All Content by nursedarrah
- Tired of the Stereotypes of Medics and EMTs
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Tired of the Stereotypes of Medics and EMTs
Anyone who criticizes an EMT or Paramedic has obviously never been the first one at the very nasty scene of bad car wreak. I have been a trauma nurse for many years, and I could never be a first responder. No matter how dirty or bloody my trauma patient is, I don't have to see the skin and muscles sliding off of their skull as I'm useless because we can't get into the car, or the oblivious drunk who is complaining about his broken foot, while the son sits in shock because both his parents died instantly on Easter Sunday. Any First responder is a true Hero, who should be honored as close to angels. The get a pass on any technical BS that some anal retentive nurse can think of, because she can't start an IV in the back of a Rig going 70 miles an hour and you know she has never needled a chest. Your patients never said your just an ambulance driver. Skip Nursing and become a perfusionist they make 150,000 a year with no Nursing Board.
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When to sign MAR
I graduated in 1994. We were told that after many deaths they were changing the way we charted our meds, effective that year. Problem was: Nurse gave Morphine-went to lunch-was hungry didn't initial- buddy who was covering, goes in to checks on patient who still complains of pain because morphine has not kicked in yet- covering nurse gives morphine. Original nurse comes back from lunch and patient is Dead. That's a problem. We were told to initial the medication at the pull down in front of room (or whatever system is). Then if for some reason it is not given then you go back and circle your initials. (Meaning medication was never ingested). Think about it what would be the rational for a circle around initials that wouldn't be there if you charted after they took it. You would simply put an R for refused or something. I have been teaching this to unlicensed personnel in the Community setting for years. And, It works. They have the MAR open, the bubble pack in front of them, they pop out the med, sign their initials, pop the next med, initial the MAR. Then count all the pills in the cup with the patient as a 4th check. Then patient swallows all at once. If phone rings now, or client has to go to bathroom, or kid gets sick, or someone codes, then MAR is signed, and charge nurse doesn't pass your pills while your doing CPR.
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Distat. What Would You Do?
In a pinch, Diastat can be put down a G-tube, if they have one. Of course you have to get a new order. Bucal or SL formulas are nice. I have heard of individuals who crushed up valium and snorted it because it worked faster and they didn't have to worry about chocking on it if they started to have another seizure. (Not exactly an approved route.) But EMT's squirt IV Narcan under the tongue all the time when no veins are left.) There is usually on out side the box answer they never teach in Nursing School.