurse. I have been argueing with management regarding a aquity scale vs the nurses we have. I know often times we hold ICU pts because the ICU nurse can't have three-somes, but yet we have 4-5-6 pts and sometimes even 7. I know personally, being the charge nurse/transfer coordinator at night, it's often difficult to handle all of that plus take a team. I'm not one of those charge nurses that sit on their butts. I feel so bad because I don't think I give good care and that's why I went into this position. IE. Stretchthin!:uhoh21:
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Oklahoma Nurses
Hi yall, I've been in nursing for 5 years and I live in Tulsa. I'm a die-hard ER nurse. Thought I never would say that, but I am. It's got it's ups and down, but you diffently get a variety of people and situations. I would love to continue my education, but unfortunately, cost is a big factor. Would love to know about any scholorships out there. Thanks
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Tonite was...tonite was...
Don't you love her job! Everyone ask why we are the way we are. Well take a good look at what we deal with. Last Saturday night: all 13 beds on the ER side full. All MC beds full. 5 in the hallway-2 of those need monitors, but unable to pull anyone in the hallway, because they need to be on monitors. So as the charge nurse I have the hallway beds and the 1 of the MC room.(we always keep on MC room open, because it has a monitor in it. Usually used for chest pains) Plus with my lovely charge nurse position, I'm also the transfer coordinator. Which I had 10 transfer calls, 8 of them I got to. So yeah I know exactly how you feel. I always say, it's a good thing I color my hair, because I would be gray haired. Hang in there. We love being ER nurses!
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hostile chargenurse
As a charge nurse myself, I do know the struggles that the charge nurse takes. There are times when I snap, but I always apoligize to the other person. Everyone in the ER is backed against the wall already, they don't need a charge nurse that is a b----!. I think you need to talk with her and tell her your stand. For one thing, she's not the boss, even though she thinks she is. She is a fellow co-worker. At least that's how I feel. I always tell my my co-workers if they have a problems with thing I do or the way I act, please don't hesitate to come talk to me. I don't want anyone to feel uncomfortable. We are a team and if someone has conflict with me or another staff member, then we're not working as a team. I hope that helps.
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Reducing misuse of Emergency Departments!
We all have good triage stories but jay levan has a point. I know I get very frustrated when the encoder goes off or I see all the people in my town check in. People need to be treated granted, I think what everyone is saying the system is abused. I also agree that our government is not doing anything to change that situation. Look at how well their dealing with the nursing shortage. On the other hand it's the PCP's that aren't doing their job. Example, we had a pt that did the right thing, he went to the after hours clinic for his c/o. They did some lab(which by the way shocked the heck out of me). The labs came back and they were totally screwed up. It read that his hemoglobin was 2. Now if this doctor had looked at the lab closely he would have realized that it was a contaminate specimen. No he sent him to the ER. We finally sent the man home after a 5 hr wait. I ask pt why they didn't they see their doctor for their complaint. Some people say "I didn't think about it" or "they told me to come here". People need to be educated! That's the big problem, because it's not happening. Just my thoughts.
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Bad ER experience...what went wrong?
I work at 557bed hospital and we have to call in our CT person and the results are faxed to Austrilia. So yes it does take along time. Granted someone should have explained to your husband what exactly was going on, but I know sometimes we do get caught up with other pt. Please don't think the ER staff doesn't care. We're just like everyone-short staff:rolleyes:
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A Nurse's Lifestyle
Ok, hears the answer. From a person looking on the outside, sure 40,000k per year sounds great, but many of us have families which takes a big chunk. Then if you took a student loan to go to school, there goes the other chunk. Next you have to look at the job as a whole. Under the discripition of nurse: maid, housekeeper, nutrionist/dietary, intrerpretor, social worker, and sometimes a security guard. Now what do all those people make a year? It doesn't add up, does it.
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I wish I had a nickel for........
I love the ones that say; I take this pill for my b/p, I don't know the name of it but it's a little yellow pill, you know what it's called. I feel like saying, oh yeah I know which one it is, but isn't that for being stupid.
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The "Queen and her son" of Frequent Flyers
Oh I think I've got the best FF's. It's a husband and wife that between the too of them weigh about 7001bs and both of them are in wheelchairs. One wheelchair is powered which the man drives and the other is manually which she is in. She holds on to his wheelchair while traveling down the road or in the halls of my ER. And by they way, he has a foley in. Please don't ask him how that works in their relationship. I'm kinda of scare to know. We simple cringe when they come in, because I don't think they have water or soap at their home. We see them very quickly, give them Lortab and send them out the door. I have another one. This guy always come in by ambulance, of course. They pick him up at Media shops or @ the strip clubs. Same complaint: Chest pain and dysuria. Always wants a female to put a cath in. I'm not touching that one.
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Do you arrest abusive patients?
Where I work is in the bad part of town and to top it off we also have a behavioral hospital across the street from us. So you can only imagine what we get. Our security guards are limited to what they can do and for PD, oh that's a joke. Their the ones bringing them in. Anyway in cases where the patient is extremly verbally abuse, that's when you give them the 10 & 2. DEFINITION you ask 10mg of Haldol and 2 of Ativan. There wonderful drugs, unless the pt has been taking PCP. Nothing pulls those pts down. I had one doctor get so angry at a patient that was being verbally abuse, he intubated him and then he said TAKE THAT! We all busted up laughing. I know not nice, but it was funny
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Eat Before You Get Here!
Oh yes, does it ever. And to top it off, those pt's asking, or let me rephrase that, demanding food are the ones that come with abd pain or n/v. You want to ask them, where's your sign. (Stupid sign that is)
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NURSES UNITE! Stand up for ourselves
Thanks. I hope things will change. The hospital I work at has been sold:) and I hope this new company will elimante several of the administration. I could only pray. Please don't get me wrong, I would hate to see anyone lose their job, but I do want people to DO their job. Thanks again for all the advise. It helps:balloons:
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The WAR between days and nights!
