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mommatrauma

mommatrauma RN

ER
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mommatrauma is a RN and specializes in ER.

Duh...I'm a nurse

mommatrauma's Latest Activity

  1. mommatrauma

    Describe Different Levels Er

    I don't agree with all of this....I'm not saying that parts of magnet status aren't BS...but its not ALL BS...and it is a ton of work to get that status...my mother is an ER nurse manager in a hospital currently on their second level of the process, and it is a long complicated process...and I have seen the hours both she, her management peers and her nursing staff have put into this....the system is not perfect...but if it was really no big deal to be a magnet hospital...noone would ever get turned down...and people do...and everyone would have it...and not everyone does...I think maybe not all of the improvements may trickle directly down to you immediately...but I think more long term you'd see the effects of it and just know there a lot of behind the scenes improvements that you may never know were even an issue...
  2. mommatrauma

    Neuro-vascular status

    I spell it out the first time I do it...but thereafter I abbreviate it...and I write my notes in body system order so at least in my notes, it goes into my extremity notes, not in my abd assessment, so it would be hard to mistake it for Nausea and vomiting in that sense...and if you say NV intact to LLE, I'm pretty sure noone is going to think your leg isn't vomiting...
  3. mommatrauma

    I don't know what to think about this?

    If we have to split the shot for two sites, we get enough people to do both shots at the same time...one in each leg...that way the child only really feels the sticks once...and its done in 5 seconds and they are on their way...I think an IV may have been more traumatic than the two shots...and the lido would have burned for a second, but the site would be numb in a few minutes...My theory is you would have had to hold her down either way...I would have stuck with the IMs, but that's just me...
  4. mommatrauma

    Erie, PA Lifestar medevac helicopter missing

    Helicopter and dead pilot found approx 5 miles out from the airport..
  5. mommatrauma

    Erie, PA Lifestar medevac helicopter missing

    I am saying some prayers...last night was bad all over, with all the storms in the area, I can't imagine IFR was much better, but if he had just called in final, he probably had already started his approach and maybe lost his bearings coming through the clouds. Our pilots will sometimes leave us at the hospital and go and refuel while we are handing over care of the patient. Depends where we are, how busy we have been and how far out we are from our base. Sad thing...you just never know...
  6. mommatrauma

    Halloween, costumes or not???

    A few of our nurses are wearing all white scrub dresses and nursing caps for the night...I think it'll be cute, and they are keeping it very tastefull...none of that naughty nurse stuff
  7. mommatrauma

    babies in the ER

    I'm not sure about the literature, I'd have to check, but when my son was born all his gavage feedings were done via OG not NG, maybe has to do with them being obligate nose breathers....all the babies in the ICN when my son was there had OG gavage, never saw an NG...In my ER under 3 months we do OGs....and then we tegaderm it to their face...did you ask the ER doc why he had you pull it out?? Maybe he had a good reason, before everyone calls him insane...
  8. mommatrauma

    Unnecessary testing

    PJ, just so you know in my ER and I'm sure as other ERs...The ER docs are done with the patient from the minute the patient is signed out to the admitting team...I have a bed, I call report, and now..in most cases I am waiting for the ICU team to finish my orders...and low and behold they decide the patient needs another test before the patient leaves the ER...trust me...I'd much rather send my patient up to the ICU and let the patient finish their work-up up there so I can move and get my next patient....Its very easy to monday morning quarterback care patients receive in other departments when you don't work in them...As a flight nurse I get to receive report from many different types of units, OR, ER, PACU, ICU, Cath lab...and every unit has their good and bad...
  9. mommatrauma

