LMH2687

We are 3:1 currently where I work, but I believe my facility is pushing for 4:1 ratio since the secretaries have recently been given the responsibility of tracking acuity levels. We're supposedly one of the top 3 busiest hospitals in the state, even as a level 3 trauma center, so I don't agree with the change. Those that do, what kind of support staff do you have and how is your triage process? We see patients quickly with avg visit We have techs but the only requirement is a high school diploma which doesn't do me any good as a second set of eyes when they don't even know what normal vitals are. Our techs main responsibilities include transporting, EKG's, and urine collection. We have may have 1 or 2medics that are techs but theyre not allowed to do anything wihin their scope of practice as a medic when they're a hospital employee in a tech role. With >60% brand new nurses on nights, we're barely treading water as a dept with 3:1 because they simply cannot keep up with having to do full triages and full work ups on back to back pts. we see 180-220 per day with more than half of that on the evening and night shift where all the new nurses are.

I work in the ER and had a diabetic pt today. Per the nursing home, pt hasn't been able to maintain her blood sugar. She's had continual bouts of hypoglycemia and has been given 3 vials of glucagon within a 24h period. They called the ambulance when she became unresponsive. Medics checked her blood sugar upon arrival and it was in the 90s but she was still unresponsive. Pt awoke en route to the hospital, rechecked sugar; it was 83. Upon arrival pt was aox3. Labs were done, urine was collected, pt had a CXR, and abdominal/pelvic CT. The CXR and CT were unremarkable. Pts WBC was 15.7, electrolytes normal and all other labs were WNLs, urine was negative. What's the source of infection?

I'm a recently new grad working in the ER, I have this predicament all the time. I essentially get one snap shot of the patient at a certain time during their infectious process and things don't always seem to "add up" the way they should. Love the ER but something to think about if you're easily frustrated. I ask LOTS of questions. :)

The hospital i'm at currently pays ADN's the same as BSN's, at least new grads. I would agree that BSN's fill more managerial positions though. 10% differential for nights.

I'm currently orienting in the E.R. and was wondering if it was ever appropriate to "check in" or visit a patient on the floor you admit them to. I know it's a fine line to walk between personal and professional and was hoping someone had an answer.

Thank you, guys so, so much! I appreciate it! I don't feel comfortable lying, but as stated, nothing is a done deal anyways. Thanks for putting my mind at ease. You guys are great.

Hey there. I am a nursing student who will be graduating in August 2014. I had a few questions regarding potential jobs. I've always had the idea that I would enjoy nursing in the emergency dept due to the fast paced environment and the fact that I haven't been overly excited about any of my other clinical rotations. I found out that we (my classmates and I) could apply early before graduating just to get the process started. I applied and interviewed with the E.D. manager in late April. At the time of my interview, the E.D. manager said I could do a 4 hour shadow in the department to make sure I liked it and then we would wait to do the peer interview (3rd and last step) until I had a scheduled NCLEX date in August since I was interviewing with her so early. I completed the 4h shadow and loved it, but was happy to know I would have the rest of the summer to make sure I didn't want to apply anywhere else. Well, the E.D. manager called me this week and requested that I do the peer interview now vs waiting until August so she could offer me a job if it goes well, but this past week I started my management/capstone and really like the manager on this intermediate critical care unit, something I didn't expect. Our instructors said many times we get job offers through our capstone. Now I want to at least wait until I orient on the intermediate critical care floor to see if I would like that, but the peer interview for the E.D. is next week and I don't start orienting to the intermediate critical care floor until the week after my interview. If the peer interview goes well with the E.D. staff, I'm at a loss on how to tell the E.D. manager that I would want some time on my current floor in capstone just to make sure I only want the emergency dept. I hope this makes sense. I would love any type of feedback you may have whether it's good or bad. Thanks so much!