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amyjm333

amyjm333 RN

Emergency/Trauma Nurse

ACLS, TNCC, NIHSS, PALS

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amyjm333 is a RN and specializes in Emergency/Trauma Nurse.

amyjm333's Latest Activity

  1. amyjm333

    Teletracking scripting

    Hi all. We are going live with teletracking this month and will be having pts wear the teletracking bracelets. Do any of you use any sort of scripting when placing the trackers on your patient’s? I’m struggling to come up with something that explains the actual benefit to the patient. Anyone have anything that works well? I guess I’m afraid our older population will be leary to be “tracked”. Any suggestions/comments?
  2. amyjm333

    Basic Seizure Care

    In the ED our standard is to initiate Seizure Precautions (bed rails up and pads placed), blood glucose taken, seizure time and length recorded, VS, verify suction is available, MD notification with med orders if applicable.
  3. amyjm333

    Tele nurse wanting to transition to ED; advice?

    I would take the above advice and talk to the director in your current hospital’s ED. They are often happy to hire nurses with experience- even if it is not in the ED. At least that’s how it is in my state. We hire even new grads, so a nurse with a year or two of tele is valued! There will be a mindset change necessary to transition to the ED from floor nursing, though. When our patients walk in, we are starting from scratch. We don’t have diagnoses and all testing is yet to be done. I have not done any floor nursing so I don’t know how long that mental switch actually takes, but several of my most beloved coworkers came down to the ED from the floor and they’ve all expressed that “it’s very very different” and that they had to change the way they thought and how they prioritized patient care. Good of luck in your transition! Being an ED nurse rocks!!
  4. amyjm333

    New ER Nurse , Feel SO stupid

    My other small piece of advice is to focus on the truly emergent patients. Most people in an ED on an average day are not at risk of dying, but some are- focus on those. Good luck to you!
  5. amyjm333

    New ER Nurse , Feel SO stupid

    Ten patients is too many! I’ve got a few years experience as an ED nurse and we get 3 patients. There are times it’s so busy I feel rushed and time crunched. I’m pretty sure if we had ten patients each and every nurse in my department would quit. (Not saying you should do that). My only suggestion is to MAKE TIME to go over those results. Also, get yourself some form of standard organization going on. All patients may end up waiting longer but I have a feeling your dept isn’t going to notice. With ten patients, no one has the time to criticize you!
  6. amyjm333

    How does your ER handle level 3 ESI pts?

    Our ESI 3s generally get labs (according to complaint), rad studies (again, according to complaint), a bag of fluids and appropriate meds to control symptoms. Once tests are resulted we either dc them w/ referral to specialist, or work on admitting them. I can’t say I feel they clog up the department, as many end up having legitimate complaints confirmed by labs and/or X-RAY/CT. I feel that the level 4&5s are the ones that should visit one of the local urgent care clinics, and could use a bit of drain-o. 🚽🚽🚽
  7. amyjm333

    Valuable life lessons from an ER nurse....

    Your kids are your responsibility.
  8. amyjm333

    Valuable life lessons from an ER nurse....

    Get yourself a PCP.
  9. amyjm333

    Brain sheet for ED?

    As a new RN in the ED I made my own “cheat sheet” - it included all the things I needed to know in order to enter the info into my triage, without getting any “hard stops” or things we MUST know to complete the triage screens in our EMR (firstnet). I would then document on the back of the sheet any meds or whatever else I needed to remember to chart. This is basically what I used. I am now able to just recall all of the triage info and just write down VS & any verbal orders the MD gives me when we are both at bedside. Or I chart at bedside in real time. It gets easier with experience, but my cheat sheet helped when I was a brand new RN in the ED :)
  10. amyjm333

    As a PA, how can I be better for the nurses in the ER?

