ED_Murse

IV lorazepam and a bag of fluids

It all depends on the situation. I try and never use 22g unless I absolutely "have" to (because they are useless if you want to infuse a large volume of fluid in a hurry). If someone comes in with a stab wound or gsw then they get a couple of 14/16g wherever veins can be found. Short of that, I tend to use 18g as standard and 20g on hard sticks. I will use the ACF or close enough to it, I find that lines in the hand tend to get dislodged easier.

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^^ This

1. You may have just finished college and be full of theoretical knowledge but you still have to learn how to do your job. Be open to all the learning experiences you can access. 2. I'm a tattooed nurse and I feel good about myself.....

i find that scissors don't just "cut" it for a lot of things in the ER. Motorbike leathers for example are especially difficult. I keep my shears clipped onto my waistband. Leatherman shears come with a holder.

Don't feed the trolls.....

That's a good lesson to have learned. Nursing is a 24hr gig and you're only there for 12 (or whatever your shift pattern is). I never (rarely) feel bad leaving stuff for the oncoming shift. I do the time critical tasks immediately, the stuff that needs to be done after that and anything else whenever I can. Not taking breaks benefits no one. Certainly not you and not the patient either. What kind of care can they expect if you're exhausted and frazzled. That doesn't mean that I won't stay late and help when it's chaos and there are still outstanding tasks because I do. I just don't feel obligated to.

It sounds like he's got a lot going on pain wise. I'd try going down the analgesia route before sedation.

The association between length of emergency department boarding and mortality. - PubMed - NCBI On the floor, you have a set number of patients. In the ER they just keep coming in. The majority of research shows that the longer admitted patients stay in the ER the worse their outcomes are. Its hard to comment on that case, maybe the pt was stable when they left the ER.

ER is a tough speciality, for the reasons that you mention and more. I wouldn't be too hasty in making a decision to leave after only 4 months. You mention that you're only a year qualified and don't have acute care experience prior to ER. It takes an experienced nurse six months to feel comfortable, for someone with your level of experience I'd be looking at staying for at least a year before making any decisions as to whether you like it. At at least a year. One day you'll realise that you're not struggling any more and new hires are coming to you for advice. Hang in there if you really want to work in the ER, it will get easier.

It's as hard as you make it. If you study the manual pre course, know your algorithms, drugs and heart rythyms it's a walk in the park. If you don't, you probably won't pass.

Like other posters have said - you need a thick skin to work in nursing, scratch that - healthcare in general. ER nurses tend to be viewed as the "odd relation" of the hospital (Not by everyone!). Same goes for ER docs. Surgeons gripe about medics and vice versa. Don't be concerned about how others view you. It's irrelevant and takes up valuable brain space. Be concerned about doing your job well because that's what matters to the most important person (your patient). Ive worked with brilliant nurses and awful nurses (we're human too and have all the accompanying human frailties) just as I know some inspiring paramedics and not to mention some truly awful ones. Id never call anyone an ambulance driver. I would however call them up on their patient care if I felt it was substandard (same as I would with any nurse). Best of luck with your studies.

The thing you're most likely to catch is chronic back pain. Don't take chances with it, always use proper m+h techniques.

Agree with what was said in the first post. Don't sell yourself short - your current workload sounds very streasful! In acute setting you will have more support, both nursing and medical.

Treat her pain. Doesn't matter if she's an ex drug user or a current drug user she is still going to experience pain the same as anyone else - she's just had major surgery. If she tells you she doesn't want opiate based analgesia then that's a different story. You should feel good about the care you provided for that patient, it's the other nurse I'd be concerned about.

Nope. I deliberately chose nursing over medicine knowing that I could have been successful doing either degree. I'm extremely proud of my profession. I feel that the people who ask those questions haven't got a clue about the nurse patient relationship. Or the nurse doctor relationship for that matter. I work closely in conjunction with some outstanding physicians but I have zero interest in doing their job.

"If the grass is greener on the other side then water your own grass more" Bigger isn't always better but then you have an idea what it's like cause you did your clinicals there. Any way you can work there per diem?

Don't be too quick to leave a job that you enjoy. There's a lot to be said for working in an environment where you are respected and are able to provide quality care for your patients.

If by cook you mean uncork a bottle of wine then yes, I cook after a 12 hr shift all the time....

If the needle was attached to the barrel the whole thing should have been discarded. The possibility for blood to enter the barrel is there. I would clarify with your local infection control people - I would be extremely surprised if they said only the needle needed to be discarded

Congratulations! ED is a fantastic area to work in. It's tough coming in as a new grad - be prepared to feel out of your depth for at least 6 months, more like a year. That will pass though! Be safe in your practice, ask lots of questions, especially the ones you think are dumb. Any department worth working in has senior staff more than willing to help out the new guys. Make sure your documentation is up to scratch. Working in such a fast paced environment it's easy to miss something and if it ain't documented you don't have a leg to stand on. Above all enjoy it - you worked hard to get here

Follow the manual. Know the algorithms, drugs and rhythms and it's very straightforward.

Why stay somewhere you hate? Makes no sense. Not judging - I've been there. Find a job you love and do that, it's much better :)

I can't count the number of times I've come on to resus literally looking like a bomb has gone off in it. You roll up your sleeves (figuratively speaking) and deal with it because you know that the previous shift has been through the wringer. Would I expect them to stay on and tidy? No way, and I know my colleagues would do the same for me.