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Emergency Department; Neonatal ICU
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HikingEDRN has 5 years experience as a BSN, RN and specializes in Emergency Department; Neonatal ICU.

HikingEDRN's Latest Activity

  1. HikingEDRN

    Thank you

    Thanks, guys. He passed away peacefully - his vitals were fine at midnight or so and they found him later. I'm so glad it happened that way.
  2. HikingEDRN

    Thank you

    I am an ER nurse and have taken care of more long term care residents than I can count. However, until yesterday, I had never stepped foot in a long term care facility. I went to visit a long-time family friend. He was living in assisted living but had a stroke and now cannot feed himself, cannot swallow well, and cannot use his right side. His liquids are thickened and all food is pureed. He has pain, will hardly eat and I have a feeling he will not be with us much longer. I am writing because of the care and compassion that his caregivers were showing him. I see all the time about the insane staffing levels at these facilities. I watched wall his nurse gently urged him to at least finish his thickened orange juice because he needs fluids. I watched the two-person assist to get him back to bed (and I couldn't resist offering to help even though I knew I would be turned down). Anyway.....thank you.....to all long term caregivers everywhere.
  3. HikingEDRN

    Bad Breath in traumatic brain injury

    Interesting. I have never heard of this and I have seen traumatically brain injured patients but only in the ED. I see you are in the neuro ICU so I assume this develops later?
  4. HikingEDRN

    Lidocaine (UroJect) for Male Foleys

    I've used it several times in the ED and, based on my personal experience, I think the patients with it seem to experience the same type of discomfort as the patients who don't get it (of course maybe the ones without out would have really freaked out). I inject it and let it sit for awhile as well use a significant amount to lubricate the catheter prior to inserting. As far as I know, we need a doctor's order - only one of our docs orders it (He's probably had a Foley before ).
  5. HikingEDRN

    Are you in a marathon today??

    Good job :) It's very satisfying to see a good outcome knowing that you played a major part. At times, one frustrating thing about the ED is that I've stabilized someone who was very sick but then I don't know what happened afterward. Usually I like my quick patient turnover but every once in awhile, a particularly intense situation makes me bummed that I am not in the position to learn how things evolved.
  6. HikingEDRN

    Making the Most of a Working Christmas

    Our census was low on Thanksgiving last year so when the mid-shift came in, most of the day-shifters were able to eat our huge potluck (including turkey with stuffing) together. We were able to return the favor for them several hours later. All in all, that year it was not a bad "major" holiday to work. As with most holidays in the ED however, I think things exploded later in the evening but I was day shift then so I was home! This year I work Christmas and I'm fine with that because I'm mid-shift so I celebrate with my kiddos in the morning and we celebrate with both sides of the family on Christmas Eve.
  7. HikingEDRN

    Yesterday was weird

    If you were not lucky, the pearls would go somewhere else than out of your pant leg. Then, you have to show up to the ER with the dreaded "foreign body" chief complaint
  8. HikingEDRN

    Justify this nursing diagnosis

    Happy to hear this. At the risk of offending alternative practitioners (and I truly don't mean to offend), that nursing dx is the most ridiculous thing I have ever heard. I was actually hoping the OP was kidding.
  9. HikingEDRN

    Getting cut short on orientation

    If it makes you feel any better, when I started in the ED, I was not a new grad but was transitioning from neonatal ICU so it was all very new to me. I showed up one morning and my charge said, "You've had enough orientation, here's your assignment." I did fine and so will you, especially if you have supportive co-workers as I did.
  10. HikingEDRN

    It's that time of year...Christmas stories

    Our NICU admitted a Jesus on Christmas Day several years ago.
  11. HikingEDRN

    I miss work

    I would at least wait until after the new year
  12. HikingEDRN

    Cardiac Arrest

    You can certainly have cardiac arrest with MI but, as others have nicely described, they are definitely not the same thing. Hopefully, you can get to the patient soon enough if they are infarcting and get them to the cardiac cath lab so those vessels supplying blood to the heart can be opened back up.
  13. HikingEDRN

    What to Do When the Doctor Throws the Nurse Under the Bus by Lying

    Love this. And another time, perhaps in another thread so as not to derail this one, I would love to know the "punched by the cardiac surgeon" story OP, so sorry this happened to you. Document it and file an incident report. Why did the hospitalist refuse? Was it a surgery order or something?
  14. HikingEDRN


    Thanks for your responses everyone. I completely agree that long term benzos are very over-prescribed. Sometimes I am appalled in the ED as a staff nurse how often I see it on the home med list as a long term medication especially in people in their 20s and 30s. I don't know if that stems from not having as many anti-anxiety alternatives even a few decades ago (some older patients don't even remember when they started taking them). Having said that, I do believe they have their place for the long-term in limited situations. And regardless of how we feel about it, these people wind up in our care inpatient and it has to be dealt with. I am currently in a surgical ICU for clinical and a big concern seems to be that the dose would have to be IV versus PO. I'm not a pharmacist but I would think the dose could be adjusted for that. And like I said earlier, even a little something is better than nothing, just to prevent withdrawal.
  15. HikingEDRN


    Hi everyone. As I've posted previously, I am an ACNP student currently rotating through the ICU. I was just wondering what others' (both RNs and NPs) experiences have been regarding benzos. It seems as though providers on rounds are not willing to schedule or even have prn benzos available for people who take them regularly. I've never seen it, but I thought benzo withdrawal was pretty nasty. I had a patient today who takes lorazepam three times a day every day. She received a prn dose overnight and scheduling it was discussed briefly but not done and I was surprised. It has happened a couple of different times on rounds with different patients. I'm well aware of the delirium guidelines and how benzos should be avoided. I just feel that if the patient is on a home medication and takes it scheduled, it might do more harm than good to withhold it. Even a lower dose would help, I think. What do you guys think?
  16. HikingEDRN

    Felt pretty proud of myself!

    I have had that happen too but only on one of my posts (the rests of my posts correctly identify my credentials). It says I'm an EMT-P and I am not. I looked at my settings and it was not checked either. And by the way, GREAT JOB

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