sandyfeet

Say that you find posts in an online group that seem to hint that the writer will attempt suicide. My question is, as a nurse are you legally obligated to report it (i.e. have the authorities perform a safety check) as a mandated reporter? Would this fall under the tenet of neglect? I don't want to debate whether you feel you would report it as a person. I am only asking if our profession as nurses legally requires us to report to the authorities when someone online seems to post a plan outlining their suicide. I have already looked on my states BRN and did not find anything specific about our legal obligation regarding online posts.

I am 37 weeks pregnant and on maternity leave, but still wanting to flex my nurse brain by reading AN. Your article made me decide to give the L&D nurses who will take care of me catered SANDWICHES! Great article!

YES. Also say "I guess you will be paying me overtime while you find another nurse to take report, because Nurse A refused to take report". That will get a manager's attention!

I think this would only help you if you were planning a career in academia. If you are hoping to end up in public health, clinics or long-term care, you should seek out internships in those areas. It also does sound like A LOT of work on top of your classes and being a single mom. Maybe you are a great student, but this amount of work sounds stressful and not necessarily helpful. At a minimum, it won't give you the hands-on patient experience an internship in the other areas would give.

My ED is constantly full. I get where OP is coming from. While I am treating your chronic pain that your PCP/pain management doc has not adequately managed, Grandma with a broken hip is waiting in the ambulance bay for an open bed. Baby with a history of febrile seizures is in the lobby with a rising temp. The patient sent in by their doc for an emergent thora/para is trying their best to breathe around all that fluid. If I seem unsympathetic to your plight, it is because otherwise I would be unsympathetic to theirs.

Yes, this happened to me for a nurse aid position. The recruiter said that there were budget cuts. I was bawling over the phone but it's not in my nature to be rude so I just tried my best to keep it together and remain polite. THEN...I got a call back a few months later from the same recruiter offering me another job. She said "You were so polite when I called to rescind the job offer and I never forgot that." SERIOUSLY. I worked as an aide for 6 months and was hired immediately into an RN position before I graduated from nursing school. Moral of the story: be polite! This might not be the end of your story with this hospital.

This is the real issue here. If OP crashes her car because she fell asleep, miscalculates a pediatric dose, gives a med to the wrong patient, or doesn't catch that her patient is crashing until it's too late, it's all on her. Sleep deprivation makes you impaired. Know your limits, follow your hospital policy, use your PTO like anyone in any other profession would do.

I believe some nursing student sins are forgivable. Before I started my pre-reqs I ran a red light with a camera, and got a ticket. Went to traffic school and got it all taken care of. When I applied for NCLEX I had to declare that I'd had a traffic violation over xyz amount of dollars. I wrote a personal statement about how I had changed, and had a friend write a personal reference to my character. Now I've been a nurse for 4 years. A nursing school may be willing to take you if you can demonstrate how you have changed and have references that attest to your character (volunteer service for example). You will have to sell it, maybe meet with the dean. You might also get some good answers from the Nurse Addiction forum. Good luck!

This is always a hot topic. It would be interesting to include in your research the acuity of patients waiting in the ER lobby for an open room...also at risk of worsening symptoms. When we have over a 2 hour wait in the ER lobby, the entire hospital hears an announcement about it.

I am in your target demographic; I just passed 2 years this summer. I am starting to get more involved by doing clinical ladder. The people I started with (also mostly new grads) are starting to do Triage because of a shortage of triage nurses on night shift, and people on day shift have complained that they are too new to take on such a task. I can see where the complaints are coming from because I don't feel ready to take on the responsibility of a full lobby! I will say that I thought I would know more by now and I've learned that knowledge is just a slow, steady process. And that sometimes I need to hear something several times to understand it, just like in nursing school.

I had a patient on a 5150 who threatened to call the news because we were holding her against her will. Luckily her husband was able to take her phone away from her. I always wondered what the news would do in a situation like that- would they report the 'story'? Or would they protect a vulnerable person?

So interesting! After I read your post, I used my school access to look up "iodine allergy" and found an article from the journal Allergy and Asthma Proceedings that talked about iodine allergy and the prevalence of iodine in our diet (salt, eggs, bread, cheese). The point of the article was to debunk the seafood/iodine connection, and that patients with allergies to seafood could still use iodinated contrast medium. ("Seafood and iodine: An analysis of a medical myth", Nov-Dec 2005). I remember when I started working as a nurse being taught to ask if the patient had a seafood allergy if they did not know if they had an iodine allergy. And for the OP, I would also use the castile soap packet.

