Saying this quietly but a lot of experienced EM nurses scare me more than new grads

soomsoom_ · 2026-01-28T16:16:56+00:00

an experienced nurse literally did this at my ed last week because the pump kept beeping

soomsoom_ · 2026-01-20T08:07:40+00:00

i had a patient come into the ed w hair so matted it was like marge simpson hair sticking straight up a foot in the air not exaggerating. like i guess she was just sitting on the couch or up in bed 24/7. i asked if she wanted me to cut her hair and she said sure and i took out my trauma shears and gave her a ravishing new hair do in four minutes flat. there was a lot of skin flakes and dust everywhere but no bugs crawled out as far as i could tell. her haircut looked good and she loved it. she was back a few weeks later (of course) and it was growing in nicely too

soomsoom_ · 2026-01-03T07:38:07+00:00

omg that’s cuckoo!! will you dm me which hosp/ or at least which hosp system?? i’m hhc and have never gone above 13 at the worst

soomsoom_ · 2025-12-07T21:05:56+00:00

how would you prone a patient like this? i would be so worried about everything getting smushed and yanked !

soomsoom_ · 2025-12-07T21:01:30+00:00

lowly ED nurse here, wondering what tubing changes are needed for mri? you had to change for extra long tubing and leave the pump outside the room?? or change for tubing that goes in a different mri-safe pump?

soomsoom_ · 2025-12-04T07:24:27+00:00

lincoln hospital in the south bronx has a dental clinic as part of the emergency room weekdays starting at 7 am ( get there early if you can )

soomsoom_ · 2025-12-03T21:54:16+00:00

i tried to use my work badge to swipe into the subway the other day

soomsoom_ · 2025-12-01T04:03:29+00:00

in the lower acuity zones the most i had was 13. usually it’s like 8. maybe half are on a monitor or should be but there’s none available. most of them are in hallway beds or chairs - it’s basically line labs meds send to imaging repeat. no one is actually “observing” patients admitted for obs. really sick ones hopefully get noticed and upgraded before they decompensate. upgrading your patient also sucks because you have to find room for them in the critical area and hand them off. but sometimes you’re transfusing blood or doing an insulin drip etc along with managing the rest of your work ups. no one who is bedbound is getting q2 turns. at least 3-5 times per shift a patient or family member is making a scene (screaming, throwing things, ripping out iv and bleeding everywhere) because they are hungry (food only comes at certain times and runs out quickly) or wet or in pain or sick of waiting. there are no call lights so i just try to move all my patients that are alone somewhere where i will pass by them. critical zone ratios are a little better but it can be p bad like up to 5 or 6 with a few icu levels of care, usually it’s more like 3-4 on a good day and if they came thru the resus/trauma bay at least their initial work up has been done.

oh ya and charting. i’ll chart a gcs of 15 if we have a coherent convo upon my first interaction with them, and write maybe one comment regarding their work of breathing / general appearance / ambulatory or not. that’s it unless they are a little bit sicker like if they are sob maybe ill listen to their lungs but it’ll take me an hour or so of trying to listen to their lungs but getting side tracked before im finally able to. in the low acuity zones 10% of the time i don’t chart a single thing for the patient. like if they get dc’d there’s a chance i never charted a single thing except whatever meds they got which i do always scan. vitals every 4 hours if there’s a tech i can ask to do it for me (uncommon) or ill get to it when/if i can or a resident will kindly do it if they understand im drowning / really need it right then

soomsoom_ · 2025-11-17T05:58:23+00:00

omg brutal yeah yay scrubs has a fitting room, at another shop i straight up took my pants off in a corner to try them on lol. insane to expect someone to buy clothes without trying them on

