jessRN0

It's the same as triage in the ER. You use your nursing judgement to assign patients to the appropriate acuity (which changes how fast a doctor sees the patient) and can order things per protocol. There is nothing about it out of a nurse's scope of practice.

We given IV decadron PO mixed with juice for our peds patients all the time. Our pharmacy actually supplies PO (liquid suspension) Zofran for peds. I have never heard of giving Zofran from an IV vial PO.

It was the best class I have taken since graduating nursing school. It gives such a good overview of anatomy, physiology, critical thinking skills, and trauma.

Many of those rounding as RNs for doctors and NOT as an NP have standing orders they write to move things along faster for the doctor. It is similar to protocols in the ER. In the ER, I have protocols for medicating and other orders I can perform before the doctor even sees the patient. It just keeps things moving along smoother if say labs are already ordered, procedures are set up for, etc. And the doctor then has to cosign the orders placed under protocol. The rounding nurse also gathers information and makes sure everything the doctor needs is available. It's nothing out of my scope of practice. This seems to be what you were describing originally.

We are experiencing some changes at the ER I work at. I'm just curious to here from some other ER nurses about the set up of your ER. (Use of Fast Tracks, CDUs, triage process, how you use your techs/aids, ER size, etc.)

I started in the Emergency Room back in October. I graduated in May of 2012 and worked inpatient ortho until I got the job in the ER. All through nursing school, I dreamed of becoming an ER nurse and new that's where I ultimately wanted to be. No other place made me feel so in love with the job I chose. Even with my previous experince coming into the ER, I thought I was going to have to give up my dream. The ER was nothing like I thought it would be. I remember coming home after orientation one day and calling my best friend (who is also an ER nurse) and crying because I was so frustrated that this wasn't what I thought and that maybe I didn't belong. The ER is a tough place to work, especially for a new grad, but there is also so much you can learn/see/do. I gave myself some more time to push through a few rough weeks of orientation, and here I am at the end of May and absolutely LOVING my job. There are still so many things I have to learn though. It never ever ends here. I have a few suggestions for you.. Talk to your manager about your preceptor. Having the right fit for a preceptor can make all the difference. You need someone whose personality meshes with yours but will also challenge you and force you to grow by leaps and bounds during your orientation. He/she needs to be completely honest with you, and you have to take the criticism with a grain of salt. Write down a list of diagnosis, meds, labs, etc that you see frequently. Study those and really try to understand what's going on. (I know...studying sounds like the last thing you want to do, but it really helps to just review some of those things.) BREATHE. You work in an EMERGENCY room. Things happen fast and you can get overwhelmed easily. Find something that you can consistently rely on to relax you after a rough shift. You'll need it. There are doctors, nurses, techs, etc that are ALWAYS around to help you. Some of them may be rude when you don't know exactly what you're doing, but you have to learn somehow. Learn who you can ask your "stupid" questions to without making you feel like it's a stupid question. You'll do great!! Welcome to the world of emergency nursing. :)