lumberjackAZRN

Totally gets easier! The pace will never change, but you will find yourself not being so frazzled all the time and not always needing to "catch up". I too work in a very busy ER non-trauma where I started as a new grad. I think starting in a ER as a new grad is easier than transferring from the floor because you know nothing else, whereas when you come from the floor you are used to a different routine and pace. I work with a few nurses who have transferred from the floor and have felt the same way, but are now cruising (and sinking) with the rest of us. Hang in there, you got this Also, if it turns out that you dont think ED is something for you, you can always change!... especially with some ED experience under your belt now.

Hi everyone! I know this thread has a lot of union information, but I am wondering if anyone has information or ideas on how to raise money for a unit based council? I work in an ED (the busiest in the state) and some nurses and I are considering starting a unit based council (management has approved). Some reasoning for starting the council is to help improve moral, increase educational training, employee feedback, etc... Some things we want to do of course will cost money and I am new to this and looking for some ideas on how to fund our unit based council. Any ideas are appreciated. :) Thanks!

Hi All, I am a nurse in a very busy ER with what seems (no exact numbers) to be a high turnover rate. For the loyal and commited nurses (and PCTs) that stick around, morale hangs a bit low. Patient ratios are reasonable- 1:4 or 1:2 for critical patients. Common feedback from employees is that they do not feel appricated for all of the hard work they do staying things like "no matter how fast or good you are, it is never good enough." Regardless of what department, does anyone have tips or ways their department has worked to improve their employee morale and in turn improve retention? Sincerely, A Staff Nurse

The ED I workin sees on average 200 patient's a day. We are an adult ED with a total of 38 beds, 4 of which are our "critical beds" and 3 are express track beds (for acuity levels 4&5). We have a psych annex which is operated by an outside company and a quiet room for sexual assault victims. One RN and a NP run our express track beds. Other RNs each have 4pts. If you're assigned the critical beds, 2pts. We usually have 2 nurses in triage and one pivot nurse (the intake/screening nurse) who assigns beds to walk-ins. We have medics and PCTs. One PCT to 8pts and medics take on same patient load in place on PCTs but have a wider scope. We also usually have a throughput (aka discharge) nurse and a tele nurse who takes in EMS calls and helps transport critical patients. We have shifts of 7a-7p, 9a-7p, 11a-11p, 3p-3a, 7p-7a Our ED has gone through tremendous changes within the last 2years to improve efficiency, d/c times, admit times, waiting times, etc... Through this change we have used what is called a LEAN philosophy. This was created by Toyota and it has had a significant impact on our ED. I'd recommend looking into it and possibly pitching it to your managers. Also improvement within the department has also been a result of heavy collaboration with the entire hospital. In regards to ready inpatient beds. Our admitted patient wait time in our ED is now down to an average of 5 hours (this includes the time spent on the ED work up). That's all I can think of off the top of my head. But I really suggest you look into the LEAN project. Here is a link: What is Lean There is so much more to it than that but it's worth looking into

It is nice to have a little reminder that others are in the same boat! Good luck to you!!

Thank you!! It sounds like a position where I am going to learn a ton and that is all I can ask for as a new graduate. Time to put this license to use! If I am formally offered the position I will be all over it like a rash lol. Also 30-40 patients holy cow!! Hats off to you no doubt!

Hi Everyone!! So I graduated in December and have been hitting the job hunt hard, especially since I passed the NCLEX. Initially, I was only applying to hospitals as it has been my ideal environment to work in... then after my first interview and rejection with a hospital I decided to keep my options open and started applying everywhere. I had an interview with a sub-acute transitional hospital which also has a long-term care facility/nursing home as a part of the organization. The interview went really well and I was unofficially offered a RN position in sub-acute (pending reference check and background check). Learning about how the facility works was very interesting, but also intimidating. I am very interested in the position, but I am a little freaked out about it as a new nurse... First, it is a heavy patient load. There are usually only two nurses working and sometimes one depending on how many beds are filled. I would have between 10-15 patients . It was explained that I would always have someone as a resource if I have questions. Also, the company was bought out (if everything works out and I get the job) I would be figuring my way around an entire transition. I would only have 1-2week orientation. And they are on computer charting, but meds are still charted using paper charting. I know this is silly, but I am nervous because I have only worked with complete computer charting through nursing school clinicals. Are these legitimate things to be nervous about? I would be nervous starting any first nursing job I was just looking for some thoughts, input, and advice on how this sounds. Regardless of this stuff I am very interested and I think I would learn a lot at the facility and build a good foundation for my career. Plus the pay is great! I just dont want to be in a situation that I am not prepared for or that puts my patients or my license at risk...and maybe I am over thinking the whole thing lol Anyways, Thanks

Hi, I am a nursing student and our assignment is to come up with a evidence based practice topic, formulate a PICO question, and later write a paper on the research we find. My problem is, I CANNOT THINK OF A TOPIC! We are completing our preceptorship this semester and I was assigned the post critical care unit; however, I have yet to start my clinical rotations and the PICO question is due tomorrow. Our instructors wanted us to come up with a topic based on the patients seen on the floor, but since I haven't been able to start yet, it is difficult. Does anyone have topic ideas?I was considering NG tube placement confirmation (aspiration, xray, ph strips), but I am not sure if you see a lot of NGs on step-down units. I also have been trying to think of things that are not over used like cough deep breathing, but at the same time something I can find evidence on. Thank you.