    Hello! I know I'm a little late to the party, but I want to tell you firstly, do not be disheartened or discouraged. As nurses, PAs, NPs, Docs, we are all on the same team! I read through all of the previous responses and bits and pieces of each rang strong in my mind as being ways our processes could improve. I'm gonna take the lazy route and just list what I think would be beneficial for all :) Please keep in mind that I am coming from an ED where the PAs and NPs usually provide care in our "Fast Track" area and see mostly 4s and the occasional 3. 1. Entering all of your diagnostic and med orders up front makes the nurses' time management easier. If your facility allows, entering med PRN orders could save you and your nurses time and energy. For example, order the ibuprofen, then put the lido patch and Tramadol in as PRN. The nurses on your team should be reassessing the pts after pain meds are given anyway, so it is not a must that they be reassessed by you as well. This can serve multiple functions: it saves you time, and shows your nurses that you trust their nursing judgements, and promotes a team/collaborative care atmosphere. You can always say, "hey Sue, I'm gonna throw in orders for pain meds for room 29, let's just start with the Ibuprofen and if she needs more the orders are there." 2. If possible, order PO meds. Unless you have a reason not to. 3. As for over-doing the workup, as a nurse I personally feel that if it makes sense, you should order it. Nurses usually only go batty when we see a urine ordered for a foot lac or an abdominal CT with oral contrast and an IV for a kid who presents with abdominal pain x2 hrs (after eating fried Oreos), no home meds given, and is jumping around and sneaking Cheetos from moms purse. 4. I don't think it's at all necessary to be overly friendly with the nurses you work with, but I do believe if you help foster a team approach, everyone will have greater satisfaction. I personally love the providers who talk to me about what they are 'thinking' about a patient (when time allows of course) and allow me to be more than just a 'task completer'. It feels so much more colaborative AND it makes me feel more comfortable to ask for education from the provider. Just My Humble Opinions :)
  11. amyjm333

    Addicts in the ED

    I am a new graduate nurse and have begun working in the ED. The other night, we had a patient (not my patient) who was a frequent flier and was seeking pain meds. The patient's nurse (who is also new to the unit, but not a new nurse) was about to discharge the patient and asked an experienced nurse if they give referrals or if we even had any pamphlets or information to provide this patient who obviously needs help. The answer was no, we have nothing. We provide nothing. I have pretty tough skin, but my heart sunk for this patient. I have wondered many times since that day what I MYSELF will do when presented with an addict of the obvious or admitted sort.... So here is my question...what do you all do? Do you have a policy regarding this? Do you provide information of your own to your patients?
  12. amyjm333

    Increasing anxiety before work

    It sounds to me like you may be having some general anxiety issues. It happens sometimes for unknown and/or unexpected reasons! Go see your primary care provider and tell him/her what's going on. I'll share my story with you: Several years ago I lost someone very very close to me when he committed suicide. It was a rough time, but by the grace of God I got through it. Fast forward 7 years and I was in my second to last/final semester in nursing school clinical. It was psychiatric nursing, & I found myself experiencing horrible anxiety each and every time I pulled up to the clinical site. I kept thinking I was going to see someone hurt themselves in the same way my loved one had died (via hanging). It was an irrational thought and I knew it, but the chemicals in my brain wouldn't comply with my sensible thinking. I visited my PCP and he suggested I take a low dose of sertraline (and informed me that he takes it too...said he would get anxious a lot about keeping patients waiting, etc...). Well, that medicine turned out to be just what my body needed. The anxiety disappeared, my occasional insomnia completely stopped, & I have never felt more myself than I do now. So, my point is....maybe you just have something physiological going on. Go see your PCP. :)
  13. amyjm333

    ED Culture

    Thank you for the info! I was just offered a position in the ED and I am so excited. I asked alot of questions in my interview and it really seemed that the unit is very collaborative and full of many, many nurses who have a true passion for teaching newer nurses, so I am thrilled to be starting once I graduate in May! (I'm actually starting in March as a extern/tech, just to get my feet wet until I'm licensed). Wish me luck! Any tips appreciated!!
  14. amyjm333

    ED Culture

    I will be graduating in May and am interested in emergency nursing. Can any of you tell me what the culture is like in your ED? I am confident that I can learn quickly and understand the steep learning curve, and believe my personality is best suited to this kind of nursing. But, I have one reservation- I don't want to work with a bunch of cut-throat, gossipy jerks. It's not that I have thin skin, bc I don't. I just prefer to work with a smart, collaborative, supportive team who can count on each other. I'm an older nursing student (30's), and if there is one thing I have learned in my life it is that you can't be happy if you're surrounded by negativity and/or mean-spiritedness. Should I worry?
  15. amyjm333

    Ivytech 2015 Fall Admission

    Yes, I am thinking perhaps Valpo did not get updated A&P grade since I just re took it this last semester. That is the only reason I could think of...Either way, I would have declined since I did get accepted into the S Bend program. :)
  16. amyjm333

    Ivytech 2015 Fall Admission

    I was accepted in SB but did not get an email. I received my letter yesterday.