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EMTandNurse2B specializes in Emergency/Trauma.

RN now!!! In Paramedic school

EMTandNurse2B's Latest Activity

  1. As a new ER nurse, I will gladly start the fluids for you if I have them. We only stock NS and LR, everything else has to come from pharmacy. I do not have time to hold the patient in the ER while waiting for some fluids to come down so I can start them. :wink2: Make sure you ask your patient's baseline and current mental status. I see this overlooked in report many times and not knowing this can cause some poor outcomes if things change quickly with the patient Ask if they have family/social support with them and/or available. I have had nurses call back down for this info several days later when the patient was getting ready to be discharged and there was nobody to drive them home. I don't remember anything about the patient for more than a few minutes after I send them up, so be sure to ask! If you work in an ICU, be sure and try to get the picture of how fast this patient crashed/became critical. It will give you an idea of how quickly they may turn sour on you. I don't envy your ER nurses having to do the med recon forms :) We only have to the intial ER recon form, and the floors do everything else. Last of all, remember that we are extremely busy and have different priorities than you do. We may ask you to hang the fluids on a stable patient so we can deal with the GSW to the chest that just walked in the door and up to the desk while we were talking to you. We will try and return the favor and help you all we can!
  2. EMTandNurse2B

    Many RN's administer IV meds wrong.

    This also drives me crazy! Also, pinching the line closed (or turning it off) when administering meds IVP into a running line (NS, or other compatable fluid). You do the same thing here when you pinch the line off, even if you use the lowest port. I puposefully open the line wide, and slowly given the med so that it flushes in slowly as I push it. I then leave it open for 1-2 minutes to flush it all in, and then put it back to the original rate.
  3. EMTandNurse2B

    Things Patients Have Taught Me NOT To Do.

    So very, very true; and unfortunately very common
  4. EMTandNurse2B

    Most Embarassing Nursing Moments

    I had to laugh at your post, for I have done the same thing several times! But nothing was as bad as last week when I put a Foley in the wrong patient!! The little lady was alert and oriented, in the ER for something minor, and didn't once say anything about it. I was soooo embarassed when I realized what I had done!:imbar The problem was, both ladies were my patients so I had to go back into her room!! :imbar But, nothing beats the night the ER doc grabbed me. :imbar I was working with a very sweet, very competent older ER doc that night. We were log rolling a MVC patient off the backboard and I was holding c-spine at the head. As we rolled off the board, the IV line got caught. I am, um, rather well-endowed, and when I bent forward to catch the IV line I, um, "draped" the patient's face. Well, the poor patient starts saying "I can't breath, I'm suffocating". I'm thinking to myself that we need to hurry, thinking that it was the position the patient was in that was causing the problem. Well, I hear the ER doc say "He's got to have an airway", and before I had the chance to look down or figure out what he was talking about, the doc had "lifted" my chest off the patient. :imbar:imbar Talk about embaressing!! The doc never said anything about it to me, just looked at me once, turned red, and left the room. The patient fortunately didn't notice (the pain of a pneumothorax, shattered shoulder, and lacerated spleen had his mind occupied). :imbar
  5. EMTandNurse2B

    Computerized charting in the ED

    My ER uses EDIS. I love, love, love it. Things are so simple, quick, and efficient. You can see the entire ER on a flow sheet, as well as who is caring for what patient and what needs to be done for each patient. We are just about to switch to EPIC, and in comparision EPIC is clumsly and slow. EDIS has a very limited number of screens to chart in, is easy to read and understand, and makes it easy to help your co-workers. Triage is rapid, Doctor orders are easy to place/complete, and even charting in a code is quick and easy.
  6. EMTandNurse2B

    new guidlines ???

    I work as an RN in a level 1 trauma center, and this is indeed the practice we are moving toward. If (and only if) the patient has obvious bleeding (inside or out-we use ultrasound), we try to limit fluids to a max of 1-3 liters, including what they got prior to arrival. We have 3-4 units of O- blood in the trauma ready to go, before the patient arrives. If there is no obvious bleeding, we use NS or LR until we know the H & H (about 5 minutes). We are also going to warming everything that goes into the patient to prevent hypothermia, another new study. Obviously, we used typed and crossmatched blood as soon as it is available, but in a bad trauma there is no time to wait for it to be typed.
  7. EMTandNurse2B

    Pinning is TODAY!!!

    Congratulations!!! I well remember my own pinning one short year ago. Enjoy the day, and don't start working to soon, you need some time off!
  8. EMTandNurse2B


    I have a very strong stomach, but I draw the line here. I have yet to see maggots on a living human (thanks to a kind coworker who removed them from between the homeless psych pt's toes), but when I do I'm pretty sure I will faint. The problem with community acquired maggots, as another poster pointed out, is that there are several kinds, and not all of them stay on the surface. Some kinds eat living flesh as well and will burrow into the person and literally eat them from the inside out. I grew up on a farm, and saw this happen twice to long-haired rabbits. Once the process starts, and the maggots are inside, they are just about impossible to get out. Now, I imagine that a human being so much larger, it would be much easier to save them, but the limb/etc might have to go. That said, ever since the rabbit incident, I DO NOT handle maggots very well. This ER nurse will be on the floor, despite her reputation for handling anything without even gagging. There is a line!
  9. EMTandNurse2B

    You Know the patient is going bad when...

