melmacrn

How does the process of nurses from other floors coming down to get pts from ED work? Is there a timeframe that receiving nurse must come get the patient from ED? Any information you can give on this is appreciated. I am so grateful for all your replies. One thing we are looking at is the benefits of the ER nurse not leaving the ED. Do any of you have information on this?

My hospital's current ER to floor admissions process involves the emergency department nurse taking the patient to their assigned room in PCU, ICU, medical-surgical or where ever the patient is admitted. This takes an emergency department off the floor in an already short staffed and busy ED. We have researched other facilities and are finding that other hospitals have individuals who come to the ED and take patients to their assigned room once a room has been assigned. Does your hospital have staff members who take admitted patients from the emergency department to their assigned rooms/departments? Is there a specific name for this process? Also if you have any research articles you would like to share regarding this (especially ones concerning patient safety). We are trying to collect research and sharing your experiences would be greatly appreciated.

I'm so glad I posted this! I felt like everyone I talked to made moving to Portland sound like an awful idea (people from Portland). I think some want to keep Portland to themselves. Selfish. Lol. :-)

Hello everyone, My family is planning to relocate to Portland at the end of the year. I'm getting discouraged looking at the job market! I started in the ER as a new grad and have been there going on 3 years. I'm ACLS, TNCC and PALS certified. I also have a BSN (and BA in journalism and communication studies). How do I establish a network when I'm over 1,000 miles away? I would really like to stay in ER (or go to ICU). With my credentials, is the job market for RNs as tough as it seems? I've never done travel nursing, but if I started with a travel company--could I stay in Portland or would you be required to travel further? Any input is appreciated.

I've been an ER nurse for a little over two years (as a new grad). Before the ER, I fainted during an abdominal packing, an epidural, a wound scrub, an even before a cesarean section even started! I still faint if I'm poked with needles. Lol. It makes me empathetic towards my patients. To this day, I haven't fainted while being an ER nurse. Almost everyone has fainted--or near fainted. Some of our best tenured nurses have faint stories! In the ER. I've relieved tenured nurses because they are getting pale and woozy! I was terrified of starting my job and fainting. The more I focused on the fear, the worse it was. You're so busy and overwhelmed the first year of the ER that you don't have time to worry about your fear. It will pass. Don't give up and you'll be laughing at your old fainting stories later along with other nurses. I promise! [emoji4].

Our department is always looking for ways to improve, as I'm sure many departments are. For those working in busy emergency departments with 15 beds or less, what has your department successfully done to be more efficient? Pod system, strategic schedule, specific nurse assignments, fast tracks? Anything your department has done that has benefited the patients and the staff, I would love to hear about. Your input is greatly appreciated!

I've never worked third shift, so this might seem like a really really dumb question. :-) I've been working first shift for the past month, but switch to the 7pm to 7am shift in a couple days. I'm scheduled November 4th (Monday) from 7p-7a. I assume I go in Monday night at 7p. Is this correct? Somebody (not a hospital worker) has me worrying that they might mean I go in on Sunday at 7pm since I'll be working over half the shift on Monday (after midnight). That doesn't sound right to me, but thought I would get your opinion. Thanks :-)

I've been taking plenty of the advice offered. :-) I found nurses I feel comfortable with, so that has helped tremendously. One of the nurses had me start an IV without assistance and then said "I'll be right back" while I was in the process of inserting the catheter. I waited for her to come back once I got a flash, but she never showed up! I did the entire IV, drew blood and sent the blood to the lab with NO assistance. I walked out of the room and there was my nurse laughing with a bunch of other nurses. THEY SET ME UP! :-) It was nice not having someone hovering over me since that's nerve wracking for anyone and even better that it was successful. I've also done like 15 ECGs without assistance, accessed a port (I was sweating on that!!! Luckily wasn't by myself), did a foley with no problem, and now I'm finishing ACLS tomorrow. I feel like I've improved in one week, so that makes me feel way better. Still worried about codes, traumas, etc. (and obviously not ready to be alone yet for everything). I just felt I should report that you were all right and things have been better. :-) Thanks again.

Good luck! I'm glad the post was able to help you out as well. :-)

I can't thank you all enough. I've been wiping away tears the entire time I've been reading your replies and wish I could hug every single one of you. I love the idea of keeping this post and going back to it in six months or so--just to see how far I've come in my position. I think I have had the mindset that they expect me to perform like a tenured nurse in the ER and I need to be realistic with myself--that is not going to happen. I really need to stop being scared of everything and just relax. I need to allow myself to make mistakes. And I definitely need to stop worry about what might go wrong (ex: what if I faint, what if I do it wrong, what if I look stupid, what if, what if what if..). It's the "what if" attitude that is really bringing my confidence down. I also need to stop worrying what other people are thinking and just worry about myself. You have all been so helpful. Thank you so much.

