ND76

I work in an outpatient opioid treatment clinic. My office is moving into a new building and we are trying to configure a bathroom setup where I can directly observe patients without actually standing in the bathroom over them, since the new bathroom is super tiny. It’s directly beside the intake office where I would be. I suggested a pass through in the wall that I could stand at and observe, with doors that could be closed if necessary if someone else needed that restroom. Someone else suggested a 2-way mirror in addition to that. Anyone here in the same situation with any ideas that have been successful for your practice?

The fact that you got ******* to crack the whip & beat a dead horse, then dance, make you the coolest people i know! And how did ***** get off the HEMSI truck without breaking something?!? My first job was as a new grad in the Peds ER at HH & I occasionally floated in the main ER some before I moved to my current job. I have had the most fun showing my new co-workers how we do it back in Bama! I was all like, "Look!! We DO have a monorail!!" We have laughed til we have cried! Nice work, HH!

I work in an accredited chest pain center, and we use ASA, NTG, lopressor, Plavix, heparin, morphine, and a statin. Zofran if nauseated/vomiting. There are always cases where one or more of those might be contraindicated, and there are certain cardiologists who specifically request no Plavix, but those are the basic drugs we give. We used to give a lot of integrilin, a double bolus then a drip, but that was before the 90 minute door to balloon time was made a core measure...it's been a while. I personally haven't given it in about five or six years, but we still get some transfers in with it hanging.

I have had an Alabama nursing license since 2000, and I have faithfully renewed it every two years, even though I live and practice in TN and hold a license there. My AL license expires 12/31/2010, and when I went to renew it online today, they wanted $200!!!! I will let it lapse and reinstate it later before I pay $200 instead of the $75 that it is SUPPOSED to cost. Did I miss some arbitrary deadline for renewal? I figured if it expired 12/31, i had until then to renew it. Besides, I didn't get a single reminder notice that my license was expiring....no email, no mailed notice, nothing! Has Alabama stopped sending them?

We don't even have it in our onmicell. We use Dilaudid and Morphine in our ER. The only place I see Demerol in our facility is in the GI Lab, and we use it with Versed for conscious sedation.

A co-worker of mine teaches CPR as well as ACLS, PALS, etc. Here is the link to his website: http://www.eliteeducationalseminars.com

I had a man sign in a few months ago with the dreaded "private" written in the chief complaint section. I figured it was the usual penile discharge or rectal complaint that this CC usually elicits. However, much to my surprise, the man told me that his member was shrinking. He had been measuring it almost daily for the last three months and had 'lost' several millimeters, according to him. He pulled out a little notepad where he had recorded the length each day. It was all I could do to perform the rest of the triage, cause God knows I wanted to ask him so many things. Like what was the temperature in the room each day when he measured? I just skimmed over the rest of the history, deferred the actual exam, and turned him over to our midlevel NP for evaluation!!

Thanks! I figured as much... I mean, good lord, I work in an ER and GOD knows that things NEVER, EVER go according to a plan there! I understand that, but I'm worried about my nervous Nellie mother-in-law and my needle/blood phobic husband more than anything. I will probably rely on you OB nurses to run interference for me when my family gets on my nerves!!! :)

Very infrequently. What gets confusing at our facility is that the city fire dept/EMS uses the fire radio, another ambulance service uses a different radio, and another two use the phone to call report. Sometimes the ones that have to call in via phone get put on hold indefinitely by someone, and they eventually just give up and hang up...But that's not their fault. A bad part of where I work is that we have TWO nursing homes within 2 minutes of the ER, too...and lord knows we get respiratory distress calls, sat of 65%, with almost NO warning. Every so often, we'll get an ambulance in that the crew didn't call report on, and it's almost ALWAYS one of our frequent fliers with the same bogus complaint he/she has had the last 437 times they came in by ambulance. We tend not to get too hot under the collar about it, because they usually get downloaded to triage, anyway.

Hello, all! I've been an ER nurse for 10 years, and while I've never delivered a baby, I've 'caught' a few over the years. But other than a brief rotation during nursing school, I have never set foot in an OB unit, and tomorrow I am being induced, first baby. Any advice, helpful hints, how to get my family NOT to tick off the nice nurses? Things I should expect? I hate being a nurse AND a patient at times, because often medical staff thinks that just because I work there, I should know what's going on...and trust me, I'm as lost as a goose! Thanks in advance!

