Latest Comments by sandyfeet

sandyfeet, ADN, MSN, RN 7,917 Views

Joined: Jul 26, '10; Posts: 423 (41% Liked) ; Likes: 413
RN; from US
Specialty: 5 year(s) of experience in Emergency Nursing

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  • 1
    cjcsoon2bnp likes this.

    I am 37 weeks pregnant and on maternity leave, but still wanting to flex my nurse brain by reading AN.
    Your article made me decide to give the L&D nurses who will take care of me catered SANDWICHES!
    Great article!

  • 12

    Quote from NicuGal
    I would have gone to the charge nurse and told him/her that the oncoming nurse was refusing report and let the CN deal with it. I have no tolerance for stupid behavior.
    YES. Also say "I guess you will be paying me overtime while you find another nurse to take report, because Nurse A refused to take report". That will get a manager's attention!

  • 5

    I think this would only help you if you were planning a career in academia. If you are hoping to end up in public health, clinics or long-term care, you should seek out internships in those areas. It also does sound like A LOT of work on top of your classes and being a single mom. Maybe you are a great student, but this amount of work sounds stressful and not necessarily helpful. At a minimum, it won't give you the hands-on patient experience an internship in the other areas would give.

  • 2
    oldpsychnurse and Emergent like this.

    Quote from Anna Flaxis
    Since the purpose of the Emergency Department is to rule out/stabilize life threatening injury/illness, we are concerned primarily with acute pain.

    Keep in mind that I am speaking of acute pain only. I'm perfectly aware that chronic pain is different. But again, in the ED, we are not in the business of treating chronic pain. If a person with chronic pain at baseline presents, it is appropriate to ask about their chronic pain, but also to explain that we're concerned here today with what is new or different from their baseline. We are not going to adjust their oxycontin dose or prescribe a fentanyl patch- that is for their primary care provider or pain specialist to do.
    My ED is constantly full. I get where OP is coming from. While I am treating your chronic pain that your PCP/pain management doc has not adequately managed, Grandma with a broken hip is waiting in the ambulance bay for an open bed. Baby with a history of febrile seizures is in the lobby with a rising temp. The patient sent in by their doc for an emergent thora/para is trying their best to breathe around all that fluid. If I seem unsympathetic to your plight, it is because otherwise I would be unsympathetic to theirs.

  • 8

    Yes, this happened to me for a nurse aid position. The recruiter said that there were budget cuts. I was bawling over the phone but it's not in my nature to be rude so I just tried my best to keep it together and remain polite.
    THEN...I got a call back a few months later from the same recruiter offering me another job. She said "You were so polite when I called to rescind the job offer and I never forgot that." SERIOUSLY.
    I worked as an aide for 6 months and was hired immediately into an RN position before I graduated from nursing school.
    Moral of the story: be polite! This might not be the end of your story with this hospital.

  • 5

    Quote from ggrn29
    If you call in according to policy guidelines, i.e. 4 hrs before shift, it's only your business what the reason is. That being said, sleep deprivation can impair judgment as badly as drugs or alcohol.
    If you make an error because you're overly tired, it will be said that you should have known better than to work in such a state.
    This is the real issue here. If OP crashes her car because she fell asleep, miscalculates a pediatric dose, gives a med to the wrong patient, or doesn't catch that her patient is crashing until it's too late, it's all on her. Sleep deprivation makes you impaired. Know your limits, follow your hospital policy, use your PTO like anyone in any other profession would do.

  • 5
    madricka, NurseEmmy, milesims, and 2 others like this.

    I believe some nursing student sins are forgivable. Before I started my pre-reqs I ran a red light with a camera, and got a ticket. Went to traffic school and got it all taken care of. When I applied for NCLEX I had to declare that I'd had a traffic violation over xyz amount of dollars. I wrote a personal statement about how I had changed, and had a friend write a personal reference to my character. Now I've been a nurse for 4 years.
    A nursing school may be willing to take you if you can demonstrate how you have changed and have references that attest to your character (volunteer service for example). You will have to sell it, maybe meet with the dean. You might also get some good answers from the Nurse Addiction forum. Good luck!

  • 3

    This is always a hot topic. It would be interesting to include in your research the acuity of patients waiting in the ER lobby for an open room...also at risk of worsening symptoms. When we have over a 2 hour wait in the ER lobby, the entire hospital hears an announcement about it.

  • 0

    I am in your target demographic; I just passed 2 years this summer. I am starting to get more involved by doing clinical ladder. The people I started with (also mostly new grads) are starting to do Triage because of a shortage of triage nurses on night shift, and people on day shift have complained that they are too new to take on such a task. I can see where the complaints are coming from because I don't feel ready to take on the responsibility of a full lobby!