    Top 3 things new grad should know about ED

    Being a preceptor I can tell you my thoughts.... 1. Ask questions...even if they sound dumb...ask..because you'll look more dumb if you didn't ask and mess something up...if you don't know something or why you are doing something...speak up...better to figure it out now while you have someone with you that can teach than waiting til you are by yourself and trying to figure it out... 2. You don't know everything..so don't be too cocky and act like you do...Noone expects a new grad to walk in and just "get it"...you'll have questions, you'll be unsure, you'll be apprehensive...its okay...just don't act like you learned all you need to know and that there is nothing more to learn...nursing is 5% school experience and 95% working experience...after 10 years...I still learn something new every single day....that's the best part of the job...you are always learning... 3. Have a little fear, it keeps you on your toes...because comfort brings complacency...I have worked in the ER for 6 years and I am knowledgable, but if you get too comfortable..you will eventually get lazy, take shortcuts, and give sub-optimal care...we've all been there at one time or another...the trick is to realize it and get yourself back on the ball... That all being said...remember the ABCs it all will come back to that time and time again...if they aren't breathing...it won't matter what their heart is doing....if they are breathing but their heart isn't beating well, it won't matter that there finger is broken....when you prioritize, always use the ABCs...if you don't have them, you have nothing...don't have tunnel vision...a trauma comes in and the patients leg is half off from the motorcycle accident he just had...and its nasty...but he's not bleeding from the site except a little oozing...everyone is so fixated on that because oh my God...its ugly...and heck, its hanging off...that they forget to realize that he has no breath sounds on the right and he has blood in his airway...look at the whole picture...then think to yourself..what will kill the patient...his leg hanging off?? Maybe if it was bleeding profusely, but its not....so the leg is not his immediate danger....could it potentially kill him later...sure...but if he dies in the meantime from his airway obstruction and dropped lung...the leg doesn't really play into it anymore and you did this man no service...catch my drift?? Also remember...drunks, druggies, diabetics and frequent fliers will burn you...this is where comfortable and complacency come into play...mary jones has been in 7 times in the last month for slurred speech...and the first 6 times it was because she was drunk...so on the 7th occasion mary comes in and she smells like ETOH and her speech is slurred and so everyone thinks Mary is just drunk again and so into a room she goes to "sleep it off" when you check on her in a few hours...she's dead...had someone checked her sugar and realized that it was only 35 when she came in, mary may still be alive....but she smelled like alcohol and speech was slurred and could have been explained away by that....but try telling that to Mary's family and their lawyer when it goes to court for negligence and malpractice.... Also...children...quiet children especially in the toddler age...be afraid...be very afraid....children will look good for a long time and when they start to look bad, they look really bad, really quickly...and then its all down hill from there.... Otherwise...good luck...keep your head up...and take a hot bath and a glass of wine when you get home at night....you'll need it!
  10. mommatrauma

    Unnecessary testing

    I've run into overtesting...but not for the reasons you suggest...I've run into it because of inexperienced docs, or patients that are poor historians that need everything worked up just because we really have no stinkin idea what is wrong with them...despite the fact that we think there is nothing at all wrong with them....There have been plenty of patients in my 10 year nursing career where I thought were being over tested...and some I've questioned and others I have not...but I can tell you that I've been surprised on more than one occasion where I think a test may have been a little over the top and something shows up on it...and if I ask the rationale for why it was ordered, it makes sense....part of it is probably a liability thing...and part of it may be over-ordering...but I've never run into a problem where tests are ordered simply for the reimbursement...because honestly...an insurance company can refuse to pay for certain things if they feel they were unecessary...so its possible that it will never get paid for....and personally I'd rather have a doctor that over orders then someone who constantly blows things off and under orders....and as for the ER and your feelings about it PJ....don't generalize...not all nurses or ERs are created equal...are there times where I don't know the answer to every question...absolutely....I try to find it out if I don't...but in the ER...I'm worried about the things that are going to kill you...ABCs...everything else is kinda secondary...so if I don't know how well someone ambulates because I haven't had the occasion to take them for a stroll and there is issue found with it...so be it...mumble away...and as for change of shift...we have no control over when our patients come into our ER...we don't round them up and say hurry up and lets get you in before the shift ends....a lot of factors effect when our patients can go up...if it happens to be right at change of shift...sorry...next time I'll ask grandmom to be more kind about picking the time when she decides to have her MI....
  11. mommatrauma

    RN to Paramedic

    They can't in PA either...
  12. mommatrauma

    Reglan IV

    That reaction is actually akathisia.
  13. mommatrauma

    Regarding paramedics in ER..why are they paid so terribly ?

    Just an FYI.."standing orders" are still doctors orders. And as a nurse in an Emergency Dept as well as a PHRN on the street or in the flight program I work in...I follow standing orders in combination with orders given on a case by case basis.
  14. mommatrauma

    Regarding paramedics in ER..why are they paid so terribly ?

    And I'm sure with a God complex like that you'll make a good name for yourself, good luck with the job...I'm glad the medics I work with actually work WITH the rest of the staff instead of trying to be better than it...It makes for better patient care. ...and since we're on the nursing topic, out of curiosity..your profile says you are a nursing student?? If being a medic pays so well where you are and its so much of a better job, why be a nurse?
  15. I have my ASN, and I am a flight nurse. I have almost completed credits for a Bachelor's in Biology, however it was put on hold a few years ago to raise my son. I am considering finishing and getting a BSN just because at this point with all my electives being done it will be an easy finish and I'll I'd still have to do is the nursing classes...In my flight service there are alot higher degreed nurses, many are NPs a few NAs and some with BSN or MSN or degrees in other majors. It is highly encouraged to continue our education and pursue higher degrees, however it is not required for the job.
  16. mommatrauma

    NPs in Flight/transport Nursing

    A few of our flight nurses went to school to be NPs, but they started as flight nurses first then did the NP. There NP skills are independent of what they do or what is required of them in the helicopter. If anything the knowledge they gained as flight nurses helped them in their NP study. They do not get paid more in the flight service because they are NPs. They moonlight as NPs when they aren't doing flight, most of them are acute care NPs.