celtchick68

Just last week. Frequent flier, 3rd visit that week, drunk, high on Percocet, comes in to detox. (sure ya did, just like the other 2 times). He's loud, obnoxious, cussing up a storm, F bombs all over the place. I repeatedly asked him to keep it down and stop cussing as he's not the only pt in the ER. He says he's sorry and 5 minutes later same stuff. His iv infiltrated and a coworker stopped the fluids for me cos I was busy at the next bed over. Next thing I see is him cussing while tearing the lock out of his arm and flinging the bloody thing across the ER. I lost it. Told him how difficult he had been since setting foot in the ER and how his behavior was unacceptable and nobody wanted to hear his dirty mouth. He apologized and said "I'm an a$$ hole". I said, "I think you're right" Imagine my distaste to return after my 2 day break to find him sitting there again.

Ruby, I believe the idea is that we're nurses. We're educated. We should be capable of answering basic questions about disease processes when asked. We deal with doctors who explain a patient's dx with them and their family and the family still has questions that may have gone unanswered or that they may have thought of after the fact. We should be able to reinforce their knowledge without running to the doctor to save us from having to know something on our own. To defer to the doctor for everything tells the patient that we are not confident with our own knowledge base.

Me? I'd do it. You'll learn more in the ER and should be able to rely on hours. The ER isn't like med surg where it's reliant on census. You never know in the ER.

I have been a nurse for the same time period (2.5 months) and frequently come across these issues. While I may be familiar with the answers to a particular diagnosis I'm somewhat hesitant to discuss it with patients because I'm uncertain exactly what the doctor has already told them or if he's even discussed their diagnosis with them yet. I recall from school that it's not the job of the RN to inform them of their diagnosis but to reinforce education etc. I work in the ER so it's a little different than on med surg in that once they get up to the floor they usually already have their dx vs a new discovery in the ER. I'm never too proud to say "I don't know" but I always follow up with "...but I'll find out." I find that I appreciate the questioning because it forces me to find the answers which helps commit it to memory.

I work for Vidant and the nurses wear black or white. Can be all black or all white or black pants/white top or white pants black top. No prints. Shoes are up to you--any color.

I've not had an interview with Grady but the ER I work in asked several prioritization type questions not so much treatment questions as each place may have their own protocol for specific complaints.

In my ER we frequently hold IVC patients for days while trying to find placement. My facility has a 30 bed psych unit but it's always full. Usually when one is discharged and on the way down in the elevator we have one we're taking up in the other elevator. We have tons of frequent fliers who abuse the services and know just what to say to get a bed and 3 square meals for 72 hours. Had a lady last week who came in on EMS with some trivial mess, was treated and released. Middle of the night she had no ride home. She mistakenly thought EMS was a 2-way taxi service and when she found out otherwise she began to c/o chest pain. Readmitted and worked up, nothing wrong with her she goes back out to the waiting room after discharge. She then gets upset when she realizes the ER isn't an all night diner and won't feed her a meal (did give her crackers and a drink) she still has no ride home and now says she wants to kill herself and is admitted yet a 3rd time in less than 5 hours. She gets her box lunch and proceeds to waste the time of everyone for the next shift waiting for psych consult.

Awesome points to consider and keep in mind. My 3rd baby was a NICU baby. She was born at 38 weeks via emergency c-section after cord prolapse. Very scary to see your child limp and blue with the NICU team performing CPR and intubating. She was the biggest baby in the NICU and fortunately had to spend only 12 hours on the vent (she extubated herself). She spent 8 days there due to needing bili blanket and them not wanting to send her home until fully resolved since the NICU only takes "clean" babies and they didn't want us to have to go to PICU if something else came up. "Luckily" for me I remained in the hospital as well due to uterine infection and a fever that would not resolve so I was able to remain with her and see her throughout the day and night. We lived over an hour away from the hospital so this was truly a blessing. The staff was incredible. They were encouraging, supportive and helpful every step of the way. As a parent I felt helpless and felt as if mother/child bonding was delayed. The staff sent pictures to me while I was in the recovery room which I thought was sweet. As a result of my experience with the NICU I find myself wanting to work there. I'm a new grad working in the ER currently. I enjoy the ER but it's not where I want to end up. For me it's a stepping stone that will open doors to a more rewarding opportunity in a year or two. The patient ratio I see as not a lot different than in ICU or SICU where it just takes a lot more individual focus to care for sicker individuals. I don't see it as less work, if anything I see it as more challenging.

Your employer isn't required to make any accommodations for you. Childcare is the sole responsibility of the parent. I can't fathom anyone thinking otherwise. I know plenty of people who were able to switch shifts or whatever to accommodate their own needs but from an employer's standpoint your parental status isn't their concern. You were hired to work x,y, z shift.

Guess that all depends on the state you're in. I'm in NC and on the MICU trucks and air medical helicopters nurses function as a nurse on any scene run. They work side by side with medics and do everything to include intubating patients in the field. They function within their scope under the license of medical control dr just as medics and EMTs do.

