TLS1

A lot going on in your post but the first thing I would look at is.. Calling out is hard on you and everyone you work with. It's hard on you because it's always tracked and will limit your options. I really don't think it's acceptable to have someone hold something over your head? It was an error that did not reach the patient. Always do an incident report on something like that and let it go. If you would have done that these people would have no power.. Guess I'm kinda confused who is threatening to make this s bigger issue? How exactly do they think that would go Nurse X made a mistake 8 weeks ago, she caught it and it didn't reach the pt. I think she should be watched because she's a risk? Ugh it's been 2 months. Identify your resources in the ER and ask advice. This could be an example of a nurse that should had zero leadership tasks... So sleepy!! Make a change find a

Gotta Say THANK YOU!! Third of Fourth day and I'm headed into work. Thanks for the feedback on my wording.. Will nix that..However I wish I had bookends !! I'm sure this will be discussed with me at work today. The ER I'm in right now is like every ER working short and feeling a increase in pt. traffic. Just found out some of our bounce is the bus just extended its hours so people are requesting transport to our hospital. However I appreciate the confirmation of my gut!! I wish RNs could unite and have a voice. I'm sure if administration worked short one shift on a full moon on a drinking holiday the KOOL AIDE they try to make us drink would be hard for them to swallow. Be Safe!!

Question: how do you feel about pressing charges against a patient that hits you? Plenty of experience with mentally ill PTs and those frequent flyers with ETOH abuse ... The drug seeking patients that get angry when they are cleared and don't get what they want. That seems part of the ER to me .. However here is the situation. Pt arrives via EMS screaming and yelling. She gets off the stretcher and tries to bolt.. Assist the pt in a room start a IV then she tries to swing at me and misses then I explain ..." Hey you made some choices and its not going well I'm your nurse and I'm going to try and make this go as smooth as possible ... However you can't hit me or the other nurses .. Labeling blood other nurse leaves to finish triage .. Pt comes to the end of the bed I turn and say "no you can't get up you will fall" boom slapped in the face .., PT has blood alcohol level above 400 driver in MVA .. Question: would you press charges? If not why? If yes why? I did press charges.. Close to a 14 hour shift. Hitting the hay !! Curious to see how other ER nurses view this! 7 BA52, 2 Marchman Acts today .. Tomorrow will better!!!!!!!

Agree Florida Hospital Tampa and HCA hospitals I would take a pass on. Tampa General only hires BSN RNs. Iasis hospitals advertise that they have a new grad program but they do not. Good luck!!

I know that Davita hires new grads and Florida Hospital Tampa has a floor dedicated to GN's. Good luck!!

I would start to brush up on that skill now. Ask each nurse you work with to show you on the next pt. they start. Watch and you may catch the step that you can do to go to 80percent. I work in an ER and when I start an IV I place the tourniquet on the pt. then open everything and then rub vigorously with alcohol. I tell my pt. the truth this will be tight but we want to do this once and only once so we are going to work together. It will help you feel the veins that you can't see quickly. Tell your charge you want to do all the IV starts that are needed on the floor. Delegate something to the RN you are starting the IV for and get the number you try up and your success rate will increase. Your friend was right there are people there to help when you need but your pts need you. Don't put yourself behind before you start. Good luck the ED needs nurses that want to be there :)

OK UPDATE Found out that they are micro focusing on this dept. to quit using agency and actually keep staff. So they floated ICU nurses to this ER and ran into problems then hired PRN staff and promised ,"bonus monies" however PRN RN come from other hospitals and aren't used to an ER where you have limited support so they don't stay. Then they declined to pay bonuses. To top it off they are trying to use the, "cheapest agency" which means they have nurses for one shift and they usually don't come back. So bottom line I'm taking shifts elsewhere and go when I'm called the same day. My agency out of there end pays a, aggravation bonus per shift. Even though it sounds crappy It caused me to become wicked efficient and develop relationships with MDs quickly. This helps me provide shorter patient stays in the ER for my patients and quicker admissions for those that do need to stay. So in the end it was a good run! I just need to flex until middle of December for vacation then back to school for another sprint. I have taken a PRN job at a new hospital and I'm not looking forward to the micromanaging that comes with it :) just a ER nurse making it work!!

Question. I have been doing PRN Agency ER at the same facility since Feb12 after a few months I started getting schedule q 6wks. Now they are staffing up and my schedule keeps getting changed. What is the normal (ha ha) amt. of times most agency nurses get cancelled? Thanks!

I just want to reiterate! You are the primary and it's up to you to use your team as resources. Everyone in the ED is there for the same reason the pt's. The previous nurse didn't get adequate access, the previous doctor didn't get an order for a central etc. No problem because your on it. Other people have said it but RT's are great teachers CALL them and say this is what I've done this is where I'm at and this is what I'm thinking/seeing. They can present to MD while you collect and coordinate the collection of diagnostics like EKG, Chest X-ray and evaluate can my pt tolerate morphine, Ativan to decrease oxygen demand? Before you know it the doctor will be there. You will then be able to bring the doctor up to speed on the pt's change of condition and determine POC. Identify the Glory go to RN/tech that can get iv's on pt's seizing blindfolded with one hand behind his/her back and say .. Teach me!! You know more than you think you do. The next pt that presents like this will be smoother, promise