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Have a question for an ER/Trauma nurse? I'll give you my best answer

TraumaRN

TraumaRN

Diamond Member
So basically this is inspired by a thought I had.

I've been an ER nurse for over 5 years now, I've always wondered what people thought of health care, specifically the ER and I'm sure there are questions they have wanted to ask, but never did. So here is your chance. I can't promise I can answer everything perfectly but I'll give it a shot.

Hell I'll even debunk any rumors/myths if people bring them up.

Who's first?
 
First question, are you male or female? Second question, do you see any doctor's preference on how well you are treated as a staff member between the sexes? Third question, I'm sure you have come across incompetent doctors, what options do have as far as taking action to make sure no one dies at their hands?
 
How many female nurses have you banged?

edit: I think you're a dude. Hopefully I'm not wrong. But you can reverse the question if needed...or not.
 
If someone comes in with a gunshot wound, or some other type of trauma, who pays the bill if the victim cannot?

Always been curious about this but never looked into it.

<--Canadian
 
I'm actually thinking of a career change and going into the nursing field. have you seen many people come into your field from another field? And how successful were/are they at the transition?
 
rcpratt said:
How many female nurses have you banged?

edit: I think you're a dude. Hopefully I'm not wrong. But you can reverse the question if needed...or not.
Click to expand...

In my lifetime 3. Yes I'm a dude.


GrumpyMan said:
First question, are you male or female? Second question, do you see any doctor's preference on how well you are treated as a staff member between the sexes? Third question, I'm sure you have come across incompetent doctors, what options do have as far as taking action to make sure no one dies at their hands?
Click to expand...

Male.

Yes and no, depends on the doctor. Also depends on their race/background. Not to sound crass or anything but I've seen some crusty old white guys and certain middle eastern types treat female co-workers like shit. Very annoying and petty in my mind. It's a giant moral killer.

Options to make sure someone doesn't die...well first off as a nurse I'm your first line of defense to make sure the doctor/resident/intern doesn't fuck up. In that regard I've made more saves on errors than I care to remember. You'll hear a lot of nurses talk about how one of our jobs is to protect you from the doctors. Scary but true sometimes. If it's something egregiously wrong, we are encouraged to speak up at the moment, and if that fails to work you file and incident report and move things up the chain of command. All 3 hospitals I've worked at will discipline you up to firing if you watched a patient error happen and didn't report it right away. And on that note hospitals aren't afraid to revoke a doctor's privileges especially if it involves any sort of patient harm.
 
DaTT said:
If someone comes in with a gunshot wound, or some other type of trauma, who pays the bill if the victim cannot?

Always been curious about this but never looked into it.

<--Canadian
Click to expand...

Rates are raised on people with insurance to cover those losses. In the end it plays out a lot like universal health care anyway, only way stupider.
 
Bulk Beef said:
Do you hire new grads?
Click to expand...

Yes. But I don't make the hiring decisions.


DaTT said:
If someone comes in with a gunshot wound, or some other type of trauma, who pays the bill if the victim cannot?

Always been curious about this but never looked into it.

<--Canadian
Click to expand...

In the United States, if the victim doesn't have insurance they have a few options. One is petitioning the hospital for charity care and/or a reduced billing charge. Many hospitals are willing to do this if you ask. Most people don't. Also you can set up monthly payments just like a loan. Sometimes the hospital will just eat the cost especially if they are unable to contact the person afterwards. The other thing is to apply for Medicare/Medicaid. Although that depends on the state you live in.

rasczak said:
I'm actually thinking of a career change and going into the nursing field. have you seen many people come into your field from another field? And how successful were/are they at the transition?
Click to expand...

I've seen many people who switched careers. And some were more successful than other people. Nursing is really about your attitude. And be willing to work hard. There are many soft cushy nursing jobs, but many of them you run your ass off day after day. When I do a 3 days of 12 hours shifts by the end of that 3rd shift I'm so tired its incredible. But that is because in the ER you are always moving. I cherish the shifts where I can sit for at least an hour. Don't switch to nursing if you think it's going to be an easy paycheck. Its not.
 
Do paramedics actually do surgical airways in the field?

