edmst

You don't do your own blood draws? And lab is allowed to touch the IV access???

This is the type of attitude that is what is hurting nursing. Nurses have to be firm but in a professional manner. Enough with the whole empathy and understanding nonsense (that is for the random family member whom the patient hasn't seen in 10 years, not the patient). The patient refused to eat all of their food. End of story. If the nurse were to force the patient to eat against their wishes, the family wouldn't like it. The patient didn't finish their all their food, the family didn't like it. The tray wasn't immediately whisked away, the family didn't like it. It's a never ending battle. These are the type of family members that wouldn't dare question a physician yet will demean a nurse all day long.

So let them lay and sleep in their urine and feces? Great nurse!....

If the patient is having aphasia, how can the patient verbalize their name, date of birth, allergies, symptom onset, medical history, etc.? Real world, stroke team would meet the potentially stroke patient at the ambulance bay. Weight HAS to be obtained in case tpa has to be given. Glucose and vitals obtained. History is obtained from family or rescue as best as we can as well as any blood thinners the individual may be on which would contraindicate tpa. When was the last time seen normal? The ER physician conducts NIH and the patient is IMMEDIATELY taken to C/T of the brain to rule out a stroke...and if it is a stroke whether it is ischemic/hemorrhagic or negative. Right after the C/T is done and is being read by the radiologist/neurologist, 2 large bore IV's are placed and labs are drawn, specifically coag's. From there, the patient may have to have a CTA and MRI and all the while assessing the patients condition. Also didn't care that you have a sim lab and made the the comment you're already prepared for it without any experience and didn't mention the most crucial aspects...but you're already prepared for it..............scary

You are already encouraging bad habits to a nursing student that he/she may carry into their nursing profession? No matter how thorough a report may have been, one must ALWAYS check the orders, labs, etc. to confirm and not take the previous nurse's word for it. Assessments on all assigned patients should be performed prior to lab draws/medication administration because the assigned patients that were taken report on are now your responsibility. To have multiple patients and give advice to take care of 1 patient at a time without doing an assessment on all their assigned patients is irresponsible. What if one of the other patients were crashing? Oh, but labs are pending for the other? Irresponsible.

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Is this post for real or a joke??????? I hope this not the future of nursing. These nursing schools are pumping out "nurses" that have no critical thinking skills or common sense. Really, why can a stainless STEEL needle puncture a vein but not a piece of PLASTIC?

Really? An ER nurse is not a first responder? At some facilities if there is a rapid response or code blue the ER team are the ones to respond. In the ER where I work, rapid responses aren't paged overhead if there is a decompensating pt in the ER because we are the code team. If a critical situation occurs anywhere on the 1st floor of the hospital--be it the ER, C/T, MRI, Ux, IR, cafeteria, lobby, visiting area, parking lot, valet, or anywhere within 250 yards of hospital property, the ER is the team to respond. Rescue is not called..If we get a code blue/stroke/stemi, ER pages overhead only to notify Cath lab/CT/MRI ready to clear the tables. The pt is first stabilized before taken to radiography which is done by ER because some Rescues are notoriously incompetent. Not every pt is stable when they come through triage. Mind you, this particular hospital I am referring to has 115,000+ ER pts/yr. You may be referring to a lower acuity ER.

To me, this is one of the MANY issues with healthcare. Healthcare is so focused on "patient/family satisfaction" as if it is a hotel or restaurant. In an emergency, I don't want family members hovering around me with no clue to whats going on or being in the way while I'm trying to maneuver around them while they stand there and wail. An example, the other day a daughter in her 50's brought her mother in her 80's to the ED with a chief complaint of of being weak, dizzy, and not being herself for the past 5 hrs. EKG showed her HR was 27. Surprisingly her BP was around 110/70. This case could've gone bad realllll quick. As I'm trying to connect the pt to the pacer pads and crash cart and then try to start a large bore IV in the AC, the daughter was refusing me to start a line in the AC because "its uncomfortable when she bends her arm". I snapped at her because we need a large IV. She was also in the way because she was trying to find an outlet to plug in her cellphone. I was able to get a line and give glucagon and eventually the HR came up. But guess what, nothing I did will matter. The fact that I snapped at the family is what is gonna matter to administartion. Any nurse with years of experience knows this is always the case.

LOL. Was that sarcasm?

I've worked the floors for quite a bit, along with CCU and neuro ICU. If you think the floors are not "structured and routine" then you'd be in for a surprise in the ED.

I know the many uses of Benadryl IV. I was just curious as to the reason why the OP gave the medication?

Really? Have you worked in an ED where in a 12 hour shift the ED will see almost 200 pt's? I doubt you have by your response. Floor nurses can get stat orders but for the most part, everything is structured and routine. Big deal if a floor nurse has to start an additional IV...Not sure what hospital you work at but a pt does not get admitted to the floor without a diagnosis (your statement seems odd because in all my years and hospitals I've worked in, a pt cannot be ADMITTED without an ADMITTING diagnosis. Really odd statement you made). And like I said, yes, there can be an occasional stat order however EVERY single order in the ER is stat and everything is timed. A chemo pt with a fever: the whole triage has to be done at bedside, whole rainbow has to be drawn (6 tubes), blood cultures x 2, lactic acid, urinalysis/urine culture has to be collected and antibiotics have to be started and all has to be done within an hour or its considered a "fallout" from CMS. Mind you, this is with 3 other pt's with severe chest pain, abdominal pain/blood transfusion/stroke/seizures. I never said we did all the work for the pt but we do work up and stabilize the pt. Again, I'm not sure what hospital you work at but at my ER, we cannot send up an unstable pt.

