ERRN92

Ive been a Nurse since 1992. Mainly in Er. Never ever ever give someone who is a crack addict - Ativan. There should be an official warning - it makes crack patients go into overdrive ( as if that were possible). Not sure why, but I have seen evidence over the years. Finally convinced my Docs that it is a BAD idea. Has anyone else experienced this?

As Nurses we are taught not to judge. However there is a fine line between compassion and being taken for granted. That is something we all have to deal with on a personal basis. As an educated Professional - Im sure you will make the right decision.

I will try to make a long story short. I got addicted to pain meds for a period of 6 months (after a wreck) - the only time i have ever abused anything. Went through the nursing recovery program (which was great) for 2 years before i got a divorce and just couldnt afford to keep up with it anymore. I had to drop out against the advice of the nursing board. I have been clean for 4 years. I started a new career that I am doing really good at. However, like most of you, nothing satisfies me more than being a nurse. I MISS taking care of people and I was pretty good at it. The only thing keeping me from going back is having to face the nursing board. Is there anyone out there that has tried to get their license back after being gone for years?

The one I hated the most is: Name 3 of your strenghts and three of you weaknesses. Admitting your weaknesses is kind of a catch 22. If you say you have none then you seem arrogant, but naming them may cause them to not hire you. Ive had that question in more than one interview, so be prepared. They dont expect you to be perfect, so just be honest.

Yes, with time, it will become second nature to you. When I first started, i really just wanted to run away from codes all together. Now, many years later, I want to be a part of every one that comes along. The more you are involved with, the more skilled you will become. Also, look into getting ACLS certified. This will help you become more confident. Thats the great thing about the Er though...your patients may look fine one minute and be crashing the next.

When a nurse gets a DUI, this raises huge red flags about the nurses lack of self control regarding addictive and mind altering substances. The nursing board is not there to protect the nurse - their purpose is to protect the public. We all know that addictions usually escalate. She may not be coming to work drunk now, but how long before she does. I think the board should be watching her closely and maybe this will be the wake up call for her to take a serious look at where her life is headed. No way did her license get revoked due to paperwork.!! If it was, she needs to get a lawyer.

Oldie but goodie..."the bleeding ALWAYS stops"

Depending on the size of your ER, you may have to start 20 IV's or more per shift. You cant help but get better at it. Dont ask someone else to try until you have at least attempted 2times on your own. The more practice you get, the faster you will learn.

........"no you cant get up and go to bathroom. You will have to learn to use the bedpan until your bolus dilantin has had time to take effect" They come into the ER because theyve been seizing today - but think they should still be allowed to get up and walk to the bathroom where they will close the door and sometimes lock it!!! There is no worse feeling than listening to someone seize inside a locked bathroom by themselves.

We're like roaches, you cant kill us. haha. :chuckle:chuckle

They should do studies on Er nurses and the rate of illness over time. I have had pts practically cough in my face and they'd later test positive for TB. Its not realistic that you're going to mask up everytime someone comes in with cold symptoms (except maybe Florence Nightengale who could do no wrong). Ive never gotten TB. When we do get exposed to something like Meningitis for example, we all get a Cipro freebie on the house. Its not that much worse than the exposure you get in the general public. Think of the air you're sharing with those around you and the things you touch that have been handled by who knows what...

The whole idea of the ER is to get pts stabilized then get them to where they need to go (admitted to the floor or discharged). The routine "usually" goes like this: a pt comes in (by self or ambulance), gets triaged to determine where they fall in the long line of pts waiting (usually done by triage nurse or MD input), once the pt is in the back - the nurse gets VS, brief medical history, nursing assessment, and complaint then reports to MD. Once you've become familiar with the Docs - the nurse pretty much knows what he is going to want - you can have the bloodwork drawn, catheter in place, etc, etc to speed things along.Depending on the MD, he will go see the pt and or just write orders. Its the nurses job to see that every order gets done and results are back as quickly as possible. MD makes diagnosis and the nurse either discharges pt or they are admitted. Now, that is a very simplified version. Problem with the Er is that you will have to deal with the crazy pts who dont belong there and want to start some drama when the pt next to them is in the middle of a code. I personally love the Er because it is very unpredictable, fast paced (every order is a NOW order kind of thing) and its challenging.

Had a pt come to the er triage desk...had on overalls and covered in paint. He was a sweet old man grinning from ear to ear and said he had a problem. His hand was wrapped in a towel. He pulls his index finger (that he had accidentally cut off with a HANDSAW) out of his pocket and politely and calmly asks if I thought we could sew it back on for him. How do you cut off an appendage with a handsaw?It couldnt have just taken one swipe with the blade!! He was toooo cute.

