nfdfiremedic BSN, RN

ED, Neuro, Management, Clinical Educator

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All Content by nfdfiremedic

  1. nfdfiremedic

    Why am I now the enemy?

    nfdfiremedic replied to FancypantsRN's topic in General Nursing

    We use EPIC. Indeed, much of the SBAR is self populated. We hand write a little 2 or 3 sentence summary up top i.e. "Came in complaining of X. We found Y, and he's being admitted for Z." And we add a...
  2. nfdfiremedic

    Digital/computerized charting...

    nfdfiremedic replied to manchmal's topic in General Nursing

    I think you are talking about the individual notes for each parameter, correct? The little white piece of paper icon you click on that lets you free-text in around 30 characters? We have those too,...
  3. nfdfiremedic

    When to say no...new grad burn out

    nfdfiremedic replied to AngelicDarkness's topic in General Nursing

    Wait a minute. they DIDN'T give you overtime because you agreed to take those shifts in advance?? My department pays overtime for anything over 40 hours per week, AND we give you a $150 bonus for...
  4. nfdfiremedic

    Favoritism in assignments

    nfdfiremedic replied to wildlaurel's topic in Patient, Colleague Relations

    When I read through the responses to this thread, I actually stopped and checked where numerous posters were from to see if any of them might be my coworkers (especially the one who called triage the...
  5. nfdfiremedic

    what is considered high acuity?

    nfdfiremedic replied to yelnikmcwawa's topic in General Nursing

    to add on to what I mentioned earlier, in my department levels 1-3 are seen in the ED and level 4's and 5's are seen in fast
  6. nfdfiremedic

    Why am I now the enemy?

    nfdfiremedic replied to FancypantsRN's topic in General Nursing

    In my hospital, we use a hand off procedure called SBAR Reporting. the SBAR acronym is probably familiar to some. It stands for "Situation, Background, Assessment, Recommendations." For us, SBAR is a...
  7. nfdfiremedic

    Who is a professional nurse?

    nfdfiremedic replied to jmqphd's topic in General Nursing

    The last thing you just mentioned there, about the patients enjoying the bright colors the nurses wear, is the leading argument against a required color in my facility. This really strikes me as a...
  8. nfdfiremedic

    Increasing ER visits because of no insurance!

    nfdfiremedic replied to Josh Brewer's topic in General Nursing

    Approximately 10-15% of the 60k we see per year have private insurance. As someone else states above, only a very small number of the patients we see per day have genuine emergencies. Out of 160-180...
  9. nfdfiremedic

    Digital/computerized charting...

    nfdfiremedic replied to manchmal's topic in General Nursing

    I have used EPIC for years and I've always been happy with it. For situations like you described (i.e. patient's sat is high 90's while awake, high 80's while asleep) I just document whatever the sat...
  10. nfdfiremedic

    what is considered high acuity?

    nfdfiremedic replied to yelnikmcwawa's topic in General Nursing

    In my ED we use the standard ESI 5 level system (Emergency Severity Index) that is recognized nation wide. 1's are in need of immediate life saving intervention. 5's could have called their doctor...
  11. nfdfiremedic

    Who is a professional nurse?

    nfdfiremedic replied to jmqphd's topic in General Nursing

    This problem exists in my workplace, but the staff are "violently opposed" to any sort of dress code. They almost staged a mutiny last year when the policy changed to no longer allow them to wear T...
  12. nfdfiremedic

    Will it be worth it?

    nfdfiremedic replied to hopefull1's topic in General Nursing

    If this is something you genuinely want, you will forever regret not doing it. You need to do what makes you happy. You should pursue it. People succeed against the odds every day. You may have a...
  13. nfdfiremedic

    Do hospital patients get better care if they're nice

    nfdfiremedic replied to Anxious Patient's topic in General Nursing

    I must say, it's probably true. If you enjoy being around the patient you'll probably find ways to be around them more. More contact with the nurse makes patients even happier, and nurses with happy...
  14. nfdfiremedic

    Does anyone really like their job?

    nfdfiremedic replied to tokmom's topic in General Nursing

    I really like my job. It's not an easy job. My department has a "Manager" and a "Coordinator." The Manager is a desk job guy. He crunches numbers, hires and fires people, and is the liason to the...
  15. nfdfiremedic

    doing the possible

    nfdfiremedic replied to eternalbride's topic in General Nursing

    I didn't fail out, but I left after the first year and didn't go back to finish for several years. I was in nursing school during the day, and a paramedic class at night. I found the excitement of...
  16. nfdfiremedic

    Ok, what's the real deal with new grads?

    nfdfiremedic replied to future nurse1's topic in General Nursing

    When I was a senior in school, all the big hospitals in nearby cities sponsored "lunches" for my entire class to try and convince us to work for them when we were finished with school a few months...
  17. nfdfiremedic

    Will I ever keep up the pace???

    nfdfiremedic replied to Traum-a-Rama's topic in Emergency

    I think the two most important things anybody can hope to learn as a new ED nurse are time management and prioritization. At any given moment throughout the day you will need to do 5 things, and only...
  18. nfdfiremedic

    Can paramedic or EMT administer an IM med like Haldol or Ativan to help unruly pt?

    nfdfiremedic replied to ~Transplant Nurse~'s topic in Emergency

    Prehospital providers don't give sedatives in this area either. I presume this is so we don't get a bunch of sleeping patients brought in to us with nothing going on for us to assess, and probably...
  19. nfdfiremedic

    NRP vs PALS?

    nfdfiremedic replied to Double-Helix's topic in General Nursing

    Depending on the field you're looking to enter, both may be recommended. In the ED, we require PALS only but staff are welcome to (and encouraged to) pursue
  20. nfdfiremedic

    why double chart?

    nfdfiremedic replied to grneyes676's topic in General Nursing

    We use an electronic record that pretty much walks you through the entire assessment, known in our system as "observations." When you fill out your observations, you click the appropriate box for each...
  21. nfdfiremedic

    patient assignment

    nfdfiremedic replied to nurselyman's topic in General Nursing

    I work in an ER, so my answer is a bit different than the others. We take great pains to make sure nurses are NOT assigned in the same rooms two days in a row. In fact, they get very upset if they...
  22. nfdfiremedic

    Top meds in the ED

    nfdfiremedic replied to CalidthreeN's topic in Emergency

    The ones I see the most are Zofran, Toradol, Dilaudid, Morphine, Albuterol, Motrin/Tylenol for non-criticals. For critical patients, the stuff I see the most would be RSI drugs (Etomidate,...
  23. nfdfiremedic

    Another CEN question

    nfdfiremedic replied to crb613's topic in Emergency

    I prepared for CEN by doing practice tests out of the ENA's book. I did about 5 of the tests. The rationales they provide for correct answers at the end of each test are very thorough and helpful....
  24. nfdfiremedic

    New to nursing leadership and having some difficulty

    nfdfiremedic replied to nfdfiremedic's topic in General Nursing

    I am quite impressed with some of the comments that have been posted here. I continue to read every word, and I think most of you have really hit the nail on the head. It almost feels like some of you...
  25. nfdfiremedic

    Help! I can't decide!

    nfdfiremedic replied to hopfrogger's topic in First Year After Licensure

    There are lots of non-bedside nurse options. Unfortunately, many of them do require a year of experience. Some things that come to mind are case management/discharge planning, home health, wound care...