I was so excited to start as a new grad in the ER. After three days of training (not ER directed, just hospital orientation) and taking two ECG/rhythms classes, I was introduced to the person I'd be with for floor orientation. I was so excited and felt like I would be comfortable with this nurse since she has a fun/outgoing personality. I am so eager to learn and want to be a great nurse. Unfortunately, my first day did NOT go as planned and I feel overwhelmed and completely foolish. I feel like they're already regretting their hiring decision with me. I did my school preceptorship (64 hours) in the ER back in June and then took NCLEX in August, so I've been out of the clinical setting for about 4 months. Everything that could have possibly gone wrong (with the exception of killing someone) went wrong. Mistake, after mistake, after mistake. Things I was comfortable with as a student. Here is a summary of my day. During all my experience in clinicals, I never left upset. I was crying the entire way home and cried for a good hour after getting home. I'm so overwhelmed and I feel like I'm letting the department down. I also feel like they just expect me to know how to do everything, and I don't. I just really need to get these feelings out. 1. Foley: My hands were sweating so bad, I couldn't get my sterile gloves on. I finally got them, but it took forever. Then, I was blank on what to do with antiseptic and even blank on what the syringe of lubricant was! I hadn't seen a foley kit since first year (I had done lots of straight caths throughout clinicals--just not foleys). I finally got the catheter in, but I was embarrassed. 2. I couldn't start an IV if my life depended on it! During my preceptorship, I was able to start them and take blood without assistance. It's like I completely forgot how to even do the steps. Plus, the person I'm with does things completely different than the person I precepted with over the summer which is frustrating. 3. Glucometer. Yeah, doesn't get much easier than doing a glucose reading...wrong. She asked me to find out what his blood sugar was and I was so excited, like "finally! something I won't mess up and can look competent at while doing"...While the machine was reading the results, I pulled the strip out (not even thinking!!!!), so of course, got an error message. 4. Went to connect IV tubing to the IV....couldn't figure out why it wouldn't go on...oh yeah, because I forgot to take off the cap. She teased me on this one and I smiled, but I was feeling so stupid. 5. Almost forgot to swab the IV port with alcohol before doing a saline push, but the trainer caught it and tried handing me a alcohol pad...that I dropped on the floor, so she got me a new one. 6. Put like four of the stickers for ECG on incorrectly because I couldn't figure out how to count the intercostal spaces. I've never done these before. 7. Was asked to reconnect a patient to monitoring...forgot to hit start on blood pressure cuff and didn't hook up the leads. THIS IS ONE DAY!!!!!!! I FEEL SO FOOLISH. It looks even worst seeing it all written out. Any past experience you've had or hope you can share would be so greatly appreciated right now. I hate feeling this way. Plus, I have ACLS training next week and I'm terrified of that as well. Did I mention I'm 6 months pregnant? Yeah, I'm just a wreck, lol.

I passed NCLEX in August and I'll be starting my first job as an RN in the ER in a couple weeks. I did my 64 hour preceptor at the ER over the summer, so I have a good idea of the routines, documentations, etc. There was a lot of tips and tricks offered by my preceptor, but SO MANY that it's impossible to remember them all. I wanted to make a little cheat sheet to keep in a binder to help me during my first few months, so any tips you would like to share would be very helpful. For example, I know there are certain drugs that are very painful to administer, so diluting them can ease discomfort. I know the orders never called for the drug to be diluted, but the nurse always knew which ones and the steps to follow--not something we're taught in school. Plus, approved ways to minimize pain during debridements or stitch removal (other than morphine prior to the procedure). Just anything you learned and would like to share which new (or even tenured) nurses would be of great help. Thank you and have a great day!!!

My husband is looking for a job right now, so there was no way I could wait. I have a 4-year-old and his list to Santa grows more and more each day. :-)

I got the job!!! I'm an ER nurse. :-)

It is definitely stressful walking into an interview pregnant. Especially when I'm 23 weeks and look like I'm 8 months, lol. They were really chatty about the pregnancy, mainly talking about how they take good care of their pregnant nurses. My preceptor in the ER (she was a reference) and one of the nurses at the interview knew I was pregnant when I was precepting, so I'm hoping they already knew about the baby when they called me for an interview.

I breastfed for three years with my last one (he was really hard to wean, lol), but I still learned a lot through your post in association with work and breastfeeding. I think right now I just have a lot of regret for not just saying "I'll take any shift you give me". I wish I wouldn't have even made the part time comment because now, even if I don't get the job based on my experience, I'll always have it in the back of my head that I didn't get the job because I messed up when asked the part/full time question.. I think I'm dwelling on it. Since I graduated, we've really be struggling financially. I just really want this job and I've been preparing and preparing to try and answer everything perfectly, so when I was told I ruined my chances and saw how mad the hubbie got--it made me take it really hard. I've applied for about 10 positions and this is the only one that has called me back, which was exciting since my overall goal was to work in the ER. Thank you for your replies (and good luck) :-)

That's good to hear. My husband is helping with the baby, which is what his argument was--I will be pumping so there will be breastmilk for him to give the baby. I just worry about my supply going down or getting too busy to pump. I've heard it's really hard to breastfeed while working three 12 hour overnight shifts, so that was my main concern. Maternity leave around here is 8 weeks. To be honest, I don't even think they wrote down my response, we were just being conversational at that point, but I'm still worried.