We had a 20 something girl that came thru the ER a few times with the same problem. Not everytime, but occassionally when she menstruated, she would have a spontaneous pneumothorax. After about 6mo of testing, they diagnosed her with some rare disease that causes this. Its been so long ago I dont remember what it was called - just that it was rare. Her family says she's moved out of town.

How about..."yes, please do call Johnny Cochran's office (theres one down the street). I'd be glad to look up the number for you. And no, you cant take the medical chart home with you!!! it doesnt belong to you, it belongs to the hospital. But, you are welcome to go thru medical records and get a copy blah blah blah. Im shaking in my shoes.!!

I have attended nurse support groups 1xwk for 2yrs and met alot of nurses in recovery. From what Ive heard (including my case), it isnt very likely that your employee will press charges. Being reported to the state board is punishment enough. When I was fired for diverting, I went and talked to my boss' boss. She said they werent interesting in sending me to jail, they just wanted me to get some help for my problem. It might be worth your ease of mind to talk to someone from the hospital (manager/supervisor) and just ask them if they will be pressing charges (in a non threatening, nondefensive attitusde). There is a statute of limitations (time period in which they can file charges). I looked it up when I got into trouble. Im from TN and it is 3yrs. If for some reason you do have to go to court: and it is your first time to be in trouble - talk to your lawyer about getting an expongement. It is a program where - once your through with your parole, they will erase it from your record. But, you have to ask for it on your first court day. It will be as if it never happened.

How about when you take a medical history and the patient denies having any problems. Then you check their meds and they're on all kinds of stuff. "I thought you said you didnt have high blood pressure?".."Oh, honey, I dont as long as Im taking my blood pressure pills." Bless their little hearts...they just dont get it. :chuckle Now, I always check meds first. Its usually more accurate than the pts recall.

I agree with loricatus. If you remember taking the order, you can rewrite it as long as you document that it is being recorded at a later date. This isnt falsifying anything because the order is valid. However, any decent lawyer will probably try to argue its validity. The first thing they will check is your policy and procedure regarding late entries. Make sure you're within the guidelines. In any case, they cant prove that you intentionally created a false order as long as you have the Doc and hospital backing you up.

AMEN!!! I like the old saying " Doctors save lives; Nurses save Doctors". I dont think they realize the impact we can have on the patient's perception of them. I quit "covering" for Doctors a looong time ago - mainly because of the lack of respect they showed toward the nursing staff. Of course, there are a few doctors who are the exception to the rule.

I work in a hospital that has a "medicine" er and a "trauma" er. Trauma er thinks they're the only nurses that save lives. They're the only nurses that are qualified to save lives. I guess no one ever dies from a heart attack, head bleeds, stroke or organ failure. There are GREAT nurses in every department. !!

Ive always wanted to say, "of course you're having chest pain and feeling sick. You've been using crack!!!!!!!!You didnt care about your health when you were shooting up, so why should you care now when you're having chest pain?" "yes, if you dont die tonight, you will probably die somewhere in the near future - its like shooting yourself over and over and then going to the er to fix it so you can do it again. UGH!!!!!!!! Why dont we make use of this valuable time by preparing your funeral arrangements. "

:twocents:Each state may be a little different. You can find it by searching the internet for "longterm care facilities regulations". Here's one, for example: http://www.pacode.com/secure/data/028/chapter211/s211.12.html Also, check with your poicy and procedure manuals. It might be listed in there. Either way, they arent going to change the way they do things. This argument is as old as nursing itself. You might want to consider a another job.

I guess it depends on your experience, then. When I left, 3yrs ago, I was making 24/hr on day shift (with 16yrs experience). I dont know what they start new nurses at. The travel and contract nurses were making closer to 30/hr - but they dont get any benefits.

I worked in Memphis for 3yrs. There are countless jobs in the area - theres a nursing home on every corner, almost. There are at least 7 major hospitals in the area, then there's work in the justice system, home health, Dialysis clinics, etc... Because of that, there is a lot of competition. So, the pay is very good. Depending, of course, on what kind of nursing you're looking for. The cost of living is only slighty higher than the surrounding areas. The public school systems are not up to par, though. They have chronic problems and have been through many superintendants, but the problems havent gotten any better. You might consider private school if you want your children to receive a decent education. Of course, with any city, there is a very high crime rate. For the most part, people working in the Memphis Metro area live outside of the city. I worked at the trauma center, and most of us drove 45min to 1.5 hours - but the pay is so good, you can afford to do that.

You need your support staff! Treat them the way you would want to be treated. They are paid to "assist the nurse", not do all the dirty work. Besides, there has to be mutual respect from both sides. Once housekeeping sees that you are willing to get in the trenches with them, chances are they will come to respect you for it and want to help you more. At least thats been my experience.