A message to new grads: NEVER.... - page 9

* un-spike the old IVF's with 100 mls left in the bag while it's still hanging * say the word "quiet" in reference to your hopes for the shift * say you've never had a patient ________ before... Read More

  1. by   LilRedRN1973
    Hmmmm...well, I'm still a student (Class of May 2005!!) but I have a few:

    Never assume it's the monitor, line, machine, etc. malfunctioning. It could very well be the patient. Case in point: MD put in art-line. Art line was working fine. Hour later art line wasn't reading. Nurse was convinced it was the art-line malfunctioning and kept screwing around with it. I walked in with my preceptor, who asked right away if the patient had a carotid pulse. After a quick check, it was determined that although the monitor had a beautiful EKG wave, patient was in PEA and probably had been. Art-line wasn't working because patient had no pulse; she had been bleeding internally from a crushed pelvis.

    Always take everything out of your pockets when accompanying patient to MRI...LOL. I was careful to remove all jewelry, watch, badges, and thought I had emptied my pockets. I quickly learned that I had forgotten a pair of scissors in my pants pocket when they flew out of my pants and attached themselves the MRI machine! Sigh.....

    Always check the cap on the tubefeed bottles. Sometimes, they are loose and when you turn them upside down to hang, they drip all over the pumps below.....or worse, the patient!

    Never assume just because you are a student, your assessment is wrong. I have had to overcome this one while working for the past year in the ICU as an Apprentice Nurse. I used to second guess myself but after reading charting that has been done by nurses who have been there for years, I realize that just because you have 10 years under your belt doesn't mean you can't be wrong (how does a patient on Norcuron do their own oral care anyways??.....LOL).

    If you do computer charting, always, always make sure you have the right patient pulled up. I was reading through the previous day's charting on my patient and came across a note that said "moderate vaginal discharge". Would have been fine except my patient was a man! LOL.

    Melanie = )
  2. by   Surgical_ICU_RN
    ...use a phrase "Nursing is 24 hours"!
    It's not an excuse!
  3. by   mercyteapot
    Never tell a child (or any other patient) something won't hurt, if it will

    Never burn bridges behind you, you never know who you might work with in another job, years later

    Never fail to remember that we take care of people, not cases

    Never think that a shift can't get any busier or worse, b/c that's when it will
  4. by   MrsStraty
    Quote from michelle95
    Along the lines of IVs and fluid...

    ...when you rare fooling with G-tubes, clamp the tube with your fingers while you are inserting or taking out your 60cc syringe...otherwise what you put in is likely to come out. Of course, we all learned this the hard way.

    Also, make friends with your unit clerks. They are really an asset. :chuckle
    Oh yes they are. Coming from a Unit Secretary of 9 years now and graduating with ADN in 11 more weeks!:hatparty: :hatparty:Hurray for me.....I cannot wait! But I love my job as a Unit Secretary at our local medical center and am starting to get alittle nervous about starting all over, being the new jack! I know my job in and out and I train almost all of the new clerks.....how long til I am comfortable with my new job as a nurse?
    I will be nice to the clerks because I "know" from experience what they are going through and I have dealt with VERY demading nurses and docs! I also was a Nurse's Assistant before Unit Sec. so I have done it all.

    MrsStraty
    ADN grad May 2005:hatparty:
  5. by   MryRose
    Quote from jaimealmostRN
    I second this! As a newbie/student, I ALWAYS say this and then feel silly. One good substitution is, "I can see your busy, but I have a question about xyz..." Great tips everyone....gee it sure is quiet in here (she says in hopes of getting more replies to this tread :chuckle ).

    I really like your tip, "I can see your busy....." ! Excellent! I too have a bad habit of apologizing for the interruption.

    Thanks for the tip!

    Hugs!
    MaryRose
  6. by   Brotherbob
    Never forget that A and B comes before C
  7. by   NurseFirst
    Quote from RNnTraining1973
    Hmmmm...well, I'm still a student (Class of May 2005!!) but I have a few:
    Always take everything out of your pockets when accompanying patient to MRI...LOL. I was careful to remove all jewelry, watch, badges, and thought I had emptied my pockets. I quickly learned that I had forgotten a pair of scissors in my pants pocket when they flew out of my pants and attached themselves the MRI machine! Sigh.....
    When I went to the MRI there they wouldn't let students accompany pts in just because of a past experience with a student who forgot their scissors...practically ruined their $1million+ machine. The MRI people did NOT find it funny, in the least...

    I *did* ask why they couldn't put in one of those metal detectors at the entrance, however. Maybe the folks who sell MRI machines should offer it as an option, if they don't already


    NurseFirst
    Last edit by NurseFirst on Feb 20, '05
  8. by   Forcemaster
    Quote from brotherbob
    never forget that a and b comes before c
    not always does a come before b or c... what if i told you i knew of a time when c can come before a..?

