boz2841

in your emergency room during triage is a full assessment done in your triage or just a triage assessment? I believe it is the patient nurse to complete a full assessment, how else are they going to know anything about their pt.

Thanks everyone for the input. xray showed pnuemonia bilat. all labs except the BNP were either wnl or within a few points of the normal range BUN Creatine were good, sorry I can't remember the exact numbers. I like the idea of CVP monitoring and getting renal involved and all of those but the intensivist refused to listen to anything I had to say. I'm fairly new at this hospital and unit, one month, so I don't have any pull with any doctors here. At my old unit it wouldn't be a problem they gave us leadway but not here. We could get any history due to her being intubated and she had no family info on her person, we even called the other local hospital to see if they had a history of her but no one did. This is a high trainsient area so she could be passing through like many do. Once again Thanks to all.

ok heres the situation a pt arrives in the ED at 0300 labs are drawn but pt is in respriatory failure and intubated. No history is known. She is sent to the unit at 0700. She recieve a bolus of 250ml NS in the ED why I'm still not sure. labs drawn on arrive to the ED show nothing outstandingly abnormal but she dose have a BNP of 420. The orders are for NS at 100ml/h which day shift starts. at 1400, 7 hrs after arriving on the unit, I/O's are done pt had 125ml of urine but had 950ml of input. Day shift hangs a 1000ml bolus. At 2200 pt had 150 of urine out another 1800ml of input, she is now +2475. I call the doctor start to go over the pt diag. and labs and was rudely cutoff being told yeah yeah.. I know all that. just give her another 1000ml bolus and give 200ml free water via NG q6h. before I had a chance to speak ealse wise the doctor hangs up. I once again check lung sounds still course but no crackles that I can make out, the pt was very obese. Pt never recieved any diuretics only fluid boluses anyone know why and why no concern over the BNP of 420 on a pt with no known history? My first thought when I placed my call was I would get an order for diuretics but I never got any they just kept feeding fluids to a pt was possible CHF. I just wonder why. by 0600, the next set of I/O's, she was now +4035 and had gained 3.4kg acording to weight.

I worked for Florida Hospital Flagler for four and a half years. I won the accolades of all of my peers and was nominated for several hospital wide awards. I did my job even going beyond my job description. I had been punched, kicked, scratched and bit by patients (overdose). When asked to do so I filled in as charge nurse even though I did not want to I did it for the unit and because it was asked of me. Then suddenly one day after having dated our unit secretary for five months her and myself were told one of us had to leave. I know what your thinking that our relationship affected my performance, not so. It wasn't till this time that 95% of the hospital found out we were dating, 5% did know. But never once did my relationship affect my performance. As a matter of fact I myself only worked three days a week and her shift overlapped mine by only 4 hours on days we both worked. Anyway I decided it would be best for me to leave and placed a two week notice (for which I have a paper stating that I did indeed give notice and am eligible for rehire). I even applied and was turned down for the ER and Med/Surg floors. Since then it has been very difficult to find a job cause for some reason whenever my references are checked prospective employers no longer become interested. I know it is illegal for a previous employers to say negative things to a prospective employer about an employee. However I can not help but think someone at Flagler has been giving negative comments about me which has in essence blackballed me for working.

I worked for Florida Hospital Flagler for four and a half years. I won the accolades of all of my peers and was nominated for several hospital wide awards. I did my job even going beyond my job description. I had been punched, kicked, scratched and bit by patients (overdose). When asked to do so I filled in as charge nurse even though I did not want to I did it for the unit and because it was asked of me. Then suddenly one day after having dated our unit secretary for five months her and myself were told one of us had to leave. I know what your thinking that our relationship affected my performance, not so. It wasn't till this time that 95% of the hospital found out we were dating, 5% did know. But never once did my relationship affect my performance. As a matter of fact I myself only worked three days a week and her shift overlapped mine by only 4 hours on days we both worked. Anyway I decided it would be best for me to leave and placed a two week notice (for which I have a paper stating that I did indeed give notice and am eligible for rehire). I even applied and was turned down for the ER and Med/Surg floors. Since then it has been very difficult to find a job cause for some reason whenever my references are checked prospective employers no longer become interested. I know it is illegal for a previous employers to say negative things to a prospective employer about an employee. However I can not help but think someone at Flagler has been giving negative comments about me which has in essence blackballed me for working.