gemmi999

I had a pt. in the ER who came in complaining about butt pain. She was from a SNF and had scabies, so it was thought she probably had bites on her butt that were infected. After talking with her/putting her on the monitor, and assessing with the MD,...

To be honest, a lot of what you're detailing should be the responsibility of the preceptor and/or charge RN on the unit. I was a new grad to the ED and my preceptor is the one who worked with me on my prioritization, etc. A couple things to conside...

Biggest, BIGGEST, thing I can do to set myself up for success is bundle care! I'd rather round on my current patient's, anticipate their needs, and then spend 15 - 30 minutes with my new patient getting hx, monitor, IV, labs, urine specimen (straight...

A couple things: 1) Preceptors can suck, but they can also be fountains of knowledge even if you don't like them personally. The biggest thing I tell people is after they're done being your preceptor, they're still your coworker. And when you have a...

In the ER I work in, we actually get quite a few students from both LVN and RN programs. A lot of times the LVN students get dropped off and they float around, trying to get skills in. They can't pass meds without their instructor but they help out...

One thing the original poster didn't note was if this was a first visit, and what the patient's baseline was. Is the patient normally non-verbal, does the patient normally lay in bed? Was there supposed to be family at the home? But yes, if in doubt...

My first nursing job, I made an error that could have really harmed a patient! My hospital didn't do BCMA so when I got a new CP patient in my bed that had computer orders for ASA and Clonidine, I administered both medications. When I went back to c...

In the ER, I have patient's leave AMA all the time. It really depends on the reason. 1) Some leave because they want to go to a different hospital, but the ambulance brought them to Local Community ER, and now they're stable enough to get a ride to ...

I am currently employed as a mid-shifter for ER. I love mid-shift, going home when it's still night and going to work in the afternoon, while it's still light. My current hospital is in the process of possibly being bough/sold and I don't want to dea...

I recently interviewed for a new ER position. The interview went very well and at the end of the interviews the manager gave a soft verbal offer, including opening up her computer and telling me which orientation dates to put down on my schedule. Sh...

I'm sorry you're going through that! It's a tough situation. A couple questions/comments: 1) Does your ER have float RNs? When I'm settling one ambulance and getting everything going, if I get a second run, I either tell them they have to wait or a...

I do wonder about critical thinking in nursing. It seems to me that a lot of the autonomy in nursing is being taken away, and after the autonomy goes, the critical thinking follows. Two incidents in my ER in the past week speak to this, to me. 1) We...

The best practice I saw for "disposable ice packs" was a school RN who took paper towel, folded it, wet it and placed it in a zip lock bag and froze it. Kids would then "mold it" over the area of injury. It stayed cold for like, 5 minutes and cost ve...

@MJW1962 -- have you started by 1) informing the patient it might be a bit bloody; 2) placing gauze under the site of the catheter; 3) Placing a finger above the catheter to occlude blood flow; 4) having everything set up ahead of time so you can gra...

I work in a community ER with a lot of either drug abusing patient's or elderly. A couple tips that work well for me: 1) look above the AC! A lot of nurses stop at the AC but if you look 2-4 inches above you can typically find something (even if it...

Today I: - Managed the rapid treatment area because we were down 1 tech and 1 LVN. Yay, 8 pts at a time with "low" priority status, meaning they didn't need a bed. - Held down an kiddo when the doctor was pulling beads out of her ear - Medicated a bu...

I've worked in numerous small, community ERs. My current ER? The ER pages the admitting MD, the admitting MD talks with the ER Doc, and the nurse hand writes orders because the admitting MD doesn't want to use the computer. Which means the ER nurse ...

I'm in the ER, so it's a little different. There's such fast patient turnover and there are always new orders. Depending on who I'm getting report from and if they're busy giving report to another RN or not, I'll look at chief complaint, age, medica...

My ER has basically 3 areas. 2 runs of 3:1 where super critical patient's are supposed to go; 4 or 5 runs of 4:1, but one of those is *always* a chair patient who doesn't need to be monitored (kids with abd. pain, cellulitis's, etc); and rapid treat...

ER is a bit different from floor nursing, but I do try to manage expectations. I will routinely tell patient's that the MD has to handle emergent cases first, and that they will be seen and have their needs addressed, but they might need to be patie...

It was a regular day in the ED. I had the back rooms, the "non-critical" patient's that are sick, but not needing to be in our (the nurses) line of sight the entire time. A woman came in complaining about n/v for four days. Through lab work and CT i...

Speaking as someone who still has to take phone orders from admitting MDs, there are nights when I don't even know my patient's labs until I have the doc on the phone and the computer in front of me. If it isn't critical then it isn't necessarily an ...

and I'm sorry you went through that. I hope your son is okay! -- 1 ) I wouldn't have given food, either, sorry not sorry. Not until I got a verbal order from ER doc or admitting MD. I keep all pt's NPO if possible surgery candidates. If your son ...

Speaking as an ER nurse, as an new grad who went straight to ER, and as a person who has taken care of many "pt holds" in the ER that should be on floors, I have a couple things to say. 1) Absolutely right--insulin should never be given IM. On top of...

Two quick notes-- 1) If you were asked to resign, but you resigned, does that really count as being fired? You officially turned in your resignation letter, yes? 2) If they did it to hire a LVN/RN, you can state "position was eliminated due to employ...