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  1. EDnurseNY

    Inpatient Boarders?

    Thanks for the replies, everyone! I appreciate them. It's pretty demoralizing not being able to do the job I was hired for. And yeah, between the boarders and the ratios (and being called lazy), we're losing nurses left and right. JKL33, can you clarify? How is it fraud? (I'm just confused by your comment. Help me understand?)
  2. EDnurseNY

    Inpatient Boarders?

    Thanks, Kuriin. I think our management has its head in the sand a bit. A lot of people are leaving d/t these problems we're having and they act as though everything's great.
  3. EDnurseNY

    Inpatient Boarders?

    I work in the ED in a mid-size city in New York. It seems that the hospital floors are always full, and most of the time we have over 30-40 inpatient boarders, sometimes up to 55. We have 60 beds in our acute area, and this leaves almost no normal patient care areas in which to treat ED patients (and so we have 50+ in the waiting room every day). We end up treating patients in stretchers and chairs in the hallways, and most of the time, my colleagues and I are acting as med/surg nurses because someone has to take care of the boarders. The ED looks like a war zone with people stacked up in the hallways. When bringing this up to any of our nurse leaders, we're told hospitals are like this everywhere and we shouldn't complain (or go anywhere else) because everywhere else has it this bad. I guess this is all a roundabout way of asking: Do other hospitals actually have these problems/is it that bad everywhere? I hear back from people who have left to travel and it seems like they don't have these problems. Sidenote: Then again, we're also told to shut up about our 6:1 staffing because back in their day it was 8:1 and we should just be thankful to be 6:1 with no PCTs, even if you have ICU players. So maybe I'm just salty in general.
  4. EDnurseNY


    My facility is just upfront about it. There's a hospital-wide announcement "[Hospital] is proud to welcome representatives from The Joint Commission. . ." And then the ensuing panic.
  5. EDnurseNY

    Starting Over at 25

    I started over! I did my prereqs in a year at age 24, started my ABSN program at age 25, and now I'm 27 and almost a year into my first nursing position. I'm very happy that I switched careers. Also, you'd have a little leg up on some of your co-workers. I'm in a specialty that attracts a lot of new, young nurses, and more than a few people have commented that I appear more mature and more comfortable in life/my own skin than my 21 year old co-workers.
  6. EDnurseNY

    When should I apply for RN positions?

    Hi! I'm not in NYC, but another city in NY. My hospital started recruiting in February, I interviewed the second week of March, and got the job the day after, on the condition I graduated and passed the NCLEX. (This was last year, I graduated May 2016)
  7. EDnurseNY

    how much lifting/transferring in ed?

    I agree with the PPs and want to add that there are also times when your co-workers may need you as immediate help if/when they get attacked. It happens a lot where I work that someone goes after one of us and we yell for help and our fellow nurses are the closest people around. You'd have to be able to run into a room and help restrain someone/hold them down until security gets there. But that's where I work, your mileage may vary. I know not all EDs are the same on this one.
  8. EDnurseNY

    How many patients you guys take on your duty?

    USA ED 4:1 or 6:1. With 6:1 we should have a tech, but it doesn't always happen.
  9. EDnurseNY

    Why wasn't I placed in the ED?

    Hi there! I had a few thoughts as I read this thread, and while not all of them might apply to you or your specific situation (as I learned reading on), I feel like I should share them. Before nursing school, I had a serious desire to work in the ED. It was the goal the entire time I was doing my pre-reqs, nursing school, capstone, etc. I was completely driven to be an ED nurse. I knew going into capstone placement time that there were 2 spots and 20 people trying for the ED. I did not get placed in the ED, and I remember being pretty upset for a bit. I did get placed in an ICU setting where I learned quite a lot and ended up loving it, but I kept driving on toward my goal of working in the ED. I feel like my story may be somewhat similar to yours. Spoiler: I did end up getting into the ED new grad residency program at my hospital! I know you ended up explaining that you weren't trying to put down your classmate, and I definitely understand the feeling of someone else getting what you want (and have wanted for a while). Do just watch how you word things, even if you're upset. There is so much of "politics" in nursing, and in the ED there are many strong personalities that have no problem repeating something you said while upset and turning it into gossip. There is also a nurse in my residency class that came in with a 'chip on their shoulder/something to prove' and trash talked people (including myself) to try and big themself up..... and almost no one wants to work with them. The ED definitely requires teamwork to function. I also saw that you decided not to talk to your school about your placement, and I definitely agree with your choice. Just like what I said about the ED, school is another place where even a misspoken, upset conversation can hurt your prospects. I don't know about your situation, but my hospital is a teaching hospital linked to the school I attended. All the professors and school officials work at the hospital, and word gets around. If you did try to raise an issue about your placement, I would not be surprised if the CVICU got wind of it. That is not the way you want your career to start, even if it's not a paid position and you're not an RN yet. Even worse, I wouldn't be surprised if the ED heard about you not getting the placement you want and "kicking up a fuss," and their first impression of you would not be a good one. A school classmate of mine managed to destroy any hope of a career in the area by literally crying to the Directors about everything she deemed an injustice (a.k.a. not what she wanted), even if it was a normal part of nursing school. You also mentioned that you don't know why standards for these placements are set but not followed. It's extremely hard to know exactly what they base their decisions on. Maybe they saw something special in your classmate during the interview. Straight A's do not necessarily correspond to great nurses, and C's do not necessarily correspond to poor nurses. I know it's hard to see right now because you're in the middle of school, but nursing school only gives you so much help in the real world and it takes a lot more to be a good nurse. Really, most of my rambling post thus far comes down to "watch your mouth and be professional, you never know who may be listening." It's true, though. Best of luck! P.S. In my ED interview, they asked about my capstone experience and what I'd picked up in the critical care setting! We do see a lot of sick patients in the ED, especially if the ICUs are full and we have to keep them with us for a while. Learn everything you can about ICU care and cardiac care, and bring it to the job interview with you (appropriately). Tell them about what makes you stand out learning-wise without being arrogant, that's how I got the job.
  10. EDnurseNY

    Are You Really a Nurse?

