kaiteeb61

The fact that some ER nurses object to using lg. bore IVs just baffles me! One of my co-workers actually works at a small ED where they get written up for using an 18G!

I completely agree with all of the previous posts! There is one thing that wasn't mentioned though - the variety of postions within the ED! I've been working ED for over 4 yrs now and am able to do triage, trauma, and radio on top of straight nursing. It's great to be able to work the front rooms with the 'sick' patients one day then have a desk job the next. Thinking about it, I just love all of the variety in general! The different patients, the different nurses from everyone around the world and every background of nursing, the variety of docs that we interact with. Reading this thread at the end of a long shift has put me in such a great mood and made me truly appreciate being an ED nurse. Thanks everyone!

something other than BNP and a chest x-ray??

I started in the ER as a new grad and worked with my preceptor on days (7a-7p) for 3 mos. Then, once I was on my own, started 3p-3a. Crazy busy shift! Like someone else mentioned, you straddle two different worlds and a million different personalities! That shift usually meant I was "float" and always running my butt off! I then went to late mornings (9a, 11a, noon) for a while which was busy as well but at least I usually had an actual assignment. Back to late mid-shift (2p, 3p, 5p) for a bit and was comfortable. Now I'm strictly night shift (7p-7a) and think it's the best. Being biased and all! For a new grad, from my experience, I'd say ideally, train on day shift, take advantage of resources and learning how things should be done while you can. Then, when you're ready, come to nights and experience real teamwork and learn how things are actually done, in less than optimal circumstances. After seeing both sides of the coin, decide which is a better fit for you and your family.

I hope you're taking well to night shift. I've worked every conceivable shift possible in the ED and have truly found a home with nights! Night shift is a whole different animal, so to speak. The staff is generally younger, more enthusiastic, and and least in our ED, works better as a team. This may be different in other EDs, but that seems to be the concensus around here. Working both straight days and straight nights, and mid-shifts straddling both, I've seen the differences first-hand and really appreciate the people I work with! Staying on topic, like most night-shifters, I prefer to work 3 in a row. Even on my days/nights off, I don't even get tired until after 2am at the earliest. The night before my first shift I try to stay up as late as possible and sleep in as late as possible. I figure going in to a 3 day run with as much sleep as I can get can only benefit me! I'm single with no kids, so I have the luxury of going home, catching up on Tivo, and eating a bowl of cereal before falling asleep. I wake up sometime around 1600, grab coffee and something to eat on the way to work, then start my 2nd night running. Same thing for the next. When I get off my 3rd shift, I either take a short nap when I get home to convert back to "days", or depending on my level of fatigue, allow myself to sleep forever! I'm sure you'll figure out what works best for your lifestyle. Gotta admit though, that bowl of cereal, or other carbs, can really help ya get to sleep after a long shift! Good luck!

Partly due to budget and partly due to a lower census during the summer, our ED supervisors have been encouraging staff to "flex" whenever possible. Not sure if other EDs do this, but for us it means voluntarily leaving a few hours early and using your PTO to fill in the extra time on your paycheck. I am a huge fan of this because it means I get extra sleep and management loves this because it saves them money! On some nights it can get pretty darn boring when we have tons of staff and only a few patients in the dept. So, recently there have been a couple people on each shift who volunteer to be flexed. We have come up with creative ways to determine who should get to flex and go home early. Our solution has been to have some sort of competition. It's a blast! Last week we had a couple ideas thrown out there. One was to have a dance-off. That, however, can be rather subjective. The next idea, submitted by our charge that night, was to see who could get their pulse ox the lowest. Weren't really feeling that one either. What we decided on was to see who could eat 6 saltine crackers in 1 minute without any water. By the way, this idea was given to us by one of our docs. So the three of us who all wanted to go home, sat down with our respective emesis basins filled with 6 unwrapped saltine crackers ready to go. We had quite an audience surrounding us including our charge and 2 docs. The clock started and we were off! The only male in the competition quickly shoved all 6 crackers in his mouth as another female and I methodically ate one by one. The time was up and even though the male nurse had them all in his mouth, he was unable to swallow anything and began spewing sawdust-like cracker particles all over the nurse's station. No winner. Then it was announced that the first person to eat all the crackers would get to go home. The other female nurse and I went at it eating the remaining crackers as fast as we could. She finished, then I finished, and the male nurse had yet to make any progress. This contest was amazing! So much fun! Last night was another slow night. Again there were multiple nurses that wanted to flex. After a few ideas had been thrown around, including who could start an IV on themselves first, we decided on first to finish a lap around the dept on a rolling stool. Absolutely hysterical! Since this has been so much fun, we have decided that a little friendly competition will now be the deciding factor in who gets to flex off the night shift from now on. We need some help though. We need more ideas for competitions. So I'm asking for any input you could provide. And as a fellow ED nurse, I'm sure you know just how crazy a breed we are, so any idea is welcome - no matter how ridiculous! Thanks in advance!

