Y2KRN

Hello, This thread is close to my heart and I can see both sides of the story. I started an ADN nursing program when I was six months pregnant with my second child. I found out I was pregnant two days before I found out that I was accepted to the nursing program. My first child was six months old. I weighed the decision very hard and chose to go forward with school. I knew that there would be unknowns with both. I won't say it was a walk in the Park but, it was doable. I had a very strong support system in my Husband. We were military and I had no family around to help. We worked it out with daycare and shedules. My husband was military at the time and would stand 24 hour duties. We scrambled and he switched many a duty to accomadate my schedule. The military hours change a lot and the are not bendable, there were times I thought I don't know how we were going to swing it. There were times when I drove to Pa from Ct and my mom took care of my son for a few days. There were tears, and uncertainty. I also had a test come back elevated that required a high level ultra-sound and possible birth defect for my unborn child. Again tears and support from my husband and family got me through. I was referred to genetic counselors by my OB and found support there. I declined an amnio. I stayed in school through it all. I finished the first semester, took my final and my beautiful baby girl was born two days after finals (early) after christmas break. It was hard, but with the right attitude and support I feel you can do it. If it doesn't work out, you can always go back to nursing school. That was how I kept things in perspective. I did not plan my second pregnancy, however I wouldn't have changed it for the world. I think you may be ahead of the game with the planning, know your support system, know that you will not be in control of everything, keep in mind that you may have to delay a semester and go back. Make yourself and your child the first priority always. The rest will fall into place. Problems and road blocks always arise, after my daughter was born healthy she failed her hearing tests for a year! That was many appointments, and tests to now juggle while still in nursing shcool. It all worked out and she now talks my ear off. You have gotten great advice here, from the nursing instructor's perspective to the Ob nurses perspective and all those inbetween. I wish you the best in your decision. Good-luck to you. Keep a positive attitude. I feel no time is the perfect time to do anything. I will say that I found it nice to be able to hold my baby when I was studying and feed her she wasn't mobile at first and she would sit by me and just be soo happy. My son was a toddler and into everything, and we did many a nursing projects together. Everyone struggles with the demands of work, school, children. I am thinking about going back to school but, now my kids are 7 and 5 and their little lives have blossomed into activities, friends, and birthday parties. I think to myself now how could I possibly go back to school now?? But, I too will soon be sitting down and planning my decision as well. Take care, Y2KRN

Hello, I just wanted to say that I know an ER nurse who got accepted into CRNA School without ICU experience. I personally have never worked ICU. However, the school he applied at was impressed with the drips we did in the ER, the conscious sedations, of course the codes, vents, and IV skills. They reccommened he take a critical care course that focused on swann cathether measurements. But, felt the rest of the skills were there to build on. Y2KRN

Hello, I can tell you that I went to the ED after working the floor for only a year. I went to the floor because that is what I was encouraged to do. I hated the floor, and I love the ED. I must tell you going to the ED was a big learning curve, I still have much to learn and you do learn every time you work. You have to know a little about everything. I have seen new grads make it and others that wanted to go to the floor. As advice the others have given you. Depending on your geographical area look for a really good orientation program. I have had to move a lot when my husband was in the military. I got a good start but, had a terrible orientation at my next ED. However, I stayed there two years and just now got a new job in the Ed. I really think part of success in the ER as a new grad comes from the orientation program. I just left a fifty bed ED because there was a mass exodus of seasoned wonderful resource, experienced nurses. I am thankful that I got a job where most of them went. I found it difficult to work in an enviroment where I was senior. There were many issues but, I have to say the one positive thing that came out of it was I found that I could hold my own and tread water when all of the resource people were gone. But, there has to be a very good blend of newbies and nurses that have been doing ER nursing for a while. I welcome the new grads but, you need the experience in the ER as well!!! Ask those kind of questions, when you interview. It is a great time to be a nurse and you do what is in you heart!!! Follow that lead and you will do just fine. Good-luck and Congrats on graduating. Y2KRN

