New Job found, but would you stay???

Be_Moore · Jul 27, 2009

Honestly, welcome to the real world.

1) Using 2 ID is a must, and shame on her.

2) NPO pretty much always means NPO except for meds. I've never seen a case where they wanted them so strictly NPO that you couldn't give meds.

3) In most places, unless it's a narcotic, they don't care about the counts. They aren't too worried about people diverting nexium and metoprolol.

4) If the BP is 114 now and you don't give it, the BP will go back up to huge numbers. The real question is...do you think the patient checks their blood pressures at home before deciding to take the pills? Definitely not.

In nursing school a lot of the information given to you is presented in a way so as to scare the life out of you. It's up to you now to figure out how scared you really should be by the information they gave you.

chicookie, BSN, RN · Jul 27, 2009

Honestly, welcome to the real world.
1) Using 2 ID is a must, and shame on her.
2) NPO pretty much always means NPO except for meds. I've never seen a case where they wanted them so strictly NPO that you couldn't give meds.
3) In most places, unless it's a narcotic, they don't care about the counts. They aren't too worried about people diverting nexium and metoprolol.
4) If the BP is 114 now and you don't give it, the BP will go back up to huge numbers. The real question is...do you think the patient checks their blood pressures at home before deciding to take the pills? Definitely not.
In nursing school a lot of the information given to you is presented in a way so as to scare the life out of you. It's up to you now to figure out how scared you really should be by the information they gave you.

yup, yup, yup, and yup.

I agree 100%. In regards to number 1, I also must add this just because the nurse does it one way doesn't mean you have to. If you feel that one way is safer, or the correct way in this case, then do it that way. Remember after a while of doing something some people tend to get lazy and skip steps. Never do this!

Its your license on the line! Worse its your patients life on the life!

and like he said, Nursing school and the real world are two completely different worlds. And feel free to ask other people. Ask for reason why, just like you asked the nurse. Always check policies. It doesn't seem like an unsafe place to me. Except for her not checking arm bands. That is a big no no!

AnnieNHRN · Jul 27, 2009

What Be_Moore said and also...

When you observe things that you are not sure about... ASK questions! A lot of these situations can be easily explained by the nurse who is working with you.

Being a new nurse is mind boggling, I know. We have all been there.

Moogie · Jul 27, 2009

Please don't give up on your job simply because of bad experiences with one preceptor.

I agree with the other posters: your preceptor was wrong when she didn't check two forms of ID before administering meds. :down:

Otherwise, everything you describe sounds pretty normal for working conditions in acute care. If the worst thing you've seen so far is your preceptor not checking ID properly when giving meds, you're probably in a pretty safe environment.

If you feel uncomfortable with your preceptor, can you ask your nurse manager for someone else? Make sure you don't put the preceptor down but perhaps you can just say that you might feel you'd "click" better with another preceptor.

miss81, BSN, RN · Jul 27, 2009

I agree...Ok the 2 ID's are important...BUT...if you've had this pt for several days a lot of nurses can skip some important steps because they "know" the patient..GOOD THING? NOPE...Happen a lot? YEP! Otherwise, it all seems pretty normal. The pt's BP is 114/80 BECAUSE he's been taking these meds. I wouldn't have held them either (in most cases)! And NPO 99% of the time means NPO with sips for meds, except with stroke pt's that have not had a swallow evaluation. And most nurses know the docs they work with and know that they really mean NPO with sips. Just ask the nurse. Usually there is a good explanation for what he/she is doing!

llg, PhD, RN · Jul 28, 2009

I'm curious ... really ... I don't mean to be obnoxious or anything ... but ...

What are they teaching about blood pressure these days? It seems as though almost every week we are getting questions by students and new grads who want to hold BP meds on patients because their BP is normal. The latest standards are that anything over 120/80 is too high. The "target" is to be below 120/80. Yet all these students and new grads seem to think that any less than that is a reason to hold the meds that are maintaining that normal BP.

