mysticalwaters1

Hi! I was just wondering in nyc how much do per diems generally make? I'm considering perdiem in er somewhere. I work in pa in an er currently for the past 5 years. Thank you!

Wow I didn't realize that! I wonder if that happens a lot. That's not fair. you can argue as you stated the primary md works over the others but if you are seen by NP and PA the insurance should cover it. I can't stand insurance and drug coverage garbage. It used to be cheaper to get generic forms of drugs. I remember not even liking that and NOW my pharmacy coverage has a list of in and out meds and equivilents of unapproved meds. Not a generic form another drug. I mean works similar but it is a different drug. I can't stand that. I was on birth control pills for cramping. Put on estrostep and yes newer and more expensive but man did this stuff work but an equivilent was trivora. Now estrostep $50/mth, trivora $5/mth and supposedly very similar. Of course for price I moved to trivora now my cramping came back not as much, heavier bleeding, skin breaking out. What the heck not fair. And my only other medicine is restatsis for dry eye after trying multitude of abx, gtts, ointment, patanol, warm compresses, punctal plug and this was the last resort. There's no equivelent for this med. It's not approved. I only have to pay 50% which is better than 100% but it's $132/mth so I pay a little over $50. I didn't have laser eye surgery, it's a chronic condition not going away. Maybe it's due to some people it works and some it doesn't. It's suppose to increase tear production but maybe i thought I read not definite. But what a pain :angryfire

Thanks for all the helpful tips! I'm feeling more comfortable with the peds pts as I work with them more. It's refreshing than the constent 90 year olds I was used to working with! Even ivs are not as intimidating as it once was for me. It was baby night the last few times I worked! I'm finding getting just the right positions go a long way. And I think I was giving too much liquid meds at once to peds pts. I have no kids and not infant relatives so this is all new I appreciate all the input thanks!!!

My ER has weekly meetings with managment and chair of the ER physicians present right at 7am. So nights come to them right after their shift. Our ER is setup so when the relief is there if it's 0715 we can go to the meeting soon and it last for 1.5-2 hours so day shift will come in and out at the begining too. People mentioned about inservices and they try to schedule ones at this time too.

I hated flu shots too b/c every time I got one my shoulder felt warm and extremely sore as if a hammer hit it. Well maybe not that bad but very painful. I still would get them and still plan too, but this year I just got one several days ago and it was slightly sore in the muscle then completely gone. It was the first time I never had lots of soreness after. Is it due to it being updated for different strains, or technique in administering it???

Well if they are getting medical care in prison don't they go by hippa too? I'm not talking about family as the OP pointed out just your one comment here.

i love the hospitalist program. mostly due to the fact we had one available day and night to call for any pt concerns. however more and more primary mds i feel in some ways abuse them to not have to come to the hospital at all for pts. i don't know if this is good or bad. if they do this they'll need more hospitalists then would maybe be the solution. a good thing then maybe the primary mds can concentrate on their practice more and not have to be oncall. however is there lack of continuity in care with the primary doctor not available in the hospital. anyway, i just know the hospitalists in my hospital are awesome. they also come to codes and anyone who doesn't have a main doctor they are their. they are usually quite thourough as well i find. actually extremely throrough. also i've made comments to my family in friends honestly i would never consider getting involved with a doctor or surgeon with a practice due to being on call and constantly working. except for hospitalists and er doctors!!! just b/c they concentrate on their designated shifts and that's it!

Hey everyone! I've moved to my ER department and was wondering if anyone had pointers on how to interact and do nursing procedures on infants and peds pts. Here are several of my concerns and if anyone else has pointers please add on, mainly a lot of it is how to position children to do what you have to do: 1. How to give medicine to infants and toddlers? I usually have a needless syringe and try to stick it in and try to put it to the back of the mouth on one side by a cheek. I thought it would force children to swallow it but many times doing this the child still spits most of it out so what do you guys do? 2. How do you get throat swabs of kids that are not cooperating? If they are screaming I usually can do it but occasionally some I start to go in and they shut their mouth. One doctor held a finger by the jaw on either side of the face. 3. How do you position infants and peds pts for ivs and im. 4. How do you use arm boards for ivs. One peds nurse told me she got annoyed when an elbow guard was on a childs wrist b/c it's suppose to be the elbow to immobilize the arm. So I thought of that but then I had a 2 year old with the iv in a wrist. Even if I used the guard on the elbow she could still use the wrist. I put it on the wrist but should I have used a guard for each area to immobilize it? Or is that more for infants? Any other pointers especially concerns peds nurses have that ER nurses should do would be helpful and appreciated! I already know to use smaller volume IV solution bags and microdrip tubing I use I believe it's called a butreol container with IV tubing, and don't sacrifice an iv line to get blood.

