Latest Comments by RNKPCE

RNKPCE 13,607 Views

Joined Sep 15, '03. Posts: 1,172 (34% Liked) Likes: 1,416

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  • 1
    fibroblast likes this.

    It may be part of a chest pain alert protocol and therefore you would have a protocol based order. Otherwise I would not give it.

  • 0

    In the US it is a session of college classes between semesters, after Xmas and New Years but before the next semester. It is usually 2-3 weeks and severals hours every day. I know one time it started after the first semester ended before the holidays, and finished up after the holidays but before the next semester. Usually only time for one class.

  • 5
    Crush, seaofclouds21, KatieMI, and 2 others like this.

    Kudos to the hospital that hired you. Hopefully they will have an awesome preceptorship program. Even fresh new grads are nervous! Congratulations!

  • 5
    RainMom, shedevilprincss, JKL33, and 2 others like this.

    Quote from MunoRN
    Regardless of Code status of the level of intervention wanted prior to cardiopulmonary arrest, pressor treatment should only be offered when medically indicated, which is to maintain end organ perfusion while a reversible cause is treated. It's not appropriate to use pressors to simply prolong the dying process.
    I completely agree.

    I have had patient's who come in the hospital who are DNR patient's but are active, independent, Alert and oriented people that if the time comes they don't want "heroic measures" done. Using pressors on a patient like I described that might come in with sepsis related to a UTI is very different than using them on an end stage cancer patient whose body is shutting down evidenced by declining mental status etc, who is on hospice.

    Agree a care conference would be helpful.

  • 7
    JBudd, Here.I.Stand, sharpeimom, and 4 others like this.

    The pain medications are likely right in the computerized draw. However when an order is entered, pharmacy usually has to authorize the order. They check for patient allergies, duplicate orders, interactions and other contraindications. Once the "stop sign" in epic is lifted the nurse can pull and administer the medication. This authorization process can vary in length of time depending how many other orders are in the queue for the pharmacist to verify, how many pharmacists are working etc. I've seen meds authorized as quickly as less than 5 minutes to up to 45 minutes. Once authorized an icon disappears on the e -record saying the medication is free to be given and the drug dispenser allows us to pull the med. In rare instances a medication can be overridden and pulled before authorization but this is usually in emergent situations such as needing to pull ativan on a patient who having a seizure. Even then sometimes the medication dispenser will not allow a medication to be overridden.

  • 0

    Quote from Nrscaroline
    I think I wasn't as clear in my first post. The floor can hold 16 patients. They initially said it was an eight bed unit, but they have been doubling rooms. Each new nurse can have a maximum of five patients at a time, since there are two new grads on the floor at all time. If the census is too full, a float nurse is required to come down. Having five patients and no CNA is challenging. Part of the reason I have trouble with time management is because I spend so much time getting people up to the bathroom, changing beds, etc. All things I don't mind doing but make it hard to be on time with meds and documentation.

    Doesn't matter how many patients you have this is not an RN new grad residency program. One week of general hospital orientation is just that. Please look for a new job if you can.

  • 2
    Serhilda and Nrscaroline like this.

    How is this considered a nurse residency program? Just cause they call it one doesn't make it one. This is not your fault. Even nurses in an actual respected nurse residency program can have struggles the first year. Even experienced nurses get more orientation than you've gotten when they go to a new facility. It you can, resign now, if not start looking for another job then resign. Sorry you are going through this.

  • 0

    It 's a tough market not going to lie. Applying for one month is nothing for the Bay area. How many places have you applied to? How far are you willing to commute for that first job. Are you applying at the right time in the cycle for new grad programs. Not having a California license yet makes it even more difficult. Even experienced nurses can have trouble getting jobs in the Bay area. Can you look into flu clinics as a temporary job while continuing to apply to in- hospital positions?

  • 2

    Quote from MJW1962
    This is a huge help but my problem is management AFTER I get blood return; coordinating the bandage without spilling blood everywhere. It can make the patient, let's say... a little less than confident in me, the nurse! Help!!! Please & Thanks!!!

    I second what a previous poster said about placing a 2x2 under the hub before removing the needle. I also have the covers to all connections loosened so I can easily remove the cover and hook up the IV. All tape torn and ready to go. I also use another finger to put pressure at the tip of the catheter to stop the flow of blood coming out and going everywhere, but the 2x2 is there just in case. It takes a little practice but I rarely have a bloody mess when starting IVs.

  • 4
    lpndeb, Kitiger, SmilingBluEyes, and 1 other like this.

    Quote from NurseCard
    Yeah, your mom sounds even healthier than my husband, whom I would fully
    expect to take care of himself and our kids, should a situation arise in which
    a snowstorm or such occurred, and he had to stay at home, and I'm stuck
    at work.

    You all be safe! I have family in Texas...
    When OP said their mom was a "senior" I was picturing someone much older. A lot of my co-workers are in the 60 y.o. range. Nice that you are concerned for her, I wish you well during this storm.

  • 5

    Quote from JustBeachyNurse

    He has no right to know what if any disciplinary action occurred with the other nurse.

    This ten times over.

  • 1
    raindrops1234 likes this.

    Because meals are delivered at varying times throughout the hospital our computer system just puts times such as 7a, 12n, 5p, and 9p for all before meal blood sugar checks and sliding scale orders. . The order does have a clarification with it that says "before meals". So on one unit breakfast may come at 7a but on an upper floor it might come until 8a. So the blood sugar might be done at 6:40a with sliding scale at 6:55a on a 7a breakfast floor but not until 7:40a and 7:55a on the floor that gets breakfast at 8a. Also if a patient wants to wait and eat lunch an hour later, until their spouse arrives we would not give their insulin until we knew they were going to be eating.

    I agree if people on your unit are just doing blood sugar checks and sliding scale with no regard to meals that is strange.

  • 12

    I expected to read something " horrible" from your title and I didn't. It's hard when you are new and don't know what to worry about and what not to worry about. A lot of dialysis patient's blood pressure will trend up close to their dialysis appointment and be significantly lower after. The nephrologist is probably comfortable letting it run higher than a primary knowing he was going to have a treatment soon and from past history.

    You did fine. Don't beat your self up over this.

  • 3

    The people I have known to do something like that have been in per diem positions and have some family/friends they can stay with while in California. Also think about mandatory meetings or education that you must attend in person. If you can do it per diem first this would be a way to test it out before uprooting your family.

  • 3
    brownbook, Here.I.Stand, and TriciaJ like this.

    So sorry you got injured. Maybe you'll want to quit your current job and start working at the hospital they took you to after your injury : ) That policy is terrible.