Please be honest. I had my second interview in the emergency room today and it went awesome, but i know they're looking for nurses with 1-2 years experience (preferred), but I'm a new graduate. I'm also pregnant, due in January, which didn't seem to be a problem. During the first interview, they said they're hiring for part-time and full-time positions and asked which I would be interested in and I said I would work whichever was given to me. The second interview was more conversational with a couple ER charge nurses. They liked my answers and were impressed with my knowledgebase as a new nurse (and that I had completed my 64 hour preceptorship over the summer in the ER). They asked if I was looking for part or full time and I said part time might work best after the baby is born, but I could work any schedule I was hired for, even if it's full time. Honest and straightforward (I thought). Now my husband thinks I'm an idiot and is irate at me for not just saying I can work any shift. He says I'm definitely not going to get the job now because they're going to think I can't handle full time with a baby. I felt great about the interview and now I feel miserable thinking I screwed it up. I can't go back on what I said and part time will work better with breastfeeding, but I could still do full time. I just feel really crappy now and need to know if I ruined my chances.

I'm so sorry I didn't reply sooner!!! Thank you or the congrats! I used Saunders and ATI. My class did an NCLEX review through ATI and we got an NCLEX essentials review book. My advice is to really focus on complications and how to fix/avoid them. Also, expect there to be content on subjects you've never heard of. Last, just because you feel like you failed the test when you leave does not mean you failed it. :-) I haven't talked to anyone that didn't 100 percent think they failed when the test turned off--but they all passed.

If the Pearsonvue trick is accurate, I PASSED :-) I couldn't enter my credit card information because I got the "good" pop up. I had 230 questions and it took me four hours. I'm pretty sure I left the building feeling the absolute worst I've ever felt about myself and started crying as soon as I saw my husband. I thought I was going to throw up when I was checking Pearson's website. Not ONE of these meds were on my test, lol. Just a bunch I had never heard of! Oh well, glad it's over and with good results. :-)

Fat soluble vitamins: All Dogs Eat Kangaroos

So, I'm studying for NCLEX (tomorrow is the big day!) and came up with a few sorta dumb med memory tricks that might help you all out (and it will help me memorize them by talking about it!--so, win-win!!!) Going by the med ending (and few are inappropriate). -afil... You won't be a-fillin anything with erectile dysfunction. -azole... It would suck to have fungus in the a-zole. -barbital.... I had a clinical instructor named Barb and she knew it all...soooo "Barb knew it all, and know it alls are depressing. (CNS Depressants) -etine (SSRI).."my mood feels e-tinee bit better" -lol....LOLs block to lower blood pressure (so, like a beta blocker...a good laugh...good mood=better blood pressure) Just an FYI, nothing to do with antidepressants, just blood pressure. -oxin...can't really share this in words, but I drew an ox laying on it's back with a tongue sticking it...because, "the ox is in heart failure". -april...April lowers your blood pressure. -Tidine (H2)..."to dine is to eat without pain". -Triptan "I trip to tan, not get headaches".

I do have generalized anxiety disorder, so that always is a possibility. Especially since my near fainting during the C-section was before the operation even began. I feel like nerves are definitely getting in the way before I even see a new procedure. I felt like I was having these episodes more often than others in my class, so that was getting my spirits down and it was embarrassing. I watched a bunch of circumcisions (the first one I kept mentally telling myself--breathe, don't lock your knees, etc...), but I was so busy comforting the baby that it didn't bother me after that. If I'm doing something hands-on, the problem happens less. I'm definitely feeling better about my decision, so I'm glad i posted. Thank you.

Ever since my OB rotation, I've been certain that I wanted to be an OB nurse. However, I seem to have a psychological response that causes me to get really dizzy, hot, shaky, the room goes gray and I have to leave before I hit the floor. I had to leave the room during an epidural when someone starting screaming from the pain (pre-existing spinal injury), another time during a debridement from road rash, and I didn't even make it to see an emergency c-section because the feeling kicked in strong before an incision was even made. I felt so bad about the c-section because I took that opportunity from other students. Unfortunately, my instructor wouldn't give me a second chance to watch a C-section. I'll be starting to apply for jobs and I really want to work in OB, but after my experience with the C-section--I'm scared I'll never have that opportunity. My instructor assured me that one of the tenured nurses had passed out watching her first lady partsl delivery and she is now one of the best OB nurses. I'm really scared to apply for something and find out later that I can't handle it. Any advice or past stories from OB would be helpful. :-)