I say bring on the vit. H IV preferred!!! However any route will do!! Y2KRN

Hello, I just wanted to tell you that my thoughts and prayers are with you!! You have received good advice here and you are definately on the right track. It is soo hard to be a young single mother, I was raised by one! I am soo proud of my mother and I know that your daughter is proud and will always be proud of you. You have accomplished soo much in your young age. You have made it through nursing school a feat in half in my book and are raising your daughter. Most nurses have chosen nursing as a second career or later in life as I did myself. I don't know that I would have been able to handle nursing at such a young age. I am very glad that you chose nursing as a profession, we need nurses just like you. You will bring a lot to nursing throughout your career, and believe it or not you already do. I am always pleased when I see a young person in nursing, you bring a whole new perspective to the field, so don't sell yourself short!! Keep the faith concentrate on your daughter and yourself, the rest will fall into place!! I hope one day when I am ill, I will have someone like you looking over me and caring for me or my family. Let us know how things go!! Denise

Hello, My son is six and a half years old. He had a bowel movement on Saturday nov.15th. His x-ray showed that he was " full of stool" as the DR. nurse said. They did not do any lab work just the x-ray of his abdomen. They also checked his blood sugar because he had some ketones in his urine. I asked for a promethazine supp. The Doc said that she finds that really does not work after a child has Ketones. The Doc told me to try fluids first. I got home and my phone was ringing and I was told he was " full of stool" and constipated. The nurse said that he had a large amount of stool in his rectum and that is was going to be very hard for him to pass. She said now the Doc wants me to administer the suppository with a lot of vaseline on it and if need be do a disimpaction. I gave him the suppository and he had bowel movement without any difficulty about an hour later. He has not vomited since I gave him the phenergan, he is still complaining about his belly hurting and the thought of food makes him "weasy" he said. Now I know he pooped most of the phenergan out and but, some of the medicine probably was absorbed. I truely hope that it is just constipation. However he had only gone three days without having a bowel movement priior to the one he had last night. I was expecting the bowel movement to be hard for hime last night and it was not. Plus all the vomiting. His belly is benign, he says it hurts, but it is soft and supple and bowel sounds are hypoactive. His pain is not localized. Anyway, thanks for the replys!! He has a re-check at 10:00 this am. Y2KRN

Hello Peds nurses, I have got a question for you! My son has been vomiting since Sunday morning. He had a fever of about 101.1, could not keep fluids down. I thought it was the flu, so I gave him lots of tlc and fluids every hour ( even though he was wretching) Gave hime tylenol and motrin around the clock. Monday came and he remained afebrile, still vomited could not keep anything down. More tlc and pushing of fluids. Got up this am vomited first thing out of bed. Called Peditrician, got an appointment for 14:45, he remained afebrile for the day. Took him to the Doc. got an x-ray of the abdomen flat and upright. Results called to me at home. Told he is constipated. I am an ER nurse have treated many children for constipation. None ever had a fever. Could he have become constipated because of the fever and dehydration?? I must confess I was thinking he may have a small bowel obstruction, but x-ray supposedly shows it is in his rectum. I would think if the obstruction is that low the child would not vomit 5+ times a day, or about 15 -20 minutes after drinking water. I kept an ongoing assessment of him, he never became tachycardic, had tears, and was voiding a little less than usual. Blood sugars remained okay. Urine at the Doc office showed some ketones not surprising he has been vomiting for three days. I guess I am just not convinced it is constipation. This is a child who has a great constitution. He however has not had a bowel movement in three days. But, did have a normal one the day before he got sick. Am I just being too synical. Does a fever go along with constipatieon??? Any insights would be appreciated. I respect my colleagues opinions and experiece. Thanks Y2KRN

Hey Speculating, That was a lot of extra work but, sounds like the outcome was well worth it for the child!!! You did the right thing!! I wish I could have had the warm fuzzies after my situation. I know I did the right thing for the little boys, but still to be treated the way I was, was awful. They have not complained as of yet so I will see what happens. I know that mom probably never followed up with a peditrician. I know I would do it again. However, I will have security with me the next time. Thanks for all the posts. It is nice to have support from colleagues!!! Y2KRN

