[gt4everpn]

#1 is very important I dont feel I got an adequate orientation at my LTC facility, I did ask for more days but ended up having to work because of low staffing! Huh, when will I learn the things I need to!! Thanks everyone for the advice!

[eccentricRN]

Originally Posted by NursePamela

Never be afraid to ask questions. If you let people know what you do not know they will be more apt to teach you and nursing is forever a learning field.

This is a good hint, I always found students ahead of me and asked questions about different instructors and what they were looking for.

Keep all your med sheets & start a binder, saves hours later on.

Have at least one person to buddy up with, you can help keep each other on track, sane, and provide moral & emotional support when the going gets rough.

Realize you're human & mistakes happen, just be sure to be honest & own up to it, & use it as a learning tool; you'll never make the same mistake twice.

Take one day at a time, and realize it must be possible to complete the program because there is a whole lot of nurses in the world!

[Jaguar Boy]

Well i'm not a nurse yet, still working in the office world...but work is work. One important lesson I learned over the last year is that people everywhere are a product of their circumstances. Nothing is personal...That angry supervisor probably has some personal issues you can only begin to imagine...you can't take it personally.

I won't be able to enter Nursing school until 2009, still doing some prereq courses, but I'm really looking forward to it!

[aecp]

Something I was told that stuck... "You dont know what you dont know." Its so true when you are starting out and it can be scary. Other things:
-The minute you start to be overconfident, you will be humbled.
-Dont be afraid to ask questions
-I have also learned latley that if you are trying to decide whether or not to call the doctor about something, you should probably be calling the doctor...
-Remember that doctors are being payed when they are on call
-Find those two nurses... the one you want to be like and the one you dont want to be like... watch and learn
-Listen to the good nurses who think out loud, they always get me thinking too!
-DOnt eat ice cream on nights... ugh I learned that the hard way
I Have a couple weeks left until my one year anniversary and I still feel like there is so much to learn! This is going to be a lifetime thing!

[Indy]

A few things I thought would help besides whatever I posted a while back:

Bag/line sets for feeding tubes: read the package. No, really. Then you avoid nearly losing your sanity when you try to fix it. Also, if it has a thing where you "set dose"- set the dose at either the amount that will infuse before your next residual check, or less than the amount in a can of whatever you put in the bag.

NG tubes, sump tubes, whatever you call them- there exists a little plug doololly to go in the blue end, if you hook it to suction, to let air out/in and keep the green crap from getting all in the patient's bed. I just don't know what it's called. It's blue and white, two prongs on one end and one on the other, about 3 inches long. It's a good invention! Lacking this, you could tie the blue end of the NG to something attached to the ceiling or the top of an IV pole, but only if you wanna flustrate the next nurse.

Dobhoff tubes. God those things are the devil. It's not entirely necessary to leave the stylet in for the xray to confirm placement, if they are weighted. The weighted end has metal in it and will show up.
Removing the stylet while the patient has a coughing fit, after you know it's in the right place, can cause the entire thing to be coughed up into the patient's mouth. Ugh. Again with these things, read the package insert as it has advice on what to put in there. Don't use the stylet to unclog the tube unless you have a very tranquil patient and you've already put warm juice and/or soda in it, and can feel it wanting to unclog, just not quite there- if you have to put the stylet in more than oh, 8 inches on an adult, just don't go any further, you ain't gonna get that clog out, not that way anyhow.

Pushing meds through a dobhoff using a syringe- for god's sake put your thumb of the hand that is holding the tube, on the little alternate port cover or you'll spray yourself in whatever you've got in the syringe. Potassium orange liquid stains wall paint. Jevity makes an excellent thing to dissolve meds in by the way, as long as it's warm.

Do not leave unused ports of a central line unclamped or suffer the wrath of the night nurse who needs to draw AM labs and the thing doesn't work. (Not only that, if the cap on the end breaks, the patient could bleed out.) Do not assume that infusing fluids into any line is enough to keep it patent, especially do not assume that if the fluids are sticky. Patients and their docs get a little upset if they have to put in new central lines for what isn't a very good reason.

With your thoroughly demented LOL's, try and figure out just exactly what they want and if it's not harmful to them or others, try to make it look like they're getting what they want. If possible. It'll save you time, aggravation and if you can arrange it, they get their meds and such. (It isn't always possible. But it's fun when it is!)

If your facility supplies things like ensure in the patient's kitchen... don't underestimate the power of a few calories on some of your elderly patients. Also, if your refrig has ice cream - ice cream, a fork, and some ensure makes a nice milkshake. Add a PRN tylenol and some LOL's sleep nicely. OH. If you have someone who's NPO except for ice chips and they're not at risk for aspirating, and they just happen to be tired of the flavor of ice: a half teaspoon of grape juice in that cup of ice and voila! flavored slushie. If they don't get it in their lungs and have no stitches in their GI tract, it's not gonna hurt.

More later....

[janfrn]

Originally Posted by Indy

NG tubes, sump tubes, whatever you call them- there exists a little plug doololly to go in the blue end, if you hook it to suction, to let air out/in and keep the green crap from getting all in the patient's bed. I just don't know what it's called. It's blue and white, two prongs on one end and one on the other, about 3 inches long. It's a good invention! Lacking this, you could tie the blue end of the NG to something attached to the ceiling or the top of an IV pole, but only if you wanna flustrate the next nurse.

Those little plugs are called anti-reflux valves and they're great work-savers! The blue end has a hole in the plug part and the white end has a lot of tiny holes (vents) around the collar that connects the two parts together but a solid plug part. If you want to let air out but keep everything else in, the blue end goes into the tube (like for the salem sump). If you want to completely close the port then put the white end in (on sump chest tubes when ready to change to closed suction). Another little use I have for these is when I have a tiny peds patient with an NG for gastric decompression. We let gravity take care of any drainage and most of the people I work with put a specimen trap on the end of the tube using the silicon tubing to collect any green goo that might come up with the air. That's all well and good, but if the kid is prolifically pumping out green goo, it's going to leak out the other port of the trap eventually unless it's a sealed set-up. I cut off a piece of the silicone tubing about 1 1/2 inches long and put the blue end of the antireflux valve into one end then push the other end of my little piece of tubing down over the open specimen port. Voila, air comes out, fluid stays in!

[Angie O'Plasty, RN]

If you borrow someone's penlight to do a neuro check, make sure you return it.

It's probably attached to her key ring. Her car key ring. Without which, she cannot go home.

'Nuff said.

[hoosiergirl1]

Peroxide removes blood (especially if you wear whites, not so sure it you want to try it on colors)

Keep in mind--Instructors do not hate you, they have to hold you to standards or else they are setting you up to fail in the professional world

Yes, you will find on clinicals that some staff nurses "eat their young", just let it roll off your back. In some ways it is a right of passage we all endure and it makes you tougher.

Put 100% into every single assignment, test, etc... Shoot for the top grades on everything. Not only will it make it easier on you come time to graduate, but if you ever decide to purse advanced practice your past nursing school GPAs are used as part of selection criteria.

YOU WILL SURVIVE!!!!!!!!!

[elliejayRN]

Don't correct your assistant nursing manager! Just bite that tongue off if you have too, let someone more seasoned correct her. There is nothing like a PO ANM! Oh, she's shoving a foley catheter in an old guy's urethra, he's screaming and bleeding, SHUT UP! It will only end badly for YOU!

unemployed RN

[ginamoore]

Is the VA Hospital a good place to work, for a 1st year nurse?