Davia

I would choose number 2 also with active kids and returning to school. It may be easier to do all the things your heart desires as far as your life goes.

Hello I have been in your shoes before. I just want to say I was thinking case management for you. I have been a nurse for 13. Years. This perspective is from my experience with the jobs I have applied for they wanted the applicant to have at least 3-5 or more years in the nursing profession. I kept applying for case manager positions only to be denied in my earlier years. About one year or less ago I interviewed and got an email about a case manager positions. Needless to say I am actually back in the field I actually transitioned to after 6 months of nurse. I am a Nephrology Nurse. I have worked in the doctors office setting and they can be just as busy as floor nursing. Especially when the patients visit is over you have to put in orders etc... Feel free to message me personally. I have many stories. Back to you sorry yes maybe case manager would be better. They do have to be on call though.

Thanks again for your input and response.

No I was not assuming. I just asked for thoughts on the right time? Also I made getting the transfusion started my priority because it was ordered and the task had not been completed. We do not know where the bleeding was coming from. I do not like it when the physician questions something that was previously ordered and not completed and then the patient ultimately has to be transferred to the ICU or something else happens. I have seen this all to many times. Thanks for your input and have a great night.

I am happy to hear all of the comments on this crucial topic. Thanks everyone.

No the Hgb iwas not 5 but approximately 6-6.3 but they did not know where the bleeding was coming from. PRBC is one of those nursing task that it's either now or right now. Not a hurry up and wait .

No the blood was not out that long. It never made it to the unit on the night shift. I was saying that I would be working on giving the blood as the top priority in my multitasking over everything else unless one of my other patients was coding or had a critical low blood glucose or something.

No I didn't come to the internet site to hear who is right and who is wrong. Yes I communicated with the nurse. I never said anyone was right or wrong. I just wanted to hear opinions. As stated in a previous thread. Nursing care is around the clock. Team work makes the dream work. Thanks for you input. Have a great afternoon.

Well said I understand stuff does happen. Nursing care is 24 hours around the clock. I would be staying late to do simple things because I didn't want it to be said that I was always leaving things for the night shift. You are right we can't waist our energy on foolishness. After all we are there for the patients and the ultimate goal is to keep them safe.

Sorry but she admitted it had been ready and all the other patients were stable. She did not have a reason. She just said she ran out of time. I had follow the nurse on previous shifts only to come in and hear the same response on several occasions . Being the person I am I just took the report and the transfusion patient was top priority unless I had a critical low Glucose and or insulin to give or a code. Team work with night and day shift working together would make the dream work.

Maybe the nurse can ask for assistance from the charge nurse. The patient may need a higher level of care and need to be watched more closely. Just a possibility.

I was informed that consent was signed, transfusion orders were in the blood was order but the blood was not administered. I was informed that the night shift nurse just did not get a chance to give it. She ran out of time. I don't have a problem with blood administration on the day shift as blood administration is time consuming on any shift. It's just a part of one of the many task nurses perform. How would you respond to the physician? when he asks how did the transfusion go on that patient that he ordered the blood transfusion on approximately 9 or 10 hours ago.

The policy is to call the doctor first of course and notify of the critically low Hgb. Then go threw the facility's protocol to administer blood products. When you have 5:1 ratio. You do have to know how to multitask and prioritize. For instance a patient having a low Hgb and a patient asking for pain meds. There are exceptions to every rule. Some patients run low and they don't want to transfuse. Also sometimes the nurses do delay patient care.

I worked the day shift. I come in to receive report on my patient load of 5:1. The night shift nurse informs me of a critical hemoglobin and that my patient needed a blood transfusion. She was aware doing the night shift of this critical low hemoglobin during the night shift. Just want to hear thoughts. What time is the best time for a transfusion?

Hello What is so different about occupational vs hospital bedside nursing! what makes u love it so much? Nusres wotk hard no matter where they go!