    *turns into... super nerd nurse*

    there is a growing amount of research into the cabc method of [font='times new roman']resuscitation.
    [font='times new roman']
    [font='times new roman']what is this i hear a minority of you say (those who i havent sent to :zzzzz anyway)?
    [font='times new roman']
    [font='times new roman']well traditional cpr starts, as we all know, with opening the airway, breathing, then circulation etc. our beloved abc of cpr right?
    [font='times new roman']
    [font='times new roman']well what if i told you that (unless the person who is about to undergo cpr has been oxygen starved for any length of time i.e. in a smoke inhalation or carbon monoxide poisioning situation) there is oxygen already dissolved in the blood stream. this mean by starting with a single cycle of chest compressions, you can deliver that oxygen to the brain sooner and buy yourself some time (admittedly not much, but evey second counts right?), then pick up your airway and breathing and continuing the 'normal cycle' of cpr...
    [font='times new roman']
    [font='times new roman']it's interesting stuff and of course, untill there is more evidence it is still a 'trial only' basis, so until then we shall put a before b and c :spin:
    [font='times new roman']
    [font='times new roman']*turns back to normal *
  9. by   NurseFirst
    Quote from Forcemaster
    Not always does A come before B or C... What if I told you I knew of a time when C can come before A..?
    Don't even get me started on "alternatives" to CPR; it is, indeed, a strange world out there. "Double compression CPR", where, alternating chest compressions are heimlich-like compressions on the abdomen; Heimlich saying that drowning victims should first be treated with a Heimlich maneuver....ah yes, the wacky, wacky, world of CPR

    NurseFirst, former and to-be CPR Instructor

    (And, for those people who are always confused...CPR really DOESN'T start with "A"--it starts with a responsiveness check, right? )
    Last edit by NurseFirst on Feb 20, '05
  10. by   Forcemaster
    Quote from NurseFirst
    Don't even get me started on "alternatives" to CPR; it is, indeed, a strange world out there. "Double compression CPR", where, alternating chest compressions are heimlich-like compressions on the abdomen; Heimlich saying that drowning victims should first be treated with a Heimlich maneuver....ah yes, the wacky, wacky, world of CPR

    NurseFirst, former and to-be CPR Instructor
    Ive heard a few good things about alternating compression CPR using a rather strange device that looks is a rigid frame with two hinged adhesive pads where the user rocks the bar (that has handles). Its a strange idea that apparently increases venous return or something like that.

    I'm rather dubious though... we all know how well 'adhesive' things stick to men with hairy chests or people who are very sweatty... I can imagine the person trying to use this 'bar thingy' having it slide all over the patient and not doing a damn bit of good...
  11. by   darinda
    Never push Kaexolate through an NG tube without thinning it down with water or you will spray it all over the ceiling. I know, I did it and the janitor refused to clean it up because he said he didn't clean up poop. He wouldn't believe it was medication!hahahahaha:chuckle




    Quote from Angie O'Plasty, RN
    * un-spike the old IVF's with 100 mls left in the bag while it's still hanging

    * say the word "quiet" in reference to your hopes for the shift

    * say you've never had a patient ________ before

    * take your stethoscope off till you're in your car and on the way home

    * plan on going to that inservice/staff meeting/whatever during your shift



    Experienced nurses, share your wisdom. What are some other things that new grads should NEVER do?
  12. by   happthearts
    One thing that chaps my hide is the nurse comes in and just starts care, not telling the PT .What there going to do ,or who they are .How rude.! Always indrouce your self to your PT. If there awake don't stand there like a ninny .

    Say Hi Mrs Garica I am Scarlet your nurse today. I am going to give you something for pain If they ask tell them what it is saved my backside when OPPs they didn't tell anyone they wern't able to take that med . Or like Iam going to set you up on the side of the bed .I am aware you have left sided weakness .So tell the Pt excally how they can help you and what they can do to help.and how you plan to set them and move them arround or to the wheel chair . So the Pt won't work against you.

    When I had been in the hospitial had both of my arms and hands bandage all the way up .Where I couldn't use them the nurses didn't even fix a call light so I could use them.The aide just postioned my food over the bed did not cut it up ,so I could at least gooble with my mouth .
    The worst was showering and peri care they just assumed I could do it with an Iv attached .Finally convinsed a male nurse to get me to trash bags to put over my arms so I could shower. I still couldn't reach to do peri care because every time I bent over I wanted to pass out from all the drugs .He had to do it. The only one there who had a mind. just did his job .and as bad as I was feeling was grateful to have his care.

    What I am trying to say here is use your head don't assume .Look at your PT know what your walking into when you walk in that room. Look at the room for the Pt and make it so the PT can handle things and introdouce yourselve .Remember that Pt is out of there element Your not.!

    Marinated nurse is one who is tenderized over the years. Just my thought
  13. by   Surgical_ICU_RN
    Quote from happthearts
    Marinated nurse is one who is tenderized over the years. Just my thought
    Excellent words, indeed!
    To continue a comparison with the meat products - "fresh" and "old", let me just add that ANY meat will get marinated instantly (and become much juicier!), if placed in a plastic bag with added tenderizer and left in a freezer until needed to use. Note: thaw slowly!

    Anyone want to try same with nurses? :chuckle

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