ER nurse needs advice

[chanab]

So I know I'm so out of the loop at this point because I haven't been on here in well over a year..... I just started my first hospital job - in an ER no less - after 3 yrs of clinic nursing. Desperately seeking advice. I am slow. I am slow at pulling meds. I never drew up morphine before from one of those glass tubes. I am slow at hanging IV's. I have not yet taken ACLS (sched for next month). And apparently I don't do compressions real well. (In my defense she was pretty much doa and they were just letting the new nurses practice). Any advice anyone can give me? Speed tricks?
Additionally I didn't tell them about Shabbos in my interview and now I think they resent me becasue they have to accomodate. Blah!
HELP!

[achot]

Hi Chana, We all start out, well, slow. It gets faster as you do the skills over and over, it helps to go over in your mind and know the steps better. It helps to know where all your equipment is stored and come prepared for each activity instead of going back and forth to get everything you need. Spend the time to improve your skills off the job by practicing them as much as possible, I understand there are simulated computer programs that might help. Some hospitals have them in the units computers. Try to stay upbeat and positive even in the face of (hopefully constructive) criticism on the unit.
Most of all BELIEVE in yourself, BELIEVE that you can do this, and daven to Hashem to help. Dont feel overly defensive about the Shabbos issue, SHabbos will protect you, try to make the most of it. I have it worse, I dont work SHabbatot where my coworkers are also Jewish and want to know why me and why not them. SO I really try to make the day what it is supposed to be in order to justify my taking off.

[medic09]

Shalom Chana! Welcome to the ER.

The best advice really is to have a mentor on your shift. Otherwise, tell your charge nurse and even some colleagues near you, 'I'm eager and learning and hard working; but I am still a bit slow and unsure where things are. Can I ask you for help if I need it?' If they run trainings and reviews, attend as many as you can.

All the things you describe improve over time. You just need some time in the environment to get up to speed. I just came back to the ER after a year away for injuries; and I too am relearning where things are and how to do things.

Speed tricks? Far better to be safe and competent, than fast. Fast comes over time. Just stay focussed, don't get distracted from the task at hand. The ER is a busy environment with constant distractions. You may be managing four dynamic patients, and you still have to stay on task and get through the 'to do' list in an orderly manner, and chart it all.

If the morphine 'glass tubes' are (Tubex or something similar) Carpuject, there should be a device you can keep in your pocket to use the tube without drawing into another syringe. They're plastic, and the hospital pharmacy should be able to give you some. I always keep two around. Mind you, some of my friends prefer to draw into a regular syringe anyway. No big trick, and it does allow for easier titration. There are other drugs that sometimes come in tubex containers; so beware not to confuse them. Mostly narcs and benzos. Read the label twice. Be aware, too, that most of those tubes have some dead air space in them; so you need to gently expel the air before injecting.

As for the Shabbat thing, well you'll remember next time to bring that up sooner. We've had some discussion of that topic on here. Hopefully it won't be any issue again for a long time.