TpaRN17

I think that ENPC is great! Even if you have to pay for it.... There is a triage component, applicable to all ages, and I think that, an a new nurse, is great! Good luck! : )

I thought your advice was great! If it is ordered and the situation is apppropriate, give the med! I wanted to elaborate on the need to use your professional judgment.

Ultimately, YOU are giving the drug and as long as YOU are doing the appropriate monitoring of pt condition then the "numbers" don't matter. (See quote above!) The drug is in YOUR hands (as far as liablitly is concered). You don't feel it is safe to give, don't! Let someone else put that on their hands. Document!

I just used this response earlier and it is the best advice I have ever received as an ER RN... "It is NOT YOUR emergency." You are the ED RN. You have to make the best of a bad situation in the time allowed. When it is done, my rule is that I give myself 15 mins after work to think about things. The good, the bad. My mistakes, what I did right. Then.. TURN IT OFF! You can't take their problems home with you.

AKA a carpuject! If you run across one, take it! If you have one, don't loose it!

Burn out! We all have those same complaints.... How much they are affecting our work can be fixed! What about going pool or PRN and trying out some other dept? Challenge your brain and your skills by shaking it up? That is what I did (go Pool) and now I get to go to different locations and work with different people. Makes that "same-old" a little different! That is the beauty of nursing, you can change your "job" but not have to change you "career." Think out-side the box! Good luck!

Obviously ACLS and PALS are necessary but I had a significant pay increase with TNCC and ENPC. Just saying! (Working on my CEN...)

There is no "help" for that other than get the largest bag possible, running as slow as possible... And get them upstairs, ASAP!

The beauty of nitro is that the half life is 1-4 mins! Usually, positioning and a few mins can correct any pressure problem. (Even if you have to give a little fluid- evaluate the extent that CHF is a problem.) It will tell you a lot, evaluating the effect of nitro on their CP. (Cardiac or not)

The best piece of advice I ever got as a new ER RN was, "It's not YOUR emergency." Superficially, it may sound like a crap attitude! However, if you remember that you are NOT the patient and NOT the family, you can take a step back and breathe! You are the nurse, there to make the best of a bad situation. Your greatest asset? You sound like you want to do a good job! That means you have set the learning curve higher for yourself. Give yourself time, and a break! Even the most experience, amazing nurses screw up or have a bad night. It goes with the territory! Trust your instincts! They will serve you well! Best of luck! PS- I cried in the doctors bathroom at least once a week for a year... I am still here! I have adapted... and drink a beer when I get home! I allow myself 15 mins to evaluate the night and then let it go. Only 15! Process, learn, release...