Jeff Bagley

As with many of the IV medications we give, there are issues dealing with ph and Osmolarity of the medication. I am curious if the nurse mixed the phenergan with the Toradol. Toradol will precipitate when mixed with just about anything but saline. I have been giving IV pheneragan in the ER for as long as I can remember. There is an old addage that will work with phenergan as well many other drugs. A wise old instructor once whispered to me "DILUTION IS THE SOLUTION!!!!!" Except with Valium of course....

I recently took over as the Nurse Director of a 14 bed ED. We have a fairly light patient load with and average of 35-45 patients a day. I know this is redicuously low for this size ED but the ED is new and they actually planned for the future for once. I am seeking a "ideal" staffing ration ( I know I seek the Holy Grail) but the staffing levels we presently have are killing the budget and I feel are out of line with present patient load. We normally staff 3 nurses on 7A, 3 nurses on 7P with a 11A-11P triage nurse. I am thinking of reducing the 7P level to two nurses, two nurses from 7A-11A, and two 11A-11P nurses. I will also add a ED Tech from 11A-11P. Is this still two much staff. I am boucing off you guys before I incur the wrath of my department.