Here's a few that we use: "Family Plan": when you get multiple patients from one family, all complaints that could/should be addressed with their PMD. "2fer": two patients from one family, one patient doesn't really need to be in the ED but since their there, another might as well get checked out too. Classic example of this, a mom brought her toddler in for "ingrown toenails" which looked to be completely normal and the kid was content, but as the mom was walking in she happened to stub her own toe and decided to check in (not a scratch in sight!) "O.L.D. Syndrome": a dx given to elderly patients that c/o generalized body aches x multiple number of years/months. "4 T's": (Teens, Tots, Tweekers, and Tw&ts) a nursing assignment that has four private rooms. This section is generally where we put the psych's, vag bleeds, and behavior issues. "Breakfast Club": patients that come in either homeless or too intoxicated to discharge who stay over night with us simply to sleep or sleep it off. They receive breakfast in the morning before being sccoted out the door. (This of course depends on many variables including who the charge is and how busy we are that night)

when i worked in family practice, i used to dread seeing my doctor sneek around the corner and while she teasingly grins, say, 'bilateral, have fun!' the trick for me would be to squeeze a couple drops of cerumenex or like-product in the ear canal, have the patient lay on the opposite side for 5 mins. then, cut the tip off of an IV cath and put it on the end of a 50cc syringe, that way you can get right in there. fill a basin with equal parts warm water and hydrogen peroxide. put an emesis basin at the side of the ear for the drainage, and to verify what was dislodged. pull the earlobe up and back, then push the fluid with quite a bit of force. always warn the patient of what to expect, ask them to notify you of any dizziness or pain. i try to avoid using the curette, as it is very easy to cause harm or further impact the cerumen. and often, the inside of an elderly patient's ear can be 'flaky' and you end up trying to remove something that is actually a part of them. tearing the skin, causing sensitivity, etc. i was usually very successful with this method and you'd be amazed at what comes out sometimes! (i.e. pencil lead, corn kernal) for patients that made no progress with this, i would have them apply the drops before bedtime for two nights, then return for another flush. hope this helps!

While I was working as an MA, I was transfered a call from the front desk. They gave me no forewarning before sending it back, turns out it was an 86 y/o female that had somehow gotten a golfball stuck 'down below'. I tried to ask her how it happened, but she avoided the question. Then I asked her how long it had been there - "oh, a few days now i suppose" And she's just now getting concerned! Our UCC didn't have any birthing forceps or suction, so we sent her to the ER. Would've loved to be there when she arrived! Sweet lil' thing, maybe attempting some sort of kegals?

Hey there! I actually live near San Diego and go to school in San Diego. Depending on how you got your LVN (community college or trade school) would help with what you're looking for. Currently, I'm going to Maric College in San Diego for my ADN and I know they have a 'bridge' program for LVN to RN. It's a bit more pricey than other schools, but if you have your pre-reqs already, it only takes a year. Another place to look into would be SDSU. They have an amazing nursing program and are contracted with the best hospitals in SD. As for a job, down in SD there are lots of Scripps hospitals all over the county and they treat their employees very well. A couple of my classmates currently work for them and love it! There's also a few Sharp hospitals around the county, with an excellent Women's Health and L&D. I can let ya know about individual hospitals strengths and weaknesses depending on what you're looking for or the area you're looking to move to. Just let me know!

Well, if this makes any sense at all, I kinda feel like Seattle is calling me. I just feel like it would be the right place for me. I really don't think I was meant to be a So. Cal. girl even though I've lived here my entire life. I don't like the beach, at least not the ones down here. I love the rain! I would much prefer a rainy day than a temperate cloudless afternoon. I hate the heat, too! And I would like to be somewhere a bit more laid-back. Everything/everyone down here is so image-oriented. Does any of this make any sense to you? Those are pretty much my reasons for wanting to move.

Hello all! I'm currently in school for my ADN, and am considering moving up to Washington when I graduate in April '06. I just wanted to get some advice from nurses that have been out there. Hoping to gain from others experiences. I'm a 24 y/o single female without children and other than my family I have nothing holding me back. I'm just trying to figure out what I would like to do when I graduate. Now rather than later and panicking. I currently live at home while I'm in school and am considering two things. First, I could stay down here in San Diego after I graduate, make use of the contacts I've made so far, work for a year, then go into traveling. Second, I could move right after i graduate and enter a new-grad program up there, then if I still want to travel, go for it. I really want to move and think starting fresh right when I graduate would be best, but I am interested in your opinions. Could it be too overwhelming? New job, new state, and everything else that goes along? I'm just scared that if i stay down here I will become attached to my colleagues, doctors, etc. and end up staying for them. I moved to San Diego right when I started as a medical asst. and loved it! I adjust well and know it was the right decision before. Any advice?