MacERRN

Any of you paramedics know what High, Hot, & Hell of alot refers to? Yeah If you worked with me you'd get all the enemas. I'd even teach you how to administer a kayexalate retention enema, a contrast enema, and the proper mixture of a milk and molasses enema. Come to think of it, we do need more paramedics in the ER.

No, I'm afraid someone is going to give a med that they're not familiar with, or legally able to give, like propofol, and a bad outcome will occure. I have worked, and precepted with many EMT-P's, and the training they receive is narrow, and the responsibility lies with the RN, who as a supervisor, is putting his/her liscence on line.

In2b8U, Are you doing brain surgery too? A few meds not carried on rigs that you had to get use to...yeah right. You hang propofol?? Your way out of your scope. We are Nurses' here. You are NOT!!

Default Re: Paramedics are taking our Nursing job! How are the hospitals replacing RNs with Paramedics? Sorry, I did'nt understand your post. It's mostly in the ED's; Instead of hiring RN's they're hiring EMT-P's. Saves the hospital a boat load on $$$. But we all know , and the research is well documented on this:The more RN's taking care of pts, the better the outcomes.

I got to beat the dead horse, I'm feeling it today as I read the classified's. Before flaming me to the burn unit, I was the 89th paramedic in Iowa. I got in on the first class opened to general population at UIHC in 1980.My license was #89. I also precept. EMT-P students in out Level 1 trauma center, so I know the training, the standard protocols taught, etc. that a paramedic obtains. I see the way hospitals are dealing with this economy, replacing RN's with Paramedics. Let see, 5 yrs of college vs a 6 month class, basically a semester if going full time(the EMSLRC at the U of Iowa has a class that will take you from EMT basic to EMT-P, only one in country I believe). Who would you want at triage? Or administering meds that they have no idea the side effects? It's a crazy world. Keep the medic's on the street and leave the nursing to nurses!

22 yrs as a ER nurse and have never had my last name on my badge. We take care of the prison population in our state, and of course, a active psych population. I have NEVER felt unprofessional by not having my last name. If you think that a full name badge makes you a better nurse....you have issues. Joe ER RN

Greeting fellow RN's: Anyone have any info on the hospital located at Red Lake, Minn. I saw a RN job listing there and am trying to gather data. If you do have some insight, please post. Thanks, JoeMac ER RN

I practice the same way. Everything is given either in a mini bag and dripped in, or at the farthest port from the pt, slowly. I'll give morphine or dilaudid at the closest port, but not tordol.

This is my favorite post on this entire site. You can really visualize..... But this is a stupid thread as common sense always rules. And there are lazy people on every unit that that will do anything, use any excuse to get out of doing their job.

I just had a pt leave with IV inplace this weekend. No way was I going to tackle him and take his IV out. He was upset we were discharging. I'm just getting sick of taking care of these ETOH/Psych pts who come in demanding something to eat, drink, and a refill on their pain meds that they "lost or had stolen," Then when you refuse, or call them on their b.s. behavior...the press-ganney police come looking for you THis is going off topic but I don't post much.But NO ONE should have to put up with with the typical ER nurse has to deal with regularly. I guess I'm just burnt. 22 yrs is too long to deal with this. These are problems that are happening across the nation. Everyone looking for handouts.

I've been an RN for 22 years. My daughter is starting nursing school this fall and here are some of the things I'm telling her: Look for a hospital that offers school loan repayment: Some hospitals will repay those loans and pay your regular salary for a certain # of years of work. Try to get a job as a tech in a hospital or nursing homes during the summer, and shifts during the week that work on your schedule. You want a hospital that offers classes for new grads besidesjust the working on the floor during your "orientation" like Critical care classes, EKG interpretation class, ACLS. Some hospitals have a 6month orientation that would include all your certification classes, computer charting specific to that hospital etc. Basically, the longest orientation you can get. Med-surg may suck, but it will lay ground work that would be priceless as you go to critical care areas. It is that reason our hospital never hired new grads into the ED. In the ED you are expected to know how to do things....ng's, foleys, artline set up, chest tube set ups, central lines, retention enemas, blah, blah. So good luck, gather the info now so your not pressured as graduation gets closer. You'll be worrying about board exams and all that.

Fast exams have become a standard assesment tool during a work-up in our ER. And the MOI of speed, and becoming thrown from vehicle would make him a trauma ALERT! We do not give oral contrast for abd/pelvic trauma CT's . Non-trauma yes, and sometimes rectal contrast....a ER favorite!! Any decent CT scanner can give enough of a clear image that they can see abnormal vs normal.