I have a friend who's going through paramedic training and he won't shut up about doing a cricothyrotomy. I'm glad he's enthusiastic about what he's doing but I'm pretty sure he's overestimating what he'll be allowed/trained to do. Would like confirmation from someone who works in a similar field.
 
TraumaRN said:
In my lifetime 3. Yes I'm a dude.




Male.

Yes and no, depends on the doctor. Also depends on their race/background. Not to sound crass or anything but I've seen some crusty old white guys and certain middle eastern types treat female co-workers like shit. Very annoying and petty in my mind. It's a giant moral killer.

Options to make sure someone doesn't die...well first off as a nurse I'm your first line of defense to make sure the doctor/resident/intern doesn't fuck up. In that regard I've made more saves on errors than I care to remember. You'll hear a lot of nurses talk about how one of our jobs is to protect you from the doctors. Scary but true sometimes. If it's something egregiously wrong, we are encouraged to speak up at the moment, and if that fails to work you file and incident report and move things up the chain of command. All 3 hospitals I've worked at will discipline you up to firing if you watched a patient error happen and didn't report it right away. And on that note hospitals aren't afraid to revoke a doctor's privileges especially if it involves any sort of patient harm.
Click to expand...


Thank you for what you for us, if it weren't for you, a couple of my friends, brothers and children would not be with me now. Being on the front lines I'm sure you never get the accolades you should. :thumbsup:
 
TraumaRN said:
Yes. But I don't make the hiring decisions.




In the United States, if the victim doesn't have insurance they have a few options. One is petitioning the hospital for charity care and/or a reduced billing charge. Many hospitals are willing to do this if you ask. Most people don't. Also you can set up monthly payments just like a loan. Sometimes the hospital will just eat the cost especially if they are unable to contact the person afterwards. The other thing is to apply for Medicare/Medicaid. Although that depends on the state you live in.



I've seen many people who switched careers. And some were more successful than other people. Nursing is really about your attitude. And be willing to work hard. There are many soft cushy nursing jobs, but many of them you run your ass off day after day. When I do a 3 days of 12 hours shifts by the end of that 3rd shift I'm so tired its incredible. But that is because in the ER you are always moving. I cherish the shifts where I can sit for at least an hour. Don't switch to nursing if you think it's going to be an easy paycheck. Its not.
Click to expand...

It's really not for the check. I feel like I want to do something more meaningful with myself by helping others when they need it most.
 
ichy said:
Do paramedics actually do surgical airways in the field?

I have a friend who's going through paramedic training and he won't shut up about doing a cricothyrotomy. I'm glad he's enthusiastic about what he's doing but I'm pretty sure he's overestimating what he'll be allowed/trained to do. Would like confirmation from someone who works in a similar field.
Click to expand...

They are trained to do them yes. How often would they do one? Almost never. In 5 years as an ER nurse and 4.5 of those years in a Level One Trauma Center ERs I've seen only maybe a dozen or so surgical airways. Generally on either people who have horrific facial trauma or to be blunt, people that are morbidly obese and we were unable to place an oral endotracheal tube. By the way, when that happens it's a serious sphincter pucker moment. If it doesn't work, you die. And I've seen a couple patients die when we couldn't establish proper airway.
 
TraumaRN said:
They are trained to do them yes. How often would they do one? Almost never. In 5 years as an ER nurse and 4.5 of those years in a Level One Trauma Center ERs I've seen only maybe a dozen or so surgical airways.
Click to expand...

Do you mean you've seen a dozen in total or a dozen done by paramedics? Thanks for the response BTW, this is interesting stuff.
 
rasczak said:
It's really not for the check. I feel like I want to do something more meaningful with myself by helping others when they need it most.
Click to expand...

Well in that case I encourage you. We need more people with that mindset. Just don't forget that mindset. I may come off as cold and cynical to most people about my job but that is because on some level as an ER nurse you have to be. If you were emotional all the time the job would just overwhelm you.

After 5 years I still love helping people. I like it when I discharge someone and they are honest to God feeling better. That makes me smile and its very satisfying. But it took me a few months to figure that out and really appreciate it.