All they can say is 'no'. (that would be discrimination to not hire you based on pregnancy status just as an aside) I'd fill out the applications and see what happens.

I just started in the ER as a new grad. I did have 15 years of experience as a paramedic in the same county so I was known to the ER staff. I tried to get on with a couple of larger hospitals but they wouldn't even consider me as a new grad in the ER. As previous poster said, ER isn't for wallflowers! If you really want it I'd suggest as others said, get the classes, the certifications and expand your search.

The ER position without a doubt. Acute care settings will enhance and improve your assessment skills with a wide variety of patients: infants, peds, adults, geriatrics as well as a variety of illnesses and traumas.

as a side note: I responded to this post with a comment as opposed to an official "reply" and was given a box that said my comment had to be reviewed by a moderator? what's up with that?

I had a food stamp felony conviction on my record from 18 years ago. I was admitted to the program, graduated and passed the NCLEX on June 5 of this year. I was granted my nursing license and started my first job in the ER last week. It obviously wasn't a problem for me. I was up front about the charges/conviction. The only holdup for me was obtaining the certified court documents from my conviction in a different state and the fact that the BON had to review my extra paperwork and explanation of events. Your nursing board for your state should have information about licensure with a criminal background.

You can also play up your previous non medical experience. Customer service, dealing with the public, handling customer complaints etc. play up time management, organizational skills etc. select buzz words/characteristics you feel embody nursing and find a way to correlate those words with what you currently do. And yes, add your clinical stuff and education. I've got a great resume with 15 years as a paramedic and still had trouble getting an interview while some of my classmates were called immediately with no experience. I think a lot of employers find no experience in medicine to be like a fresh canvas--easy to train them how the want them instead of possibly having a person they have to retrain or cast out possible bad habits.

I've not dealt with codes in the hospital setting yet as I'm a brand new grad but I've been a paramedic for 15 years and have run lead on more of them than I can remember. In the field there's no official debriefing or counseling. I've always had a sort of after action review between myself and my partner to discuss what went well, what went wrong, what could be improved on in the future etc. if its a particularly difficult case--pediatric code, trauma related code or whatever they do offer a critical incident stress debriefing and counseling available. For the most part it's a job, you do what you're supposed to do and you move on. Can't get bogged down with emotion or you can't do the job.

Get to pumping and stockpile.

If the patient or their healthcare POA has indicated the patient is to be a DNR then I'm not understanding why you would call the rapid response team who handles resuscitations to intervene. You treat the patients and you keep them comfortable but you do not take any heroic efforts to preserve the life...no bagging, no CPR, no defib, no intubation.

The nurse you describe sounds like a bully to me. If everyone stands up to her and holds her accountable then she has to change her ways. One can't demand something from others without holding themselves to the same standard. I would have loved to take her up on that opportunity to speak with management: Why yes, nurse Ratchet, let's do go to the manager so we can also discuss your omission of critical lab values on a severely hypokalemic patient during shift report and while we're talking with the manager we can also discuss the daily expectations where orders are concerned at shift change. I hate a bully

If it were me and I just started a new position I would take this opportunity to tell whoever is orienting/precepting me that I've never placed an IV. Not your fault I suppose (did they not even teach you in your lab at school?) but I can't imagine going through all those clinicals and intern/capstone/preceptorship for school and not having done this. It's a moot point now though. My advice is to just be honest and ask someone to help you learn the skill. Depending on your unit there may be ample opportunities to learn or they can send you to another unit like the ER to learn.

I also took my test at 1:00 pm. The night before I read through the test taking strategy/tips from Hurst review book once. Read through it again right before going in to test. Other than that I didn't worry about it because there's no way you can prepare for what your test will be like. You'll come out of there certain you've failed, as if you didn't recognize anything on it. If you've spent hours upon hours of prep work studying you'll think, "Why did I waste all that time? They didn't ask anything that I studied." I say enjoy your evening, don't stress. You'll pass it or you'll fail it. Either way it's over. If you pass that's great. If you fail you have a better idea of what to expect the next time and you'll pass it then. $0.02

I've just graduated and passed the NCLEX but I've been a paramedic for 15 years.

It does make sense. I still don't see it as a big deal. Better to take and make it a teachable moment. Those things are where we learn the best. You'll never disconnect it in that manner again I bet. In the future I would attempt to get very clear and up front guidelines from your instructor/preceptor so these "errors" aren't made again. In my school new skills were to be observed by our instructor and after that was done successfully we were able to repeat that task again unassisted. They just wanted to be sure we knew what we were doing.

I don't see how you put the patient in danger (I'm assuming that there was some sort of extension set attached to the IV catheter and that you didn't disconnect the IV tubing from the IV hub and allow the patient to bleed everywhere). I get what you're saying you did and I think it's ridiculous that you would have to redo the clinical. If only my opinion mattered......