Okami_CCRN, ADN 12,993 Views
Joined: Oct 15, '07;
Posts: 814 (46% Liked)
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We prefer to do the 250ml IVF bolus challenge instead of the passive leg raise.
We do our daily weights on the bed, so often patients don't even know they are being weighed.
One of the most important things you can do is explain the importance of being weighed, from management of CHF to proper dosing of medication. And if they continue to refuse, document and inform the attending/resident.
Never skip personal professional liability insurance, regardless of specialty or unit mortality rate.
I have witnessed nurses who thought they were doing right by their patients by placing order for lactates, ABG's, and chest x-rays when they were "missing".
Well a nurse once placed an order for a some lab that came back critical and when she went to inform the physician his reply was " I didn't order that test, who ordered that?", it was a VERY awkward situation and thank god he didn't escalate it, but sternly told the nurse that he should be called prior or orders being placed.
You should look up what your state's board of nursing considers abandonment; more often than not you must have to accept a patient assignment and then abandon your patients by not reporting off to another RN. Thus leaving the patients without a nurse to care for them.
In regards to your retro pay, if you did not have it in writing then you can not prove that it was offered. Chances are you will not be able to obtain retro pay as it was not mentioned in your hire paperwork.
Legally, yes the CNA and PCT have the ability to feed patients. The real question here is should they?
If a stroke patient has such difficulty swallowing that they require more assistance than increasing the HOB >60 degrees and utilizing thickened liquids, then the RN should feed the patient for the first few meals to assess their ability and determine what is the best possible way to feed them to prevent pocketing and aspiration.
If you are noticing that the patient is coughing between bites it may be time to have speech re-evaluate their ability to swallow.
When I was in nursing school we were advised not to take any classes with clinical nursing classes. I had classmates that decided not to listen to the advice and they either failed the nursing course, the gen. ed course, or both.
Personally, I hate taking science courses in the summer as I would be in school 4 days a week. Our science courses in the summer session was a 3 hour lecture twice a week with a 3 hour lab twice a week.
In order to satisfy throughput our target time is one hour from the moment the patient is assigned a bed. Obviously this doesn't always work out especially if the floor cannot take report, but our ICU has such high patient turnover that it is not uncommon to transfer 5 patients out and get 6-8 admissions.
If you are already working in a critical care unit your best bet is to contact the pharmacy for policy and procedure regarding drip concentration and max rates. You will find that many facilities utilize different max rates and concentrations.
At some institutions vasopressin is non-titratable, in others it is. Some places max out norepinephrine at 10mcg/min while others max out at 30mcg/min. While a drug guide can give you great information regarding drug classes, actions, etc you should always follow hospital policy and procedure.
A good way to remember is to put your credentials in the order of least likely to lose to most likely to lose. For example; John Doe MSN, RN, CCRN.
I commend you for wanting to pursue certification in your specialty, however I wouldn't recommend studying until you have been in critical care for at least 2 years.
At this time in your career you should focus on becoming competent and proficient, which can take up to a year or more for some individuals. There are tons of study materials such as DVD's, books, online and in-person review classes. Figure out your learning style and choose one that fits best for you.
Also, make sure to log on to the AACN website and review the CCRN requirements. Best of luck!
This is my first post and while there have been similar posts about getting into a nursing program with a low GPA bachelor's degree, I have some very specific questions. So thank you in advance.
I graduated with an Associates of Science Degree from a Community College with a GPA of 3.13 and just last year a Bachelor of Science in Biotechnology with a GPA of 2.26. My University did not transfer my Community College GPA hence this GPA is pretty much my Major GPA as well (I was fortunate to save $ and take almost all pre-requisites at community) With that being said, my academic problems started due to personal matters and while a 2.26 does not look like much it is to be noted I was below a 1.8 at one point, so I really believe I have the aptitude and study habits to be successful in a nursing program. I have been considering nursing for a while now, before I even completed my Bachelor of Science, I just wanted to complete my program because of all the amount (blood, sweat, tears, money) I had put in. Anyways with that being said, on to my questions:
1. Is it unheard of for people who already have a bachelor's degree and an associates to go back and get a second associates degree (in nursing)?
It is quite common for people to have a degree in an unrelated field and then receive a nursing degree. I for one graduated with a BA in biology and am now finishing an RN-BSN program.
2. If I am to get into an Associates of Science (Nursing) program at the same community college I received my first degree in, and end up doing very well in my coursework, will applying for a BSN program ONLY consider my GPA from the later associates degree? This college seems to offer an ADN-BSN track linking with a University for qualified transfer students (I still have yet to talk to an advisor to get all the information on this)
Most RN-BSN programs require a minimum GPA of 2.5, which usually is related to the nursing degree. However, you must submit ALL transcripts from ALL institutions of higher learning. When I applied for my current RN-BSN program and submitted all of my college transcripts, I was awarded credit in almost all general education categories to the point where I only needed to take 10 courses to graduate (most were senior level nursing courses).
3. As you can tell I'm not asking about getting into an Accelerated BSN Nursing Program, it would be the ideal choice if my Undergrad GPA was higher, I don't want to go back to my University and repeat courses at the moment because it's just too expensive, and i'd have to go for a year or two just to get it at 2.5 (Why not spend that time/money getting an associates and trying to go for an ADN-BSN program.) With all this being said, could someone enlighten me on anything else I should consider?
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