Couple of tips... Does meditech have something like 'acronym expansion'? I use SCM and will use the acronym $discharged that the system writes out as "Patient AOx4, respirations even and unlabored. Patient states pain level tolerable to leave facility at this time" and use that on my discharge note. Little things like this save only seconds, but over 12 hours it adds up! When I first started, it was hard for me to get a patient history unless I was standing still and looking the patient right in the eyes. BIG time sucker. Now I get history while hooking them up to the monitor. If they are vomiting I get history while starting the IV. You get the idea. Before I leave the room I make sure to chart and then I might say "I just want to clarify, you said your symptoms started yesterday?" or something to that nature. When you are new and have a preceptor, other nurses usually won't help you out for two reasons. One, you already have two nurses to cover one patient load, so you technically already have "help". Two, when you are new is the time to struggle, figure out your rhythm, figure out your resources. You can't start out relying on other people's help. All of this does not include Level 2 ESI or higher. If your co-workers are not helping you during acute strokes or full arrests there is something wrong. It gets better but these are the rough times!

Ancillary is the correct term, because it means someone who provides support. It's not diminutive. I had only one serious problem with an US tech in my two years so far as a nurse. I had a pregnant patient in police custody because she was using drugs and was arrested in the street. She also had a UTI and was receiving IV antibiotics. The US tech came to the bedside to verify the pregnancy and said the the police officer "They're giving a pregnant woman antibiotics? That's awful." She didn't realize that I was right outside of the room and heard everything. Now I would have walked into the room and said something to her face about the meth probably being worse for her fetus than a Category C antibiotic, but at the time I was too shy and new so I talked to my charge nurse and wrote an incident report. Luckily the patient was so out of it, she didn't hear anything. But I always wondered what the cop thought of me and my competency after hearing that comment.

The problem with leaving a shoe or a purse in the backseat (or a diaper bag in the front) is that the parent has to have the foresight to arrange it that way. Excluding negligent parents, the problem with forgetting your child in the car seems to be one of multitasking and distraction. Someone is in a hurry and is not going to take the 10 seconds to throw their purse in the back because they are focused on completing some other goal. I am currently pregnant so this is a hot topic for me. Maybe a sensor in the back seat that registers weight (like a car seat) and alerts you when you open your door? Like how my car tells me to buckle up my heavy work bag when I put it in the passenger seat?

Patients usually don't get violent out of nowhere. There are many verbal and physical cues that lead up to physical violence and you should be trained to spot them so you can de-escalate the situation. If I feel threatened I back away and yell "Call a Code Gray!" and yes, situations have occurred when staff came running and the patient is looking at us innocently. But I would rather be safe than sorry. Usually once a patient starts raising their voice, if it's not my patient I will walk over to see what is going on, and other staff members will come over too. My ED also uses MOAB training and our staff is really good about backing up each other. I think it's been made clear by previous posters that you can never hit a patient. No matter what.

Emergency Department: Patients who "know" they need an MRI or other expensive test for chronic condition. I love when the doctors shut them down with statements like "Since this is a chronic condition, it is technically out of my expertise. You need to see an XYZ specialist." Helicopter parents of children of any age, especially of grown adult children. How are you not embarrassed that your mother "has to" argue on your behalf? The drunks that repeatedly come in wasted and say they are suicidal, then sober up, deny suicidal ideation, and become nightmares. "I hate this place!!!". Well, great. Then stop telling the ambulance to come here.

I happened to look this up recently because I was worried about my own exposure to second hand marijuana smoke and found this article referencing a study from 1986. Not much else out there. Basically, you'd have to be exposed to high levels (no ventilation, pure smoke) for extended amounts of time over several days. In the study it was 1 hour of exposure for 6 consecutive days. Legalized marijunana and secondhand smoke: Is it possible to get a contact high?

