RNKPCE 13,156 Views
Joined Sep 15, '03.
Posts: 1,168 (34% Liked)
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.
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.
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.
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?
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!!!
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
You all be safe! I have family in Texas...
He has no right to know what if any disciplinary action occurred with the other nurse.
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.
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.
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.
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.
I'd say it all depends. I know someone who was PRN and was making more than benefitted. Then she took a benefitted position and took a cut in pay. She wasn't going to get to take planned (tickets bought) vacation and was given the option to returned to PRN. However they didn't give her the extra money back. Non union facility that had recently been acquired by a big for profit company.
At my hospital(union) they have to post positions for a certain number of days. Whoever wants to apply does so and then it is given to the most senior person. There is no obligation by management to call all the staff that ever said they wanted to switch to day shift. It would be nice if he did but not required. Someone I know is looking for a certain type of position (day shift, no weekend, anywhere in the organization) she frequents the online job board several times a week looking for new postings. I'm sorry this didn't work out for you. I'd have a professional discussion with my manager again about wanting to switch and ask how you can become aware of any openings going forward.
If that is a standard order where you work maybe the order needs to be changed and read "notify MD for symptomatic bradycardia less than 60" or "50". On telemetry many patients have heart rates below 60, some from meds, some because they are fit etc. Same thing for heart rate above 100. Not unusual for a pneumonia patient to have a heart rate between 90-110 if they are running a fever.
Hospitals with high retention rates and low turnover rates may have an older work force.
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