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Gloves
In your ED what kind of disposable, non-sterile gloves do you use? We used to use Kimberley Clark's gray nitrile gloves. Which are amazing. Now we've switched to S2S 506 series gloves which rip most of the time. They are terrible gloves. They tried a couple months ago with another kind of S2S gloves and told management basically we hate them. You would be in a huge mess with a patient and they would rip. It is bad for our safety and patients! Just puzzled as to why they would try another kind of the same brand. Our current Kimberly Clark gloves are amazing! What's your thoughts??
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How Hard is it to Start in the ER?
It depends where you start. What state are you applying in? Different states and different hospitals want different things. One hospital may be open to new grads and another not. I would say a teaching hospital is going to hire new grads easier, and just be yourself. I started 2.5 years ago in my ED as a new grad and we have several. Just depends where you are unfortunately and if you are willing to relocate to get the job or spend some time on medsurg and then transfer. Good luck!
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CS
Propofol, so short acting that you can cut it off and they wake up quicker. I think they end up doing better too.
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Difficult situations
Thank you everyone for the hugs, advice and just listening. It's nice to know others understand because you've been in similar situations that have got to you. There were many questions raised the night about our FNE coverage and process as well that hopefully we will have positive changes from. At the end when she was able to speak to us she looked me in the eye and gave me the most heart felt, sincere "thank you." That is why we do what we do. To make people feel better in their worst moment. Thanks for all you guys do, be safe out there and know that from one ED to another, we are thinking about ya!
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Difficult situations
I've been an ED nurse for 2.5 years..I've seen numerous things in that time. And many things are sad and really hard to deal with. However, the other day we got a young girl who had been raped, abducted and dropped off for the police to find her. She came in hysterical (like any sane person would), the female officer and I worked with her for hours. She finally was able to calm down to record her story only after running around the room and frantically crying, yelling that he was going to come find her. For whatever reason I can't get her or the situation out of my head. I feel so terrible for her and there was many other factors in the story but has anyone else just ever had a patient that has stuck with you and you aren't sure why? I mean I've seen some gruesome things but none of that really has affected me this way. Any tips?
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Curious about something...Anyone heard of droperidol given for migraines?
At my facility we give it not all the time but frequently for migraine headaches in combination with usually benedryl. It works really well!!!
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Whats your biggest pet peeve working in the ED?
My pet peeve is when I am clearly spread thin with two ICU patients and another patient who is there for a small lip lac and they are complaining about the wait. After explaining 2 times why they are waiting I basically told them that there are several sick patients in the ER right now and as soon as the doctor can come they will. (It was a high acuity night) Family of the patient proceeds to say well I understand there is sick people but we need to be seen too! Ugh. They had been waiting an hour.... I just don't think people understand sometimes.
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Ultrasound IV placement
We started this about 6 months ago, prior to that the physicians could only do it. We actually have a class this week to learn! Really excited to learn!
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Nights in the ER??
In my ER night shifters stay together. We are such an awesome team! We always have each others back. I love night shift and my teammates. :)
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Whats your biggest pet peeve working in the ED?
I had a pt the other night who insisted I stick him in the hand and no where else. My reply? I'll stick you wherever I can, and I'm going to stick you where I can make sure I don't have to repeatedly stick you. Luckily he had great hand veins and he got an 18. :) 24 year old with tats, piercings, and who informed me he passes out when he gets stuck. He ended up in trendelenburg. :)
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How can we make the process of report from ER to floor better?
I would agree it is a bed control problem...it is always so busy with admits from ER and upstairs is usually full so it creates a grid lock.. They say they are working on it but I feel like it hasn't gotten any better maybe even worse...
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How can we make the process of report from ER to floor better?
It is also very interesting that where I work at shift change all our patients get their bed assignments. I could say it is equally suspicious.
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nurses and EMT's
You are not a taxi driver, you are a medical professional with skills and experience to take care of patients prehospital. Shame on them.
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How can we make the process of report from ER to floor better?
We are a team, we understand the floor is busy too. However, we might be pushy because we know a code, trauma, or critical pt is coming in and we need that bed. We aren't trying to be unfair, ugly, demanding or rude we just want to be ready and be able to use the best resources on a critical pt.
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How can we make the process of report from ER to floor better?
Level of care is determined by hospitalist and ED attending. My report whether verbal or EMR review will not change pt level of care. We do EMR reviews and call once the floor has had 20 minutes to view the chart, we ask if they have questions and they go up. We only accompany a pt to the ICU as RN's. our techs take our med surg and step down pts up. This works well for us. I mean there is always going to be room for improvement, we are human. However, this is a level one trauma and it is so busy sometimes we are trying to get people upstairs or wherever they need to go because we have many more rolling in through the ambulance bay or from triage. I don't think you will understand until you see the chaos first hand.