Peg804

I am a first born, Dad was not alcoholic, Mom also a nurse and a first born-no alcoholic, cousin Anne-first born, aunt Edith-second child-no alcohol, aunt Helen-5th born, no alcohol, etc. I come from a family of nurses, maybe we need more alcohol??????

Yes, you are employed by the hospital that sent you, but are you legally covered if something bad happens. I do not think you are covered by the state, you can only do what is in your nurse practice act. And that does not cover you for what could happen on a transport gone bad. You cannot perform the prehosptital skills of an paramedic or a phrn/hp. Can you legally intubate?? Perform a cric???? If you are not a prehospital provider, no you cannot. What is your hospital going to say when you have a patient go bad. Who are they going to protect???? Certainly not the lowly nurse who did not know any better, and only went for a ride. Better to have those trained and certified caring for the patient rather that risking your patients life and your license.

Just my 2 cents, but I must comment, RN to paramedic. There is a vast difference between and RN and an paramedic, or if you are in such a state, a phrn/hp (prehospital rn-who has challenged the nat reg testing and has the approp skills, or paramedic. If you are thinking of challenging any prehospital course, you better get some field experience. The world of an RN, and the world of a PHRN/HP are completely different. When you get that patient in the ED, they are packaged for you, meaning they are immobilized, splinted, bleeding is controlled, intubated, defib, etc. In the field you are the one who is doing the packaging. you are the one making the decisions. There is a vast difference intubating in a lab vs the back seat of vehicle which is crushed under an tractor trailer, let alone the IV start. You have you to rely on. Make sure that you have the experience to work in the prehospital world. I do both, and I have the greatest respect for fiedl medics and the few PHRN/HP;s that are out there. Most of us, atleast in PA, actually started as EMT's. Good luck to those who join us, but make sure you are ready. cause you cannot yell, start over. at 2am on the interstate. Just my 2 cents Peg

You should definately take an EMT-Basic course-this is the basis of emergency care. You have to look at what you can legally do in your state. and what you are covered to do. Just because you take and pass a course does not mean you can do everything that was taught in the course. If you are am EMT-B, recognized by your state, and the prison recognizes you in that position, then you can perform the skills. Immobilization, stabilization, basic stuff. If you take a phrn course, or paramedic course, then you learn a lot of things that you can only do under the direction of a command physician. I don't think the prison has a medical command physician on staff. Why does it take 30 minutes for EMS???? Please remember, don;t do anything that you are not legally covered to do.

I just wondered if you had approached admin to see if they would cover you if something awful happened. unfortunately I had something awful happen on a rountine retrieval for one of the units I work for. We transported a patient out of the Pittsburgh area, massive CVA-coming closer to home for rehab. actually was going to New Jersey Nursing. Rehab facility, No DNR, coded, awful trying to find a receiving facility, patient ended up intubated, etc when we arrived at a NY ed. Physician was not sure what to say Any way patient is still alive. A routine retrieval gone bad-just my luck. Let me know what happened at your facility. My inlaws lived in port deposit maryland for a while, sstill have friends there. Where are you located. perhaps I can help your situation

Right you are, follow your gut instinct. If they say they are going to die, they will. If they say they have to put their feet on the floor, watch out, death is just around the courner.

I am an HP (PHRN) in PA.I challenged the course. I was also an emt since I was 16 yrs old. I would recommend that you take an EMT basic course, if you are trully going to work the streets. you need to know how to immobilize a patient, how the extricate them, you need haz mat, perhaps vehilce rescue, etc. It is not as easy as it sounds. I see nurses who say they want to challenge, and I cringe. They have no idea what they are infor. think about it 3 am on the interstate in a snow storm, victim entrapped, you are the lone als provider for who ever is in that van trapped under the semi. Make sure before you challenge that you know what you are infor, cause, guess what, you are on you own out there, GEt as much prehospital training as you can, there are mandatory course you must pass, federally mandated- haz mat r I, I recommend operations level, basic vehicle rescue, advanced if you can find the course. PHTLS or BTLS, ACLS If I can help you in any way let me know, Just. please, make sure you are prepared.

Oh, love it, one complaint, How about when your run out of room on the triage because they have so many complaints. LOL, I have to bite my lip to keep from laughing in their face. Isn;t it sad what people think are emergencies. I just want to screen at them GET OUT. They are the one who lodge the complaints that they waited for hours for treatment, and guess what there was no FREE coffee in the urn OOPS I was caring for the patients who really needed to be there. We had one family(the entire family usually is seen when the come in once a week) who called the patient advocate because there was no hot chocolate inthe waiting room, and nothing to eat, cause they were hungry. I get hungry too=guess what eat at home or pack a lunch we are not the soup kitchen

I get paid 2.00 to be oncall for the ED or for ICCT. If I get called into the ED I do not start getting me salary until I get there, different for ICCT-I get paid for each call I triage-maybe only 10 minutes on the phone, but if I have to do the transfer I get pain from when I get the call-no I do not charge them for showering, etc. but that is how we work, I may talk to 10 different facilities during my oncall, ever leave my house and get pain 2 hrs, I also may get a call, take 15 minutes to drive to meet the ambulance or the plane, and get paid for it, also for my paper work time after the transfer-usually 15 minutes. The other service I work for 2.00 an hour for oncall, then clock starts ticking once I accept call.