It's honestly a heavy burden to know that when I walk in that room people have an innate trust of me, and every little thing I do is scrutinized. It's your responsibility as a nurse to NOT break that trust and not do something to mess things up. Whether you realize it or not(and some nurses don't) most patients look up to you and need you to provide levity for their situation.
 
ichy said:
Do you mean you've seen a dozen in total or a dozen done by paramedics? Thanks for the response BTW, this is interesting stuff.
Click to expand...

I've seen a dozen total. Maybe more then that but not more than 20. I've seen a grand total of ONE done in the field by a paramedic.
 
What kind of turnaround time on STAT troponin tests do you get from your lab? Ever get an erroneous troponin result reported out from the lab?
 
Why do triage nurses often make people with significant problems wait hours?

I experenced one of these horror stories my self. I now have a permenant scar on the outer edge cornea because of it.
 
My sister is finishing up her RN education, did a rotation (or whatever you call the training period as part of school) in the ER and liked it. She's considering whether she wants to go that direction long term. What things do you like about it, and what things do you dislike? She's level-headed, good under pressure with a generally good attitude about life and people.
 
I've had a spontaneous pneumothorax (collapsed lung in layman's terms) that required a chest tube insertion to heal it properly. I was given (I think I remember correctly) lydocane local anesthetic to numb the area of the initial incision and then some morphine for the actual tube insertion (they started the morphine as soon as the incision was done and then cut the drip as soon as they had the tube in place).

I was awake and conscious the whole time. My question is this: while it hurt and is not something I would like to endure again, was the morphine THAT much of a difference? I did not feel myself that "out of it" at all, yet several nurses and the doc said I handled it all much better than they anticipated I would. One was a military field medic and he said he's seen more than a few that usually involve lots of screaming and yelling if the patient is conscious.

For the record, just after the finished taping everything in place, they needed an xray to verify the tube position and THAT is when I felt it all. A burning ball of fire just behind my shoulder blade. Sitting up, then forward for the xray plate to go behind my back and then sitting back SUCKED!!!!!
 
Senor_Bubbles said:
Most fucked up thing you've seen?
Click to expand...

I've seen more than a few.

Top three most fucked up would be:

1.) Lady who had most of her face blown off by a 3 inch professional firework mortar shell. It had misfired in the tube and instead of letting it be, she looked down the barrel and tried to relight it. It went off in the tube. Her 2 kids and husband were <50 feet away when it happened. I still have occasional nightmares about that. Actually just typing it gave me the chills. Obviously did not survive.

2.) A true mafia style hit/beating. Actually it was a drug dealer who obviously pissed somebody off. He had been shot once in each knee, then beaten with a baseball bat. After they shot him in the knees they then broke his knees with the bat, then broke both wrists and both elbows with the baseball bat. He had multiple open fractures(as in bone poking out through the skin) Strangely enough they left his face alone. Also broke 8 of his ribs IIRC. He lived.

3.) Guy versus semi truck. Was changing the a flat on the freeway and a semi truck just clipped his two legs. He had what we call a degloving injury. Basically the force of the impact was so great and because it momentarily pinned him between the ground and the truck it literally tore the skin right off both legs from about mid thigh down to his ankles. When he rolled in the door you could see all the musculature, ligaments etc. No skin at all. He did not survive.
 
DCal430 said:
Why do triage nurses often make people with significant problems wait hours?

I experenced one of these horror stories my self. I now have a permenant scar on the outer edge cornea because of it.
Click to expand...

A busy ED can have over 100,000 visits a year. They have to weigh room counts, staff availability and more importantly try and figure out how bad someone is f'd up based on a couple minute assessment. With that high of volume they are going to miss a couple things that are more serious than it previously seemed.
 
ichy said:
Do paramedics actually do surgical airways in the field?

I have a friend who's going through paramedic training and he won't shut up about doing a cricothyrotomy. I'm glad he's enthusiastic about what he's doing but I'm pretty sure he's overestimating what he'll be allowed/trained to do. Would like confirmation from someone who works in a similar field.
Click to expand...
Yes, but I've only done one. Pleural decompression, yes, three times. Intubation, oral/nasal, tons.
 
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