Biffs25

Personally, I would have at least checked for a pulse to ensure the respirations you described weren't true respirations and not agonal respirations as she died, but as previously stated, with such a long response time her prognosis was not good. With a massive head injury such as you described, maybe they could have saved her in the sense of her heart was still beating and she was alive on a ventilator, but it sounds like she would have never been alert and functional ever again. Another consideration would be how entrapped she was within the vehicle. Even if they were going to attempt to rescucitate her, the lengthy extrication on top of the lengthy response time doesn't give the patient good odds at survival. Just my thought process at work.

All I have to say is AMEN. oh and, if you're in my firehouse, it's my remote control!! hahaha

I think this depends on the program and where the rotations were held. I went to a 4 year program and was given a whole year of critical care classroom and clinical time that most local ASN programs do not get. I feel that after seeing new grads from ASN programs, that I was much better prepared for managing the more acute patients. Having never inserted a Foley or seen a chest tube seems to be lack of clinical coordination. The clinical instructors for that institution need to ensure their students are recieving a well rounded clinical experience.

and Here it is, You have officially pissed of someone who was hit by a drunk driver while driving home from working in the ER one night. What happened? The guy had a "couple of beers", drove himself home, crossed the double yellow line, and hit me even though i tried to swerve out of the way. I was pinned in the car, had an open tib/fib fracture, a femur fracture, a bruised pelvis, vascular damage in my leg, and avulsed the majority of my left forearm. I got multiple units of blood, an 8 hour reconstructive surgery on my leg, and Oh yeah, this was thanksgiving day. Way to spend a holiday. But I guess it's ok because he only had a few beers and he was a hard working person right? His blood alcohol level was 1.0, right at the state limit to get charged with a DUI. So don't forget, there are many factors involved in how much you can drink and still be under the legal limit, and no matter what the limit is, you still might not be ok to drive. So DON'T DRINK AND DRIVE. I almost died because of people like you who write off the fact that they made a bad decision and how it must be the police's fault you got a DUI or it's the license plates fault you got pulled over. Until you grow up you won't be a good nurse.

So If you were born in 1982 such as I was, and I just graduated this past year from my 4 year BSN, which I entered right out of high schoool, did you go to college when you were 10 so you could complete your Masters in Education, then your CRNA, and then go on to get your Ph.D.? I also am a paramedic, and was a CNA by state standards as I worked in an ER as a tech during nursing school. I guess it's possible to have already taken the CCRN course if you worked enough in critical care, but when did you have time to fly? You listed the CFRN exam, so just curious as to whom you flew with. I'd say this guy is a joke. Plus, you figure someone who has gone through masters in education work, etc. that he wouldn't use grammar such as "the state has gave us nurses" and "you aren't nothing unless you are a real nurse"

I work at Suburban Hospital in Bethesda MD, and we occasionally have problems locating a monitor cable or something, but I have to say we are very well stocked. We have 8 pixus stations with supplies, plus our 2 med pixus stations. We also have items which we order for ourselves and keep in the management offices in case one can't be found or runs out, etc.

I disagree with this statement. Much of nursing is evidenced based practice. We utilize research for basing our standards of practice, and many many units have a process where you can change unit based standards of practice by proposing the change and backing this change with enough evidence supporting it's benefits. I used to work at the national institutes of health, where there are tons of "research nurses" and their job is to conduct research programs and further the evidence based practice field.

Going through school I was called the "Murse" by the females in my class. It, to them, qualified the fact that I was the male nursing student, and became a long lasting joke, such as all the Focker comments after meet the parents came out. I'm not suggesting we change the name, and know I have worked hard to be called a nurse, but i thought it was funny all the while. So maybe you can start introducing yourself as a "Murse" and see if people pick up on it :clown: You can be the new trend setter.

I still can't believe that after all this, and what people have been telling you, that you are talking about your personal life, i.e. the car accident and your boyfriend, in this letter. It's unprofessional. You made a huge error which you could lose your job for, and you are citing car accidents and your boyfriend as reasons why you did it? no, you did it because you are lazy and made a horrible decision. I agree with a few of the posters here, find another job. If you worked at my doctors office, or at the office of any of my family members and I found out you were falsifying medical documents, I'd have your job taken away and possibly take legal action depending on the outcome of the patient's care.

Ok, i just have to point this out, I never once threw out credentials, or letters behind my name... you just said "People need to get over themselves...I don't care what abbreviations you have behind your name" yet you are the one who listed this: "5+ years in E.D., 2 years in Level I Trauma Center (S.I.C.U.), as well as 4 years as CCEMT-P, and 2 years as a flight medid, and an RN with CEN, CCRN, ACLS, TNCC, PALS, NRP, ABLS, and whatever other abbreviations you can think of." I said RN because I have personally never heard of a program that has a LPN/LVN to Medic program, but I am aware of multiple RN to medic programs. So, it wasn't me trying to be rude about anything, it was I was unaware such a program existed. Now, follow your own advise, and get over yourself.

thank you 11, I am definately not condoning any RN taking an ACLS course and being able to call themselves a paramedic. I do, however, feel that it's possible for experienced critical care RN's to become great medics through an abridged paramedic course once they have taken an EMT-Basic class and have pre-hospital experience, speaking from both the EMS and hospital side of the equation.

