How lame is this

Nurses General Nursing

Published

I am part of a internship program as a LVN to RN program.

One of the RNs asked me to verify and sign off on her heparin, when I looked, it was below the 5ml mark which is indicated by a long line. She insisted that the level mark was the "dot" which is located BELOW the long line. I explained that in school we were taught it was the long line that indicated the amount. She looked at me and asked me, "So, are you telling me how to do my job now?". What the heck. I told her that I was just telling her what we learned in school. After a few rounds over what was right and what was wrong, her insisting she was right and I was wrong she left, and I did not sign off on it.

While I was working with a patient she called me out of the room to inform that she verified it with another nurse and that it is to the long line and that she did not want me to learn the "wrong" way. I bit my lip, but what I really wanted to say was, "I did not learn the wrong way." but sometimes it is better not to cause waves.

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Then we had a pt who had cellulitis of the supra pubic region. She told a nurse on the floor that it was because "the patient was dirty and did not wash there". How LAME and cruel.

Specializes in Perinatal, Education.

It is always units--concentration will be different and it is never measured in mls. I am also not trying to be nit-picky, I just know that I can have 10unit flushes in 1ml and 5,000unit sq injections in 0.5ml. BTW--we have 10unit flushes because my pregnant patients are hypercoaguable (sp?). But, the bigger thing is that, yes, it is always the line however you are measuring.

I have been on both sides of the being new thing :-). I had a new grad with me the other day who got all bent out of shape because I was recapping the needle after drawing up meds in the med room. I was using an 18gauge needle to draw up a med I was going to give IVP. I recapped the needle to keep the tip of the syringe as sterile as possible as I walked down the hall and into the pt's room to then take the needle off and give the med. She had a hard time seeing past the "never recap a needle" adage to see what I was doing in the big picture. I am not applying this scenario to how to measure meds, I am just saying that there is some adjustment between ideals and reality. Safety and accuracy are key--they are many ways to get there. But, I remember being truly appalled at some of the things I saw right out of school (still am at times, I guess! :-)).

Uh.....5mL of heparin is a rather large dose. The large amount is the important detail here. I'd at least double check that one....

Darlin', I'd pick my battles if I were you. Some things are worth fighting about. But others, such as a miniscule difference in the volume of a syringe, are really not worth getting your knickers in a knot over. It is totally within your right not to sign off on it if you are uncomfortable doing so, as it is your license, and I don't fault you for that.

However, from one newbie to another, remember that you are the new kid on the block and the nurses have A LOT to teach you that you did not learn in school.

Did you not see where I stated that I did not bother with it and did not want to cause waves. Although I am "new" I am not going to stand by and let someone tell me what I think is wrong if I believe I am not wrong. Just because I am a student, does not mean that I know nothing, at the same time, just because a nurse has been one for a long time means she knows everything.

I totally agree with you.

I think she is a good nurse in some regard, there are other issues that she has done, I have observed and thought were wrong.

It is always units--concentration will be different and it is never measured in mls. I am also not trying to be nit-picky, I just know that I can have 10unit flushes in 1ml and 5,000unit sq injections in 0.5ml. BTW--we have 10unit flushes because my pregnant patients are hypercoaguable (sp?). But, the bigger thing is that, yes, it is always the line however you are measuring.

I have been on both sides of the being new thing :-). I had a new grad with me the other day who got all bent out of shape because I was recapping the needle after drawing up meds in the med room. I was using an 18gauge needle to draw up a med I was going to give IVP. I recapped the needle to keep the tip of the syringe as sterile as possible as I walked down the hall and into the pt's room to then take the needle off and give the med. She had a hard time seeing past the "never recap a needle" adage to see what I was doing in the big picture. I am not applying this scenario to how to measure meds, I am just saying that there is some adjustment between ideals and reality. Safety and accuracy are key--they are many ways to get there. But, I remember being truly appalled at some of the things I saw right out of school (still am at times, I guess! :-)).

This is what I am seeing. It is called, "real world nursing" compared to "Pass school and NCLEX nursing". I did not see anythign wrong with you recapping the needle. We were taught no recapping after you have injected someone, before hand it would be ok, especially for what you had practiced it for.

You know, when I was doing dialysis and I was a new LPN,

my RN told me to pull up a little more than called for when instilling the heparin that would dwell in a patient's CVC between treatments ... to make sure that it created a "bubble at the tip." She said that if the catheter held (for example) 1.2cc's, then I should pull up 1.3ml's to instill...

Maybe this nurse is the same....

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