I have a few questions: What was the Benadryl given for? Did the pt experience an adverse/allergic response from the medication? Did you override the medication or had "leftover" in a vial from another pt? Don't get me wrong, you definitely were beyond our scope of practice but I am curious as to why you did what you did? (Sorry if that sounds abrupt, I'm a male nurse, its what we do lol.)

I work in a VERY busy ED in S. Florida (3rd busiest) so I can chime in from experience. I used to work the floors many years ago but I think what the floor nurses don't understand is everything is beyond our control. We only have so many beds and if a critical pt comes in, we have to have a bed available, so the time whether its around shift change or not does not matter to us when sending a pt up. The other day in pre-shift actually, we all commented that miraculously beds open up around 1800 (approximately 15-20 at a time) even though all day nothing was available. We have to send pt's up because we can't tell rescue they cant bring pts because its about to be shift change, so why should the floor nurses get that luxury? You complained about having 4 pt's and then an admission. Try having 5 pt's in the ED. Every order in the ED is STAT. It's not easy doing stat orders for 5 different pt's. At least on the floor the orders are routine and structured...not so in the ED. Pt's that are admitted to the floors are already worked up. They've been triaged by ED, IV started by ED or rescue, blood work completed in ED, imaging(s) completed in ED, and diagnosis finalized in ED.

Don't sweat it. A patient will never be satisfied, they will always have a complaint (trust me I been a nurse for 15+ years from tele to icu to er). What gets me is nurses tend to be the WORST family members and are to the point of harassing the nurse yet they forget how much they dislike it when they are working and are being harassed. The system is broken. The other day a pt came in with V-fib by rescue and they coded the pt and the pt made it. The primary nurse was doing the documentation assisting with intubation, inserting OG tube, inserting foley, cleaning up the pt, charting, speaking with the family members, giving report to ICU, transporting pt to ICU. Then she comes downstairs to 2 whiny pieces of crap human beings: the pt and her daughter (who is a nurse) complaining to the clinical manager that she's been calling for her nurse for more than an hour-the reason was because she wanted to know if the hospital provided cellphone chargers. And guess what? When the patient's satisfaction survey call comes in, it's going to be negative on the nurse. So like I said don't sweat, what can you do?...

Nope, you're not looking at the big picture. Although not that common, if the site the wife started became infected and caused her husband to be septic, then who's to blame? You better believe hospitals have lawyers light years better than any nurse could afford.

Why do nurses all of a sudden forget what it's like to be a nurse when they are not on the clock - dealing with needy pt's yet the pt's are chatting up a storm on their cellphone, pt's only complaining of pain once you walk in the room, complaining of abdominal pain and n/v only to find the pt eating greasy fast food brought by family members, drawing blood, cleaning pt's? If the pt and spouse let it go for 6 hrs, it is not "stat". "Stat" is for emergent/life threatening situations. Seriously, you would have made a huge stink when OP herself admitted she and her spouse let the pain last for 6 hours?

What I don't get is the "5 hour rapid response"? Why did it take so long to stabilize the pt/why did it take 5 hrs for the pt to code once rapid response was called? Was the rapid response not managed properly? That should be brought to management's attention.

Yes I understand the difference between correlation and causation and truthfully I do not appreciate your reply. Either you are a new grad who has not has much exposure/experience or you haven't had a patient who's had the Guillain-Barré syndrome as a result from a vaccine. You're just wasting my time. Talk to me when you get your MSN...

Such an ignorant comment. I know and have witnessed PERSONALLY individuals that ended up having severe reactions including facial paralysis.

With all due respect, I'm not sure how long you have been a nurse but we do get paid poorly considering the amount of work we do and the responsibility we hold (in the ED at least). Congrats on the fact that you are not struggling at all. However, a lot of nurses complain about the lackluster salary due to student loans, mortgages, personal expenses, family expenses, car payments, etc.

A nurse's salary is extremely limited especially factoring in student loans and current bills/loans/mortgages. Yes, in certain areas the salary is greater but so is the cost of living. Nursing is a very stressful job both physically and mentally. You stated you purchased a "nice" car and a "nice" diamond ring yet are lecturing about living "frugally."

She/he has yet to "master" pharmacology...

I'll be straight forward with you because as an adult, I believe the best advice is not the sugar coated advice but the real cold hard truth. I have worked in med surge, tele, stepdown, tiny bit of ICU, and now settled into one of the busiest ED's in a large metropolitan city (which the ED sees appx. 100,000 pts/year). You have this illusion that a nurse's salary will be sufficient enough to pay off your student loans, pay for your current bills and such, and after those bills are paid, you will be having enough left over to save to purchase your own business. That's unrealistic. the salary just isn't there.