agldragonRN

It's part of being a new nurse. Things will get better as you learn the routine. Don't hesitate to ask for help when you need it. You will have tons of questions and remember that there is no stupid question. Good luck.

Good job. It's nice when you make correct nursing judgements, right? I called 911 myself in the past and sent out patients and getting the orders after the fact. I would just like to make some suggestions when this happens again in the future so you can add extra nursing interventions in this situation and chart it as well. Next time, you can use a non-rebreather mask instead so you can give more concentrated oxygen to the patient and see if this brings up the oxygen saturation (make sure patient has no dx of COPD before you crank up the oxygen). You can also put patient in high fowler's position and see if this will bring up the oxygen saturation. Lastly, you can elevate the legs and see if this will bring up the the blood pressure. You probably did these already and just didn't include them in your post. I usually do the above interventions in your scenario before calling the doctor and tell the MD if they were effective or not. I then chart everything. Again, good job and be proud. You probably saved this patient's life.

Nice!

I would call it a surgical wound as well on my wound sheet and charting. But now that you mentioned this scenario and if I get a patient like that in the future, I will probably include "Per hospital records, surgical wound was previously stage IV." But I will always call it surgical wound in my charting.

What break?

Was it fungal rash? If nobody inform the doctor yet, you should. The doctor will probably order Nystatin powder BID x 14 days.

Usually, steri-strips is not removed until they fall off by themselves. In your case, I would have removed it as well so I can clean the whole wound properly. If the treatment order says use steri-strips, I would call the doctor to get it changed. Your skin tear is +MRSA. Did the doctor order Bactroban oint? If I were to recommend a Tx for your skin tear, I would recommend the following: LLE skin tear - Cleanse with NSS. Pat dry. Apply Bactroban oint. Cover with Vaseline gauze, 4x4. Wrap with Kerlix (Kling) BID, PRN x 14 days. Do you have a wound care nurse in your facility? I would let her/him know if you have one.

You are a new nurse NuringBro and willing to learn from your mistakes. I applaud you for that. Same experience happened to me when I was a new LPN. I was embarrassed after a patient asked me and I did not know the answer and that made me look up every single med and become familiar with all of my patients' meds. I had 25 patients on 3-11 shift in LTC. I would go home and review the meds again. After a while, several of my coworkers were asking me "what's this med for?". Keep doing what you are doing and try to learn as much meds as you can and you will be a talking PDR in no time. Maybe next time this happens, you can say "You know what, I am unfamiliar with this medication. I looked this up earlier but I want to double check your chart again to give you the correction information." Good luck!

Can you be more specific? What kind of discoloration? Bruise? sDTI? In my facility, an incident report needs to written when finding bruise and sDTI.

The day you enroll. You can take two nursing exams before enrolling-Health and Safety & Transitions. You have to apply to do this though. I recommend you do this as this will help you not pay the second annual fee if you finished the program in less than 1 year. Please double check my information as things may have changed since I completed the program. Good Luck!

Congrats RN!!

There is one regular LPN in my subacute unit that I would prefer to take care of a family member over most of the RNs on the sub-acute floor. Maybe who ever is staffing your sub-acute floor prefers some of the experienced LPNs in the sub-acute unit? Or is it really LPN in sub-acute and RN in LTC rule? When I was an LPN, I would get floated to the sub-acute unit from time to time even though there was an RN working the other LTC floor. I was told I could handle the sub-acute floor. There is not really any major things an LPN cannot do in my LTC/sub-acute facility because we always have an RN supervisor around for the "RN stuff". When I became an RN, I was floated more frequently to the sub-acute unit and disliked it because I did not like doing admissions/readmissions. I was working 3-11 shift so most admissions come on my shift. Personally, I would be happy if I were in your facility because I would be in the LTC side with the "stable patients". :)

Wow 8 fingers only? That is new to me but oh well I learn something new everyday. I will start using your system.

Thanks for the refresher. Yup I know the phalanges: proximal, medial, and distal. Thumb only has proximal and distal phalanges. But my question is how did you learn it? If you read the charting "4th finger", would you think of ring or little finger? Thanks.

That's how I have always taken it and I chart same way too but I want to be sure I am charting it correctly. I googled it and both seems to be correct. But wikipedia seems to agree with my coworker-4th finger is the pinky. This is basic anatomy and I am surprised I did not know the 4th finger is the pinky! I won't chart with numbers anymore and just use thumb, index, middle, ring, and little finger.