Nursekat64

I hope all of you can help........ The ER I currently work in is in need of a Trauma Coordinator. I have been designated to set this up. Out of the 2 hospitals in our city we are the Largest and receive many traumas, some of which we keep and othes we ship to a larger city. Being in a small community many of our staff have never worked anywhere but this ER and we are no where near JC standards, and I am having some rebuttle with the staff to change. Although when a trauma arrives it seems that all of the nurses run in, but chaos sets in and many things do not get done. Ihope that by reaching out to you all that you could help me in which direction to go. Management sees the need for this and so do our doctors, so I have that support, but they are also unsure about how to set this up . Thank you in advance for your help:rolleyes:

I always have a dedicated line for heparin but at the hospital in which I work many nurses hang heparin as a secondary with NS as a primary and low port it in..... And I keep diprovan on a dedicated line as well but here again many nures low port it as a secondary to NS.....

I work in a very busy ER inner city ER.... I have a few questions.. I have seen these things done many different ways but no one definative protocol.... #1) When giving a IV bolus of Heparin what concentration do you use? #2) Do you low port Heparin and use it as a secondary? #3) Do you low port Diprovan or use it as a primary line? #4) What meds does your facility low port? Thanks.......

Questions??? I have seen these things done many different ways by many different nurses and cannot find a definative protocol....... # 1 ) When giving a Heparin bolus before starting a Heparin :specs:drip what concentration do you use? # 2) Do you low port Heparin as a secondary? #3) Do you low port Diprovan? or hang it as a primary ? #4) What meds does your facility low port? Thanks .....

I am writing today in response to what I have seen in my community, and wanted to know if you all are seeing the same things. I am an RN in our cities largest ER, and over the past 6 months I have taken care of an increasing number of adolscents and young adults who are using "dust remover" compressed air cans for an instant "rush" in the form of "huffing". I have been a ER nurse for 20 years and it seems to me that more and more overdoses and "huffing" episodes are occurring. I had a pateint who was in Full Arrest and was a known "huffer". During the code there was more and more frank bleeding from the ETT, NGT, orally and nasally.Unfortunately the patient did not survive despite our best efforts and ACLS protocol. I was wondering how many others have seen the frank bleeding after ingestion of "dust remover" compressed air cans. We believe it changes the clotting factors and predisposes your patient to bleeding out. The back of the cans say" Do not use adrenaline, epinephrine or similar drugs after exposure". Does anyone know why? I would appreciate any and all comments and information you all can give me. I do propose to place the cans behind counters and ask consumers to sign for them, as we do many other medications and items that are potientally harmful. Write your congressman, your mayor, or any elected official. The general public is already overwhelmed with information about "pot, crack, meth, and alcohol" on our youth, but I am not so sure about this one. I believe that we as nurses can make a differece, we can unite to form our own campaign to save our adolescents and young adults. WE have the power, WE have the influence., WE have the education, WE can save lives. Thanks for letting me vent------ Kat:o

While at work one evening in the ER a gentleman was placed in my room with the diagnosis of SOB. I went in to do my RN assessment and while taking his history he disclosed that he had been running a fever with SOB for the past 3 weeks and became increasing SOB this evening. My assessment reveled a fever of 104.2 orally, and diminished breath sounds in the lobes of the left lung. I went ahead and started the pneumonia protocol, started his IV drew blood and blood cultures, ordered and Xray and started IV antibiotics. The physician walked up to me and said," I dont think this man has pneumonia I think his lung is collapsed". I gathered my supplies to assist with chest tube insertion. The patient was sediated and the physician started the procedure. At the point when he opened the pleural cavity an immediate gush of pus came running out of the patients chest, we placed the chest tube to suction via pleural -vac and immediately returned 2100 cc of pus into the collection chamber!!!!! Needless to say that after the patient awoke from sediation he was feeling much better, except for the large chest tube we had just placed. So even though he didn't have pneumonia, as I thought he was still in great need of IV antibiotics.

I am so very sorry for the loss. When children die the world stops for the parent. I have worked in a pediatric ER for 15 years and phenergan supp. were used many years ago, when that was all there was to give. Now we only give zofran. I am currently working in a adult ER but we see many peds patients, and with my experience and when I am there I get all the peds patients. Many caregivers are uncomfortable with handling pediatric patients and I believe that there should be a PALS certified caregiver available at any given time. I would venture to say that this child was in hypovolemic shock, and had PALS guidelines been followed the outcome could have been different. Again I am so very sorry for the loss.

Thanks for checking that out, it was brought up in class today. This post is part of an assignment for a Role deveolpment course I am taking. I wanted to get a feel of how different hospitals and nursing homes work as a team nursing approach, when the team isn't really a team after all....

The Northern state is Maine

Recently My class and I went to the ARNA and NSNA state convention in Hot Springs. The Keynote speaker was Doctorate prepared and an advocate of geriatric nursing. Her focus was susposed to be in the implementation of a program, within the next 5 years, called geriatric excellence in Nursing, focusing on nursing homes. She wants the nursing homes to become magnet status as some hospitals are. During her speech, ( I guess she was unaware that there were ASN RN's and LPN's in the crowd), she bashed the ASN RN, and LPN role in the nursing home, and praised the Med Tech role. Her statement was to the effect of ' I would like to see all nursing homes have only BSN nurses, and Med techs, because LPN's are not competent to perform basic care nor do they have any management experience.... Our patients have pressure sores because the LPN's are not turning them'. Needless to say my class, who are all LPN's that will graduate as RN in december, got up and walked out. We were not the only school to do this. My points are as follows, 1) The nursing field is composed of many levels of education, and we all depend on each other. 2) Med techs are dangerous, and their skills and level of education is questionable, being do they assess heart rate and BP before giving digoxin and other medications that can alter vital signs? 3) The nursing shortage is real enough as it is, do we need to futher compromise patient safety by deleting the ASN RN and the LPN?.Not everyone has the time or money to become a BSN. 4) In a perfect world all nurses could be BSN and above, but then in a perfect world no one would be ill. I have since learned that a northern state has deleted the LPN programs all together, and is replacing LPN's with Med tech's or RN's. Although I plan to go on to the Master Degree program, I will always be a LPN and ASN RN advocate.

I am in school. I graduate in December. I will go on to get my Advanced Practice Nurse degree, open an office in rural Arkansas where the need is tremendous. I already have a physician whom I will work for and with, and I am starting to build my office now. But that is so not the point........

You are truly unique. I wish that more managrs were more like you. It makes a huge difference in how the unit runs and how well the patients are cared for, when the staff knows that management really cares. I hope that your staff recognize how lucky they are in having you there.

Thank you.:)

shannon, Thank you. I will send you the information. I need about 25 LPN's to join to become an active chapter in Tennessee. Kathryn

Yes, feel free to email me Kat:D