My patient was playing sports and hurt himself, came in my ambulance SCREAMING. When the doctor came into the room, his cell phone rang and he took the call. I.e. pause the screaming, take a phone call. The doctor was so surprised he left to see another patient. When the patient got off his phone call he asked me what was going on and I said his exam was incomplete because he took a phone call, but I could ask the doctor to come back. The patient became furious and said "My dog is dying and I don't care what happens to me. That was my dog's caregiver. I don't need your judgement about my phone call. I need to speak to your manager because this treatment is ridiculous!". My charge went in to talk to him and came out quickly; she said to me "I guess I couldn't help. He told me I was worthless and to get the %$@ out of his room. We can give him the number for patient relations." All I could think of was that playing sports while the dog was dying was ok, but now we were holding him back from being with his dog by giving him medical treatment for his hysterical pain!

Had a 17 year old female come in by ACLS; heroin OD in field, found by mother. Medics bagged her and gave Narcan IM. When she arrived in my room she was angry at the world. Patient refused vital signs (alert, skin PWD, speech clear). Explained to parents half-life of Narcan. MD entered room. Patient interrupted us several times to "please talk to my parents ALONE, don't I have the right to do that?!?". With various curse words thrown in. Once doc and I had everything sorted out, we stepped out. Patient proceeds to beg, cry and whine to parents to take her out of ED because "I've been through this before and all they do is watch me!" and "I know I'm not going to die. I can tell." I get my Charge Nurse involved, thinking this will be a restraints and security watch moment, and leave the floor to transport up a patient on a Cardizem drip. When I come back, my charge shows me the AMA form the parents and doctor signed. I burst into tears (hey, I'm pregnant and having mood swings!) and as I discharge the patient I look the mother in the eye and say "I just want to verify that you understand you are risking permanent disability or death". Mother acknowledges. What makes me furious is that these were not your usual crap parents that you would expect to be, well, crap parents. When the visit started the parents seemed to be on board with medically treating their daughter that had OD'd on heroin. And at some point they had this thought: "Hey, these medical professionals don't know what they are talking about. I'm going to listen to the reasoning of my IV drug-addict daughter!". And then she got them to buy in on what she was saying! So clearly the heroin is the tip of the iceberg of a family where the parents have no control and the daughter gets to do whatever she wants. To that I say "Why even call 911? If you really don't care if she lives or dies, what does it matter?". What I wish I would have said to her and her parents was "If you OD again when you are 18, you are legally an adult and no one can take you out against medical advice. We will tie you down in order to monitor you and keep you safe. You will have no rights because you'll be considered incapacitated." And also "Yes, we are judging you, parents. We are judging your complete lack of control and lack of common sense. Yes, we think you are bad parents!" The only thing that makes me feel "happy" if that is even possible to say about this terrible situation, is that they will foot the entire bill since they went AMA. After they were gone I had parents bring in their 7 year old daughter who swallowed a penny. Upon discharge the mother asked if she could take home our ED blanket. I told her no and she said "Oh. But it's so cold!". Um, hell no. It was 102F today and people were literally dropping like it's hot all over the county. You don't get to take a blanket! Phew...thanks for letting me vent. What are your bad parent stories?

Yup. Home care instructions: "Stop smoking pot. It is making you sick." Done!

I just want to say that this comment is pure genius! I love it. That is exactly how I feel in the ED; watching, watching, watching for signs of an attack!

The secret bathroom is KEY to survival! I have the key codes to 2 different department's bathrooms, and also have another secret bathroom in the basement just in case!

I like how this thread has turned into "let's gross out a pre-nursing student". I didn't feel nausea very often in nursing school or at work, but I did have anxiety diarrhea for weeks when I first started working on my own with no preceptor. It made me wonder if I had contracted C Diff. Luckily that was not the case! Actually, now that I think of it, I don't like watching Incision and Drainage procedures. Usually I am too busy to hang out and watch, but a few weeks ago I got to see bilateral antecubital abcessess drained from an IV drug user. It was like watching a cream puff get the cream pushed out. And it really seemed like the size of a small cream puff!

Done! You may want to add to your data the department of the nurses who took this survey; some of your questions I answered "daily" because I get new patients every day being in the ED. Someone who has the same patient for 12 hours straight would answer that question differently. I think a large problem is family pressing silent on the monitors--then I may have no idea that a patient is alarming unless I am physically looking at their monitor. Usually if I hear someone else's room alarming, I will walk in and adjust/retake a BP/etc, and then tell the nurse. IE: "Room 24's BP was 88/56 but when I took it again it was 94/72", " I adjusted the ST alarms in Room 30 for you", etc.