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Who else uses Saline Flushes for contacts?
Sometimes I wear contacts and when they get dry I/we use saline flushes or saline "pink" bullets to re-wet them My coworker told me that's actually bad for the contact. Has anyone else heard of this? I can only speculate: the sodium and/or chloride is bad for the contact?
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Snowed in ER's, what do you guys do?
I work in California where I don't see any snow where I'm at. When there is heavy snow and you're on shift; do you guys camp out in the ER if the roads are closed? And do you keep working since the other shift can't come in? I've always been curious about that
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Documentation of EKG in ED for reimbursement purposes
My hospital that uses EPIC is now retraining RN's/Tech's to document in certain areas of the chart to collect revenue.... And yes, we have to check a box that the EKG was done so the bean counters can collect and charge for it...
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emergency prepared
Best to ask a Paramedic for an Emergency Bag in your car. They are one of the most prepared for first-responders for out-of-hospital cases. But basics: Gauze, seat-belt cutter, trauma sheers, car window breaker, towels, road flares, blanket..... etc. They main thing you did in this scenario above; was to make sure another human being was ok =)
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Establishing Identity of ED Patients
Simple: Ask for ID of any form; if none (highly suspicious) then you can contact the police if you have reasonable doubt (drug seeking behavior) if the patient is committing fraud. By law in California you must keep some type of ID on you at all times. Real Life examples: 1) pt comes in via ambulance "Kidney Stone" pain, I remember this patient months ago from a tattoo I recognized. My memory flashes to me "Drug seeking behavior, he will cut himself somewhere and place a drop of blood in the urine sample" I have him a chance to confess his true name; he didn't, I called the police. He then Eloped 2) pt comes in via ambulance, another nurse recognizes him as a pt before, but pt gives a different name. Asked him first to clarify, he denies allegations. Called police and they found his correct name and sited him for fraudulent behavior.
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ER Doc, "I need Succ!"
Ah yes, "Roc" he must be old school.
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ER Doc, "I need Succ!"
This recent TRUE story that happened 1 wk ago; thought it would be funny to my fellow RN's here. 3AM Code Blue called to M/S floor ERMD and ER Charge respond. ERMD about to intubate and says "I need Succ!" M/S RN leaves and brings back socks.... (ER Doc jaw drops...) True Story!
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IV Therapy
In general for ER's you have some "standard guidelines" Example: ER (A), Line and lab all urgent patients (ESI 3,2,1) ER (B), Line and lab, place orders: Chem 7, CBC, Lft's, Meds: I.e Zofran (docs will then co sign) ER ©, Line and lab if your nursing judgement thinks your patient needs it ER (D), If you have an old-school doctor that rarely orders much, then wait... Best thing to do as a new-grad who is unfamiliar with treatment in the ER; as your fellow coworker "Hey, should I line and lab him?"
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What is the "best" stethoscope for the ED?
Looks like Littmann Cardio III has won the vote! Don't buy the electronic one; 3 of the nurses that have bought it in my ER have glitched and had to be returned to fix it (free of charge to fix).
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Has this happened to you???
From what was stated: - Yes, you should have been reassigned - Did you write/file "objection of assignment" form? (not sure if you are Unionized - CNA)
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CDC: 1 in 5 in US visit ED each year
That topic has been brought up in my ER and the majority of those non-emergent cases are young adults. They new generation have poor coping mechanisms for minor complaints/illnesses - and/or - mostly are impatient to wait or scheduling an Urgent Care Appt. The main thing is the culture now is; "impatience" IMO; Facebook, Instagram, Google search - gives the younger generations instant gratitude by posting comments and receiving instant replies/satisfactions. So they want everything now...
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Taking the CEN to get hired at a trauma center
Majority of the responses above are "No," which I to concur. However, I'm part of the ER interview committee in my Dept., having the CEN would mostly benefit you if, another applicant has similar Nursing background as you (Tele/ICU, and years of experience). Our culture in my department and most ERs, if there are two applicants; ER experience vs. Tele/ICU experience; 95% of the time we will take the ER RN. The only 5% of RN's (Tele/ICU) that have worked their way in, is "who they know" (managers, charge nurses, nursing sup) or Job Realignment and they are pushed into the ER (because we are somewhat always hiring). GL
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I Got a Peds ER job as New Grad..HELP
^ I second that =)
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the homeless that wander in...
When I escort the homeless out the ambulance doors, I say "Welcome Home!"
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Nurse burnout-How do you handle it?
Alcohol