I've been reading everyone comments, which by the way are great. I would like to know if anyone has issues between the other shift nurses. In my ER we work 12 hour shifts. I work nights as the charge nurse and nothing peeves more is when I come on to my shift and I have nothing do work with. IE. syringes, needles, are even NS. Why is it so difficult to stock these things. Every morning before I leave these things are stocked! I've nicely talked to the day charge nurses about assisting us in this problem. I also state we are a family and should play nice with each other. But I get blown off. :angryfire :rotfl: I've spoken to the day staff and yet again it continues to happen. PLEASE!!! I need some advise. I don't believe in, "well if they don't do it for us I won't do it for them" It's a very busy ER! things need to be there to take care of pt. Another thing that makes me blow my top, is when they say, "Oh we just got busy about an hour ago" :angryfire You look at the board of all the rooms and see that 10 patients have rooms to go upstairs and no one has called report or tryed to get patients upstairs. And then theres 30 people in the waiting room to be seen. HELP!!!!
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NURSES UNITE! Stand up for ourselves
Thanks for all the replys. I appreciate it. Sometimes you feel that you stand alone. But the question is still at hand. Your right, there are wonderful nurses out there that care what is going on, but are burned out, that their leaving the field completly. Half the people, well probaly 3/4 of the people I graduated with no longer work in the field. Doesn't that tell anyone something. I know a couple of years ago, my hospital voted YES for a union. Which by the way, the issue is in court. But my state turned around and made a law-The right to work. Which makes the union non-existing. So that tells me that my own state doesn't give a darn about nurses. But yet those people that are in our state legislation want a good nurse to take care of them if they come into my ER with chest pain. You know the funny thing about all this is? I use to be so compassionate, so loving--and now I'm tough. I come home from working a 12 hour shift, hurting and yes sometimes crying. I know that I put everything they I have into my job. And I know everyone on this web site does the same thing. We care!! It simple, I guess. We want the same respect that we're giving to our employer.
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NURSES UNITE! Stand up for ourselves
When do we say enough is enough? We're overworked, underpayed, and unappreciated. I've been a nurse for 5 years, but I feel like I've been in this for 25 years. I hear everyone say: If only I could spend more time with patients or If they would give us a little more money> And everyones right! We sure in the heck didn't go into this field to make the money, we went into to it to take care of people. We take the verbal abouse and yes sometimes the physical abuse(you can tell I work in the ER) simply because we care about people and their well being. We want to help them through their troubles and their pains, but yet we're not able to do that. Why? I know at the hospital I work at we have to many CEO's, assistants, and managers taking up space. NOT ENOUGH NURSES. We've turned healthcare into a business. It can't be ran like that. Granted their several people that I take care of that don't have a dime to their name, but that doesn't mean I treat them any differently. What's the answer? Next question-MONEY! None us are asking for 3.5 million a year(Unlike our CEO) but we would like to be able to afford the cost of living. Look at the gas prices. Pretty soon the hospitals will have a bus to pick us up at our homes so we can work. Face it, the cost of living has continously risen in the 5 years. Has our wages? Sure we may have gotten a few cents here, but does that really help? You need to ask yourself, if all the nurses on your shift called in, what would administration do? They need us! Our patients need us! I know in the ER, it never stops. Is a union the answer? If we don't stand up, we'll continue to be pushed the the side. I know I've my complaints, but I continue to go unheard. Please don't get me wrong, I love my job. I'm proud to be a nurse! I just don't want to end up at the review board defending myself! If anyone has the answers, I'm eager to listen.:)
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Anyone work in Tulsa, Oklahoma?
I also work down the street on 21st and Utica. I work in the ER. I've been there for 5 years. My salary has varied over the years. Like to know how long you've been a nurse and what area you work in?
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NURSES UNITE! Stand up for ourselves
When do we say enough is enough? We're overworked, underpayed, and unappreciated. I've been a nurse for 5 years, but I feel like I've been in this for 25 years. I hear everyone say: If only I could spend more time with patients or If they would give us a little more money. And everyones right! We sure in the heck didn't go into this field to make the money, we went into to take care of people. We take the verbal abuse and yes sometimes the physical abuse(you can tell I work in the ER) simply because we care about people and their well being. We want to help them through their troubles and their pains, but yet we're not able to that. Why? I know at the hospital I work at we have to many CEO's, assistants, and managers taking up space. We've turned healthcare into a business. It can't be ran like that. Granted their several people that I take care of that don't have a dime to their name, but that doesn't mean I treat them any different. What's the answer? Next question-MONEY! None us are asking for 3.5 million a year, but we would like to be able to afford the cost of living. Look at the gas prices. Pretty soon the hospitals will have a bus to pick us up at our homes so we can work. Face it, the cost of living has continously risen in the last 5 years. Has our wages? Sure we may have gotten a few cents here, but does that really help? You need to ask yourself, if all the nurses on your shift called in, what would administration do? They need us! Our patients need us! I know in the ER, it never stops. Is a union the answer? If we don't stand up, we'll continue to be pushed to the side. I know I've voiced my complaints, but I continue to go unheard. Please don't get me wrong, I love my job. I'm proud to be a nurse! I just don't want to end up at the review board defending my job! If anyone has the answers, I'm eager to listen.
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Federalize Nursing Licenses! Who's with me?
I agree a 100% also. Thank about it. Theres a nursing shortage across the country, but yet each state sets their price on the nursing license. You know how that old saying goes, "The rich getter richer and the poor get poorer!