It depends on what I needed... I'm having my baby at Baptist Womens. I will take my child once it is born to Methodist Germantown. If I was having chest pain I'd go to St. Francis. If I were severely injured or burned, The Med. (Full disclosure...I've worked at Baptist East, Methodist Central, and SFH-Memphis)

Unfortunately, yes... As soon as the schedule comes out, people grab it and start scouring it to make sure that no one got any extra shifts, and that someone didn't get more weekend hours (i.e. more diff=more money) than the rest of the staff. There are a couple of nurses I work with who have a list of all the other staff and how many hours they are actually hired for. For example, we have three different levels of 'full time'. There is a 64 hr per payperiod FT, a 72 hr per pp FT, and an 80 hr per pp FT. We now work 12 hour shifts, so most of the 32 hour per week people actually get a full 36 hour week. Well...you should hear the stink that is being raised over that. There are some nurses who "take notes" in case they get in trouble for something, that way they can point a finger at others. There have also been more trivial writeups lately. I just try to come in, do everything strictly according to policy, bust my butt for 12 hours, and keep my patients happy and get out unscathed. I'm PRN, and only entitled to 20 hours per 4 week schedule. But I'm flexible, and work days, nights, evenings, and in two other departments. I'm getting enough hours right now, because I can cover holes and will work whatever I can. I usually end up working at least 36 hours per week. But it's cutthroat among regular staff members who can 'only work nights,' or can 'only work weekend days,' or who refuse to get pulled to another unit if they're needed. I'm afraid a lot of people are digging their own grave.

Yep. Things are NOT rosy in Memphis right now, at ANY facility. Hours are tight everywhere, money is even tighter, and there is a general state of unrest among not only my co-workers, but my friends who work for other hospitals. We're all worried. It used to be you tolerated living in Memphis because the money was good and you could get plenty of overtime. It was a great place to work if you were single and rented and didn't need a good school system or had to worry about property taxes, etc. But as our hours have dwindled and our pay has been frozen, it's not worth it anymore...to me, anyway.

I'm worried. I work for a hospital owned by a national healthcare company, and the hospital I work at is supposed to be one of their 'better' hospitals. But we're sinking FAST. Our benefits have been slashed, we've laid off over 40 people (mostly non-clinical positions) in the past two weeks, they aren't filling ANY open positions, and our staffing is cut to bare bones. There is a general feeling of unrest because heads are rolling right and left, and for trivial things. The staff is getting quite desperate for hours, and there's a feeling of 'every man for himself' because we feel like management has utterly deserted us and doesn't really care about the staff OR the patients anymore....just the bottom line. I almost wish we'd get sold or our parent company would file for bankruptcy and we could turn into a non-profit.

Thanks all that replied... I'm actually the third pregnant nurse at work right now, don't drink the water! Two other girls are due this month and still working. We are blessed that our co-workers help us out, and the charge nurses watch out for us as well. I'm only 2 months along, and I've not had any issues so far. I'm hungry a lot, and I'm tired a lot, but I think I was that way before I got pregnant. :) I'm going to just play it by ear...what I've done is cut back to two ER shifts a week, and one of them is a night shift in the chest pain section, which isn't as busy as the medical ER. I do that 12 hour night shift, take a couple days off and then do an 8 hour day in GI and a 12 hour day in medical ER and that's my week. So far, so good. I'm still transporting my own patients if they're on 'good' stretchers (read: that actually STEER) or in wheelchairs and not morbidly obese. Usually when patients find out I'm pregnant, they bend over backwards to be sweet to me. I was a little green the other morning, and one of my patients' family members went to get themselves something to eat, and brought me back some ginger ale as a surprise. So, here's to a healthy pregnancy...I HAVE to keep working and active or my butt will get as big as the side of the house!

I agree with the above poster...Memphis Jewish Home is top notch. I work in an ER, and while there are some nursing homes that I wouldn't send my dog to, I actually don't mind getting patients from MJH at all. The residents and staff all seem very content, and the patients appear to be extremely well cared for. St. Francis has a geri-psych floor, I know. But I think they are on a hiring freeze right now...the staff is all very uneasy concerning the 'state of the union' so to speak.

I recently found out I'm pregnant, and am wondering how long I will be able to stay at work (realistically...) We are a Level II, 50 bed ER, and since our staffing has been cut down to bare bones (5 patients apiece, but more at times) we literally run and gun for 12 hours straight. It's easy for people to say, 'slow down, take it easy,' but it's not in my nature. Right now I'm still in my first trimester, and I'm doing everything I normally do, just asking for a little more help with transporting and turning/pulling patients up, etc. I've been thinking I would go to triage when I got too big to actually move, but they've recently cut us down to one triage nurse, and it's not like triage is a 'sit down' job anyway. I tend to be up and down just as much when I'm there as when I have a patient load. I have the option to transfer to GI Lab, which is a Monday-Friday, 7a-3p shift, and would probably be physically easier, but I don't really want to... I'm an ER nurse to the core, and am bored out of my gourd when I'm checking in patients who are having OP colonoscopies. I know this is a huge forum...can someone share their experiences with me?

Yep. It's the circle of life. Then the EMS workers go home and kick their dog. HAHAHA! Just kidding. But it's true. I've seen it. As soon as we hear "MFD #5 to XYZ Hospital" on the radio, a collective groan goes up, no one wants to get the call, and eventually someone hits the button and snarls at the poor unsuspecting paramedic.

