S.T.A.C.E.Y

Suck it up, learn what it is the profs want to hear, and tow the party line. While yes, there is alot of good stuff you need to learn in nursing school, the key is realizing that a huge chunk of surviving nursing school is realing that much of it is BS that you simply need to get through in order to graduate and be the kind of nurse you want to be.

In my hospital, the trauma bay is staffed by the general ER nurses. The float nurses in the ER float into the trauma room when there is a trauma, and if it is a particularly crazy or busy trauma (or lots of 'em), the ER nurses have to cover each other to allow more ER nurses to go assist in the trauma room. Not all patients who come in as a trauma are a big messy trauma, so the time limit can vary greatly. A particularly bad trauma may only be in the trauma room for At my hospital, trauma patients are admitted to the ICU if critical or the trauma floor if stable. Our trauma floor nurses (med-surg, mostly surg), and our ICU nurses all consider themselves trauma nurses as well. They deal with the trauma patients in the longer term. Trauma floor nurses deal with the quads, paras, nasty dressings, chest tubes, traction, casts, etc. Does this help?

Everyone always has a different number. Usually something less than 50 ml/hr. Common rates I've heard people state/defend: 10ml/hr, 30ml/hr, 35ml/hr I have never heard of any solid references for any number, but there has been a suprising number of people defend their preferred number to the death.

In our hosital, the OR was notified when a bad trauma was suspected (not all trauma cases) OR nurses NEVER came up to the trauma room. Occassionally trauma patients were in the operating room

The course was required by my dept (and probably every other ER), so I took it. I was genuinely looking forward to the course, and having looked at the text and content that the course was supposed to cover, it looked like it would be totally worth the money. Sadly, my TNCC teacher wasn't the greatest. I really felt like it was big waste of money. Was it worth it in my experience, no. Could it have been a great course, yes.

From my own personal practice: 1. Tylenol 2. Gravol (Canadian anti-emetic/anti-nauseant) 3. Ancef 4. Dopamine 5. Ceftriaxone 6. Fentanyl 7. Versed 8. Morphine 9. Ativan 10. Aspirin

http://www.icufaqs.org/ ICU material, but a great review for ER nursing.

Like daytonite said: 1. Learn the basic electrical pathway of the heart, and how a NORMAL heart rhythm travels. Learn NORMAL SINUS RHYTHM. 2. Learn your sinus rhythms, normal sinus, sinus brady, sinus tachy, sinus arrhythmia, sinus arrest, sinus block. Learn what each rhythm is actually doing electrically, the correlation between electrical and mechanical, the criteria you look for to diagnose a rhythm, and then study what to do about it. 3. After you have mastered sinus rhythms, move on to other atrial rhythms. A-fib, A-flutter, PACs, SVT, PAT. Same as above: Learn what each rhythm is actually doing electrically, the correlation between electrical and mechanical, the criteria you look for to diagnose a rhythm, and then study what to do about it. 4. Then move further down the electrical pathway of the heart. Learn the junctional rhythms, and info associated with each rhythm. PJCs, junctional rhythm, accelerated junctional, junctional tachycardia. 5. Then move further down the electrical pathway of the heart. Learn the ventricular rhythms, and info associated with each rhythm. PVCs (lots of terms to know here), V fib, Vtach (stable, unstable, pulseless), idioventricular, accelerated idioventricular, etc. Don't bite off more than you can chew. Work through these rhythms slowly, and don't move on to the next rhythm until you have mastered the previous group. It will not help you in the least of you can KIND of recognize a rhythm, but aren't sure if maybe it is afib or maybe it isn't. Don't even start looking at 12 lead ECGs until you master the dysrhythmias.

Psych and community clinical we had to wear business casual attire. No specific colours or specifics. Profs were insistent that we were NOT to wear scrubs, jeans, running shoes, shorts, or short skirts.

As an emerg nurse I desperately wanted more education on: - How exactly patients are supposed to be weaned (I had no idea what the RT was doing when they said they were weaning) - Hemodynamic monitoring (MAP, CVP, Central Line stuff) - ET tube cuff pressure assessments. (10cc vs less, fistula development, and cuff leaks) - The expanded neuro assessment

Your assessment of the patient, may effect which health issue to tackle first. The patient may be very interested in losing weight and eating healthy, but have no interest in hearing about quitting smoking. In that case, it may be better to tackle the diet issue first. On the other hand, if the patient is from a culture that consistently eats high fat foods, and the patient has expressed willingness to quit smoking, then smoking may be the better idea. Sometimes its all about picking your battles. Sure the patient should do both, but in reality, that may not be case.

I've ALWAYS been taught that it goes by what you hear. Sometimes if you can't hear where at first, you watch the needle for some indication of where you SHOULD be hearing the sound, then listen closer. As the previous poster said though, ask the prof just in case. Nursing school is mostly about towing the party line, so if the prof that is testing you insists it goes by the bouncing needle, just do as she says for the test.

