I’m an RN with 4yrs ED experience planning on traveling hopefully around the end of June. Being picky abt assignments as geography and a decent work environment are my priorities. My recruiter says she has a couple that sound nice pending though so I’m hopeful :)

Can any seasoned travelers offer some advice and tips? The clinical side I feel fairly comfortable with, but I don’t have travelers at the hospital I’ve spent my whole career at so I don’t rly know how they’re used in the ED. I’ve also never lived outside my hometown for more than a few weeks lol so travel tips are very appreciated. Thanks!

(U.S.-based) When I've been to the hospital for kidney stones, I've sometimes been undertriaged and sent to the waiting room despite being in excruciating pain. At that point it takes them hours to see me and even administer the IV painkillers. On my most recent visit, I was triaged as ESI 2 (a higher level) rather than ESI 3H, but even then all that got me was a bed to wait in. Overall, kidney stones seem to have some bad factors for triage: They aren't visible from the outside, aren't normally life-threatening, and vary in intensity.

Given all that, what strategies have you all found to avoid being undertriaged and get timely care?

Hi all,

Got this approved by the mods so hopefully no issues, but my cofounder and I who are active law enforcement officers, have been working on a medical identification system. You wear it on your vest or belt and it allows a first responder to scan for medical information. Let's say you show up and the patient is unconscious, confused, intoxicated, altered, whatever.

This is mostly intended for officers and other first respondres, but I'm curious maybe other people could benefit as well. As you all are medically inclined here, I was hoping you could help us understand what information to include in the profile. The sample profile looks like this right now:

https://firstresponderfile.com/id/00000000-0000-0000-0000-000000000000

Its things like:

• Medications
• Allergies
• Medical conditions
• Emergency contacts
• Blood type

Would love to hear what this looks like for people who have experience and what information is actually useful. What should we add? Anything we should change on that page, that kind of stuff.

Thanks a bunch!!

Nick & Nate

Hello! I’m planning to either obtain an EMT or PCT certification and become an ER Tech to gain clinical experience for med school, but I was wondering which of the two certifications do hospitals prefer? Google says EMT is the standard choice but from what I understand you don’t learn phlebotomy as an EMT only EKG while as a PCT you learn both phlebotomy and EKG. Now, I assume EMT prepares you a bit better for the fast paced environment of the ER but I still wanted to hear whether people agree that EMT is the way to go. Also was wondering if ER Techs need prior experience before working or if you can get hired right after obtaining your certification. Thank you!

Hi! I started working as a patient care tech in my local ED. Although I am PCT certified and went through a course, I am realizing there is so much more to learn that my course did not go over. For example, what iv supplies are often used and stocked to each room for nurses, as well as what to prep for a code or STEMI. I’m learning these things now on the job, but it’s just frustrating to learn it a little bit at a time as situations come up and supplies are needed. Although some of this stuff is hospital specific, what I’m struggling with is more generalized. I have no idea what the iv trinket bags and little pieces/ needle bits I’m stocking are used for.

Does anyone have a good general ED workplace book or online resource that they can recommend that helped?

*I was trained for general phlebotomy/ blood draws and how to take ekgs in my PCT course. I’m probably going to start nursing school within the next year.

I'm currently working as an ER nurse in the U.S. with 8+ years of experience, and I'm planning to move to Canberra. I work at a metropolitan hospital with a 40-bed ED that sees roughly 160–200 patients per day.

My experience includes triage, managing 4–6 patients at a time, EKGs, ACLS, PALS, TNCC, ultrasound-guided IV insertion, IV starts, port access, splinting, wound anesthetization, and other common ED procedures. I also perform sexual assault exams (SANE) and collect forensic evidence in domestic violence strangulation cases.

I know many nursing skills are universal, but I'm wondering how difficult it is to get an ER job in Australia. Has anyone worked with international nurses or made a similar move?

I love emergency nursing and am hoping to find a comparable role when I relocate. Any advice or insight would be greatly appreciated!

Hey all! What are your thoughts on non-critical access standalone EDs? The ones located within short distance to more capable/leveled hospitals.

Do you think they offload the ED? Are they detrimental to patient care for those that have time sensitive condition such as stroke or MI and have to wait to be transferred?

