alm3RN

Great read, thanks so much for posting it!

In my hospital, that is one of the worst shifts It is busy from the beginning until the end and the nurses who work that shift cover 7-7 lunches and usually don't get their own. Just bring snacks! And be prepared to hit the ground running from beginning to end!

Hi Jenna! Congratulations on your new job! I, too, am a new nurse and started out in the Emergency Department. I have been working in my hospital since October, and I will not lie to you, it was VERY hard on me at first. I am typically extremely hard on myself and a tad bit of a perfectionist, this would usually make me feel like I didn't do "as good as I could have" by the end of the shift. I am still learning to leave work at work and give myself a pat on the back at the end of the day for doing the best job I could. Make sure you have a life outside of work, for the first few months after orientation, I was a stressed/anxious/depressed mess. All I could think about was work and the stresses that come with it. I had stopped exercising, hanging out with my friends and family, and was just in a general funk. Don't let this happen to you! Exercise is an AMAZING de-stresser. Eating healthy will give you the energy you need to make it through the shifts. Understand that this is the hardest transition you will go through and that no matter what, time will continue to move on and you will continue to get accustomed to the flow of your unit and even get excited about work! (I never thought I would be excited about work when I first started!) Teamwork is a HUGE aspect of Emergency Nursing. Help your coworkers when you can, they will return the favor if you fall behind or need assistance. ALWAYS keep this mentality! Be friendly with EVERYONE on the unit; doctors, housekeeping, radiologists, techs; NO ONE is better than anyone and you can learn from everyone! As previous posters have said, NO ONE IS PERFECT. Every day is a learning experience and you should definitely learn to greet these experiences with open arms and don't allow yourself to feel as though you "should already know that". Nursing school is a completely different world. If I have a lot to do on certain patients, I will "print screen" the orders and grab EVERYTHING before I go into the room. Saves so much time! Triple check everything, document as best as you can, keep a little notebook for notes and times if you don't think you will have the time to document on the computer, this has saved me many times. Check your pockets before you leave, make sure you have wasted all your meds before you go home! As you get more used to your unit, you will find your own way of doing things, and that is great. Whatever works best for you is what you need to follow! I wish you the BEST of luck and welcome you to the wonderful world of Emergency nursing! You will love it :)

I agree with you all. I just wish I pushed the doc harder to keep him. He wasn't having it though

As far as I remember glucose levels were within range

I work in the Emergency Department and am a fairly new grad, 6 months out of school. I had a patient come in this past weekend and I just can't stop thinking about what I could have done differently as I am usually very, very hard on myself. Here's the scenario: Parents bring their 4 year old child in to the ED with chief complaint of fever and abdominal pain for the past three days. They deny any other symptoms except three episodes of emesis over the course of the three days he has been sick. I medicate him for his 102.1 fever with Tylenol, draw some blood, give him some fluids and anti-nausea medication. Pt is vitally stable, crying but consolable, and sleeping on bed with mom as it is 3 am. Send urine to lab, it is dark in color. Once all the results come back, he is diagnosed with "fever in children, vomiting in children, UTI, and renal insufficiency". His BUN was 39 and Cr. 1.6. Pt is discharged and parents are given instructions to follow up with PCP and urologist. Fast forward to the next night, pt is brought back to ED by parents stating that his abdominal pain has not decreased, but parents now state that en route to ED, child began having difficulty breathing. Pt ends up satting at 84% on RA, and gets admitted to hospital with a diagnosis of pneumonia as well as the diagnoses that were given the night before. Long story short, pt ends up getting intubated as soon as he arrives to PICU. The pt was mine the first night, but I saw him come into triage the second night. I guess my question is was the doc wrong in discharging a 4 year old with renal insufficiency? Are the two diagnoses related? What causes a 4 year old to even have renal insufficiency? I guess I'm mostly just looking for reassurance, when the pt was mine, he was totally stable and there wasn't even an indication for a chest x-ray or any respiratory related exams. I just feel bad that we maybe could have prevented all this from happening. I'm not as familiar with pediatric patients as I should be, but am hoping I can get some advice/words of wisdom from you more experienced nurses out there

Hello all! I have been an avid allnurses reader throughout nursing school, but have yet to post! I graduated with a BSN in August and received my RN license in October (Thank God that stress is over!) I recently began working in the ED at one of the local hospitals where I live and I could not be more happy with my decision. I am currently doing shifts with my preceptor from 7p-7a and I just have a few questions to ask regarding the adjustment. First of all, what sleep schedule has worked best for you all? I really don't like keeping the same schedule during my days/nights off because I like to spend time with my family. Lately, I have been staying up until 5-7am the morning of my first night shift and sleeping until around 4-5pm. It has worked for me so far, but am wondering if there is a healthier alternative? Also, I am a health and wellness enthusiast (to put it lightly) and I love exercising and sticking to a work out routine. However, due to my recent change in schedule, I haven't made it to the gym in about a month because I am so groggy and feel like I don't have the energy. Do any of you all have a work out schedule that works out for you and your work schedule? Once I get back into the routine, I'm sure I'll be more motivated to go. Lastly, what type of meals/snacks do you eat during a shift? I'm trying to eat very healthy (especially considering I haven't made it to the gym in a while) and because I've heard most night nurses gain a bit of weight in the beginning (AH!). Any other tips/advice is welcome!! :)