thelema13

thelema13

ED

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All Content by thelema13

  1. Central line protocols

    thelema13 replied to brainkandy87's topic in Emergency

    Goes case by case, if the patient has pipes we feel comfortable to admit with at least 2 large bore IV's. If they have crap for veins, the ED doc will throw in a CVC before admission. Sometimes we...

  2. Florida Keys travel assignments/agencies

    thelema13 replied to Ashley0828's topic in Travel

    I just relocated from central Florida to the Florida Keys and got a job. They never paid me my travel pay, hired me for critical care and worked my on med-surg with 6-7 patients. Hospital smelled like...

  3. Is this common? The new face of the ED

    thelema13 replied to mariposa311's topic in Emergency

    I feel your pain. No raises here either, for 3 years (about to be 4) even though we were nationally recognized in Consumer Reports and US News, ranked in the top 20's in the state of Florida. We got...

  4. First peds code

    thelema13 replied to brainkandy87's topic in Emergency

    We coded a 4 yr old that took a handful of her father's clonidine. They brought her in flaccid, purple and apneic. We bagged her until she turned pink again and intubated. Her mother and father were...

  5. Rx drug abuse in your ED- steps you take?

    thelema13 posted a topic in Emergency

    I have been getting fed up with the number of people coming into my ED drug seeking. One of the PA's have access to a database of all providers, pharmacies and pt info related to schedule 2, 3 and 4...

  6. Ruptured Appendix

    thelema13 replied to MassED's topic in Emergency

    Never heard of a ruptured appy not going to surgery. Recently, the docs have been treating early appendicitis with IV abx regimen and close monitoring for about 4-5 days. Recently had my charge nurse...

  7. Nurses taking patient's off backboards without doctor clearnce?

    thelema13 replied to the big nurse's topic in Emergency

    I do a trauma assessment, and as long as they have a c-collar, no reason for them to stay on a backboard unless there is a hip/pelvic pain or spinal pain. I grab a doc when they roll in the door or...

  8. ER Nurses: What did you do before the ER?

    thelema13 replied to ivyleaf's topic in Emergency

    I was a chef for 8 years before becoming a nurse. I graduated and went straight to the ED. I told them I was very good under high-stress, fast paced environment, and great dealing with people....

  9. Vent: "I should warn you, I'm a tough stick..."

    thelema13 replied to Anna Flaxis's topic in Emergency

    I don't like the hand either. I am quite fond of the saphenous vein, hard to miss and doesn't roll often. Even if they are a hard stick, I can usually weasel a 20g in. And in the case of the 16 year...

  10. Have been in the ER for 3 hrs now....

    thelema13 replied to MadpeysRN's topic in Emergency

    I like this

  11. Sometimes you just can't bite your tongue.....

    thelema13 replied to hiddencatRN's topic in Emergency

    Sometimes blunt truth is the best thing for a patient. Like the 400+ lb lady who has come into the ED x3 in the past week, all by EMS for knee pain. I got her the last time. I added morbid obesity on...

  12. New ED Program: Charting vs. Patient Care

    thelema13 replied to heidi5093's topic in Emergency

    An on-call doc and not in house?

  13. How can you neglect a patient and live with yourself?

    thelema13 replied to brainkandy87's topic in Emergency

    Already

  14. How can you neglect a patient and live with yourself?

    thelema13 replied to brainkandy87's topic in Emergency

    Recently admitted a woman from a NH with a report of anuria. I DC her foley and a large amount of pus came gushing out. The worst pyuria I have ever seen, no urine output, excoriated labia and lady...

  15. burnout in ER

    thelema13 replied to pm2rn's topic in Emergency

    Yeah, I feel your pain. Can't tell you how many times I have ran out a room during a code and a patient is standing outside their door "I need my antibiotics, my cold won't get better on it's own." Or...

  16. Do you give mag off pump?

    thelema13 replied to BellaInBlueScrubsRN's topic in Emergency

    So, Zosyn on floor for 4 hours, Zosyn in ED for 30

  17. Do you give mag off pump?

    thelema13 replied to BellaInBlueScrubsRN's topic in Emergency

    We give 2g mag as a bolus infusion for asthma attacks as well. Has something to do with stabilizing the mucous membranes in the lungs and reverses bronchospasm, if I remember correctly. Of course pt...

  18. Jaded

    thelema13 replied to RustyMedic's topic in Emergency

    I don't let patients push me around. No, there will be no McDonald's for you, Ms. DKA. No, your child does not need an abx for a cold. No, you are having charges pressed against you because you broke...

  19. Frequent Flyers

    thelema13 replied to RustyMedic's topic in Emergency

    :yelclap: Sometimes you wish no one was looking...... I get sick of seeing wasted resources. EMS brings in 'my elbow feel funny' and 'I might be pregnant, either 5 weeks or 5 months, you know, new...

  20. False documentation... more common than you think.

    thelema13 replied to OnlybyHisgraceRN's topic in Patient Safety Issues

    I have filled out many risk masters with no action taken. I have gone to multiple meetings, requested by myself, to speak with the ED director or manager about a nurse/incident/labs lost/yadda yadda....

  21. What is up with all the Dilaudid?

    thelema13 replied to rgroyer1RNBSN's topic in Emergency

    Yeah, it pretty much takes an act of god to get any analgesia for the people we tube in my ED. One doc will routinely order it if he performs the intubation, but unfortunately he has been called back...

  22. Blood Infusion

    thelema13 replied to Medic7714's topic in Emergency

    250cc bag of NS to KVO when not running blood or in between units, also used for flush if needed. I use pump tubing on my blood products. I'll make sure the blood goes in on time, and if there is a...

  23. What is up with all the Dilaudid?

    thelema13 replied to rgroyer1RNBSN's topic in Emergency

    One of our docs loves dilaudid, hands it out to everyone. I tend to request morphine if a patient is really hurting, I am able to give more if need be. I have also heard there is no ceiling on...

  24. jehovahs witness- refusing to..

    thelema13 replied to Skylar86's topic in Emergency

    I had a JW patient with an Hgb of 6.1, refused transfusion and kept having syncopal episodes. We couldn't force her to take blood. It's their right to

  25. Great moments in bad judgement

    thelema13 replied to emtb2rn's topic in Emergency

    The RN (me) that turned around and punched the wall after a patient/bed combo rolled over right foot. Boxer's fx and great toe fx, and a worker's comp claim in the works. Wonder how that will