rjflyn

rjflyn ASN, RN

Emergency

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All Content by rjflyn

  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...
  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....
  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
  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...
  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...
  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...
  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...
  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...
  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...
  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...
  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....
  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...
  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...
  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...
  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....
  16. Giving narcotics to patients with no ride

    This is one of those slippery slope issues that has been discussed on numerous occasions. The long and short of it is one needs to follow appropriate policy and procedures while providing appropriate...
  17. 1st Nursing Cartoon caption contest - win $100

    And I thought my dogs were
  18. I'm trying my best, but seriously stop putting me down on the phone

    IM an old ED nurse and can be short at times but: Personally just let me know 1) whos coming, 2) what you did 3) make sure you send paperwork- its aggravating to get pts from LTC and have nothing then...
  19. 2012, no longer willing to settle

    Ok, just some insight- my manager for example who herself has a DNP degree, prefers to hire BSN nurses mainly due to the fact that with the multitude of applications that she sees the nurses are so...
  20. I'm leaving my beloved ED

    I'm with Merlee, after 20+ years I can equivocally say you know that they say the grass is greener, but often times its greener because it has different manure spread upon it. I wish you best and...
  21. American Red Cross and Hipaa

    Being a supervisor, I would in fact just confirm that it is in fact actually the Red Cross calling. I get calls all night long from people saying they are someone they are not, caller ID tags 90% of...
  22. Violation of HIPAA?

    Actually HIPAA rules put you in violation if you know a violation is taking place by not reporting. Most states have whistleblower statues that provide protection as well so, I would report
  23. Benadryl use with Dilaudid.. just curious!

    Of course there now is a national shortage of injectable Benadryl, so the truly in need wont complain when you offer oral meds. The ones who will complain will be the ones who solely want it more for...
  24. Hospital Using FirstNet in ER?

    PM for more
  25. Interview for ER/ school conflict

    Like the others have mentioned Monday has typically been the busiest day in the ED. That said our schedule requirement when we have our nurse make out their request for self schedule for the 4 week...