ScrappytheCoco

I'm gonna break your TOS and ask one question...do you live in a large city? I worked in a mid sized hospital in a smaller town in the South as a patient care tech in nursing school- OR/PACU. They hired ADNs all the time, new graduates even.

I understand what you mean...but I also understand the phrase as well. I work ED so many of my pts are on continuous monitoring. A few weeks ago I was in a patient's room when one of the techs came in and told me there was an emergency next door and the physician wanted me in there right away. The patient was a middle aged person with abdominal pain who had spent 4 hours in the ED with stable vitals. I walk in to see the monitor showing a BP of 72/49. HR is normal, and the patient is pink, sitting up in bed, asymptomatic. One of the techs is putting in a second iv and they've started a fluid bolus on the other. The doctor starts barking at me about why he wasn't informed that the patient was unstable. He continued to bark regarding fluid orders and pressors if she wasn't fluid responsive. The patient told me she felt fine. I walked up to her and noted her BP cuff was extremely loose, and had fallen down below her elbow. I responsitioned the cuff and the resulting pressure was completely normal, in the range she had been in since arrival. I asked if anyone had checked the cuff before we just started blasting this asymptomatic patient with fluids an an unecessary second iv. Everyone just stared and the doctor huffed out. another time a nurse came out screaming her pt was in vtach, put the pads on and everyone rushed in to help. We walked in to see a rhythm that looked nothing like vtach.It was artifact and incorrect lead placement which caused the monitor to alarm vtach...and the nurse decided to completely abandon her own common sense I suppose. treat the patient, not the monitor.

I did mine at UT Arlington, you take stats while you're in the program.

Several of the hospitals I work for have a place to document the patient's behavior next to their stated pain level. One even asks for the nurse's "total pain impression."

I attended nursing school at a community college that was vocationally focused...they had a program which provided a childcare voucher for school/clinical days only for students that met certain income requirements. I would talk with the financial aid office...you never know.

None of these situations involve stupid mistakes. You aren't going to remember everything...good Lord, at 5 weeks in you don't even know what you don't know, especially on a critical care unit. This really shouldn't be acceptable. Your preceptor is a jerk.

Great Lakes state non-union contract/agency ED 3 years experience $52.50 an hour plus diffs varies by contract

Stick anyone and everyone you can. ED is the best place IMO because you will have the opportunity to stick frat boys with ropes for veins, 99 year old Nanas on Coumadin, babies, and everyone in between. Doing is the only way to learn with this skill.

Sometimes it seems difficult to palpate a pulse if the pt is severely bradycardia from vasovagal syncope. I've seen this happen at countless RRs I've been to on the floor. Observe for respiratory effort as well.

Got my ADN and BSN for about $15,000 in total. That was only a few years ago. You don't have to spend $90 grand on a nursing degree!

My current agency contract is in an urgent care that shares an office with family practice. The FP office has 7 providers always 3-4 front desk staff, 6 medical assistants, 4 RNs, and 4-5 administrative type staff that handle referrals and such. There is also an office manager and nursing supervisor. How on earth does your provider expect you to do all of that by yourself?

ED is what I was offered as a new grad. L&D was what I thought I really wanted so I worked ED kept looking around until an ob job turned up. I didn't last long and came screaming back to the ED. As much as I wanted to hate the ED, I'm really good at it. Sometimes you can't always know what speciality fits you until you try it out.

Does the pt have a hx of afib? If so, this is not something I'm going to get excited about as long as the rate isn't rapid and the patient is anticoagulated appropriately. Maybe the RN felt like you were tossing her under the bus in front of the MD?

I ask about POA status, etc if the pt is still in the facility and I can verify. If not, I say "unfortunately it is a violation of a federal privacy law for me to provide you with that information." I repeat as many times as needed. When they say they're going to call an administrator, I ask if they'd like me to transfer them directly:)

I've worked tons of ERs of all sizes, in 2 different states, and it literally never fails that there are no beds all day, or a bed appears at 1600-1700. The hospitalist goes in (finally) and places orders at 1800. By the time I do any stats that he's ordered and find someone to babysit my other 4 patients (some of whom could be ICU admits or have stat orders as well) and find a tech to help me transfer the patient once we're on the floor, it's 1830. There are ESI level 2's coming in droves by ambulance and flooding the waiting room. The admitted patient has somewhere to go, and we need to flow patients. It's a safety concern. Additionally, I feel like as ED nurses we're not quite as sympathetic as other floors when it comes to admissions. We don't get to tell EMS "Sorry, no STEMIs right now, it's 1900, you'll have to wait till 1945." I understand that we're all busy but I promise at least on my end it's not vindictive, it's just what happens.