FLorida_624

I wish I could have found this post before I quit my ED position...and thats after 12 years of nursing experience! All of it in LTC, however. After 4 weeks of orientation, I decided it wasn't for me. But the commenters on this post raise such valid points!

Last names are absolutely not necessary.

Your reply is exceptionally helpful. I am terrified, which is not a part of my being so it's hard to admit. But these are people and I need to know what I'm doing. I know a lot of it comes with experience. I have an IV med focus (its bad! But getting better) because it's foreign, and answers seem to vary from nurse to nurse. And considering it is the staple of almost every ER visit, I need to feel confident when administering them. I know I can refer to my drug guide for dilutents and push time frames, but no where can I find how much it should be diluted in or how much to give with each push. I find diluting everything (thus far) in 10 cc NS while pushing slowly is creating almost 5 mins for each IV med. Needless to say, reeeeally slowing me down. Could I not just decrease the dilutent (say use 5cc instead) while pushing 1/2 mL to 1mL every 15 to 30 seconds or so? Or should I stick with the 10cc and push the same amount, just more frequently like every 5 seconds? Not being able to find those answers is annoying me to my core.

Yes, I'm quite confident (and overly comfortable) in the LTC setting and know I'm a good resource there. I'm trying to breathe, hyperventilating even! :) Not really but I am trying to absorb EVERY thing which is also slowing me but that's ok. So yes, feeling ignorant. I'm hanging in there. Thanks so much for the advice!

Long story short, I graduated RN school in September. I've always (since getting my CNA in 2002, LPN in 2006) wanted my RN so I could begin working in the ED. Now that I'm there, I'm terrified!! So I've got 12 yrs on nurse experience but every bit of that is in Long term care. So the ED has been a BIG change. Which I anticipated. But I'm almost reverting. I just completed my 5th shift and I, with tears in my eyes, do not know that this is for me. I'm so paranoid about IV pushes (do NOT do these in LTC), am I pushing too fast, is it really in there, are they allergic, is there air in that line, is this the right med...all while trying to learn a stupid computer system. I'm never going to make it to the trauma rooms, and feel as though I'll never make it through this 1:4 if I'm not confident. Is everyone this nervous starting ED? Am I being silly? I know that its early on, but holy crap. And advice, suggestions, or self reflection is appreciated!

Just asking in peoples experience because I can't seem to find a direct answer. I just finished my RN program. I work in Indiana. I'm wondering the standard dollar pay increase from LPN to RN? I had figured at least $3-$4, but my DON kinda laughed that off. Thank you in advance!!

There was some great advice here. Unfortunately, she has since turned in her notice. She had a fall and admission in one night, decided that was too much for her, returned the next night and gave a notice that she would not be returning.

I apologize for the lack of clarity. Yes it is LTC.

I have a situation at work that I'm having a bit of issue with, and am asking for opinions. I'm a supervisor at work. Recently, we've hired a nurse that has an unbearable personality. So unbearable, I'm finding it hard to even be tolerant. Last week, I went over orientation paperwork with her, and she had to excuse herself to go cry. Twice. Mind you, the paperwork was not overwhelming, a simple checklist. I tried being empathetic, in which she responded her AC at home was broke. She hadn't slept well. I figure ok, some people are just overly sensitive. However, I was told she went to others making it seem as if I myself had made her cry, and perhaps even intentional. I will admit, I have chronic RBF syndrome (no need to deny it lol) but I at no point was mean to her (I would admit this). No BS straight to the point attitude, sure, but not mean. (Mind you, I'm in my last quarter of RN school, kinda dry of a sense of humor right now). At this point, I really want no interaction unless she has a question/concern about our residents or her job duties and responsibilities. I'm just wondering, especially as a supervisor, how others would approach this issue?? How does one really deal with an employee that you have a personality clash with?

I agree. I work in LTC and pull out and off everything. But I know if the family is wanting an autopsy, regardless of setting, nothing is removed as it becomes part of the autopsy report.

A lot of RNs have obtained their ADN or BSN, come straight out of school, and have little to no floor experience, especially in LTC. That speaks for itself.

My question is, I understand the time frame of drawing peaks and troughs, but not when. Say they want them with 3rd dose. So do I start with a trough before third dose, then a peak an hr after (making it basically a trough and peak right), or do I start with the peak after 3rd dose and basically get the trough before fourth dose?