Treat the patient, not the monitor...Was there a pulse? If not, then i would assume the proper procedures were followed. If all that was being treated was the monitor, then shame on all practitioners involved. To answer your question however, I have seen a conversion from asystole to NSR with one dose of epi and one dose of atropine together, but the rythm didn't last. I have personally never seen an asystolic patient "biting down", but have had a hard time opening the mouth for intubation. As far as a sentinel event, trust your instincts, talk to fellow co-workers. but remember the monitor doesn't always tell the truth.

Now I'm going to throw something out there that might stir the pot a little..but... At my university, the only male nursing instructors we had were gay. I have no issues with people's choice of sexual orientation; however I feel that with homosexual male instructors, the equality of men and women in the classroom and clinical settings were made worse than with the female instructors because they often favored the females more than the male students. So having male instructors will not necessarily help the situation per se. Some of the best male role models I had in terms of nursing were the ones I met through working as an ER tech, and could see how an experienced male nurse handled himself in a variety of situations. You can't get this from instructors who are openly gay, patients pick up on this and treat them differently than a straight male taking care of female patients, at least in my experience.

why waste your time bagging if the air is going into the lungs and not being circulated? your rationale makes no sense.

i was a little pissed off about the comment made "she's just the nurse, maybe she doesn't know" in relation to the patient seeing the nurse smile and not the doctor, and how the lack of a smile related to her condition. And personally i think the whole reading of the mind thing was a little over-exaggerated.

Had a patient a couple weeks ago who had fallen at home and of course couldn't get up, laid in his own urine and stool for a few days, dehydrated as hell, I can't remember his labs but his temp when he came in was 84.0 F rectally. He bought himself some time in the ICU. :selfbonk:

Washington DC area, the ICU at the hospital where I work is short 40% of their nursing staff quota....

I agree. I feel that in any critical care setting you should have the ability to get assistance from other nurses with your patients, no matter how experienced you are. I love the ER I work in because it is such a team approach to everyone's patient. No matter what nurse is assigned to the patient, you will almost always find other nurses and the techs helping with other nurses patients. this works wonders when one nurse gets the crashing patient and needs to devote time to that patient, other nurses can then pick up the slack with their other patients. The more experienced nurses should also know from their time in that you don't know everything right away, and learning on the job happens. They should not shun you because you are still learning. If there is a nurse who thinks s/he knows everything there is to know about every patient in every situation, then there is something wrong. Good luck on your decision, but remember every time you change settings there is a new amount of learning associated with the area.

30 ambulances....understaffed....ccu, icu, and med/surg full....no breaks...chemical spill accross the street, decon patients... so much fun...

what part of MD are you from?

It's nice to see some high school seniors with some pep and who know what they want to do. I don't know much about george mason, but I know JMU has a good reputation for their nursing program. I applied there (i'm from maryland) and didn't get in, I ended up going to Georgetown instead, so apparently out of state applications there are getting somewhat competitive. If you live in VA, then you have much better chances and will pay less money to go there, which works out great. I personally would suggest either EMS experience (becoming an EMT or paramedic) during college, or working as a nurse tech in a hospital in an area that you think you would enjoy. If you are interested in Peds, i'd look for local hospitals with good pediatrics in them for you to start working in. I would suggest trying to find a good pediatric ICU for you to set your sights on, you would learn the most intense things there, and it would be great experience. You'll just have to see where they are hiring and what experience you need first. Good luck!!

I've had patients coming in as trauma codes from accidents involving them on motorcycles... EMS and ER people don't call them donorcycles for nothing, the previous post stating that there would be a lot less organ donors if there weren't any motorcycles is correct. One of my buddies was in an accident on a motorcycle, he's got plenty of scars, aches, and pains to prove it. He was in a coma and had multiple surgeries to reconstruct his leg. Do yourself a favor and buy an X box motorcycle game or something else instead. There is minimal protection for you on a cycle, and I know there are many good motorcycle operators out there, so this is nothing against those who ride them, it's the chances with the bad car drivers that you take. You simply have a much better chance not getting injured in a car that has seatbelts, airbags and rollbars than you do on a bike. Those driving cars, running cyclists off the road, running red lights, etc are the ones that will take your life. It matters not your experience on the bike.

Coumadin was one of the meds you listed as not giving, which PROBABLY won't have any ill effect, but there is potential for ill effect if one of the other people you work with made the same mistake and the patient goes without his coumadin for a while. Do you feel that a DVT or PE are not life threatening, because I sure do. If the patient has chronic Afib he is ready to brew clots to send off to lungs or legs, etc. and could be lethal. Don't assume a dose or two is ok to miss.

Becoming an EMT regularly only takes a couple months, if not only one month depending on the class shedule. It is the becoming a paramedic in a couple months that some people might not like the idea of. I personally feel that if an RN has years of critical care experience, ER and ICU specifically, and have been an EMT previously, there are not many skills that they would need to be trained with. Intubation, needle decompression, and a few other skills would need to be learned, but in general the assessment and management of patients are quite similar to the ER setting. Any ER nurse with a good amount of experience, with a couple months training, could make a GREAT paramedic...it all depends on the person and how they handle having to work on the street.

I think it would have helped if you had taken the drug test...and if that didn't work, then I guess you should have been EXTRA careful to not get those medication errors during your probation period. Yes, mistakes happen, but apparently your rate of mistakes were high enough that it concerned people. frankly, if I were your patient, I would want you suspended also if you kept making medication errors. That could kill someone. I hope it works out and you get to practice again, but please be careful!