I've been second guessing my neuro exams on ER patients, and am now wondering what kind of neuro exam others do on a patient presenting with neuro symptoms? Confusion, dizzyness, balance issues, stroke symptoms, etc. My usual neuro exam include GCS, orientation to person-place-time, pupils, bilateral hand/foot strength, and questions about headaches, nausea, vomiting, confusion and balance. What actual other assessment do you do? I've been observing the docs do their neuro exams which are WAY more thorough, and I wonder if my nursing assessment should include more. But, frankly, beyond charting any descrepencies, I wouldn't know what to do with the information or what it means. I found a link on the net about cranial nerve assessments that is pretty simplified, but i'm wondering is this too much?!?! Basically, I guess the question I'm asking here is what is YOUR practice for neuro assessments? How much do you know? If you do an extensive exam, how do you find this changes your nursing practice?

Standard Rule is an ECG within 10 minutes of arrival for any chest pain or cardiac symptoms. Maybe researching the barriers to staff obtaining an ECG within 10 minutes. Can look into training issues, process issues, attitude issues, etc. I think this would be a great topic, and could actually a helpful research paper for an ER dpt looking to decrease recognition of STEMIs.

Actually, the assignment has several parts. Initially I was looking for info for one section, then started looking for info on other sections. Thankyou for the search word suggestions.....I will try those.

Thankyou very much for that suggestion! I'll look for articles from there!

Ok, I've tried several database searches including CINAHL, but have only come up with about three articles so far. I found three about the patient's perspective, and the nurses role in decreasing anxiety, and helping the patient through the procedure. I found one list of cath lab nursing competencies.....but thats it. Does anyone know of an article out there that discusses the cath lab nurse's role?! Pleaseeeeeeeeeeeeeee???

I'm doing an assignment for a post-grad RN course, specific to cardiac nursing. I followed a patient through the cath lab and into CCU, and now have to write a case study about it. One criteria of the assignment states: "Discuss nursing concerns during the procedure and potential risks to the patient". I can write about this no problem, but need some journal articles to back up what I'm saying. Can anyone suggest some good articles to use here? I've found lots out there, but mostly very medical/scientific studies. Do you know of anything better, more geared to nursing? Thanks for your help! S.T.A.C.E.Y

We were doing a code in the simulation lab with a dummy on the table who you actually shock with a real defib. We were going through the code, leader called clear and we all stepped back. Just as she hit the shock button, someone noticed I had put my foot up to rest on one of the wheels. I was standing back, but the room was small and for whatever reason had just put my foot up to rest there. Thankfully I pulled it back before I got shocked. Now I am EXTRA careful with the "I'm clear, you're clear, we're all CLEAR!!"

I agree with you, and while thats all well & good, thats not always the best option. I know in my department, so many new people have been hired over the past few years that the senior staff have actually gotten very tired of orienting new people and explaining P & P over and over again. Most actually refuse now, they just want to show up, do their job, and be done with it. Most of our preceptors have less than 3 yrs in the department, and they're often far better preceptors because they remember the stuff they didn't know, the stuff no body told them, and the stuff they had to lookup themselves. I agree with you 9 months isn't much, but I don't think that time should be the only criteria.

I would go to a local college/university and look for student rooms for rent in the area....try even craigslist or other similar boards. Even just to have a small room in a house nearby, with a futon, a tv, and a mini-fridge will make this situation work, and be cost effective (much better than gas probably). And, its not all the time, just before/after shifts, or for napping. Not your home, just a place to stay. I drive 1 to 1.5 hours to work some days, and its AWFUL. Don't forget that in bad traffic (think accidents!) and bad weather (think slow!) that that 2hr 15min drive could possibly become 3+ hours. Please don't think about taking this job without getting yourself a place to stay nearby. In a year and a half of work I've fallen asleep on the drive home from work once, and it scared the hell out of me. Happened only one block away from home, and could easily have killed me. Fell asleep at a red light......out cold. And my drive is HALF of yours. 2+ hours each way will leave you no time to sleep.

TTC Route Map: http://www3.ttc.ca/images/fixedImages/TTCRideGuide_5.pdf Looks like you could take the subway to eglinton, then bus 54 or 34 to Eglinton/Leslie.....although you might want to take a trial run to find the right building. I go by that intersection often and there aren't any buildings right at that intersection....you might have a little hunting to do.

There are multiple Toronto exam sites I believe, with many more in the Toronto Area. Do you know which site exactly? I believe the big one was the Metro Toronto Convention Center, is that where you are going?

Thats GREAT!!! Thankyou so much! What a great help! Any other info/help others could give would still be appreciated.

I'm doing a project for a class I'm taking, and I would like to compare Hospital Infant Abductions from the past to how they are handled now. I have a present day example from my own community where the baby was located & returned safely to her family because of the use of security video cameras, Province-wide amber alerts, media awareness, and co-operation between organizations/agencies. However, I am struggling to find a specific example from the past, which is why I turn to you all.... If anyone can think back (before 1990 preferrably) to when a baby was abducted from a hospital, the baby may have been found or not.......any info you could give me would be helpful in directing my search for resources: year/date, hospital info, baby/family name, city/state/province, etc. PLEASE help me for this project!