streptococcus

I agree that paramedics are trained for the "Out of hospital environment" or field work, and RNs are trained for the hospital environment. However, a RN is not necessarily better than a Paramedic and a Paramedic is not better than an RN. I have two full time careers; one as a fire department firefighting Paramedic, and another as an Emergency Dept Registered Nurse. Therefore, I also get to perform and observe both areas of health care. I would rather have a Paramedic provide care to me in the field, and I simultaneously would prefer the care of an RN in the hospital. I have responded to many emergencies where a clueless RN was on scene freaking out, not knowing what to do. Most RNs do not experience emergency situations outside of the cushy hospital and therefore, they often are no better than an untrained bystander on scene. On the RN side of the issue, I get to experience and do so much more in my ER than I ever do in the field and I am a much better paramedic because of my RN experience. I am also a better RN because of my Paramedic experience as well and will not spaz out the way a few other nurses do during a crisis.

I am pretty sure it is a HIPPA violation to give a patient's SSN to police without a warrent.

Taking, or (Measuring) an individual's blood pressure is a basic skill not a treatment. Your can purchase cheap machines to measure BP at many stores, and these machine do not receive regular calibration either. Therefore, I cannot perceive how measuring someone's blood pressure is an issue. The difficulty would arise when one attempts to provide health care advice related to blood pressure.

I wish you the best in your career and life QueensNurse. It seems that the ED, while initially exciting, will eventually progress to being a repetitive task for those of us new to the emergency department.

Sorry about my post concerning my new ED job. I thought I followed the correct process to send the e-mail directly to LunahRN, but obviously I failed. Ooops, my bad

LunahRN, I have to tell you that I have watched for your post since I decided years ago to obtain my RN through Excelsior College. Along with the fact that you were a paramedic obtaining your RN through Excelsior also has provided me a little extra motivation and encouragement along the way. Well now I have my RN degree and Tennessee RN license. I had an interview yesterday and to my utter disbelief, was offered a night **** position after an interview by the ED's DON and four night shift charge / head nurses with a large ED here in the Memphis region. I am still in shock because the day before the interview, I spoke to the ED Manger by telephone and she informed me rightly so, that I had a few strikes against me in trying to land a job as a new RN. One strike is that I will stay working with my fire department which works 24 hour shifts. The second strike is the lack of a clinical process with Excelsior College. Despite my belief that I could not possibly get a position in the ER, I decided to give the meeting with the ED manager a try with the hope to at least get some professional advice. When I arrived for my appointment, I overheard the ED Manager tell her secretary that as a result of a couple of pressing issues that just occurred, she would not be able to do the interview, but instead, another nurse would do the interview. After hearing this statement, it just reinforced my belief that I was just out of luck. A few minutes later, a nurse walks up and introduces himself as the Director of Nursing for all of this particular hospital system’s emergency departments. I just knew that this interview with the big man of the ED would be the death of any chance I had. The ED’s DON sat me down and asked a few easy questions about my experience and expectations. After he completed his portion of the interview, the four night shift’s head nurses come in to interview me as well. When they walked in, they all sat down to form a crescent shape around me. They were the predators and I was their prey. Again I thought, “Here comes the real grilling.” However, those nurses including the director were some of the most pleasant people I have ever met. After the four night shift nurses completed asking me their questions, the DON returned and told me that the night nurses recommended that he hire me! As I type this page, I am still in shock. I think I should ask my wife to slap me to make sure I am awake. It will be tough to work two full time jobs. One being 24-hour shifts at the fire department and the other 12 hour nights in the ED, but I am motivated to make this work for at least a year, until I can prove myself and then change my status to part time. The eventual part time status I want will only be so I can wok the ED schedule around my fire department schedule a little better. I also see you have your CEN, which I have been studying for as well. I plan to take the CEN in about three months. I am so psyched that I am already unable to sleep throughout the night without awakening to the thought of how will I do, or will I be a good ED nurse. Onward I go. I will now be able to post my thoughts and try to help other new emergency nurses as they ask questions on this site. Thanks for the motivation

Hello Brian, I have applied for a few positions at St. Francis as well as Baptist and Methodist systems. I basically would take what ever position I could get, because my view is beggars cant be picky. I also realize that no matter what position I start in as an RN, I have a tremendous amount to learn. I believe the Cardiac floor would be a great area to work in and would appreciate the assistance. Thank You Sir!