Hello Fellow ER nurses, I just have to vent!!! I am soo tired of the abuse we take as ER nurses. Here is the scenario, just happened on my last shift! Come in get report, have a patient little boy, six up for discharge after his bolus of fluids are infused. Told little boy had tylenol for his fever. Go into room, mother out smoking, father in the room, tylenol laying on counter not adminsitered. Fluids on the IV pole not attached to the prn adapter. No pump in the room, however some progress is made, buretrol tubing is primed and hanging capped off. Mom comes back from smoke break and has another little boy with her who is waiting to be triaged. I get him triaged his temp is 104.5, I agree to take on the child as an extra patient so we can keep the family together, charge nurse not happy. Then mother decides that she needs to be seen. Kids don't seem to be comfortable with Dad, Mom is the one who they want and the one who calms them. So, I go to the Doc. tell him that mom wants to be seen as well. I triage her and start a line. Again Charge nurse not happy but, works with me to keep family together. Now I have a seven patient load, and of course my trauma room is occupied. One child has bronchitis the other a virus that we treat for with antibiiotics. Discharge finally comes and I go in to re-vitalize the family. One of the little boys fights getting his temp taken. I understand he is sick and just wants to be left alone. After much convincing by the parents the child allows me to put the thermometer in his mouth. He starts gagging immediately and says I am sticking it down his throat. I tell the parents that I am going to go check another patient and that I will be back. As I leave the room I hear the mother say, that f#$%*^& b!@*& better stop sticking my kid or I am going to punch her in the face. I spin on my heels and go back into the room and explain that the child is not feeling well and that I did not stick the thermometer down the childs throat. They then started screaming that I have been mean to them all night long and that I kept giving the children dirty looks. They stated in a not so nice way that they wanted me removed from the case. I really wanted to let them have it both barrels! I didn't though I just said fine. I got one of my co-workers to go in and discharge them. I was soo mad though. I am tired of going the extra mile to be treated like crap!!! I wish we could bring back some respect for our profession. Or at least be able to defend ourselves when white trash people such as these decide they want to threaten us, without feeling that if we did so the hospital would have our job! It is all about customer service and I felt that I gave those little boys excellent care and kept them together for their comfort. I know I did the right thing for the boys but, the mother and father (who by the way were not even married anymore) needed to taken out back and shot in the head!!!! UGH, I was supported by management, staff and the physcian in the case thank-goodness. I really hope that they call and complain!!! However, I wonder how much support I would have been given if I would have told them exactly where to go and what kind of parents I thought that they were? For the record the kids had been sick for a week. Mother did not give a lick of medicine and brought herself in two days before and was treated, before she ever brought the little boys in. Thanks for letting me vent Y2KRN

Hello Kats, I started out as a surgical tech, thought that I would go straight into nursing school from there. I ended up being a surgical technician for ten years. The money was okay and I got to do a lot of traveling, got married etc, etc. I went to nursing school thinking I was going to an Operating Room Rn. I am now an ER nurse and love what I do. So much opens up for you when you go to nursing school. I was able to transfer some classes toward the nursing program. Things like Anatomy and Physiology, microbiology, english, math courses, psychology. As for program specific courses there were none that could transfer. You will get an in depth curricula about the instrumentation, sterilization procedures, and go into depth about a surgical procedure itself. These I felt were valuable courses that I did not get with a nursing program. I have never regretted being a surgical technologist first. It is very informative and you learn about the human body very well. It is nice for me now because when I have a patient that I am getting ready to go to the OR, I actually know what is going to happen with their surgery, it will help you in nursing school too when you are doing assessments to know how they did the surgery. When you go to get your nursing degree it will be helpful. If you want to be an OR nurse you will have a great advantage because you will know how to scrub. You do not learn how to do this in nursing school, you don't learn the surgical instruments, and surgical scrub how to manage a back table and mayo, or do sponge, needle, and instrument counts. Surgeons love to teach that has been my experience more so than many other types of physicians. The OR is very technical and you will be able to see the role of the RN, observe how to assist with intubation, position patients, use laser, phaco machines, sterilizers, endoscopes etc. Call pay is good and if you work in a bigger facility you may get a perfect flexible schedule, so that you can continue to work and go to nursing school. I have not heard of any program that bridges surgical tech to nursing but, it does give you a good base for going into nursing. Nursing school teaches you how to assess patients and you learn much more about disease process and the big picture of things. But, when you have a heads up of how the inside of the body works it makes a lot more sense to learn how to assess the function and disease processes that are going on in the body. I wish you luck, with whatever you decide to do. Y2KRN

