Latest Comments by Lev <3

Lev <3, BSN, RN 43,351 Views

Joined Jun 3, '11 - from 'Another planet'. Lev <3 is a ED Registered Nurse. She has '4' year(s) of experience and specializes in 'Emergency - CEN, upstairs, troll bashing'. Posts: 2,657 (52% Liked) Likes: 4,910

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  • 0

    What about focusing on making sure that he takes his diuretic? Many patients don't like taking their lasix because it makes them urinate a lot, so they will skip doses. Is there a nursing diagnosis related to educating the patient about taking his medications as prescribed? You can do a priority diagnosis related to seeking help if he becomes short of breath and a secondary diagnosis related to taking medications and understanding the importance of adhering to the schedule. If the patient smokes, you can do further education about not smoking.

  • 0

    Prolonged seizure activity can cause hypoglycemia and I have seen a case of hypokalemia. This patient had seized for over an hour and her potassium dropped from around 4.5 to 3.3. (Some may have been dilutional from fluids too). Think about exercise and activity - uses glucose and all that muscle contraction requires potassium.

  • 0

    Quote from mhingis
    Thank you for your reply. First term student in an associates program. My background in medicine has always been from a provider/medical diagnosis frame of reference. It's a little tougher trying to adjust to a nursing diagnosis point of view. We have only had two clinical days this term so far and have two more this Thursday and Friday. Beforehand, we are assigned age, sex, principle medical dx, and 3 medications the patient is on. We come up with two anticipated priority needs, a goal for each, and two interventions. Certainly it's tougher not yet having laid eyes on the patient and interacted. Certainly, I would think in this case some issues would be decreased cardiac output and activity intolerance would be a couple priority needs. I'm sure I'll add and/or change some of these once I see the patient.

    I know I'll get better at the care plans as I progress through the program. It's just a different mind-set than I've been used to. If you have any other helpful tips or good/credible websites for nursing dxs/interventions for various conditions, I would very much appreciate it.

    I think your priority needs are spot on a for a patient with paroxysmal afib. If there is a nursing diagnosis related to effective circulation aka prevention of blood clots that is an idea as well.

  • 0

    Part of active listening is about asking open ended questions which show that you have heard what they said and you want to know more.

    For example:

    Patient: Why is GOD punishing me?

    Nurse: What feelings are you having right now which make you feel that GOD is punishing you?

    Or you can offer the services of a chaplain.

    Patient: Please stay longer

    Nurse: I know you want me to stay longer and sit with you but I have to check on another patient. I will be back soon, I promise.

    Patient: I'm tired and I have no interest in anything

    Nurse: I see that you are tired..Is there anything I can do to make you feel more comfortable so you can get some rest?

    I don't understand what the patient especially a patient on hospice is trying to ask in the second question...

  • 1
    Emergent likes this.

    Quote from Ruas61
    Everyone who has an occasional, or even every day glass of wine or an ounce or two of liquor, is not an alcoholic. They are not going to go into DT's. You might want to look into alcohol and addiction.
    LOL..I was about to post that just because you drink daily does not mean you will go into DTs a couple days later from withdrawal..

  • 0

    He: So you survived the snowstorm and hospital hotel?

    She: Have you seen my face? I'm exhausted. Where is a normal blanket?

  • 1
    NurseOnAMotorcycle likes this.

    One thing that I would love to see our volunteers do is to make sure that the room is stocked with enough blankets and gowns. And to make sure supplies are stocked in general.

  • 1
    Dianna11 likes this.

    My bag has motrin, pens, trauma shears, my lunch, and nursing references. My locker has an extra stethoscope and random education stuff from work. My car has
    a full change of scrubs including underwear.

  • 3
    xoemmylouox, amzyRN, and NRSKarenRN like this.

    I would give a copy of your printed and signed resignation letter to one of the HR people and then I would visit your boss and hand the same to her directly. The letter should be addressed to your boss and include that day's date and your last day of employment. Then I would email a copy of the letter to your manager and cc the HR person. This is what I did when I resigned.

