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  1. EDrunnerRN

    Skin assessment in the ED

    Ohh please tell me you are joking?! Sadly, I could see my ER forcing one more juggling act on the ER staff nurse. The ONLY time I note skin assessment is if there is reason. For instance, my patient comes in with altered mental status I will note the decub on his buttocks as he could be septic. But it he comes in with respiratory distress and gets himself a tube, then no I did not get past The "B" in my ABC's, his skin tear is besides the point. The ER should be a focused assessment and take care of the emergency at hand, not the besides the point diagnosis. When do the ER nurses perform these detailed assessments? In between intubating room 1, getting the MI in room 2 to the cath lab in
  2. EDrunnerRN

    What is your WORST ER story?

    Babies/Children are ALWAYS the worst! As for advice, be aware of your religous/spiritual aspect. When I have a patient die I say a prayer for the family/friends and find comfort in comforting the family. I also run and many, many of my long runs occur after stressful ER days! Additionally, at my hospital we have an inservice to help cope with death, check and see if your hospital does this too.
  3. EDrunnerRN

    Top meds in the ED

    Off the top of my head I would say I give Zofran, Phenergan, Albuterol, Solumedrol, Prednisone, Decadron, Benadryl, Pepcid, ASA, Tylenol, Motrin, Toradol, Morphine, Fentanyl, Lopressor, Metoprolol, Integrilin, Nitro, Adenosine, Cardizem, Dopamine, Levophed, Atropine, Regular Insulin, Lovenox, Heparin, Haldol, Narcan, Versed, Ativan, Succinylcholine, Sodium Bicarb, D50, Lasix, Rocephin, Flagyl, Levaquin, Vancomycin, Cipro, Bactrim, Ancef, Tetnus; the most
  4. EDrunnerRN

    nitro drips

    I dont know all the details but if a Nitro drip is involved I use a bedpan. One of our hats is to keep the patient safe. Any cardiac complaint gets a bedside comode and if drips are involved or the patient continues to c/o CP stick to the bed pan. You can never be overly cautious with these ones. Acuity 3's and below I tend to use bedside comodes/bedpans.
  5. EDrunnerRN

    How often does this REALLY happen?!

    It's true we, nurses, are not perfect...gasp! I keep a note pad on my night stand because it seems that around 2 am I wake up and remember that I forgot to chart something. Personally, I have noticed that these instances happen more when we are "slammed" or do not have adequate staffing for the shift. Senior nurses tell me this is not something that changes with time...
  6. EDrunnerRN

    Can an ER Nurse to an ER Physician?

    I know a D.O. who did this. It is my understanding that DO programs are more likely to take people from the medical field than an MD program. But heck, I also know anesthesiologist who went from GED to RN to MD. You have a dream go for it, it doesn't matter how you get there!
  7. EDrunnerRN

    Intubated Pt's Using Bedside Comodes

    Ok...a few days ago an ICU nurse, at my facility, stated that stable intubated patients on the Unit use bedside comodes. My first thought was you are joking, right?! No, she was serious! I don't pretend to be an ICU nurse or know the aspects of care that pertain to ICU nursing but in the ER I would NEVER place an intubated pt on a bedside comode for obvious reasons, they are not stable. Can any ICU nurses out there back up her statement? For some odd reason, I keep picturing an intubated patient on a bedside comode and find it HILARIOUS! I think I need to see this to believe it!!
  8. EDrunnerRN

    IV Fluid/IV Tubing

    How do the different hospitals out there charge for IV fluids and IV tubing??? We currently use a pharmacy charge sheet, where we place pharmacy stickers, that are located on each package of the fluid/tubing. This is not working well and lots of lost charges. Any better ideas?
  9. EDrunnerRN

    Things noane told you about nursing

    As a brand new nurse, I remember thinking no one told me in nursing school how HARD being a nurse is. When I say HARD, I mean HARD. There are days when you get off work and feel as if you literally cannot walk. You are exhausted mentally, physically, and emotionally. My fiance refers to this state of mind as "zombied out." This is something you will ONLY understand after being an RN. Secondly, you will be shocked at how unappreciative the public is. Hearing a "thank you" is rare, even after you busted your a** off to make sure the patient will live to see tomorrow. Those are the days you browse online for change of career opportunities. However, those rare instances when you do hear "thank you" or know that you are part of the reason someone has a second chance at life is something you will never forget and that's what makes it all worth it! There will be days where you ask yourself is this really my life? But, as many times as I have asked myself that question, I could not imagine doing anything other than nursing. Enjoy your nursing adventure!
  10. EDrunnerRN

    ...annoying little BCx pet peeve...

    It is also required where I work to swipe the top of each bottle with an alcohol pad. I ALWAYS do this step because I have received many phone calls from lab with "out of range" blood cultures, which includes one abnormal blood culture, most likely caused by normal flora that contaminated the culture. If only one bottle is contaminated it is thrown out as an outlier.
  11. EDrunnerRN

    Rocephin Question

    I ALWAYS, ALWAYS dilute with Lido. When administering this medication I do a slow push allowing the lido to numb the area, as that is the intention of the Lido. I also make sure the medication is well mixed by rolling it several times between hands. Word from the wise, never spill this medication on yourself...if you want to get back at someone spill this medication on them, accidentally of course
  12. EDrunnerRN

    MD vs DO

    In the ER where I work we have both MD's and DO's. I LOVE our DO's. Unlike many of the MD's they are not so quick to prescribe a "cure all medication." In fact, one of our DO's gets a lot of grief from patient's because she refuses to prescribe antibiotics to the patient with cold symptoms for 3 days, instead she gives them a print out on how to treat the common cold...I am definately a fan of the DO's!
  13. EDrunnerRN

    Nurses in Japan

    This post is just a reminder to keep our fellow nurses in Japan in your thoughts and prayers. I am sure they are being overworked, feeling overwhelmed, as well as dealing with their own emotional battles at this time. Today's epic catastrophe brought me back to a conversation I had with a Japanese friend, a few years back. I was in nursing school at the time and I asked her about nursing in Japan...she stated that the field of nursing was not well respected. In fact, many jobs such as custodian, handyman, mechanic payed much more. Now knowing how much we, as nurses, have to invest ourselves into our work I am in disbelief by her comments. We are fortunate here, to be in a profession that is respected as well as considered "making a good living." Let's keep our nurses in Japan in our thoughts and prayers as they are needed in this time of crisis...
  14. EDrunnerRN

    Worried...did not clamp main IV line.

    Never worked the PCA pumps as I am an ER nurse but how much could you have really gave him just by adding a little pressure 2 mg? Its an IV medication so you would have seen pretty immediate changes in VS if you really gave him a big bolus. Now ya got me interested in how these things work...might take a trip to the ICU tomorrow...
  15. EDrunnerRN

    HIPPA Violation?

    In the ER I work at we receive many of these phone calls. Normally they ask if so and so is in the ER and as long as they have not blocked their information we can say "yes" or "no." If more information is requested I normally have the family come to the phone or return the call. Even though we are only trying to help, patient privacy is something to be taken serious and our patients trust us to keep their information private. As far as giving out lab values that is something I only do if requested by the MD, out of the RN scope to interpret. In your situation, it doesnt sound like you will be reprimanded. Maybe just a wake up call, next time could be worse?! I would definately check out the policy where you work to find out just what information you can and cannot give out.