This is my pet peeve! One floor where I work is notorious for this. I don't give a flying crap if they're rude to me when I bring the patient up, I'm a big girl and will get over it. I just smile and bounce around and tell them how lucky they are that I chose to grace them with my presence and bring them a delightful patient for admission. But when they're acting like whiny brats and making their snippy comments in front of the patient is when I blow my top! I actually had a sweet little old lady ask me one time if her nurse was mad at HER!!! I rolled her into her room while three nurses and two techs sat scowling and huffing and sighing loudly at the desk, AFTER I had asked for lifting help not once, but twice. She looked up at me and said, "Oh, dear, I hope I'm not going to be any trouble for them." Or, this classic that I hear ALL the time: As soon as I get off the elevator with a patient, I hear, "Oh, Good Lord...ANOTHER one? We're closed. You've already been up here too many times. We're not taking anymore patients tonight." They may be joking, but the patient doesn't give a ****. They're sick and don't need to hear it.

it's morphine... and that's been a problem at every place i've worked, as long as i've worked. i haven't actually heard the term "roxies" though.

This is lifted directly from their application. It might look a little weird, it won't copy right. But don't let the 2.5 GPA fool you. It is a very tough program with the highest pass rate in the state of AL right now. The faculty separate the sheep from the goats (so to speak) very quickly. OVERVIEW OF APPLICATION PROCESS All applicants are encouraged to begin the application process well in advance of the deadline to assure a completed processed application by the deadline date. Minimum admission requirements (see application for full details) 1.Admission to the University of North Alabama by October 1. 2.Receipt of completed nursing application by October 1. 3.Possess a UNA GPA and/or a minimum cumulative GPA of 2.5 at time of appl. 4.Achieve a grade of "C" or better in all required prerequisites. 5.Successful completion of pre-nursing curriculum by end of current semester. 6.Signed consent and completed criminal background check by October 1. 7.Completion of Assessment Exam. (dates are given on the application) Admission to the BSN major is competitive and admission is limited. Meeting the minimum admission requirements does not guarantee acceptance to the nursing program. ADMISSION IS BASED ON A CALCULATED CUMULATIVE INDEX outlined below. After meeting the minimum admissions requirements, applicants are ranked using the following point system: (Maximum total points possible = 19) 1.UNA or Combined GPA 3.5 - 4.0=5 pts. 3.0 - 3.49=4 pts. 2.5 - 2.9=3 pts 2.ACT Composite Scores 23 - Above=4 pts. 20-22=3 pts. 17-19=2 pts. 0 -16=1 pt. 3.Entry Status Complete prereqs. In current semester=1 pt. Courses remain at end of semester=0 pts. 4.Assessment Exam90 - Above= 2 pts. 80 -89 = 1 pt. 79 or below= 0 pts. Points are given for Reading Comprehension and Vocabulary combined, Math, and A & P for a maximum total of 6 points. 5.Hours completed at UNA: (does not include currently enrolled hours) 55 or greater = 3 pts. 30 - 54 = 2 pts. 20 - 29 = 1 pt. 12 - 19 = 0.5 pt. 11 or below = 0

Minimum of 2.5. http://www2.una.edu/nursing/

I have been 'sortasick' since the day after Christmas! Not sick enough to call in, but too sick to function properly at work. My symptoms change every day, they've ran the gamut from nasal congestion, post-nasal drip, cough, sore throat, headache, low grade temp, losing my voice, nausea, etc. I never know which one is going to show up which day! I thought I had made a turn for the better two days ago, and hadn't taken any OTC meds since Saturday. WRONG! I woke up this morning with sore throat, bad sinus drainage, an annoying tickle in my throat, and a blinding headache again. Everyone I know at work is fighting either this or the stomach bug.

I started as a new grad in the Peds ER several years ago. There were two of us that they hired at the same time, we were the first "newbies" they had hired in a long, long time. I loved it. I am so glad they took a chance on us and took the time to train us. I didn't really know what I wanted to do as far as nursing went, but I very quickly figured out that God put me on this earth to be a kick ass ER nurse. I've since left and went on into adult ER and now cardiac emergency, but I was prepared for the fast pace and the fact anything could happen. I will say that had I went straight to adult ER, they would have probably eaten me for breakfast. I think I had an excellent preceptor and other skilled mentors who almost coddled me at first, and it was a small ER with a very NICE staff and it kind of 'eased' me into ER nursing. It shocked me when I moved and took a job in an inner city ER and realized that I didn't have to be sugar and sunshine all the time.

Heck, they have it good! I started at HH in 2000 and my starting pay at the time was $13.75!!! We got an across the board increase to $15 shortly thereafter, and when I left after a couple of years I had made it up to $19.00 base...It's terrible what hospitals in north Alabama pay their nurses, but it's a supply and demand thing. WAY too many nursing schools within a 100 mile radius churning out nurses...no shortage means no chance for demanding better pay.