Don't listen to those who discourage you for taking an ED job, it is the most wonderful place to work. The people you work with will become your extended family, much stronger than those who work on the floor. You will learn from each other. I am thankful that I work in the ED I do, I can rely, and you will too, on those you work with. the formality with MD;s is not there, yes they are the doc. but. atleast where I am, there is an "we're all in this together" feeling, The docs actually ask for ideas, especially with arrests, medical or traumatic. You trully gain an entire family. It is hard work, dinner is an afterthought eaten while standing in the kitchen, etc. It is never the same, unlike the floors, you have to know alot about everything from the neonate (rate) to the geriatric, medical to trauma, etc, But it is the greatest place with the greatest people I can imagine. Good luck to you, ignore those that do not support you, get all the education you can. If I can do anything for you or answer any questions (I am said by some to be old-can you believe that-I do not) let me know-if nothing else I am here for support,

What is it about EMERGENCY that you to not understand. If you have had the same pain for a year, why is it an emergency now???? We are not a dentist, we will not pull your tooth, perhaps you should have brushed the two teeth you had left. As one of our pa's said we should have lines for what these patients want, Line one pain meds, Line two note for day off fom work, Line three admit to hosp. etc, when max in line is exceeded too bad, come back tomorrow-like the free cheese line. Oh, but if you have the special card, that all of us who are working are paying for, pick line four-for any stupid complaint you can think of, and yes, the doctor will see you, too bad you stubbed your toe, or got hit with that sippy cup the kid threw (yes it did happen). it is ok that you have been here everyother day for the past 2 yrs. Anyway, once again I am venting, bad night, too little patience left. I cannot even imagine why someone would wait 6 hrs to be seen for anything, well I guess you h ave to make sure the welfare card still works!!!!

Welcome to the wonderful world of ED nursing. The best piece of advice I can give you is that you can only do what you can do. You have one brain and two hands. You can do one thing at a time. Don;t try to do everything. Take a look at the big picture. Remember most people that present to the ED do not really need to be there. But those that do deserve the very best that you can give them, and the others can wait. ED is by priority, that is just the way it is. Use your coworkers, maybe they cannot do the tasks for you, but remember that they are there, and you are not alone. Most importantly remember people die, no matter what we do, or how well we do it, they die. Young or old, it is their time, and there is nothing that we can do about it. Do your best, that is all that anyone can ask of you, and all you can ask of yourself. Good luck

If there is a code called in out clinic or medical arts building, or cancer treatment center (all connected to the hosp by walkways) the ED responds with prepared code bag-monitor/defib. litter, RN, tech and Doc respond from ED, resp tech, perhaps Hospitalist (hospital md). Basically scoop pt back to ED, BCLS, monitor, maybe intubate-but BVM works, first round of meds. Goal is to get pt to ED, too hard to work code in elevator. Although I have done it prehospital.

I worked nights in the ED for years before i changed jobs- slept when I could-but never got enough sleep. the worked days for a while and then eves. Hosp consolidated and found myself in home health . liked it but had to get back into hosp and ed. Well I did, night shift of course. I had to go straight home-no stops, no chatting, take a quick shower and go to bed with the tv on some nonsense noise channel. We live in the country so not much noise. If I started laundry, or anything, I was doomed to no sleep, as it was I was side awake by 2 and that was that. Tried to sleep like some to in evening, I felt like I was hung over. Now I work 3p-1a or 1p-11p, still cannot fall asleep until 3 or 4, like tonight, When I did nights there were some days that I could not get enough sleep no matter what I did. Good luck. you will get used to it, I did, my Mother worked as nursing supervisor for over 40 years on night shift.

I think you have every right to be testy and then some. I have no doubt thatthe triple alarm you are talking about can be heart everywhere, and they chose to ignore it. A memo is a good idea, but shouldn;t common sense come into play here. A patient's monitor alarm has sounded, I guess you are the only one who is tuned into that frequency, Come on, maybe they are good people, but if we do not all work together, we are done for. what it the patient have been in vent tach, or vent fib, and it was ignored or "not heard". I would not want to be that nurse when the lawsuit came down. I don;t think the excuse that i wasn;t working that side of the unit will hold much water.