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Kooky Korky 20,354 Views

Joined Feb 12, '10. Posts: 3,244 (52% Liked) Likes: 4,351

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  • Jun 21

    If you don't like what you're doing, then why not apply for those "impressive" specialties you obviously envy rather than insulting an entire nursing specialty?

  • Jun 21

    Yay! Welcome to the ICU world. This morning in a couple of hours, I am starting the orientation of a brand new RN to the Surgical/Neuro ICU. In the past I have oriented nurses with some previous nursing experience, so this will be new to me, too.

    TIPS:
    •Ask questions...of anyone who you think can guide you to the answer. That means doctors, nurses, techs, secretaries. Their knowledge will be varied, and it will all contribute to making you a better nurse.
    •Watch closely in a code. Codes can be intimidating and chaotic (often needlessly). If a code is called, get in there. Do compressions. Pay attention to the roles of each participant. You'll learn how to filter out the "extra" noises and focus on the patient and which voice you need to hear.
    • Search out learning opportunities. Ideally, your preceptor will be aware of procedures taking place on the unit that, as a nurse, you will be expected to play a part in. Watch the procedure and pay attention to what role you will ultimately be assigned to.
    •Open the drawers of code carts (although don't crack the only one on the floor; look through one that has been opened.) Know where frequently used materials are in the supply room; it will keep the frenzy at bay if you need something quickly.
    •No matter what nursing school you went to, they did not teach you everything. It is okay to answer, "I don't know." In fact, if that is NOT your answer several times a shift, there is a problem. Then figure out where to find the answer, whether it is on line or a book, or a coworker.
    RESOURCES:
    •"Concise Review of Critical Care, Trauma, and Emergency Medicine" by Asif Anwar, MD. It's set up by system and will give you insight about what treatments may be ordered for your patient given a specific diagnosis.
    •"The Ventilator Book" by William Owens, MD. It has nice large text and gives excellent explanations of pulmonary pathophysiologies and what ventilator setting may be used.
    •A nursing journal. I like "Nursing 2017 Critical Care" (or whatever the current year is). It is not too cerebral and it covers pertinent ICU topics well.
    •Look at your hospital protocols for each new experience or procedure. Look up every medication you are giving to a patient. Yes, these things take time, but you will increase your knowledge base, and your patient will be safe.

    Good luck!

  • Jun 19

    The nurse is responsible for the administration of the medication and needs to complete an incident report for leaving the medication at the bedside.

  • Jun 19

    Quote from HonestyAlways
    I appreciate the responses and have taken action by reporting to the regulating entity. I knew in my heart what was right and I guess I just needed confirmation that I was doing what was in the best interest of the vulnerable parties involved. I am relieved to have this chapter in my career closed but am nervous about my future, of course. In the end I have done what is right and I will hang my hat on that.
    Moral distress in nursing is all too common.

  • Jun 19

    You can take a carotid or wrist pulse, and count respirations. "Make it happen" is such a jerk response, but that doesn't necessarily mean the supervisor knows some of the other staff are faking numbers.

    I would recommend verifying with the administration if they know about the lack of equipment. If it's a small town nursing home, probably most of the patients there are there under Medicaid, and if it's the only nursing home, getting it shut down could leave the patients with nowhere to go. I would report the _individuals_ you know are faking the numbers to administration. That's the least you can do. Also, could the community help with acquiring equipment? Local churches might be willing to fundraise or donate equipment needed. The local pharmacy and physician practices might also be willing to donate.

    I don't know what BP equipment you were looking at on Amazon, but manual blod pressure cuffs are available at the drug store for less than $20. I think it's worth it to get one just to get fluent in taking BP.

  • Jun 18

    Quote from Kooky Korky
    It's been more than 30 years since this all happened and I still think about writing a letter to the ##$#%% who are in power at that stinking facility.
    Wait, this was something that happened 30 YEARS AGO? Time to build a bridge.

    And yes, the statute of limitations expired 12 years ago.

  • Jun 18

    Quote from Kooky Korky
    So no narcotic is available before oral Percocet? What if Toradol IV seems to not cover the pain?
    Then we'd get an order for IV morphine or dilaudid, or PO oxycodone. But Toradol and Percocet are what's part of the post-op order set.

    We wouldn't just let the woman lie there in pain. If we're giving Toradol q 6 and Percocet ii q 4 and it's not covering it, we'd call the provider and get an order for something more.

  • Jun 18

    This was 30 yrs ago you said? Hopefully they've made advances in pain control since then! I totally agree with you though -- any other abdominal surgery requires an IV narcotic, and a Cesarean delivery *is* abdominal surgery. Heck I am a "grand multip" and get excruciating postpartum cramping, and all of my OB/CNMs have sent me home with 20 or 30 Percocets.... and I didn't have any incisions!

    And the rooming in? Sure they encourage it, if not require it (thinking of hospitals with no well baby nursery)... but the couplet still gets a nurse, and should reasonably expect help if she asks for it. Especially where pt safety is concerned.

  • Jun 18

    Agree with Quazar. That was just ****** care. I'm sorry that happened to her.

  • Jun 18

    One call that's all to Joint Commission!

  • Jun 18

    To quote the great Bob Dylan: "The Times They are A-Changin."

  • Jun 18

    Sooo I just got offered the job! Guess it just goes to show that you can never truly decipher what someone means over email lol. I'm so surprised tho.

  • Jun 18

    Quote from Ebussman
    During the peer interview I was told I would hear back early the next week. So on weds when I hadn't heard I emailed the hiring manager to reiterate my interest and ask if any decisions have been made. However, in my email I made a small typo... The interview was on 6/5 and I accidently wrote 5/5... I received this email in response....

    You interviewed on June 5th with me, not May 5th. You then were Peer Interviewed on June 8th. There are other candidates going through the same process. We will be making a decision on Friday.
    I tend to be the anxious type, but I find that many times when I ass-u-me someone is snippy or mad at me, they weren't. They're stressed or busy. If you say (you shouldn't) "I am so sorry I got the month wrong in my email", she'll probably say, "what are you talking about?" So disregard it and carry on.

    If it doesn't work out, I doubt your inquiry will be the reason. Best wishes for a successful job hunt!

  • Jun 17

    Thanks for the advice. I am applying to other jobs as we speak. Hopefully something good happens soon!

  • Jun 17

    There's still hope. You're reading too much into it.


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