elisa938

I work in the ED in a town surrounded by Assissted livings, ECF's, SNF's etc so we get LOTS of the confused pts. We also get an inexplicably high number of psych... (I am not a fan psych) anyway, so one night we had probably 6 psych pts (about 25ish% of our census. 3 of which were mine. I then get (per squad) a nonverbal combative 76 year old with demetia that is normally A&O x3. She was not as nonverbal as they orginally thought, it took about 2 hours but then she looks at me and conversation as follows (abridged version) pt whispers"you're not real" me "of course I am" pt "no! No you aren't! You can't be! You're dead" me "no i'm alive, this is the hospital" pt "i'm dead too, and i'm going to hell" me "no, its ok, we are both alive you aren't going to hell, we are going to help you feel better" pt "no!! No! I'm dead! You're dead! We are already in hell!!" um... 3 psychs pts in a crazy ED... That is not having the best of days... How does one argue with that... I could barely contain myself in the room I had to ask some one else to come talk to her so I could compose myself! Every time i have a bad night i think of her and i start laughing... Bad day gets better, who knew being in hell could make it better! Lol

When i started on prereq's i worked 40 hours a week and took 12 credit semesters (almost exclusively online) because i had all the sciences, plus ethics to get through. My micro was the only one not online and it was a 6a-9a class 4 days a week for 5 weeks... It was tough and definately have to study, but it will be good practice! It did certainly help me w time management skills... Then went into a 12 month accelerated nursing program where I changed classes q. 7 weeks... It was tough, but doable, biggest thing is time management! :-)

I agree with the other draws on the economy for the record...

the whole basic point is people that are not here via legal status are again asking us to change our laws to suit their needs. There is something fundamentally wrong with that no matter your feelings on immigration.

Reply to 17, if i broke in to your house and sat on the couch and said you are now responsible for my education and my food and my housing what would you do? Would it make any difference if i said ok i'll pay for my education, but i'm going to live in your house and you dont have a choice? Again it has nothing to do with whether they are working or just accepting benefits or are seeking an education and maybe even paying for it. It is that fact that they have so little respect for our country that they say i'm here now so deal with it. I'm truly sorry it is so bad for them where they are from, but the more we have to deal with people that are here against the law it takes away room and makes it harder for people who are trying to do the right thing. people who want a better life should have every opportunity to ATTEMPT to obtain it. They shouldnt break the laws to do so and there is never any guarantee in life.

Responding to #23. If they cant get here legally by immigration status and are in undue danger in their country they can seek asylum here, but there is still a Legal process to do it. And yes by flooding our cities they are truly robbing the hardworking americans of their money in every dollar that goes to them unearned. They are in fact taking jobs from americans, they may be the lowliest of the low but our citizens should be given priority. I truly feel for them, however, i do believe in our constitution and our most basic laws, and i'm sorry its my parents fault i didnt fill out the paper work when i was 18 is not an excuse. There are a mulitiude of ways to enter this country, and i am happy to aid any one that comes through the front door. And as far as making decisions that have hurt people, yes we all have but most of us have either seek ammends or stop doing what is causing the hurt. They continue to promote and propogate it, (and yes our government has a large hand to play in this) and as long as we sit back and say "there is no other way" so we just have to accept it we are hurting our country for generations to come, paying for people that again are taking money from us putting us even more deeply in debt that our great grand children will still be trying to pay off... I do feel for them, but I believe in taking care of my family first, are 350million of them, as well as any of our invited visitors!

Then they should apply for legal status. If they continue to be here after they are of an age to seek legal status then they are knowingly violating the law and are knowingly continuing to do so. So again, i support your education and accomplishments fantastic, but how are you any better than your parents? You know you are not legally here, so if you want to stay... Do the paper work!

While I support immigration, i do not support people breaking our laws to be here. I'm sorry but if they can't be trusted to enter via the front door but instead sneak in through the back and demand our resources (sounds like thievery to me) how am i supposed to trust that they are going to follow safe practice laws. They got an education, they passed boards, fantastic, now try working honestly instead of taking jobs from people that did it the legal way. Support our legal American citizens and support legal immigration!

In response to NOADLS....Haha came up as the first option for me!

I work in an ED with no aids so we get this fun problem all the time, the biggest thing i try to do (and quick disclaimer i am HORRIBLE at placing bed pans appropriately...) is get a chucks under them, get them on the bed pan, then actually place a diaper between thier legs in front of the bed pan and sit them up as much as possible. Side note, i often make jokes with the patient about my bad aim or just want to make sure we dont get splash back so we dont get your pants wet etc. it usually puts the pt at ease, takes the reduces the feelings of indignity and helps them feel more comfortable on the pan. The sitting up can also help them feel like they are in a more natural positon. I do the same w my supine pts, minus the sitting up part. It really is amazing how far it can go to make jokes or take the pressure off the patient. As to the original intention of the post, it is miserable to pee as a girl... Just do your best and remember talking w the pt can go a long way. I've even set my pivot pts up on a bed pan on a chair w a chucks under it for those that can stand but cant or shouldnt do more than stans and pivot... Instant bedside commodes...

So when I was in nursing school every semester i thought i found my niche... I loved cardiac step down... Until i found med/surg and oncology, then i found l&d and the babies (who isnt a sucker for the squishy cheeks and big eyes...) and knew that i was ultimately gonna be a neonatal NP... And then I graduated and got an opportunity to shadow in the ED... I spent 4 hours there and spent the next 4 months shadowing 2-3 days a week until they finally decided to start paying me since I was always there anyway! I have been there 18 months and I honestly can not imagine being anywhere else. I get all the different specialties, (i also have the attention span of a chinchilla) so as soon as i start to get bored with one pt i'm rolling them out and the next on comes rolling in... And oh how the words Trauma or FA gets my blood going and my adrenaline up. I love going into work everyday, and get excited constantly because amidst the montony of the "oh my tummy hurts for the last 20 minutes so clearly I must be dying"s is a treasure trove of educational opportunities... I mean where else can i get a metabolic acidosis, acute respiratory acidosis, acute uti, benzo od, acute renal failure, hyperkalemia, acute stemi, leukocytosis, rhabdo, septic shock and shock liver (all in one pt!!! I think i used just about every nursing skill on them...) followed by a trauma, fa, stroke and just because everyone needs a breather-- a good ole psych pt... So point is... I am was very blessed to find a unit that feeds my chichilla sized attention span, my need to constantly move and my insatiable desire to learn, right out of the gate. The thought of going to that previously coveted med/surg job now makes my blood run cold! I am now working on my CEN and looking into various programs that would facilitate becoming an ER NP. And I cant wait!