I think that your nurse was proably very qualified, however, I could understand her not wanting to let you fly because she was so unfamiliar with the place herself. Believe me I was in your shoes not too very long ago and you will get plenty opportunity to learn IV's etc. I went to shcool in New England and we were not even allowed to start IV's and you should see me go now others seek me out to start their iv's. You will get the experience you need. Good Luck Y2KRN

Hello ernurse728, I think that they are still working out the details of this new system. We got a memo stating that we call the floor and alert the unit clerk that we are going to be faxing report on the patient going into 420. Then we fax report, ( we have a totally computerized charting system specific to the ED) all of our ER nursing notes go to the floor, from triage information to in er treatments and medications given. After that the floor has twenty minutes till the patient arrives. We carry phones with us, so we give our name and portable phone extension so if the floor nurse has any questions they can contact us. I don't know how to fix the dilemma that came up with me on the first night. I didn't see patient that the floor nurse had questions about. However, the questions she was asking were things that she just needed to look for, however if it was a question about baseline or medication administration or something then I probably would not have been able to help her anyway. Which can happen even when a report is called. However, no we do not at this time need to confirm with the receiving nurse that the patient is being moved. We do not fax report to any of our ICU's or our Rapid Admissions Unit. We still call report to them. We are supposed to be expanding our rapid admissions unit soon. We do not send a cover sheet though and I think maybe we should. Our management thinks labs can be looked up by the floor nurse, as well as x-rays. If the house Doctor has seen the patient then we fax their orders as well. We try to initiate any orders the house Doc has given. If I was the nurse receiving report I would like to know if the patient has a high k+ or something without having to look it all up. I send the lab results anyway. I think a cover sheet would be good to, just to give a little baseline nursing observation. "The patient has been comforatable, or is anxious, may be a little stoic you may want to ask him about his pain etc. There has been many changes since I started working at this Ed. We went from a 30 bed Er seeing 80,000 patients a year, to a brand new 50 bed er not including fast track. On top of this major move, we went live with an all computerized charting and tracking system specifically designed for an emergency department however the catch is "we are this new company's beta site." So, they are working out their kinks with our ED. I was completely overwhelmed at first, but it is getting better. Our computer system in the ED is separate from the rest of hospital and there were major issues to deal with. We are now interfaced with the lab so that is a great improvement, but we are still not interfaced with radioloy which is our weakest link right now. During the early summer we had so much hate mail via editorials from the community, morale became very low. Complaints were mostly about wait times which could be up to 6-8hrs. Plus we had many staffing issues. They have improved on staffing issues and are now hiring paramedics (god bless our medics, and techs) which has also helped greatly. Holding patients is another issue. Our beds fill up fast and the hospital is currently building an addition which will house two more ICU units and I think more monitored beds. We have three ICU units now. CICU, MICU, and SICU. I think the worst part is not moving patients though because the family wants you feed them, do all their meds, etc. and really doesn't understand that we just can't do all that when the code or trauma is in the next room. Some families understand but, most don't you tell them we have a critical patient and their retort is well you should have enough people to help because our family member is critical too. What can you say to that?? Our patient ratio is 5 to one and most assignments include a trauma room. This is a big improvement however to the not so long ago past when we would have to cover for lunch and have 10 or a little more patients to look after. When we would have a trauma then the rest of our patient's were fending for themselves however that was more of a staffing issue. Whew, I went off on a tangent, but it feels good to get all out. It is getting better and the floors are still not happy with the faxed report but, I think it will take time to adjust. I know that one good measure I think from being a floor nurse is that, they will not have to come to the phone to get a report from the Er and can continue that med pass or endo-tracheal suction they were doing. I remember that I hated to be called to the phone, when I was trying to push multiple crushed meds through a g-tube or suctioning a vent patient. Thanks for listening, Denise

