blueinplaid

Thank you guys for your support. Ya'll made me feel much better! I had felt violated that the pt was aware of what she was doing- that it was done maliciously and with intent. I really appreciate this place as a sounding board and appreciate most of you, my coworkers, in this profession we are in. Cheers to those of us who choose the frontlines! :w00t:

I find it interesting that the title of the post went past. Venting. I am glad to see that we support each other in here and things that are aired are taken as that.

It happened. I left the ER showered, braless, but in a fresh pair of scrubs thanks to an overdose patient who threw a cup of charcoal directly on me. A seemingly, "cooperative" patient who appeared to be willing to drink her charcoal rather than getting the "tube". She took the entire cup, held it like she was going to drink it, than proceeded to splash the whole cup in my face and throw the cup across the room. I was covered from the top of my head to the top of my scrub with black charcoal. I was furious. I did manage to walk out of the room without a word, taking my glasses off so I could see.......charcoal was everywhere....great to absorb drugs, not so fashionable as an ensemble. I make jokes, but I am furious. I feel .....disrespected and her without repercussions. She was restrained, but the physician in the end decided to not give her the charcoal so she didn't have to have an ngt. I am furious about that.....She laid on the bed, not caring about the restraints even, which got to me. At least she could have been was upset or coming down or something! Mind you, I have been cursed at spit on (attempted), and all sorts of things, but for some reason this particular incident is poking at my last nerve, most likely bc she knew what she was doing., and while she was under the influence of something, she was calm otherwise and following commands. Meanwhile, I had a heck of a time getting the stuff off me, my glasses, and likely lost my favorite pair of scrubs bc of it. It was a direct attack on my person. Grrrr. I do pride myself on being calm, respectful and kind, but omg. I wanted to punch that girl in the face lol. breathing......breathing.......:angryfire

Honestly I don't believe that there is an "elitest" attitude that is specific to one floor, ICU, NICU, PICU, etc. I do remember however that when I accepted patients from the ED when I worked in the PICU that I wasn't always happy with the state that said patients arrived in.....Since working the ER, I see now that priorities are different in each unit. When I say priorities, I am not referring to the basic ones, like ABC's, but beyond that. I have had to send patients upstairs in sheets that are a wrinkled mess and that kind of thing due to whatever other craziness that is emerging from the room next door, the ambulance coming in, etc. It would do us all some good to have a floor sharing experience to see the difficulties that we all share working on our prospective units and maybe those looks or sighs or attitudes wouldn't be as prevalent.

I don't believe that whether I share my last name is a reflection of my professionalism; my nursing care does that for me. My last name is on my badge in the ED, but in small letters. My first name is in bold black and my last name is small print, different font altogether and in white, making it difficult to ascertain just by glance. For those patients who ask my last name, I comply most of the time. Whether it is or not, I personally feel more comfortable keeping that information to myself and not voluntering it.

YES I abhorred it! I work with several ER techs that are in nursing school now and let me tell you, I am soooo happy that I am not going through that again! I enjoyed talking with the patients but man, the course work, the lack of sleep, the stress!! Nursing school and test anxiety and being relatively shy...those things make for tense couple of years! It has been ten years since I graduated from my BSN program, but I can remember my profs, the course work, the patho flow charts....on and on and on! lOne day at a time. Each day leads you one step closer to the goal. It is worth it. Course once you graduate, there is a whole other fear in that learning period, but you start getting paid for that and the learning at that point is pretty awesome.

courtney, let me say good going, girl! First off because your pt survived the night, that can be a feat in itself with a DIC pt. With that sort of bleeding it can feel like youre just trying to stay above water- if that! so you did well. i know i look back frequently over my shift and analyze what i could have done better, done faster, seen quicker...whatever....i feel that i am a good nurse for it so i hope you do too! we used pressure control settings for our little ones frequently for lungs that were noncompliant- had been ventilated before for an extended period of time or whatever. it is a more acute setting than volume control. if the ventilator were to deliver that set amount of volume to a patient with very stiff lungs, it could give them a pneumo or worse. pressure control delivers a certain amount of pressure with each breath- so your tidal volume is what you need to pay close attention to. if it starts to decrease then something is changing with your patient i.e. waking up from sedation/paralytics, or need to be suctioned etc. with volume control, the amount of pressure could change to deliver whatever the volume is set to. we used also prvc which is both pressure and volume regulated again to be aware of the amount of pressure the vent is giving to deliver a set volume. it has been a long time since i've had to think about this, so i am removing a lot of cob webs! working in my er now doesn't give me the time to think about those things! hope this helps!