Thanks for all of your advice.

Advise from Nurse Managers My story I have desired an RN degree for many years but could not attend the traditional nursing programs due to my fire department schedule of 24 hours on duty. Well, a few years ago I met a nurse who had obtained his RN through Excelsior College's self-study program for paramedics and LPNs. After contacting my state board of nursing to ensure they accepted Excelsior grads, I applied and just recently graduated this past November and passed the NCLEX in January 2010. I work ten 24-hour shifts per month at the fire department as a paramedic. Therefore, I have an average of 20 days per month off duty in which I can work as an RN. I do not believe most RNs work 20 days per month, so I assume I have plenty of time to work as a nurse. The problem I seek advice for is that all my applications for part time RN positions in the Memphis, TN area have been summarily rejected. Unsure why because no one sends any feedback, but I believe it is because they all ask for one year of experience. So I ask you, how can I get one year of experience if nurse managers will not give me a chance? I have been under the impression that I would not have any difficulties obtaining an RN job because I have been a paramedic for so long. Apparently I have been incorrect in that assumption. It seems to me that a new RN with Paramedic experience would at least have a little bit better chance of obtaining a job than a new nurse with no patient care experience other than from clinicals. As an extra, I am currently studying for the BCEN exam and should take it in about one month, with the hope that passing the emergency nurse's exam will help me. I would appreciate ANY advice. Thanks in advance for your time

As an 18 year paramedic and new RN; I thank you for your appreciation.

Would this be an intravenouse drip solution?

One of the problems with nursing is that most nurses have no formal training in management, supervision, or how to combine them to be a good leader. Therefore, their reasoning processes involve a lot of trial and error learning, often contamination by friendship and cliques.

It is permissible to have a conscious hypoglycemic patient orally ingest a high glucose drink or paste as a conservative measure to elevate her glucose level. However, you can never administer an oral drink to an unconscious patient, and we all know why.

Yes, both forms of ventricular tachycardia are shockable. For the unconscious patient you defibrillate For the conscious patient, you use synchronized cardioversion For unconscious defibrillation, you shock randomly For conscious synchronized cardioversion, you switch the cardiac monitor to its synchronized mode and it analyzes the patient’s rhythm and delivers a shock right after the R wave of the heart’s cardiac cycle. The monitor does this to reduce the chance of turning the ventricular tachycardia into ventricular fibrillation. Ventricular tachycardia can occur while the patient is alert or unconscious, and much depends on the patient’s ability to tolerate the rapid ventricular rate. Some healthier patients can tolerate the increased rate of ventricular contractions and remain conscious, while others with multiple medical conditions may not be able to tolerate the fast rate and become unconscious due to lack of cerebral perfusion. If the patient is unconscious with ventricular tachycardia, you should defibrillate with 200 jules immediately in an attempt to reset the myocardium’s electrical circuit to a slower rate. If the patient is conscious and stable, then consider providing oxygen, starting an IV, and administering Amiodarone or lidocaine. If the patient is conscious and unstable, then you give oxygen, start an IV and administer Diazepam to sedation the patient prior to shocking using the monitor’s Synchronized cardioversion setting.

Male physicians assist with infant deliveries and as a male RN/ Paramedic, I also have assisted patients with the births of their infants. Just because one is a female most certainly does not prove they know more about deliveries. Most female nurses probably could not explain their own menstrual cycle to you if you asked them to.