Well we went with our new policy for faxing report! It started Yesterday. Last night I get to work at 1900 of course there is a change of shift admission. The nurse signing off to me takes care of getting the patient admitted and faxes report. I go on about taking care of my four other patients. My medic and tech transport patient for the off going nurse. At 19:47 I get a call from the floor, saying that there is a patient in bed so and so, and I have no idea why he is here. I explain that the off going nurse faxed report and had the patient taken to the floor. She said well I have many questions, I told her that I would try to answer some of them but, that I never laid eyes on the patient. She was soo furious. The first question she comes out with is what is the diagnosis?? I say very nice that there is an admitting sheet with the admitting diagnosis. She said yes here it is. Then she said does he have any allergies?? I realized at that point she was not reading the fax or chart at all. I kindly said please read the chart and if she had any more questions to call me and I gave her my extension. She said what kind of nurse are you, when you can't answer simple questions about a patient you sent to me, and hung up. I was flabbergasted! I told my charge nurse and she said well it is the first day we are doing this. I said yes that is true, and I understand it is stressful when things change. I do understand that. However to be disrespectful to other professionals is just infuriating. She did call me back about 20 min later after she had read the chart and started yelling that the patient should have gone to the Rapid admissions unit. I gave her right to my charge nurse, because I thought if I was going to have to spend one more minute on the line with her I was going to be the one who was unprofessional!!!! I hope things get better and we can make this work. I like being able to move patients. Carolina thank you for your input as well. I have been on the other side of the tracks and remember what it was like getting admission upon admission with no end in sight! I'll admit it was not my cup of tea! It is very stressful to have long lists of meds to give, charting to do, rounds to do, Docs to call, and patient families to deal with. We do appreciate you and know that you also have emergencies to deal with. I know it is not easy up there, no speciality in nursing is!!!!!! I guess we just have to keep moving forward and try to change what we can and improve systems. Take the things that work with old systems and chuck what doesn't work. I guess it all breaks down to good communication. It is the ER nurses job to ensure all infromation is there for the floor, and to try and accomadate and complete as much information and orders as we possibly can for the floor nurse. In turn respectful communication would be nice from the floors sometimes. I used to hate when the ER called too, but I always tried to be nice because I was not in there shoes and they were not in mine or the cause of most of the floor problems. As the floor is not the only cause of not moving patients in the ER. There are many factors that go in to it, as we have seen from the above posts. Let's just try and respect eachother. Thanks to all who responded!! I will let you know if the faxing of report flys, or sinks. P.S. It is frustrating when you get no help transferring patient, getting them on tele, changing pumps, etc. Happy Holiday's Y2KRN

Hello, Happy Turkey Day to all!! I was wondering if any of you use a faxed report system at your hospital?? We are really having a hard time moving patients. We have a rapid admissions unit however when that gets full, we are sol. We are going to try faxing report and see how that goes. Right now the biggest problem is, the floor saying that the beds are not clean. I hope this works, it will make my day if it does!! Once we fax report the floor will have 20 minutes to be ready. Now I have been a floor nurse and I know both sides to the story. I was just wondering how it works at different facilities. Thanks Y2KRN

I vote for the belly button ring!! Heck if I had the flat stomach of my younger years I would probably want to do it myself! A tatoo in my opinion is different, because it is there forever, if it isn't it is a big process to get rid of it. I would want my daughter to wait for a tatoo. The belly-button ring can always be taken out!! JMHO Y2KRN