    Yeeahh...I went to my dermatologist's office and a medical assistant took my vitals and went over my med list. She told me to stop taking/avoid one of my medications. I was pretty mad about that. She had no standing to give medical or medication advice. I'm still kicking myself that I didn't speak up, since other people might not understand that she hasn't had the education or licensure allowing her to advise on things like that and might trust her advice. My doctors and I work together to determine the best med course for me, not her.
  11. EDnurseNY

    Feeling extremely underappreciated

    Help me understand a bit here, since my ED doesn't have paramedics practicing as paramedics... what is your job description? I'm trying to figure out what in the medic scope of practice you'd do in the ED.
  12. Nope, no med/surg needed! And I think this depends on what state you're in. In my state (NY), as far as I know, if you're a new grad in the ED you need to be in a residency program of at least six months. It used to be a year, but there are exceptions. The program I'm in is six months plus one of a "buddy system" with other residents. I think this goes all ways, Med/Surg, ED, ICU. I feel like in a perfect world, everyone would routinely shadow at least one day in each setting. We get calls in the ED all the time from irate floor nurses with things like "why didn't you place that Foley before sending my patient up?!" And if we were honest, the answer would be some thing like "Because another of my patients crashed and I had to start compressions and call a code, not place a Foley." or "Right after calling report, a septic patient rolled into another of my rooms and his pressure was 70/30 so that was my priority, not a Foley." Literally just the other day, a nurse on med/psych called my CRN to try and report me for not getting a (not-immediately-critical) urine sample before sending the patient. I had a patient who couldn't breathe roll in right after giving report. Each area has their stresses and it would be nice if we could all be a bit more empathetic with each other. I understand that floor nurses are very, very busy. When I have admitted patients boarding in the ED, things take much more time. We all need to cut each other some slack. Sorry for the soap box!
  13. With my mom, the only people that would've been around to care for her were me and my sister, and I had been caring for her for a while at that point. The arguments of "but there are hospice facilities! And SNFs! And home nurses! And respite care! How could you not want to take your mom home?! Suck it up! You're stronger than you think! I did it for my loved one, so can you!" frustrate me. There were no open beds in hospice facilities. Her insurance wouldn't pay for a SNF and she wasn't eligible for Medicaid. The home nurses could stop by only up to three times a week for a half hour each time just to check in and drop off meds. The "respite care" was two hours once a week, maximum, if we were lucky enough to have a worker available. The wound from the cancer eroding her skin/tissues evolved quickly and veins would pop, drenching her hospital bed in blood and would take every trick the nurses had to stop because bleeding out would've been a terrible way to die. Thankfully, the doctors and nurses agreed that it was time for us to stop being her 24/7 home nurses and be her daughters again until she passed. We were able to keep her in the hospital to get the (comfort) care she needed. As a nurse (now), I hate it when those attitudes are taken toward families who are grieving and may lack support to take care of their loved ones. Family members should be family members at the end of life, and not end up resenting their ill loved one and feeling terrible about it after they die. ETA: Don't get me wrong, I love the hospice philosophy and our nurses and hospice liaison were absolutely wonderful. I had also had plenty of time to come to terms with what was going on and had no unrealistic expectations about her outcomes. I didn't want her kept in the hospital, but we really had little choice.
  14. EDnurseNY

    New grad & I just got a job- I need advice

    Hi there, congrats on graduating and finding a job! I went through the same kind of stress with my Xanax. I have anxiety and I have sought treatment. I also know not to use it before coming to work (it makes me sleep and I rarely use it anyway). I was terrified of that physical, I worked through what to say with my practitioners, I was ready to have them provide statements that I was seeking treatment and I was safe to practice, I had my prescriptions lined up, I made sure to put down the Xanax PRN on the med list form and on the history under "psychiatric conditions," I put Anxiety to explain/justify it...... Occupational Med doctor never even asked about it because I was thorough on the forms and I got the green light three days later when I had my PPD read. If it helps you, talk to your provider about what to say. They know your case and they know what it's like to be licensed and have your life under a microscope. They can help you figure out how to explain not too much and not too little, and ask if they'd be willing to write a statement that they're following your care. The big phrase is "This medication is prescribed by a doctor who is following/monitoring my care."
  15. EDnurseNY

    Barcode scanning in ED?

    We scan our meds at the ED I work at. It's really not as bad as it sounds, the only time it's a pain in the a-- is when we have admitted patients and you have to do a 20-med med pass and all the rest of your patients are more critical. Then again, it'd be annoying even without scanning, scanning is the easy part. I also feel a lot safer with med scanning. Of course I check everything before giving, but I like having a safety net that's not distracted by other patients or a loud environment or anything else. Or if a nurse is covering for me (on break), I'll have peace of mind the right dose, med, etc. is being given. We also have a computer with a scanner in each room and they usually work.