SMARN

Not sure what my biggest pet peeve is but here are a few: Def get annoyed by women who come in for a urine hcg. Ppl who come in around 0500 with "back pain x1 week" and one of the first things out of their mouth is "...and I'll need a work excuse". Pts who complain of pain 15/10. I have told my patients before that I would never want to have pain 10/10 b/c I would have to be on death's door. And I thought kidney stones were bad!! Parents who bring their kids in for fever but never checked the temp at home and/or didn't give any meds. My ER is just down the road from Walmart and most of our pts have to pass it in order to get to us. Really? Is our motrin magical? Pumps - where the heck do they go?!?! Why can we never find any pumps in the ED and yet the floors have them stockpiled? Ugh, just return the darn things and we'll bring one up with the next pt who is admitted. Doctors who try to weasel out of discharging the pt. It's what you're paid to do. Go talk to the pt and tell them their results. Do not give me the results and ask me to pass it on that they are all neg and the pt needs to follow up with their PCP. That's all I can think of for now...I've had an easy week so all the normal peeves are not in the forefront.

I chart that "patient reports some improvement to pain, per FACES chart XX/10, pt in NAD in bed texting on phone and watching tv."

Haha, I get that from the day shifters A LOT! :)

Hosp FT - navy, white, or grey in ER. Can wear hospital tees on Fridays. Hosp PRN - anything goes!

Viced, I am interviewing at dekalb medical next week. You nearby? Have any insight - good bad ugly? Grew up in jonesboro, lived in Kennesaw, for 12 years (it's been about 6 yrs since we moved). Just not familiar with that area in detail....

Omg, are you my twin?! I also wear saucony's with the arch inserts! (arch 3000 from hibbetts sports). Love them! I do love danskos and satinas though, and will change them around to keep from getting used to them too much. My calves get tight if I don't, for some reason.

I'm in GA. Started out at $19.50/hr. Hospital had an across-the-board $1/hr raise for all RNs in my first six months so I was at $20.50, $21.07 at my first yr review. However, I work prn at another hosp ER and make the per diem $30/hr. I have an interview next week, as a 2-yr, for $25.80/hr. In my experience, short lived as it is, it doesn't pay to be loyal - you have to hospital shop. Good luck!

What is it with elderly dementia patients and superhuman strength?! The must shocked I've ever been was with a 90yr old who almost broke my finger bending it backwards as I was holding her hand during an i&o cath!!

I too have a rare talent in my ED with IV sticks. I work nights and am a go-to person for those who have a tough time with their sticks. I am happy to help too, as it just gives me more practice with different veins. Like others gave said, I actually enjoy the challenge! If I get it first try, the patient us super happy and they think I'm awesome (lol, win-win). If I can't, well that's what they were expecting so it's not a letdown... I rarely have to stick more than once, but depending on the situation and acuity, I have no problem sticking more than twice or just going for the EJ. One hospital I work at makes you have 3yrs before bring allowed to stick an EJ, the other allows it if you're an RN, no time requirement. For whatever reason, the nurses in our hospitals are allowed to do a manual IO but only midlevels and MDs are allowed to use the drill...

I don't know if anything works but I for one would like every one of the floor and icu nurses at my hosp to have to work one day in the ER. I know their jobs are hard too but they have no clue how it is downstairs and yet complain like nobody's business!! Most of our icu nurses have worked floor and step down only - and many of the whiniest floor nurses are fairly new and been on the floor since graduation. Gets me hot when they complain bc it's usually over the pettiest things. Meanwhile, the lobby's backed up 20+, ER is full, EMS is steady pouring in, and I haven't eaten or peed since getting to work...

So, I asked around my ED to the other nurses if they've ever given IV meds PO. They all kinda looked at me like I was growing horns out if my head, lol. I took that as a no. I asked our night shift PA if she ever had (she was an EMT, then an RN) - she said she hadn't given it PO, but she has given IV Valium in the rectum for a seizure pt who was a hard stick with no line.

I find being passive aggressive is way more satisfying than any other responses. It's something I use all the time, though, so it's pretty common practice anyway, lol. I can make someone think I'm totally agreeing with them while I'm actually making fun of them. Happy patient, happy me. :)

Well, I read about it on the FDA site and didn't see much info pertaining to increased efficacy with longer infusion times. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1635208/ The above research study didn't show any benefits to the patient on continuous infusions vs intermittent, similar to the 30-min vs 4-hr infusion times. I'm glad we still run it in over 30min. :)

The problem with the frequent flyers is this - THEY know their cc is BS. 99.9% of the time they aren't there bc they've had a significant change in sxs or they've completed their med regimen and feel no better. That's when it becomes so darn aggravating!! Ex. - 62yo female in all the time for earache/headache. Seriously, is seen about 5x week for these sxs. Is noncompliant with insulin and bp meds so her bp is always high and sugar requires a lab draw for a value. She can't be seen quickly for the ear pain d/t the bs and bp but all she wants is dilaudid and she knows she won't go to fast track with her VS like they are (and she won't get dilaudid in fast track). She knows she needs ear surgery but said she's "too busy" for it. Grrr. Then had another pt, 34yo, seen 3x in one 24hr day for sore throat. I walk in the room on the 3rd visit to get history and she had the sound of peritonsillar abscess. Sure enough, that's what it was - iv steroids and abx started asap. She kept saying she hated to bother us over and over. I told her she needed to be seen for that, that's what we're here for, etc. Things could have quickly gone south for her d/t the severe amount of swelling in her throat.... *sigh* In both cases, my taxes go to help pay for the Medicaid/Medicare and my premiums and copays are high to offset funds the hospital won't collect from those indigent care or nonpayers. But with the latter, my money "feels" better spent.

4hrs?! Wow, why the change? Manufacturer? We still run ours in over 30 min. Longest abx we run in takes 2 hours (vanc, etc). 4 hrs is crazy; as much as we use zosyn, we would def have to change meds.