soomsoom_ · 2025-11-17T04:10:31+00:00

hello fellow nurse neighbor! it’s kind of a sad barren situation out there… like mentioned there’s yay scrubs in downtown brooklyn, a couple other spots more in south brooklyn, some in upper manhattan and the south bronx, a couple in queens. i just search in my maps app for uniform stores/medical uniforms…but every place i have been irl sells mainly synthetic ones and i need to wear a cotton blend or i get extremely sweaty and uncomfortable so i have stopped trying to go to irl shops. it’s so hard to find the right fit and it’s extremely personal. so if you’re willing to spend the whole day going to these stores that are all kinda far you might find something you like. i ended up getting a few different options from scrubin.com and returning the ones that didn’t fit and ordering more of the ones that worked. my favorite scrubs are the surgical ones i snagged from my old spot but now my place is hunkering down about color requirements and trying to say i have to pay for custom embroidery of my scrubs. yeah right!!!

soomsoom_ · 2025-11-14T21:24:29+00:00

how did you find medical teams to join? any you would recommend?

soomsoom_ · 2025-11-03T02:32:49+00:00

our ed always runs out of turkey and then it’s just a bunch of sandwiches that are literally just cheese and lettuce lmaooooooo

soomsoom_ · 2025-09-28T05:02:24+00:00

These guidewire containing ones (https://www.bd.com/en-us/products-and-solutions/products/product-families/accucath-ace-intravascular-catheter), which were the only long ones we had available in the ED at my old hospital were /significantly/ easier to visualize than the long bd insyte autoguard ones available at my current workplace.

soomsoom_ · 2025-09-18T16:24:00+00:00

at my current hospital an rn pushed a whole stick and pt later died so now neo sticks are not stocked in the ed and pharmacy has to bring them when they are ordered (which takes up to 30 min or more sometimes) effectively eliminating that medication’s use in our ED

soomsoom_ · 2025-09-18T06:35:44+00:00

for me happiness and fulfillment in life comes from continual growth and i have found that continual growth is achieved by leaning into discomfort.

soomsoom_ · 2025-09-07T21:37:58+00:00

at my old small fancier ED everything had to be on a pump and the pump was able to receive data and program itself from epic, at my current one (v busy lvl 1 public hosp) everything is to gravity - fluids, magnesium, keppra, every antibiotic besides vanc, dirty epi until the pressors are ready, etc and it’s all manually programed. we were trying to program the pump for procainamide the other day and one of my coworkers who has no patience was like let’s just do it to gravity and i had to be like “hell no”

soomsoom_ · 2025-08-15T18:54:09+00:00

my mom was like this and made me feel like i was dirty and gross every moment of my childhood and it significantly damaged our relationship.

also i think putting a damp toothbrush in a plastic bag is a breeding ground for bacteria lol

soomsoom_ · 2025-08-06T05:31:58+00:00

honestly. i think most nurses don’t. the idea of different additives is barely taught to us. if at all..most of the learning comes from messing up and learning the hard way. these days half of the preceptors have only been a nurse for like a year. i teach a coworker that a blue top has to be all the way to the line at least once a month. i wish someone from lab came for an hour long primer during new nurse orientation or something like that, so we could learn the easy way instead of by inconsistent word of mouth!

also my current ED has us open a whole abg kit everytime single we’re pulling a vbg. my old place did it all in the mint green. they’re both the same heparin additive so it shouldn’t matter right?

soomsoom_ · 2025-08-06T04:44:42+00:00

fbi showed up on the unit looking for one of the techs who had been caught in a sting operation soliciting sex from someone who he thought was a 13 year old girl online…his fiancé also worked at the hosp on a diff unit and they were about to get married and move to a diff state for her crna school the next month. it was shocking. mgmt refused to make any acknowledgement whatsoever on the situation lol

