ERHack

our ED uses toradol IV all the time provided there are no contraindications (bleeds, allergies, etc). Its even part of our protocol orders (standing set of orders for certain complaint pathways, such as poss UTI, Kidney stone) The protocol dose for Toradol at our hospital used to be 30mg IV, however it recently changed to 15mg IV based on research that suggested the therapeutic effect could be reached at this lower dosage and that a higher dosage such as 30 IV rarely increased effectiveness (this per our ED med director, unfortunately dont know what sources he cited) As far as reactions, I have never encountered a pt who c/o burning or irritation at the IV insertion site due to the med (such as is common with phenergan). IM injection of Toradol however is a different story. I have had pts c/o burning with IM injections (usually 60mg).

if they need a SG, they need an ICU bed...so get em on up there. Thats pretty much our ED philosophy.

Congratulations on passing!!!!! And oh yeah, one other thing.... YOULL BE SOOOOORRRRRYYYYYY!!!!!!!!!!!!! (just kidding....i think)

Ive got one. What do you say to the irate mother who has brought her child into the ED at 2 oclock in the morning for a c/o that he has had for 2 weeks, and who is now lecturing you on how it is unacceptable to have to wait for 3 hours to be seen? My answer- "well Im sorry ma'am, but this is not Burger King, and unfortunately, we do not do things 'your way right away' here in the ER. Unfortunately, the gentleman who needed a tube put down his throat so that he could keep on breathing took precedent over the cough that your son has had for the past 2 weeks. And yes, youre right, we should have more people working here, but unfortunately, (and I dont know why) there arent too many people who are eager to be standing here in my position trying to explain why the wait is so long". Yes, i said this to her among other things, and yes, I was bad, and yes, i should try to be more empathetic, and yes, i had a tone with her all the while, but hey, you know you've said worse (me too) and it felt good dammit! sorry if this really isnt related to the original post, but it is kinda an ER question, isnt it? I think it might fit under psych-social area, no?

Ive said it once, and Ill say it a thousand times again. "nurses eat their young". why is that? Do what I say Im going to do when the crap's hit the fan again, and I'm feeling like a way out. "Screw nursing, Im gonna work at Starbucks! At least they get tips sometimes..." No seriously, keep fighting for what you want. If you want to be a nurse bad enough, you will make it (though it may be through a different program). Good luck, mucho prayers out to ya.

You already know what you did wrong, and after this, you probably won't make that mistake again. Then again, maybe you will. However, I think the most dangerous thing would be for you to walk around feeling as though you are never going to make any mistake again. The ER game is a brutal one. Everything is fast and furious, and sometimes it takes thick skin, not only because of the way we are sometimes treated, but also because of experiences like this one that you are going through. Bottom line, no one should judge you cause I guarantee everyone has made their own mistakes (and im sure some a lot lot worse). Learn from it, alright, beat yourself up about it for a while (cause thats what i do too), then roll your sleeves up and get back to work! Sometimes you just gotta sit back when the whole thing is crashing around you and say "well, the pt is still breathing right? then my job's done" . Please, whatever you do, don't feel youre not going to be a good nurse because of it. After all, we NEED more nurses so badly! YES, I NEED A DAY OFF!!! PLEASE, SOMEONE PASS THE BOARDS SO I CAN HAVE SOME VACATION TIME!!!! Uh, er, sorry bout that. Got a little carried away.... good luck!

Obvious deformity. Nuff said.

Hmmm, there have been nights when there is only one or two female RNs on our crew. We have a nice mix of characters, as every ED Im sure has. To tell you the truth, I cant say that there is a difference I can notice with females vs males (besides the obvious). Every one as an individual has a different personality, some strong, some more laid back. Its impossible to attribute that difference to sex. (maybe lack of hehe) Hmmm, is this answer beginning to appear a bit TOO Politically correct? oh well.... As for the more compassionate argument...well, I'll tell ya. I have seen plenty of women who seem quite cold with their patients. I have been thanked many a time by my own patients for my caring and attentive manner of practice, especially after taking over from a female nurse. Oddly enough, I find that some female nurses are actually harder on their female patients for being wimpy or too sensitive to pain or discomfort ("your pain is STILL a TEN!?!?) Anyhow, my position is this. We are supposedly trained to be non-judgemental and empathetic to our patients. I say we should give eachother as coworkers at least that much. After all, when the crap hits the fan, who's got your back?

Hmmm, thought and thought about it, but sorry, can't think of anything funny during a code. Working in ER, full arrests are usually kinda hectic. I guess the only thing thats funny is when someone else gets the full arrest that comes in at 0655 when your shift is over at 0700. haha now THAT's funny!

Nursing school was the WORST and best time of my life. Strategies for survival? If you want it bad enough, you will survive. Just dont take things TOO seriously. You will not be perfect, you have a lot to learn, and no matter what other nurses tell you or how they treat you during clinicals (nurses have a tendency to eat their young) remember above all else that every single nurse has been in your shoes. Oh yeah, STUDY GROUP STUDY GROUP STUDY GROUP!!! (and lots of drinking after big exams!)

As a nursing extern, youre going to be exposed to a lot of new things, experiences, personalities. People in the medical field are not perfect, after all, they are people. Your job is to act like a filter at this point in your career, and take the good stuff that you find as your own (professional behavior, caring, knowledge, coping mechanisms), while making it a point to exclude the bad stuff (unprofessional behavior, negligent habits, etc). Remember, things unfortunately do not change. Wherever you go in your career, there will be good and bad. Remember, it is YOUR responsibility to do the right thing.