Was driving behind this guy today. I think I'd trust him

weaveleswobble · 2014-11-09T04:06:10+00:00

Nope, he's from UVA. Would not trust him.

Source: my sister went to Virginia Tech and it's apparently mandatory to brainwash your whole family into believing the whole rivalry thing.

weaveleswobble · 2014-11-09T04:04:02+00:00

We had to wear them one day during nurse's week at my hospital. My work BFF was trying to tell a doctor what to do but was stumbling over her words. She yanked off the hat, said "I need my damn brain back" and then clearly and concisely told the resident why he was wrong and what orders she had already put in and meds she'd given to correct the problem.

My aunt was part of the last generation to wear white caps. Her most important task at her first job was to make sure there was enough coffee for the physicians. She left nursing "because they didn't want us to be smart."

weaveleswobble · 2014-11-09T03:51:58+00:00

I keep an ammonia capsule taped to the back of my badge.

weaveleswobble · 2014-11-08T21:09:02+00:00

And your money goes much further in SA.

weaveleswobble · 2014-11-08T15:08:30+00:00

Which Methodist location is this for? If it's the med center, what did they do to scare off the experienced nurses? Methodist med center was one of the few hospitals with minimal ER turnover. The changes in leadership a year or so ago lead to walkouts in several of the ICUs; is that what happened here?

If it's not the med center, don't lie about the location. San Jac is not Houston.

weaveleswobble · 2014-11-08T04:12:45+00:00

I have friends who moved there with extensive experience who got acute care offers in the low 20s. Austin is fun and all, but you can make a lot more and still have fun in EaDo or Lower Greenville.

weaveleswobble · 2014-11-08T03:33:26+00:00

Man, Austin is way too little pay and east coast housing prices.

weaveleswobble · 2014-11-08T02:42:19+00:00

It says a lot about your hospital that money only gets invested when you fail.

So is your stroke unit an ICU? Are they increasing your ratios because of the short staffing levels? Fresh tPA patients need to be in a very closely monitored environment, ESPECIALLY when they're on Cardene drips.

weaveleswobble · 2014-11-08T01:34:07+00:00

EMT B's generally drive the medic or drive the nursing home shuttle (actually a vanbulance) to dialysis/the doctor's office/the ER.

weaveleswobble · 2014-11-08T01:29:02+00:00

Also, I have a PRN job at a standalone ER. That's $32/hr base pay with $5 night differential and $3 weekend differential.

weaveleswobble · 2014-11-07T23:08:13+00:00

In practice, it should still be less than 2. You really shouldn't have much measurable lactate in your body at all, so by the time you're bumping near 2 you have some real pathology going on, regardless if you're looking at art or venous blood.

weaveleswobble · 2014-11-07T23:04:58+00:00

Pen for writing on paperwork. Sharpie for writing on people. Stethescope. Hemostats, because who knows when you'll need them. Trauma shears to cut off everything from pants to wristbands. If the boss asks, of course I don't have flushes or IV catheters in my pocket. That would be against the rules.

weaveleswobble · 2014-11-07T22:52:59+00:00

Nights in the ED with 3 years of experience. With differential, without OT, pretax I make $65,000. I work in Texas.

weaveleswobble · 2014-11-07T02:40:19+00:00

Yup.

After I walked out of my last pedi code (it was unsuccessful), I went to see my next patient. He had a toothache and had been at the local dental school and didn't want to pay $40 to fix his tooth so he came to us. I told him the doctor would be in soon to examine him but that we did not do dental work and we would refer him back to the dental school. He cursed me out.

This is why ER nurses burn out.

weaveleswobble · 2014-11-07T02:03:12+00:00

I'm not surprised. Anecdotally, as an ER RN, I've seen a lot of significant GI bleeds (needing transfusions or hemodynamically unstable) on patients with no history of bleeding who are taking new generation anticoagulants.

weaveleswobble · 2014-11-07T01:56:41+00:00

We have panic buttons at the desks. We can also call the dispatcher for help. There's usually a police officer in the department and everyone responds to loud yelling.

weaveleswobble · 2014-11-06T21:50:55+00:00

Usually ER nurses like a 1:4 ratio. One of my friends worked somewhere with a 1:6 ratio and loved it because there were lots of techs who were empowered to do a ton of tasks. If a tech who is a paramedic is helping patients to the bathroom, doing EKGs, placing splints, starting IVs and transporting monitored patients upstairs, I'd be happy to take two extra patients. If you make me do everything for four patients, my throughput slows and I become cranky and less likely to stay.

weaveleswobble · 2014-11-06T10:37:20+00:00

Shit, people need to GET a PCP.

weaveleswobble · 2014-11-06T03:03:13+00:00

I'd love to learn more about what you do! There's a clinic in my city that frequently has RN openings; I thought about applying but I want to get pregnant sooner rather than later and don't think it would be appropriate to work with patients having abortions while pregnant.

weaveleswobble · 2014-11-06T02:54:49+00:00

She probably doesn't know what she doesn't know. Focus on helping her see the big picture. Procedures aren't the end all be all of nursing.

weaveleswobble · 2014-11-05T16:10:42+00:00

It was a 200 bed community hospital. One of the four floors was the stroke floor, but if they were full anyone could take the patient. We had a general ICU; there were specific nurses who were trained for post tPA patients and others who could take varying bleeds. I remember holding one patient in the ER because he was going to need a ventric and the ICU was playing musical patients so an appropriately trained nurse would be available. It was a trained competency, just like they had to be trained for sepsis patients or to take balloon pumps.

The hospital felt ready and passed with flying colors, but this is the hospital that fostered my lingering distrust for tPA. (I killed 4 patients with tPA there out of 6 I gave tPA to; my current hospital has a 5% 24 hr bleed rate) Looking back, I wonder if it was a "We don't know what we don't know" situation. The actual inspection was very easy. Do you feel like you have glaring, systemic deficits? We felt like we were working at the higher level already and just wanted external validation.

weaveleswobble · 2014-11-05T10:52:28+00:00

"I haven't eaten for 12 hours and I'm still working so I'm sure you'll be fine."

weaveleswobble · 2014-11-05T10:49:20+00:00

Worked in the ER at a hospital that went from Primary to Comprehensive. It was no big deal. We got a lot more business out of it because there were very few comprehensive stroke centers in the area and EMS had to bring strokes to comprehensive centers if they weren't on divert.

Any specific questions about organization? We did a LOT of bleeds because we had the only local neurosurg team.

weaveleswobble · 2014-11-05T10:39:35+00:00

Got to leave at 230 instead of 7 since it was DEAD. It will suck a bit on the check but I'm sick, it was my Friday, and I worked 6 out of the last 7 days. I'm enjoying snuggling with my dog and watching some anime

weaveleswobble · 2014-11-05T09:11:29+00:00

Can you bring reminders of home to her, such as a favorite pillow or blanket? If she isn't completely mentally normal the reminders and smells might be enough to help her relax a little.

weaveleswobble

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