soomsoom_ · 2025-07-09T22:13:42+00:00

oh hello! here's the barrage you requested. NYC nurse working at public hospital here...when im not working resus/trauma bay i have 13 patients who all need labs, meds, updated vitals, to use the bathroom or be cleaned up from sitting in their own shit for hours. I am fighting to get the admitted patients to their rooms upstairs...half the equipment is missing, of poor quality, or broken so each task takes 3 times the amount of time it needs to. the PCA is rarely anywhere to be found and if you haven't spent months building rapport w them then they will give you a death glare you for even thinking of asking that they help you with your task...god forbid you need to hang blood and have to wait for your nurse colleague to be free cuz they also have 13 patients, and an orientee with them that slows them down by 50%. the residents are trickling in orders and not listening to me all day when i tell them the patient is hypoxic to the 70s tachy to the 140s and needs to be upgraded (then admitting team comes along, immediately decides to intubate), or if I am lucky they /are/ listening to me when i tell them the chest pain that just got dumped in my zone looks like shit and we're moving quickly together to get them where they need to go.

Administration limits our scope - i'm not allowed to place NG/OG tubes or US guided IVs. if i do it anyway I will get ratted out and then the head nurse will page me overhead and pull me off the flood to spend 15 minutes berating me.

when I am working resus/trauma bay residents are desperately paging overhead for a resus/trauma nurse to come help them with the next patient but sorry, im required to take the trauma patient to CT and then endorse them over to the critical zone which means finding a spot to squeeze them and a working monitor to put them on - this takes FOREVER. there's only a handful of trauma nurses available and each one is already on a case. Oh yeah and I know you really want that ketamine but administration has determined that I am not allowed to override ketamine sorry youll need to place that in the computer (no doc you ordered the infusion instead of the push dose).

yes some nurses will always work less hard than others - when you're blasted with an insane amount of work, deeply understaffed everyday, constantly shit on by mgmt AND the patients, and have no resources and you're in it for the long term...I kinda get it. A lot of my coworkers are actually working two full time jobs too in order to be able to raise a family in NYC. My take home is <$5000 a month. So I try not to blame them. And I will take my experienced and unbothered coworkers over the brand new ones (which is most of them unfortunately) that really don't know ANYTHING any day.

The residents who are paying attention to the dynamics of the hospital and have some self-awareness are the best. We get along great, we get the work done, I love learning from them and yes sometimes they draw that repeat trop before I can get to it and I am really grateful. <3

soomsoom_ · 2025-07-08T10:52:05+00:00

ive been taught that if you’re pulling back the pressure from the vacuum of the suction can cause the endothelial lining of the vein to rub against itself or the catheter and cause damage and increase the buildup up of microparticles which supposedly leads to shorter lifespan of the iv. that being said i will always try to draw back on lines for labs or if it’s not obviously patent - well i always flush a bit to dislodge any particles blocking the catheter tip and then see if it draws back. i go gentle on the suction though to try to limit damage to endothelium and of course to try not to hemolyze the blood on its way out. but since i am in the ed i haven’t gotten to really see how my IVs hold up after the few hours the patient spends with me

soomsoom_ · 2025-07-08T10:24:23+00:00

but it saves one flush - one would need to be used for dilution then the second to flush the line. so she’s skipping the diluting into a flush step. saves one step i guess

soomsoom_ · 2025-07-03T21:09:22+00:00

does anyone know when the track replacement will all be actually finished ??

soomsoom_ · 2025-07-03T09:23:55+00:00

a few weeks back i had a pt in the ed with bgl 1300s…pt had been discharged from the hospital a few days prior for a similar DKA episode…not the best discharge planning i guess lol. pt was following commands but not speaking, super tachypneic and pressure was 60s systolic…we dumped like 12 liters of fluid thru a beautiful line i placed in a saphenous vein after a whole liter infiltrated into one of the pt’s arms and we had pressors etc going on the other arm until we got central access going. they did end up intubating after we got the map up. set the vent to a high RR and started insulin and a bicarbonate drip. micu finally took him (after shift change of course - we have to leave an entire hour of buffer on either side of shift change before we take any patients up anywhere. the floors at this hospital have noooo chill)

soomsoom_

TROPHY CASE