    When the patient looks at me and says "I'm not sick enough to be here, my family (neighbor, etc), dragged me in, let me go home and I'll be fine". Had this happen to me several times in the last few months. All of these patients were dead/coded/in the ICU in a few minutes after saying these words. This included the guy with the pulsating knife sticking out of his chest (gotta love the ER!)
  10. EMTandNurse2B

    blackout curtains advice

    I took cardboard and stapled in to a wooden frame that just fits inside the window. A little weather stripping makes it seal, and no light at all gets through. A fan on, and a towel under the door; and I can sleep all day.
  11. EMTandNurse2B

    Adequate Staffing = I Love my Job

    I feel the same way about my job. The nights we have enough staff I come home smiling. The nights we are short, I come home crying and work on my resume before bed.
  12. I'm so excited right now!! I applied three weeks ago, interviewed last week, and heard back today that I got an RN position for my dream job!!!! I graduate in four weeks from tomorrow, move 800 miles two days later, and start my new job a week after that. This job is working as RN in the Emergency Room of a 550 bed hospital. I've always wanted to be a nurse and work in the ER since I was a little kid. Now, after four years of hard work and tears, I'm almost done. I've spent the last school year and parts of the other three years supporting myself, paying for my tuition, and going to school full time. Currently, I work three part-time jobs and attend nursing school full time. Finally, all my hard work is almost over!!! Plus, the head of the nursing program stopped me today and told me that I'm getting the Outstanding Nursing Graduate Award at graduation. Two pieces of exciting news in one afternoon!!! Well, I just thought I would share my good news!
  13. EMTandNurse2B

    Just got my Littmann Master Cardiology Stethoscope..

    I have a Cardiology III and love it. It never leaves my neck for fear it will walk off. That came back to bite me on my first day on the job as a new LPN. I had decided to not take my stethoscope for fear of I don't know what. I had been previously informed that the nursing home prefers we use the ones they provided. So, I go in to take an apical pulse on a patient before giving his Coreg (he has problems with arrythmias so we watch closely). I couldn't hear a thing with the cheap stethoscope! I'm nervous as can be, this is my first night on the job, and I can't even find a heartbeat! The patient informed me that he was still alive, so he had to have a heartbeat, but I counldn't hear it! I finally found the very faint heartbeat with the stethoscope, but the nurse did wonder what took me so long to count a pulse! The rest of the night I had to really concentrate to hear anything out of that scope. The next night I had my own stethoscope around my neck.
  14. EMTandNurse2B

    Humorous student awards

    How about the one with the strangest patient request? Like the lady that asked me to push her prolapsed hemorrhoids back in, or the patient who asked to replace her prolapsed uterus. ask them for the strangest request they have received and then award to the strangest one.
  15. EMTandNurse2B

    I am now a LPN!!!!

    Thanks everybody! I ended up choosing to work in a Long Term Care facility for $6.00 more an hour, even though I would have enjoyed the hospital more. Oh well, I need the money now and I can work at the hospital when I graduate. Thanks again for all the congratulations!
  16. EMTandNurse2B

    I am now a LPN!!!!

    I did it! I passed the LPN NCLEX!!! :balloons: ! I'm official now!!! This is such an incredible blessing for me right now. I am in semester four of five in an ADN program. After semester three, we are eligible to take our LPN NCLEX. I couldn't take it right away due to money issues, but a wonderful nursing professor finally dragged it out of me why I hadn't taken it yet, and she found a way to pay for it for me!!:balloons: (a help service in the college) I am so grateful to her for this! On top of nursing school I have been faced with several major things this semester. My parents were helping out with my school, paying my tuition and whatever else I couldn't afford on my tutoring salary. However, my Dad lost his job last January, and hasn't had one since. I haven't been making much at my tutoring job, and what I did make now had to cover everything. I couldn't affor my NCLEX, yet I desperately needed it to get a LPN job to pay for school. This was on top of moving, loosing my dog, strained relationships, and other issues this semester. So, my professor's care really made the difference for me!! I did find a job, actually two of them, that are waiting to hear from me that I passed the NCLEX. Now, I can call the one of my choice and tell them I did it!! I'm so happy right now I'm almost crying. After all this lack of sleep, tears, determination, and hard work, I finally did it! I can hopefully now orient to my new job next week and afford to finish RN school. I so want to graduate next year, I have made many sacrifices to get this far and I want to finish! I love nursing, and am told that I do well in my clinicals. I just want to make it to graduation. So, long-winded way of saying I DID IT!!!! Thank you all, I don't post much but I do read allot, and I appreciate the support on here. I often come and read just to remind myself that someday it will all be over. Thanks!