Latest Comments by Jolie

Jolie 28,029 Views

Joined Oct 17, '01. Posts: 9,510 (48% Liked) Likes: 13,577

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    How is the medication supplied? Are you adding concentrated MgSO4 to a liter of fluid? (I sincerely hope not.) Is pharmacy supplying you with a pre-mixed solution? (I sure hope so.)

    How rapidly are you going to infuse the bolus? Once it is infused, what is your maintenance rate?

    Why is your patient receiving this medication? How will you monitor her condition? What safety measures will you take?

    These are the questions you need to answer to complete your assignment.

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    poppycat, Sour Lemon, and chare like this.

    Stepping up on my soapbox. If your nursing education program hasn't addressed the basic issues of NCLEX registration and application for licensure, they need to do so. Please contact your academic advisor or the program director and request an appointment to discuss these very important questions, and then insist they provide the same for your classmates.

    I'm not sure if you are not yet far enough along in your program to have been exposed to this information, or if like a growing number of programs, it is not provided in a comprehensive manner, but any basic nursing education program that fails to inform its students of these critical professional issues is failing to meet its responsibilities.

    Stepping down now Best of luck to you.

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    Kitiger, poppycat, lyrern, and 4 others like this.

    I'm a dinosaur, not having practiced in a hospital setting for almost 20 years. But I vividly recall some train-wreck deliveries where we had to estimate weight of a critically ill newborn, calculate doses and draw up code meds based upon that estimate. In one case, the delivery took place on the way into the hospital with no scale in sight, in another case, the room was so poorly designed and set-up, the scale was there, but completely inaccessible. Mental math saved those days.

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    Can anyone recommend a referral center for treatment of resistant depression (possibly bipolar spectrum)? In need of a thorough review of 5-year history of ineffective treatment, including current course of ECT, in a young adult who is now experiencing worse depression than ever before. Would also like to be evaluated for possible use of ketamine infusions.

    Thanks for anything you can suggest.

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    No advice to offer, just want to wish you the very best. I lived in Charlotte years ago and would love to go back. Congratulations on your upcoming graduation and new adventures!

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    The agency responsible for licensure in IL is the Department of Professional and Financial Regulation (IDPFR).

    State of Illinois | Department of Financial & Professional Regulation

    You should be able to find the information you need regarding licensure by endorsement here. IL is notoriously slow in processing paperwork, so it might be a good idea to start the process as far in advance of your move as possible. IL is not a compact state, and doesn't participate in NURSYS, to my knowledge.

    Good luck!

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    VivaLasViejas likes this.

    OR nursing, school nursing or an office setting may be good options. Best of luck to you

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    Generally speaking, terms of endearment don't bother me. But I had to peel myself off the ceiling today following a phone call from a representative of administration at a local hospital.

    A family member is being treated there and had an outrageous encounter with a hospitalist physician, which I witnessed. I was too flustered to address it right then and there, so I called the Patient Advocate Hotline when I got home, reached someone's voicemail with a cheery message that I would receive a return call within 24 hours. Today (2 days later) I called again and got a live person who took my information and informed me that someone would promptly investigate and get back to me. Yeah, sure.

    But throughout the conversation, Ms. Perky kept referring to me by a cutesy version of my first name. A version I. NEVER. USE. Even if she misunderstood the pronunciation of my name, there is no way she would have come up with this name. Perhaps it was compounded by my utter exasperation at the situation that prompted my call to the hotline in the first place, but I wanted to reach thru the phone line and choke her. I probably would have if she'd called me that name one more time.

    Vent over. I feel better now

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    Susie2310 likes this.

    I recently had a course of PT for an ankle injury. The first thing I did was to take a survey on an iPad about my reasons for seeking treatment, goals and expectations, limitations, etc. It seemed like a pretty efficient way of gathering that data, which was then compared to a survey at my last treatment. The therapist reviewed the final results with me to demonstrate my progress and what I should continue to work on at home. I found the immediate feedback useful for that purpose.

    If I had been handed an iPad to read instructional material, I would have been much less impressed. It sounds like your hospital has found a way to turf the responsibility for education back on to the patient, at a time when interaction with an experienced nurse is needed for clarification and reassurance. I would not be happy, as a patient or as a staff nurse.

    Your description reminds me of my recent experiences in doctors' offices where the almighty EMR apparently trumps thoughtful conversation and interaction between the patient and provider. I regularly see one doctor whose office is not set up with laptops, but rather uses desk top computers, forcing the provider to have his/her back to the patient during most discussions. In my OB?GYN's office there is apparently a Wi-Fi "dead zone" that prevents reception in some exam rooms. My NP literally had to run out to the hallway to enter information at multiple points during my last exam.

    In many ways, this is not an advancement, but an impediment to good relationships and patient care.

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    WineRN, Oma to 11, MrNurse(x2), and 10 others like this.

    My daughter, now a college freshman was in 1st grade when she outwitted the PE teacher and got her entire class out of the pacer test. It was one of my proudest Mama moments

    On an unseasonably warm spring afternoon, the little darlings were informed that they were going to do the pacer test. It also happened to be picture day, so they were all dressed to the nines. My daughter, never one to shrink from a challenge, let Big Hulky Gym Teacher know that their mamas would be sooooo disappointed if they were all hot, sweaty and red-faced in their special spring pictures. He relented and let them play four square instead. Little did he know that pictures had been taken at 8:30 that morning, but then no one ever accused him of being overly-observant. Amazing that they managed to successfully enter 2nd grade that fall without a current pacer score!