Thanks to everyone's response. I have been seeing pt B and then finishing A, but I don't think I stopped to think about the exact physiology behind it, just sort of instinctively knew. Stopping to think is hard for me when time is of the essense! I am learning and growing every day in my nursing career!

i am working in austin now as staff in the ED. i interviewed with Brackenridge Hospital downtown and they were niiice, but the money wasn't there and the stress was bad for the nurses. I interviewed with St. David's in South Austin where I liked the people and the philosophy. I have been here for a few weeks and still like the people! so far so good. i do know that seton uses an agency called Premier Staffing where they work only for Seton. There is another agency called ALL About Staffing that works around Austin as well. If you happen to be looking for a staff position, I really recommend St. David's. I like it very much! If you care to know more, let me know! I

I am relatively new to the ED, and am working on organizing my time/priorities and am curious to hear how others do it. For instance, let's say I get patient A, a chest pain with a positive history, has had two ntg, an IV, and NTP placed to chest en route via EMS; pressure is now a 4/10. While I am converting his IV to ours/attempting to draw labs from said site, the tech is getting the ekg etc. Dr. orders aspirin and metoprolol. i send the labs off, but before I can give him his meds, i get patient B who also has similar history, no ntg, no paste, (chest pain obviously), but is getting an EKG. Neither EKG shows acute abnormalities. Now, my question is, do i finish with patient A, or do i check B, assess his pain for myself, give him his aspirin, ntg, etc. I run ito this frequently. i find myself going to patient B to try to give him some relief with ntg, but that means Patient A is suffering without being completed.....i suppose i should complete patient A? I am guessing that maybe i should take a minute or two to read the triage report more thoroughly and make a quick decision that way, or go into the room? It's the shifting of priorities that I struggle with, but also the reason why I enjoy the challenge of the ED dept. It's hard to stay focused! :monkeydance: Comments appreciatede!

I may not be much help as I am not only new to the ten hour shift, but new to this hospital as well. I work in the ER and will be starting a 9 am to 7 pm shift, four days a week. i know there are 4 of us now that do this. Most of the rest of the staff work two twelve and two eight hour shifts, varying between 7 am-7 pm, where they work 7-3 pm as their 8 hr, the opposite for nights, and an 11 am to 11 pm shift, where their 8 hr is 3 pm to 11 pm shift, which is what i am getting off of this week. There is a 1 pm scattered in there I believe to assist someone who needs those particular hours for school. I know I like doing two twelves and two eights, so we will see how this ten hour will do! I know that our director is very flexible, citing that he retains his staff by trying to work with his nurses' schedules....I think there are those that do the twelve hour shift too. Our director says that he doesn't have a problem getting people to come in extra when staff knows that he works with their schedules.... hope this helps!:monkeydance:

I worked 12 hr shifts for my whole career with shorter hours thrown in as extra shifts. I just started a new ER position where they offer a variety of shifts, and have taken a 9 am to 7 pm schedule. I have been working 8 hrs on myo orientation which is wonderful- coming home at a decent hour, I still have energy and the ability to things during the morning or at night, and I can communicate with my family! With 12's, yes I had more days off, but I was so exhausted that I lost one of those days (or more) anyway! We will see how this ten hour shift works out for me!

I am relatively new to ER so this thread is awesome! I had a pt who came in diaphoretic, unable to follow commands, and pale in his 40's. The paramedics said that his friend reported him throwing up blood while at lunch, but they never saw any and we in the er saw only food particles on his clothing, shoes, etc. He was very restless, therefore difficult to get a bp but was was 121/70's with heart rate in the 80's. His extremeties were cool. His wife who was an RN called to say that his only history is hypothyroidism. He is in his forties. We took him for CT of his head, and then did a PE protocol on him.... any thoughts on the results? He also became more coherent while in CT. I was not able to get BP's on him there as he was still very restless, but his heart rate remained in the 80's. I learned a new rule of thumb for myself with this patient! Any thoughts as to what the CT showed?

What a wonderful thread! I have my own "feel good" story to offer, but it involves the hospital not a single individual. I recently started at a new hospital which has recently instated in the last months an award called the "ICARE" award. The CEO of the hospital stood up in front of dozens of people and read aloud nominating letters from staff and/or pts while the winners stood next to him, glowing. Four nurses and one maintenance man received trophies, a check for $125, and the recognition from the hospital and friends for a job well done. I was moved to see CEO and other administrators there acknowledging them! More of this needs to be done for people!

I am looking for agency work in Austin, TX. Has anyone heard anything good, bad, indifferent? I am biding my time now for the new children's hospital to open in the spring or summer of next year....any advice would be appreciated!