So ... what are schools teaching to give them that impression? Are the schools teaching that you should give the meds only if the person has a higher than normal BP?

MedSurgeMess · Jul 28, 2009

Just because 1 nurse seems unsafe to you, doesn't mean that the whole facility is unsafe. As long as you are doing what is safe for your patients, you should be okay. Go for it!

chicookie, BSN, RN · Jul 28, 2009

I'm curious ... really ... I don't mean to be obnoxious or anything ... but ...
What are they teaching about blood pressure these days? It seems as though almost every week we are getting questions by students and new grads who want to hold BP meds on patients because their BP is normal. The latest standards are that anything over 120/80 is too high. The "target" is to be below 120/80. Yet all these students and new grads seem to think that any less than that is a reason to hold the meds that are maintaining that normal BP.
So ... what are schools teaching to give them that impression? Are the schools teaching that you should give the meds only if the person has a higher than normal BP?

You know, I was just thinking this and realized that I thought the same not to long ago. I remember my instructor scaring us by saying that if we gave BP meds when the the BP was low/ normal then the patient would bottom out............I am trying to think if that is exactly what she said. Lack of communication maybe. Scare tatics that are oh so prevalent in nursing school. Lack of specific info on the important things. Who knows.

Moogie · Jul 28, 2009

You know, I was just thinking this and realized that I thought the same not to long ago. I remember my instructor scaring us by saying that if we gave BP meds when the the BP was low/ normal then the patient would bottom out............I am trying to think if that is exactly what she said. Lack of communication maybe. Scare tatics that oh so prevalent in nursing school. Lack of specific info on the important things. Who knows.

I remember the scare tactics, too, and that was thirty years ago. :eek:

Chicookie, you're very bright and sensible. Especially since you made the transition from student to nurse not that long ago, what do you think would be better than the scare tactics? How can nurse educators, particularly clinical instructors, impress upon their students what signs and symptoms are critical without scaring the stuffing out of them?

I'm curious because I have taught clinicals and am planning on eventually returning to teaching nursing after getting done with a graduate degree. I tried to be laid-back as an instructor and I didn't like the scare tactics. So I am very interested in your input! Thanks!

leslie :-D · Jul 28, 2009

except for not checking for 2 forms of id, i'm sorry, but i am just not seeing anything so earth-shattering that would warrant leaving a job.

furthermore, and you said it yourself, you have gotten a job on a unit where the nurses are "nice" and seem willing to help/answer questions.

it sounds like a goldmine, to me...

esp when you hear about the horror stories out there.

yes, i would stay.

and keep mental notes, for when you are on your own, and will be able to do it according to your nsg judgment.

wishing you the very best.

leslie

chicookie, BSN, RN · Jul 28, 2009

I remember the scare tactics, too, and that was thirty years ago.
Chicookie, you're very bright and sensible. Especially since you made the transition from student to nurse not that long ago, what do you think would be better than the scare tactics? How can nurse educators, particularly clinical instructors, impress upon their students what signs and symptoms are critical without scaring the stuffing out of them?
I'm curious because I have taught clinicals and am planning on eventually returning to teaching nursing after getting done with a graduate degree. I tried to be laid-back as an instructor and I didn't like the scare tactics. So I am very interested in your input! Thanks!

Thank you!

My last nursing instructor was the best because she was very forward. (she did use the scare tactic once. I gave colace instead of aspirin and she knew it before I gave it. scared the pants off of me. ) But when it came to explaining things she was very blunt. She would make us think without making us feel stupid. I also loved how she would ask for our powerpoints and then do a mini review after clinical. But she would do it differently, for example she would say ok book situation this, real world situation is this. She was blunt about everything, when she taught me about CBI, she would say this is important and this important. This is a short cut. When I started on the floor, those short cuts and important stuff were the things I remembered the most. Especially with me, just be forward don't beat around the bush. You don't have to scare someone to show that it is important. Just say its important! LOL but that is just me.