Pros and cons of being an ER nurse

Dixiecup · Jul 3, 2007

Originally posted by Dixiecup
"I work in LTC. Had a pt with 101 temp. no order for tylenol. I called the Dr to see if I could give tylenol and see what happened. But he gave me a direct order to send to the ER,
The ER nurse threw a fit because I sent a pt with 101 temp. "Hadn't I ever heard of Tylenol?" Didn't bother to listen when I tried to tell him that was the Dr. order, not much I could do about it!"
Sorry, I did not mean to offend anyone by my statement earlier. The patient in particular that I was speaking about (temp of 99.1 as stated by the nursing home) did not have a temperature upon arrival to the ED, the MD was not called, and tylenol (which was ordered on the MAR) was not given. I've even had LTC facilities send patients for "fever", but when I call to find out how high it was, nobody knows because nobody documented it. I understand that the elderly often present differently when acutely ill, but there are times when the ED is appropriate and there are times when the ED is not appropriate. I often wonder why the MD's never come check out the patient prior to sending them to the ED.
I greatly appreciate the LTC nurses who us send patients for a workup who provide thorough nursing care and document the situation; "pt lethargic, VS xyz, BG abc, MD notified, orders received, tylenol given for fever, MD order to send to ED", etc. It just gets frustrating when we get patients with no documentation, and nobody at the facility seems to know exactly why they sent the patient to us and no nursing interventions were attempted. And I often wonder why we get so many LTC patients sent to us on Friday and Saturday evenings...

I was in no way offended. Just relaying a story! I was actually embarrased to send the pt but had no choice.

schizo_maja · Jul 5, 2007

pro's

>> the organized chaos. when an outsider looks into the ed, most are overwhelmed, but when you're in the middle of it, you exactly knows what's happening to everyone and everything.

>> anticipation. the need to be one step ahead of eveything, a simple decision of which angiocath to use at that instant saves not only time, but lives and limbs.

>> discharge them or admit them. pts doesn't have to stay at they ed longer than necessry, especially those bses.

>> 12 hours too short, timeflies, before you know it, its change of shift and there still code blue form to fill.

>> i get to dance with the attendings (salsa and merengue)

>> seldom do we do morning care!

cons

>> drunks ( need to say more? )

>> full code at change of shift (somewhat like it too)

>> no routine, everything happens all at the same time (which for me is a pro too)

>>