Yes, I know. But the NP's and PA's I've worked with in level 2's and 3's over the years, have never been primary on a trauma pt.

Sounds like a typical weekend noc shift in our ER. But we have 6 working RN's and 1 Charge nurse who should be taking pt's but doesn't, (that could be another thread). 35 beds. Usually full when we start at 19:00 till about 0300 then trickles down. Unsafe staffing is a regular topic. Usually the thing that suffers the most is our charting, we aren't charting near enough, but we have to move the meat!!

What is that hospitals trauma designation?? Level 1,2,3?? Does sound like he was triaged to a fast track area is he was seen by a NP from the start. Although his MOI would have made him a trauma ALERT at our hosptial and he would have been evaluated by the trauma team which consist of 3 surgery residents, & a staff ER physician. He would have gotten 2 large bore IV's, a foley and a NG. Chest and pelvis plain films in the ER room, and then to CT for head and c-spine. Followed by more plain films of T and L spine. If everything checked out OK, he probably would have gone to tub room in our burn center for debriebment. And probably an oberservation admisson, again due to the MOI, AND 3RD DEGEE BURNS.

2 yrs med-surg could mean the difference between flourishing vs failing in the ER. I just haven't seen and good extended orientation in the ER that would prepare a new grad well enough to get comfortable for a long time. Where as ICU's and step-down units, med-surg, usually have a well establidhed orientation schedule that is more suited towards bring new grads into the work force.

I work a weekend package Fri. Sat 19-07 and will be fishing during the week. Sunday am after work I'm heading North to Alexandria Minn. for a week of walleye fishing. Nothing better than a walleye shore lunch!!!

Hey man, I turkey hunted on a plantation (Tara)just outside of Vicksberg, Mis. I won the trip from a show on ESPN. Wayne Pearson's Outdoor adventure. Anyway it was a blast. Saw abunch of critters running around that I thought was a pack of dogs...turned out to be deer. Our deer grow much bigger her in Iowa. Thabnks for the reply...good hunting/fishing

This summer we are adding 5 new grads to our staffing.It is a managment decision, not supported by our working nurses. Will they be put in a sink or swimm situation?? Probably. But that is the nature of the beast. 5 yrs ago there was a policy that new grads would not have been hired in our ER. In the mean time our census went up 15% a yr, and our aquity continues to be high. We also are getting more and more people using the ER as primary access for their health, which has been adding to the national problem of ER overcrowding for the last 15 yrs. So we can work short, or hire the new grads. We have no choice as our current staffing issues are leading to burn out and increase in daily shift sign offs. To the new grad going into an ER I say it will be a struggle, and I wouldn't recommend it to anyone. ER's need nurses who can hit the ground running. It's not a good learning enviroment as the physician's expect the nurses to know the standard treatment regimine's for whatever hit's the door. From adult medical issue's to peds trauma. Could go on and on about why new grads shouldn't start in a ER, but the bottom line is it's the new reality, and a product of our f... up system of health care in the USA.

Greetings all: Interesting reading all these threads indicating our problems are not isolated to certain regions, but rather a national problem with poor staffing, over crowed ER's with non-emergant pts, being lead by incompentent managers, and low saleries. Just wondering if we have other things in common, like fresh water fishing, or enjoying the outdoors, ie.,camping, hunting? Several of us are trying to get together this spring and fish after work. It's better than hitting the taverns, or strip clubs, as far as debriefing after a nasty shift. Post what you like to do as far as outdoor leisure. Maybe we can do some swap fishing trips, hunting trips, etc. JoeMac ER RN University of Iowa Hospitals

Best advice is don't complain and just do your job. The doc's will like you cuz all of us old nurses are jadded and love to complain about everything.

GIve them a "B52" (5mg Haldol 2mg Ativan) Code Pink (Babe in the depatment) HBT (High Bit%H Titer)

"Not a guy, but I do love to trout fish" So Tina, you single?...you have a boat? If so, send a pic...of the boat! Joe ER RN

"I just can't believe how someone can be so perverted, selfish..." It is easy to understand. This world is full of devils. Their juice is meth, and crack. They prey on the young, the weak, the VULNERABLE. That is why you should trust NO ONE, and train your kids to TRUST NO ONE!

"What are your opinions of the nursing school, the trauma center, and nursing in general in that town"? The University of Iowa is the best paying job in the State. However, that isn't saying much if your coming from another state as we are the lowest medicare reimburshment state in the country,and our pay reflect the reimburshment... lowest pay in the country. The U. has the only Level 1 trauma center west of Des Moines. Very busy teaching hospital & Iowa City is a very cool town, so things kind of even out in the end.