I understand feeling the way you do but I really feel a lot of it is to vent and honestly it is quite funny. You really do have to joke about it. Now some posts can be too much and downright nasty. I think many of us understand we are health care professionals and not every pt knows all the stuff we do. I hear fellow nurses all the time make comments here and there it is funny but would never outright in front of a pt ridicule them. Some I think do get cynical probably they see the same thing over and over again. But I really feel it's just a coping mechanism and any other person does the same thing in there jobs for people not aware of their specialty.

Well I worked on a crazy respitory med surg unit for 3 years. Not as many years as you did but enought that I felt totally stagnated. Was not interesting. Limitted staff. Extremely needy pts and families with not enough help to address concerns. Sicker pts but still same conditions. Issues with coworkers that built up year after year. Finally a bunch of us all left to other areas. I moved to the ER and while I've been there 6months and does get crazy it's a different busy and I am much happier there. I do find it fullfilling. I learn new stuff and see interesting cases all the time. It's challenging and allways changing. I feel like I really help my pts. I feel more apprecitive there. My iv skills, and foley insertion improved DRAUMATICALLY. As well as seeing a multitude of different pts. It's wonderful. I tend to stay in my comfort zone so if my previous position was not driving me nuts I may have stayed and turned very nasty and depressed. Anyway back to someone working for many years and moving, another nurse on the same floor I worked on worked there for 20 long years and finally moved to short procedural unit. Does lots of colonoscopies, egds, and same day surgery stuff. She seems to really enjoy it. Also another RN left too after like 15 years there to just a float nurse. She would never have thought to float and she did and loves it. Mostly b/c she's not involved on politics on the floor and if she has a bad night she is usually some place different anyway! So anyway it seems in nursing you do have to move around. It's a hard job. Good luck to you hope you enjoye becomming a mid wife!

I'm in NE pa and one of the busiest ERs in the state. We have no such free clinics at least in my several towns surrounding the hospital. There's a community center for children and it's limitted. My grandmother in CT has a "Doc in a box" and sounds great! Has an MD and it's for non real emergent stuff but to get you in quick and out than using an ER or overbooked primary md office. My area sadly really if you don't have insurance YOU ARE SCREWED. And not all jobs offer insurance or have decent insurance. Something really needs to be done with this. I really feel it's a right to have medical coverage. I really think universal health care may have to be a reality b/c I see no other way. Despite issues and cost with it we are already in a black hole now. And for those who have the money they can get it. Even with my insurance if something happened to me I barely make enough to save a little. And yea I have a nice tv, dvd, car but I'm not totally blowing money. It's just healthcare CAN be so expensive it just takes one incidence even with insurance to get you in debt. I can't help the people against fixing this or providing some solution for everyone involved are against it but wait till something happens to you and you get screwed. It's just a mess.

Actually, I found it rather truthful and pointing out there needs to be more staffing, more space, and more resources for people without insurance. And I didn't find it slamming healthcare workers either. I was about to pounce about ER forced to be the backup for failure in healthcare such as lack of insurance, primary mds, and pt's not comming in with true emergencies but it actually mentioned all that! Ok I cringed when it said ambulance will get you in faster but they were refering to an authentic emergency and stating don't drive it it really is a problem. And DEFINITELY a pt can be forgotten despite all best intentions. I think it really is useful for pts to ask the ?s and it even points out don't be rude just firmly ask your questions. Infact I was really impressed how it mentioned if it is a simple cough go to the primary md first but does mention a problem with the ED is people with no insurance. It really is an eye opener and other nonhealthcare workers get to see it. AND THE MED LIST suggestion while common sense to me it was great they mentioned it. I think it was a good article.

I had a $3,000 sign on bonus and a $5,000 tuition reimbursement which was AWESOME for me. Staffing I think is allways an issue but overal my hospital I feel is alright although definitely issues. However, one of my coworkers called himself "nurse whore" b/c his plan was to go to places to get all the sign on bonuses. So one nearby area had a $15,000 sign on bonus for a 2 year commitment. Needless to say in less than 3 months he was back. It was AWFUL. No staffing and horrible work atmosphere, no secretary 10 pts with admissions no one to answer the phones limitted techs. So yes you have to becareful and while definitely bonuses are great for you you have to think is it well worth it if the working condition is awful I live near NYC so I often thought well mabye travel there for higher pay but the idea of that long commute just not for me at all even with more money. So there are definitely bonuses but it does seem the very large ones has an extremely high turnover rate. Oh yeah my tuition rembursement went straight to my college and the $3,000 bonus was split at $1,000 intervals throught my first year.

My one coworker couldn't stand working on our med surg floor after 7 years and switched to education as well and is enjoying it very much. I've used DR. Scholls arch support things in my shoes that help. I used to use Rockers shoes by Cherokee b/c it had nice arch support but when I switched to 12 hour shifts the sole was to thin. I switched to sketcher shoes mainly for the big cushiony sole and added arch support which helps. I try to sit when I can even if it's for 30sec while I make an addition to my charts.