panurse123

Zofran, Morphine, Dilauded, rocephin, solumedrol ( ER )

VVhere I vvork they dont recommend nevv RN's take ACLS until they have 6 mos on the floor. Go figure. Taking mine next month!

Thats what I was thinking. I have given it twice, the first time it worked, after the first dose (6mg) but it returned in about 20min. At the time I was so nervous ( I'm a newbie) that I dont remember what her rhythm was when she converted. But after she converted the second time she was put on a amiodarone drip. Reading this thread made me wonder, if its not svt, would adenosine work? If it's afib w/ rvr, will it also respond to adenosine? I had a pt the other day who had a hx of a fib w/ rvr. She came in with a rate in 160's, but basically asymptomatic. She was a little SOB, but also had copd and used 02 at home. She was not responding to 3 boluses of cardizem. Her BP dropped, but not her heart rate. She was switched to amiodarone, and admitted. Later it made me wonder why the cardizem did not work. She had been converted in the past with cardizem successfully. Maybe they were trying to treat the wrong rhythm?

According to the Lovenox website.. the anterior or posterior lateral abdominal wall. aka..love handles

Just wondering...if the 6-12-12 is given, and the pt does not convert...what would that mean?? what next? DC?

Its not a bad job - especially if you are in school, you'll get lots of studying done! Yes- you'll have to stay in room even of family is there ( if they are suicidal/homicidal) you may have to even stand at doorway when they are in bathroom. It is the nurses responsibility to tell you why the pt needs a sitter. Usually, unless you are a CNA/tech - you can't do ANY pt care. even helping them out of bed to bathroom, you should not do. Basically you have to be oriented/trained in any pt care, or you leave the hospital responsible for a fall/problem. It's a great first job in a hospital!

I agree with Heron - I was just in the exact situation, but before I talked to the manager I heard that 3 other night shifters wanted it, so I never made my wishes known. I think as long as you acknowledge that other may have seniority and it is only a request, its okay to do. I dreaded moving to nights - but I actaully love it, and I'm glad things worked out the way the did!

The top 10 meds given in the ED - ( morphine, dilauded, zofran, reglan, rocephin, zithro, heparin, cardizem, nitro, toradol - in my ER )and their parameters/related assessment and more about cardiac rhythms.

I went to that website, but could not find a clear list of requirements for certification. I did, however, find a consultant in a neighboring town. I have emailed her to get some guidance on how involved this process is!

I have heard of Lidocaine mixed with Rocephin when given IM because it is painful. I think the difference between the 1% or 2% is just that, 1mg/ml or 2/ml, and I believe IV doses treat arrhythmia.

I just came off a 6 month orientation for as a new grad in the ER. I got an EKG class - that covered much more than I got in school. I think to be successful you need to know your resources - use the pharmacy, get comfortable accessing hospital policies, specifically how certain meds are given. I have found that I give the same 10-15 ALL the time, and I try to look up any new meds and make a little index card on them so I get more comfortable with them. ER is a hard place to start, its fast paced and anything can come through the door ( and into your room!) at any time. Your openess to learn, and be up-front with things you dont know will have a huge impact on your experience. Take every opportunity to learn. Co-workers appreciate a new grad that says " I dont know how to do that" or " can you explain that to me". Best of Luck to you!! Try kathywhite.com - they sell a great little reference book that has almost everything you need! stat med drip charts, procedure notes, rhythm id, its great!

I have always been interested in being a lactation consultant, I am curious about employment. Do most consultants work for a hospital, or independently? My breastfeeding days were years ago - but I remember having a consultant come to my hopsital room, but also think that when I had my youngest, the midwifery group sent one to my home. Is there just one certification for this?

I think forcing yourself to create habits can keep you safe. FORCE yourself to ID your patients, FORCE yourself to verfiy allergies and say OUTLOUD - ok, you are Mary Smith and you are getting 2mg Morphine ( look at bottle/syrine as you say it) and 4mg of Zofran for your pain and nausea. You are not allergic to this drugs, correct? After a couple months, this safety net is in place and it can reduce the risk of a med error. Its like putting on a seatbelt before you pull out of the drive, just comes automatically.