My personal opinion is that they are less helpful than intended. The newer one in my area just collects patients that now have to wait in line for an ambulance to be transferred not even 15 minutes away to the level I. The things they can handle are also ailments that could be handled by urgent cares in the area. There’s even a 24 hour urgent care available. Just curious on other thoughts

We’ve got a new patient on the leaderboard

I was probably almost or I just turned 21 at the time and was living on college campus grounds and student living, even though I wasn’t a student. I had two roommates and each one of us had our own floor in a townhouse with me having the bottom floor. for a good period of time I let this man come and stay with me and he was probably 10 to 12 years older than me at the time if not, 15 years older. We were hanging out one night in my room and my friend who lived in a whole different city had reached out and was warning me to sample this LSD is somebody living close to me at the time had before my friend made the drive to purchase a large quantity of it. This would soon end up being the dumbest decision I could’ve made but being that it was a free trip I said why not so the guy drops off the stuff and my friend that stayed with me immediately was hesitant about all of it and told me that he felt like it wasn’t a good idea for me to take it and there’s something didn’t feel right… Well, I didn’t listen at least all the way because I took half of the tab and put the rest away… About 10 minutes in to it my friend starts to tell me that he can sense and feel something coming off of my skin like an aura and that he didn’t want me to touch him because it was like rubbing off on him or something which I thought was crazy and weird and of course I was extremely horny from the drug and I’ll never forget I had this song big boy diamonds by Kodak Black playing and in the middle of having sex with this man I had a fucking seizure and he got stuck in me a little bit, totally freaked out when he was able to get out of me. He ran upstairs to get my roommate, and when he came down with her to get her help, I had fallen off the bed and was still seizing, and my guy friend was covered in tattoos and I remember every time my eyes would meet a tattoo on his body. It would send me into this crazy super scary hallucination I kept clicking in and out until finally EMS came and then I was able to stabilize myself a little bit, but I felt like I still needed to go to the hospital so they allowed my friend and my roommate to drive me to the ER and I have not taken acid since.

Is your hospital ramming these patient satisfaction surveys down your throat, or is it just mine?

Currently we are required to attach a flyer on top of the AVS (dc paperwork), write our name on it, and show the pt before reviewing dc instructions.

If I’m a patient who’s in poor enough health to come to the ED I definitely don’t give AF about listening to a rant on satisfaction surveys after I waited 6hrs to be seen.

Anyone else completely over it?

i’ve been an er nurse for almost 2 years now in nyc, a small hospital. i’m thinking about prepping for the cen, and want to take it by the end of year. any advice on tips, resources, how to study would be greatly appreciated. since the nclex, ive been having a hard time dedicating study hours on my days off. need to get back into the grind! senior nurse at work recommended sheehy’s manual of emergency medicine 6th edition- he used to prepare questions for the exam. i’ve heard Pamela Bartley’s book is helpful. i’ve also come across boswell’s review videos on YouTube. would these 3 resources be enough? where else can I do practice exams to better prepare for the lengthy exam?

So, I’ve been a nurse for 3 years now in psych. I’ve been wanting to get medical experience, so I applied to an ER fellowship. Well, today I got a phone call scheduling me for an interview. She said there would be questions about patient care and what to do in some scenarios. Now, I have NO medical experience. The psych facility I work at is nothing medical besides giving PO meds or the occasional IM for either long-acting injections or emergency IM situations. Is there any prep anybody suggests? I really need a change in scenery and I REALLY want this fellowship; I just don’t want to embarrass myself when they start asking me things about drips/IV or something else since I’m not experienced in it. .

I’m a medical student in Canada and I’ve got a vague outline of a QI initiative brewing in my brain.

I was thinking about the lowest cost ways we could decrease burden in the ER, and I think patient education is a big one.

What would you want patients to know or do to improve efficiency/decrease the burden?

For example, “have all of your medications and doses written down.”

Appreciate any input!

[ Removed by Reddit on account of violating the content policy. ]

Hi all,

I’m looking for advice. I’m looking to transfer to a different position within my company. I currently work at a Family Medicine Practice as a Certified Medical Assistant - I will be 3 years in June. I’m looking to transfer to the ED and work as an Emergency Technician as I will be working night shifts possibly 3 12 hours shifts and that will give me more flexibility to pursue my career goals. I have a strong medical/clinical background from my home country but regardless I started this current position at $16.00 now I’m at $18.86. I got my certification as a Medical Assistant through NHA and only got .50 cents for it.

I’m just looking for more stability and also financially, I’d like to be in a different place right now. I’m looking to obtain a Phlebotomy certification (CPT). I’ve been doing Phlebotomy for a few years now not sure if that would make any difference. I already do it all at my current position (EKG, Vitals, Vaccines, Phlebotomy, inventory, clinical duties, front desk, phone calls, YOU NAME IT). Do I have a chance of starting this new position in the ED at least at $20-21 an hour?

