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scubanurse

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Everything posted by scubanurse

  1. I use ETCO2 on any patient I give narcs to, any respiratory distress patient, and any overdose patient. It's not up for discussion in my mind, we have a tool that is useful and proven to improve patient outcomes, so why not use it? Most nurses I work with do the same and the few who don't use it, can't give me a good reason as to why they won't. Every EMS system that transports to us has it as well and uses it in the same cases as described above. We also always use the inline CO2 monitor for all tubed patients.
  2. I used to treat them as any other call. We occasionally have OB's ride down from the mountains with patients in labor and once they hit out doors they are just a friend to the patient. Most of the docs up in the mountains have a good relationship with the EMS crews so they are welcome on the ride, but the EMS crew's can't take their orders since they are not the medical director. We've had a few docs call in to our ER though to get orders for more pain meds, etc. I'm not allowed as an ER nurse to take an order from an inpatient doc, only our ER doc's. Makes codes really fun when we go up to the floor and they start telling me what to start the norepi or dopamine at...
  3. In my ER, the nurses make the decision of which company to go with. We have contracts with two local companies, both contracts state they have <30min to respond to transfer a patient to either their home or another facility. If they quote us >30 we go with the other contract. The other night both companies were quoting me >60 minutes so I called my buddy at a 3rd company and they were there in about 5 minutes. Most ER nurses will go with whoever has the shortest response time, and who they have had positive experiences with. While I LOVE free pens, they don't drive my decision to go with one company over another. Good working relationships with the local nurses, positive attitude when you do respond, and providing excellent care to the patients will help you get called more often. We are very unfortunately driven by customer satisfaction scores and we do hear frequently about the quality of the ambulance company we choose to send them home with and if that feedback is negative you can bet your bottom that we won't be eager to use them again.
  4. In Colorado it is now a 2nd degree felony assault to intentionally hit an emergency nurse or provider. This is a huge plus in the emergency world, but there is still so much farther we need to go! Why is it that a drunk driver who gets behind the wheel of a car is held responsible for damages they cause, but a drunk patient who becomes combative with medical staff isn't? It's just such a stupid situation. Sometimes I wonder why I even do this anymore when people don't give a flying F*$%.
  5. https://ems.creighton.edu/training-certification/pre-hospital-care-emt-nurses-0 Anyone know of this program? I've tried google and found their facebook page that seems to have good reviews, but wanted to check here as well. Thanks guys
  6. We have Glide scope in our ED and it is present for every intubation we do. Most of our docs though intubate by traditional visualization and have the glide scope there to ward off evil spirits. A few docs use the bougie when having a difficult time visualizing the cords, and they'll do this before they go to the glide scope. I'll have to talk to them some more to see if they just don't like the glide scope and that's why they don't use it. I believe our field medics us the same method as I haven't seen them with any video laryngoscopy. We get nasally intubated patients a lot from one service, which is always fun to deal with.
  7. I have PTSD and postpartum depression/anxiety and it has changed me as a provider. There are some patients that make me use all my positive coping skills to treat, and there are others that remind me that this is why I lived. As far as your diagnosis, man, I'm not sure. I am all for openness when it comes to mental illness and believe that the more we talk about it, the better we'll all be. ASPD is a pretty hefty diagnosis to carry and is not given lightly to people. There are those that would question whether I should be a trauma nurse or not based on my diagnosis, so I only can imagine what your co-workers think of yours. Good luck and I hope you can be a solid provider for your patients.
  8. As a former medic and current ER nurse, I can tell you that you can do both. I am actually about to start back with getting my EMT-B since I was silly and let everything lapse several years ago. I am going back to get my EMT and then my paramedic so that I can do flights. I've worked in the ER for a few years now and plan to transition to the ICU in a year or two. 1) I started in EMS because like all, I wanted to help people. I had a friend in high school who told me about becoming a junior member, and it sounded fun and cool. 12 years later, I'm still in emergency medicine. 2) I regret letting my certifications laps when I was younger. I moved to Colorado where EMT-I/99 wasn't really recognized and so I gave it all up for nursing. While I absolutely freaking love being a nurse, I miss EMS and being out in the field more. 3) If you continue and get your P, get your RN, the opportunities are endless. There are always jobs out there for either one, and especially for both. You could do flights, you could work in a trauma center, you could work in ground transport, you could do anything really. Good luck and like Mike said, keep getting the pre-req's for nursing while finishing your EMS stuff, you'll thank him for that advice at some point.
  9. I don't have much to add other than I was in your shoes once. I'm an ER nurse now and going back and getting my basic again this summer because I miss EMS so damn much. Hang in there my friend Katie, BScN, RN, CEN
  10. I jumped and it brought back some memories and emotions for me.
  11. Not a grammar Nazi, they just mean two very different things.
  12. who couldn't care less There is an image that the public has of a health care provider, and a sloppy hair style usually does not fit that style.
  13. scubanurse

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  14. Oh I was a member of the page back then lol. We bag people sitting up all the time, especially the exacerbations that we are prepping to intubate, RT will bag them in fowlers while we're drawing up the RSI meds.
  15. https://www.nremt.org/nremt/about/psychomotor_exam_emt.asp Here is a list of the skills you are expected to complete for the NREMT Basic exam.
  16. I know some departments down in Montgomery County that would take ya!
  17. Yeah, it's going to be tough to convince the husband to move, but a girl can dream. I'd love to work at UMD, but that might be a reach for me.
  18. Haha I think it would be by the ocean or in DE, I just miss my parents (in Pasadena) and being back over Christmas made me miss them even more! Annapolis would be cool too.
  19. 1) build up the courage to have my neck fused 2) take The Certified Emergency Nurses exam in 2 weeks 3) spend more time with my family 4) decide where we're going to move to (Alaska, Maine, Maryland, or Montana are top of the list right now) 5) loose weight and cook more meals at home
  20. I like the idea a lot. I don't have a whole lot of free time with an infant, school, and work, but I'm happy to help out in any way you need. I imagine maybe each chapter being a different topic, like "Field Pronouncement" and then the chapter discusses our experiences pronouncing patients in the field and tips for talking with the families?
  21. Do you want to be an RN or a Paramedic? In my experience going through nursing school takes up a good majority of your time and brain capacity, so if you want to be an RN, focus on that and succeed at that.
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