  • 0

    This is my third year with malpractice insurance and I am up for renewal with NSO. I would like to be sure that the malpractice insurance will actually be effective if I were to require it. Has anyone actually had to use their malpractice insurance? Which company have you used/recommend?


  • 0

    Yes, a 6-7 ratio is very high. I don't know how I would manage with that ratio. Do your patients board for hours in the ED? Our ratio is is 1:4 in the main ED and up to 7-8 in fast track (4s-5s with occasional soft 3s). It is normal to feel completely overwhelmed and like a new grad all over again. I too was a very strong med-surg nurse who transferred to the ED. In the ED it is a whole new territory, especially in a trauma center. I don't work in a trauma center but work in a very high volume, high acuity ED, also the "busiest in the state." If any one has every watched that show Code Black - that is our waiting room on an almost daily basis - very crowded. We call the waiting room "the jungle." I have been the in the ED for almost two years and I am still not 100% comfortable. As long as your preceptor is not discussing every little mistake with management I would just put up with her. As long as she doesn't criticize you in front of patients.

  • 1
    JustBeachyNurse likes this.

    Could any registered nurse answer these 5 simple questions for my school project please? Also if you could please state what floor/unit you work/worked on.

    1. What made you choose nursing?

    I chose nursing because it was a solid career choice, was interesting and stimulating, required contact with people, and seemed to be in demand (well it was easier to get a job before the recession)

    2. Is nursing rewarding? What has been your most rewarding experience?

    Nursing is rewarding when people appreciate what you do and when you can make a difference, which doesn't happen all the time. I don't have a specific example.

    3. What type of issues have you experienced that are a conflict to nursing?

    The issues I have experienced are managers who are out of touch with their staff, staff feeling out of touch with upper management aka the big wigs, supplies not being stocked, and chronic staff turnover with high patient acuity.

    4. What do you see as the future of nursing?

    In the future of nursing I see more RNs getting graduate degrees and less RNs wanting to stay at the bedside for long. I do not see national set staffing ratios for decades to come.

    5. What duties are included in your job description?

    Assess patients and implement the plan of care. Triage patients. Maintain a safe patient environment. Document in the medical record. Administer medications. Lift heavy loads. Be on feet for extended periods of time (not joking these are in the job descriptions).

  • 0

    Thanks for your reply. Yeah, I have been working on the ok with "good enough." I have modified her assessments (mostly the cardiac rhythm assessment because she has no tele experience and will document sinus rhythm for a patient who is tachycardic for example even though I have explained this to her).

    I think I need to be present but not interfere unless patient safety is at stake. Is that a good way to look at it?

  • 0

    Anxiety is normal. Nursing school is a huge challenge for most individuals. If you are nervous about skills, practice as much as you can. Practice in the skills labs and jump at any opportunity to do it in real life. Also, watching skills videos helps too. As far as meds go, typically your clinical instructor will need to be there with you when you give meds. Also, as long as you follow the 5 rights of medication administration you should be fine.

    Knowledge is a great anxiety reliever. Fear of the unknown and all that.

  • 2
    l1234567 and Ruby Vee like this.

    Quote from Ruby Vee
    It concerns me that so many young nurses don't seem to understand the differences between "finishing my competencies" and "being competent." Do they really think that a brief class and a multiple choice test makes them COMPETENT? Or do they not understand the word or the idea of competence?

    Quote from Nori.Giselle
    It seems pretty clear that you don't understand what competence is. You have no idea what is required to be deemed competent at my place of employment. Obviously its more than merely "a brief class and a multiple choice test"... You're really reaching..
    You clearly have no respect for seasoned nurses, even those in your specialty (critical care).

    Ruby Vee can run circles around you, competencies completed or not.

    So be careful.

    And check your attitude at the door.