    I will say that I thought I would know more by now and I've learned that knowledge is just a slow, steady process. And that sometimes I need to hear something several times to understand it, just like in nursing school.

  • 2
    kalycat and joyful_wanderer like this.

    I had a patient on a 5150 who threatened to call the news because we were holding her against her will. Luckily her husband was able to take her phone away from her. I always wondered what the news would do in a situation like that- would they report the 'story'? Or would they protect a vulnerable person?

  • 1
    dortizjr1 likes this.

    Quote from ~*Stargazer*~
    The "iodine allergy" is a bit of a myth. Simply because a person states an allergy to iodine does not automatically mean that they will have an adverse reaction to the iodine used to prep for foley insertion. In fact, iodine allergies are really questionable since iodine is in your body and is necessary to maintain life.
    So interesting! After I read your post, I used my school access to look up "iodine allergy" and found an article from the journal Allergy and Asthma Proceedings that talked about iodine allergy and the prevalence of iodine in our diet (salt, eggs, bread, cheese). The point of the article was to debunk the seafood/iodine connection, and that patients with allergies to seafood could still use iodinated contrast medium. ("Seafood and iodine: An analysis of a medical myth", Nov-Dec 2005). I remember when I started working as a nurse being taught to ask if the patient had a seafood allergy if they did not know if they had an iodine allergy.

    And for the OP, I would also use the castile soap packet.

  • 0

    Couple of tips...

    Does meditech have something like 'acronym expansion'? I use SCM and will use the acronym $discharged that the system writes out as "Patient AOx4, respirations even and unlabored. Patient states pain level tolerable to leave facility at this time" and use that on my discharge note. Little things like this save only seconds, but over 12 hours it adds up!

    When I first started, it was hard for me to get a patient history unless I was standing still and looking the patient right in the eyes. BIG time sucker. Now I get history while hooking them up to the monitor. If they are vomiting I get history while starting the IV. You get the idea. Before I leave the room I make sure to chart and then I might say "I just want to clarify, you said your symptoms started yesterday?" or something to that nature.

    When you are new and have a preceptor, other nurses usually won't help you out for two reasons. One, you already have two nurses to cover one patient load, so you technically already have "help". Two, when you are new is the time to struggle, figure out your rhythm, figure out your resources. You can't start out relying on other people's help. All of this does not include Level 2 ESI or higher. If your co-workers are not helping you during acute strokes or full arrests there is something wrong.

    It gets better but these are the rough times!

  • 3
    tokmom, LadyFree28, and TriciaJ like this.

    Ancillary is the correct term, because it means someone who provides support. It's not diminutive.
    I had only one serious problem with an US tech in my two years so far as a nurse. I had a pregnant patient in police custody because she was using drugs and was arrested in the street. She also had a UTI and was receiving IV antibiotics. The US tech came to the bedside to verify the pregnancy and said the the police officer "They're giving a pregnant woman antibiotics? That's awful." She didn't realize that I was right outside of the room and heard everything. Now I would have walked into the room and said something to her face about the meth probably being worse for her fetus than a Category C antibiotic, but at the time I was too shy and new so I talked to my charge nurse and wrote an incident report. Luckily the patient was so out of it, she didn't hear anything. But I always wondered what the cop thought of me and my competency after hearing that comment.

  • 1
    uRNmyway likes this.

    The problem with leaving a shoe or a purse in the backseat (or a diaper bag in the front) is that the parent has to have the foresight to arrange it that way. Excluding negligent parents, the problem with forgetting your child in the car seems to be one of multitasking and distraction. Someone is in a hurry and is not going to take the 10 seconds to throw their purse in the back because they are focused on completing some other goal.
    I am currently pregnant so this is a hot topic for me. Maybe a sensor in the back seat that registers weight (like a car seat) and alerts you when you open your door? Like how my car tells me to buckle up my heavy work bag when I put it in the passenger seat?

  • 10
    LadyFree28, edmia, twinkletoes53, and 7 others like this.

    Patients usually don't get violent out of nowhere. There are many verbal and physical cues that lead up to physical violence and you should be trained to spot them so you can de-escalate the situation. If I feel threatened I back away and yell "Call a Code Gray!" and yes, situations have occurred when staff came running and the patient is looking at us innocently. But I would rather be safe than sorry. Usually once a patient starts raising their voice, if it's not my patient I will walk over to see what is going on, and other staff members will come over too. My ED also uses MOAB training and our staff is really good about backing up each other.
    I think it's been made clear by previous posters that you can never hit a patient. No matter what.