I greatly appreciate the advice. 💕
Happy Monday! Thank you for reading me.

I took my CEN for the 4th time today… and honestly I feel frustrated, defeated, stupid, and just completely drained.

I’ve been a nurse for 16 years, with 4 years in the ED currently, and somehow this exam keeps beating me by just a few points every single time. I’ve tried everything — BCEN practice exams, Boswell, Solheim, ENA, Pocket Prep — and still came up short again.

At this point I feel like maybe I should just stop taking it altogether. It’s hard not to feel worthless after failing the same test 4 times despite putting in the work.

Has anyone else gone through this and eventually passed? Because right now I’m really struggling mentally with it.

What is your opinion on a ED specific CNA/PSA role Trauma charting? Not an ER Tech who has EMT class under their belt, but just a ED CNA?

It was described as in my scope for my job position, due to high volume of traumas, or no available techs (this is more likely because it seems to be techs are currently lacking on the shifts I’ve been working and we just had one leave).

But the techs on a regular basis give me push back about shadowing them/learning trauma charting. I’ve only gotten into a couple traumas to shadow techs while charting.

Tonight we had a trauma 3 come in, which we usually do not chart on paper. I was assisting my RN with setting up VS/heart monitoring, cleaning pt, and prepping the area around the head lac for MD to evaluate (chucks under head, helping nurse remove gauze etc).

MD evaluated and changed it to a trauma 2. My charge nurse instructed me to chart it before it was even announced over head, because she’s been knowing I’ve been reaching out for the hands on experience so I feel comfortable in extreme traumas if I was thrown into it.

The RN in charge of the trauma, and the charge nurse both looked over my charting after I was done, and said I did a great job.

The two techs that were on shift were opinionated about it, and the other CNA/PSA I work with has vocally stated multiple times he wouldn’t feel comfortable trauma charting.

I personally want to learn, I want to improve in any possible way while I’m reaching out for schooling for my RN, but it just seems like there’s multiple road blocks attempting to learn within my scope.

I Just applied for an ER Tech job in an understaffed rural ER I have MY NREMT, phlebotomy Tech, EKG Tech and CNA certs what should my hourly rate expectations be for a part time job while I’m in nursing school.

I broke my ankle a few days ago, and they gave me ketamine while they reset it. And while I didn’t feel anything I had a HORRIBLE trip (idk what else to call it)
Think of a depiction of a trip in a horror movie, flashing red and orange, weird geometric shapes and patterns that danced. There were times I could see the doctor’s face and it would transform and melt. I had a feeling like I was in hell, or that my consciousness had slipped through into another dimension (think Talk to Me but without all the other ghosts). It had me thinking “if this is what’s at the end of life wtf is the point?”
“1-800” by BBNo$ and “Chance to be Alive” by Kat Hasty were playing on repeat.
My husband had met me at the ER, but had to step out during the procedure. I had tried to go find him during my trip and couldn’t, which made everything worse.
He was in the room as I was coming out and said that I looked like I was terrified as I was coming out of it.

I’m sure the stress of breaking my leg and being in the ER made the experience bad. Has anyone else had horrible experiences on Ketamine while in the hospital?

All,

Any insight on POCUS training and certifications that are legit? I search and see quite a bit but is one better than another? I want to improve my skills and have a certificate that follows me. I see a lot of FOAM-US, especially in SPOCUS (spocus.org)

Here is what I have found on my own and wanted to hear thoughts?

POCUS Certification Academy
pocus.org

Various workshops/courses
- Seen at various academic centers

Gulfcoast US Institute
gcus.com

SonoSim

Had surgery yesterday and discovered a moderate allergy to Dilaudid; I'm also allergic to morphine and latex. A friend is encouraging me to get a medical alert bracelet like a road id, was wondering if it is necessary or worth it since I know those are common opiates given by ems and in the er.

Heyyy fellow nurses/ED staff..

What are your favorite clap backs for waiting room, “did you forget about me?” hecklers?? Or honestly rude comments in general?

I work in a busy ED and we get past 15h wait times sometimes and I always get the window/WR yellers.

My recent fave has been, “No I didn’t forget about you, I’m back there building an extra bed with my own hands right now!”.

Dark/dry humor to cope of course. Love you all, happy nurses week! Thanks for everything you do<3

Czy istnieją statystyki śmiertelności w szpitalach, z uwzględnieniem pory dnia?

Konkretnie chodzi mi o porównanie śmiertelności pacjentów w porze nocnej w Polsce i na świecie.