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    SopranoKris, Meriwhen, roser13, and 1 other like this.

    You may be able to find a state that will grant you a license if you pass NCLEX after a 4 year lapse and multiple attempts. But that does not guarantee that TX will extend you the privilege of endorsing that license to your home state.

    Each state sets its own licensure requirements, and few (if any) limit those requirements to graduation from a nursing education program and passing NCLEX. Virtually all, if not all, have additional standards including specific testing requirements, remedial education, background checks, health requirements, etc. which you may or may not meet.

    Also, when a nurse has an established license in one state and wishes to practice in another state, s/he does NOT transfer that license. S/he applies for a second license by endorsement, which is a process by which the new state determines whether or not the candidate meets the above requirements that are specific to the new state. This is the point at which candidates who "worked around" licensure requirements are likely to be denied.

    The only other alternative I can suggest is to obtain a license elsewhere, then work elsewhere for an extended period of time (a number of years). At that point, the state of TX may be willing to issue you a license by endorsement, based upon a long track record of successful practice out of state.

    Frankly, obtaining remedial education sounds a whole lot easier, quicker and more certain. Good luck.

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    RNOTODAY, cyc0sys, LadyFree28, and 16 others like this.

    Quote from Strugaaa4eva
    So I am seeking some advice as to why this occurred and am still pondering on what could have I done wrong for this to have such a bad ending. After searching and searching years and years for a hospital job (I've always worked in subacute rehab settings) and have been craving a hospital job for nearly 5 years as it will be 5 years this coming May that I graduated from nursing school. Long story short, I was hired by a local hospital and all was going well with the first week of orientation. I mean, c'mon it was only classroom work and I passed all the required exams such as the IV and medication administration. I had to take a personal call during the last 1/2 hour of our last day of class and when I returned the nurse educator was saying how I shouldn't give her a heart attack next time about not telling her where I was. I explained what had occurred and I didn't realize that 5 days later I was going to be reprimanded for that. I received a call from the unit manager I was supposed to work at stating that I was technically supposed to come this weekend for my first day of clinical orientation (I was hired as a per diem nurse) she told me that I don't need to come. Refusing to provide further information, when I asked her if the position was terminated she said "yeah kinda, you'll get a letter in the mail explaining everything." I'm really baffled about this? I seriously didn't do anything and am unsure why did this lead up to here?

    Please take note, only constructive comments will be accepted otherwise demeaning, ridiculing words will be flagged. I just need to get some advice as to why this happened and if it is something usual?
    As a former nurse manager and now a business owner in a different field, I see a number of possible reasons for the unfortunate outcome of your brief employment. I'll try to keep my comments constructive so as not to "be flagged," whatever that means. I'll start by answering your question of whether this is "something unusual?" It depends. In a job-seeker's market where there are more positions to be filled than qualified candidates, your experience is probably rare. Since you come from a LTC setting where jobs typically outnumber qualified nurses, the standards and expectations of hospital personnel may have seemed uptight and excessive to you. But in a setting where full-time, benefits-eligible positions don't become available every day, personnel managers can be choosy. Very choosy.

    Without belaboring the point, your remarks regarding the classroom portion of your orientation seem a bit flippant. Let's face it, this is no one's favorite part of the job, not the educator teaching, nor the candidates enduring long lectures and skills checks of basic material, but it is critical for standardization, patient safety, regulatory compliance and legal protection. It helps to put forth one's best effort for all of these reasons. Is there any chance that your lack of enthusiasm and/or disdain for these activities may have come across to others? I would be willing to bet so.

    Near the end of that class period, you went missing unannounced for 30 minutes. While I seriously doubt that anyone was concerned for your safety, the instructor was responsible for knowing the whereabouts of her students in the event of a disaster, drill or emergency phone call from your family looking for you. Nothing makes people more anxious and defensive than being held responsible for something completely out of their control, like the disappearance of an adult student.

    The issue of carrying and answering your personal phone during hospital orientation is a divisive one, on which we here will never all agree. It is something of a generational divide, with those of us over 40 remembering well how to survive and thrive without constant contact from the outside world, and many under that age unable to fathom that very circumstance. I will simply say that as a new employee it is best to learn upfront the expectations of your employer. I encourage new employees to come right out and ask, so there are no misunderstandings. Had you asked the instructor at the beginning of the day if it was acceptable to keep your phone on you and excuse yourself to answer it, I believe you might still be employed. Had you answered the call and immediately notified your lawyer that you couldn't talk, and would call back later, you might have endured a lecture, but still had a job. But disappearing for a 30 minute phone call, I'm quite certain, did you in.

    The delay between your phone incident and receiving notification that your services were not required probably represented the discussion between human resources, the educator teaching your orientation class, and the manager of the floor to which you were going to be assigned. These 3 people all had a stake in your employment and reason to discuss your progress. They probably had a meeting scheduled sometime between your week-long class and the beginning of floor shifts for the nurses in your cohort. They identified the apparent strengths, weaknesses and special skills of the group to best place them. With an obvious negative, you didn't make the cut.

    With no intention of placing you on a clinical unit, there was no reason for HR or the nurse manager to bring you in for a meeting or exit interview. Exit meetings rarely are productive when they involve employees with such a brief tenure. They saved you time, hassle and embarrassment.

    Please move on with a better understanding of expectations in the workplace. Good luck to you.

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    My native tongue is Sarcasm. That isn't as well accepted in the workplace as it should be, so I have to fall back on English, much to my dismay.

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