rjflyn

rjflyn ASN, RN

Emergency
Member Member Nurse
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rjflyn has 23 years experience as a ASN, RN and specializes in Emergency.

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  1. Does This ED Tech Screening Question Seem Odd?

    Most are looking for a certain personality type but anyone can BS at test. What you can't is a first impression. Can tell if someone is going to fit you mix with in the first 5 mins or not. The questions you ask are just because you have to.
  2. No cardioversion due to risk of embolism?

    But doesnt ACLS also say a pt with chest pain and a heart rate in excess of 150 is by definition unstable and waiting around for a hour and a half for a test probably isn't the greatest course either. I for one want to know what the cardiologist he ...
  3. DONT Am I clear. Everyone in the ED will hate you. My last place had Plusechek and its great noiw I'm at a place that has Cerners First net and its slow and bulky.
  4. Cooler weather and homeless "patients"

    I dont know how much work up "ankle pain" requires. At my facility thats a complaint that typically if its during the hours its open goes through our express care area, if not its treated as such and they are in and out as fast as they can be seen a...
  5. What is your ER's PCI med protocol?

    The standard of care for PCI is 90 mins. Though if there is no in house cath lab, then the standard is thrombolytics within 60 mins of arrival. I even know of some EMS systems that carry Retavase as they have transport times that cant exceed an ho...
  6. Why drug someone who does'nt want to be drugged?

    May have given you Morphine because if that ED was like mine they may have not had any IV Toradol to give. We have be without for the last couple months. When we do have it pharmacy has be limiting it to 15mg and then only one time dosages and admi...
  7. Need some advice / reassurance

    Well, thats quite a conundrum. From a supervisory stand point most of the problems a department has is due to attendance. HR erred by even letting your file get to the interview stage, so now they are kind of stuck. What I would personally do, w...
  8. Do you give mag off pump?

    Generally 2G hour on pump is the limit unless its 1) OB for pregnancy induced hypertension/ and its complications, 2) asthma. On Zosyn our facility too has gone to the hour time frame save for the ED we still do 30 minutes because ED doctors genera...
  9. What is up with all the Dilaudid?

    Well since i work as a supervisor and deal with complaints. I give my two cents. When I get a pt who complains that " the doctor didn't give me anything for pain". But then I check the chart and more often than not there is clearly Tylenol or Motr...
  10. jehovahs witness- refusing to..

    Though we do work in the ED and on occasion a person will be unconscious, unresponsive, have massive blood loss and they will get O negative. At the time we had no idea as to what their religious preferences were. It is something that we all have a...
  11. Pts right to refuse treatment

    Kind of thin as far as suicidal goes. Though most doctors and facilities wouldnt let a patient whom has received narcotics leave that soon after receiving them though there are exceptions. Personally I know the kind, the providers I work with woul...
  12. STEMI Protocols

    I can say its about universal everyone has a STEMI box. Paperwork, we catch up later- ours is computerized as is the orders. Consent is the MDs to get, if the need a witness the are required to ask us for it. As for all the stuff we do to the pati...
  13. Drug testing a RN while a patient in the er

    What the OP describes would be something that would fall under my facilities fitness for duty policy. She describe abnormal behavior that if I as a supervisor would have observed I would have most likely needed a UDS- of with the policy requires to ...
  14. "You've got 4 days to improve or else..." ... advice?

    At last check Med/Surg is now being considered a specialty so where is one to go. That said 20 wks is an awful long orientation. Most jobs only have 90 probationary periods, were you or the employer can say you didnt work out and thats it. I th...
  15. Giving narcotics to patients with no ride

    I wanna work where you can afford/have cab vouchers, I as the supervisor would spend my whole night writing them. Having said that there is even liability in putting someone in a cab after narcs. Whats to say once said cab leaves the guy just doe...