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TigraRN's Latest Activity

  1. TigraRN

    New California Nurse to Patient Ratio

    1:6 in ER, all 6 being MedSurg patients, 1:3 ICU "with a nurse extender" (who cannot be given appropriate orientation time). It really depends on the day. Rapidcare patients ESI 4 - a lot 😉.
  2. TigraRN

    Your Favorite Nursing "Hack"

    Burping NS bags to save the tubing if a second bolus is needed later.
  3. TigraRN

    Resign first or wait until I find out if I'm fired?

    Calliope26, what happened if you don't mind me asking?
  4. TigraRN

    ER Overtime?

    In our facility, you can usually pick a shift a week or so. Also, flexing in and out is easy, if you need more beauty rest or need to come home earlier. Basically, the schedule can be flexible.
  5. TigraRN

    Notes in 3rd person style

    In nursing school, we were taught to describe things in the third person and stay neutral. Sometimes I use "I" if something needs to be clear.
  6. TigraRN

    Reasons nurses get fired

    1. Checking BG on someone who refused it. 2. HIPAA violation
  7. TigraRN

    Patients Say the Darnedest Things Nurses Week Contest

    A patient came in for a glue stick stuck in his rectum. I explained the dangers of using glue the way he did, to what he replied: "Don't worry, it's non-toxic".
  8. TigraRN

    My IV Skills are Terrible!!!

    It is actually good that you need to insert them every day, because now it is only a matter of time till you become a pro. What I found helpful for myself: 1) do not look for a veing, but feel for it; it needs to be nice and "plumpy" or collapsible. Once you feel it, move around and try to trace which direction it goes. Don't trust your eyes! It could be misleading if you don't feel it. I don't ever poke if I don't feel it. 2) If the patient is a hardstick, or if someone is asking you to start an IV, because they couldn't - bring a hot pack with you and place it on the AC or wherever you are aiming at (antecubitals are usually the easiest and fastest). While you are priming tubing and unwrapping the packing, the warm pack will do its job. 3) If the patient is, let's say, somebody with fragile skin, bruising from coumadin, or you have a feeling it may burst - don't use a tourniquet. 4) If the veins are too tiny - try ripping off the glove on your index finger (left finger if you are right-handed) and after using alcohol swab on the finger, feel for the vein again. 5) if you don't need a large gauge - go ahead and use a 22 of even a 24. 6) never be in a rush, it only makes things worse 7) don't feel bad if you haven't found a vein on one side and had to switch sides a couple times. 8 ) Distract the patient, don't be nervous and never feel bad if you didn't get it, because you really tried. Maybe you could also talk to someone on your unit who is really good at it and ask for their advice, or maybe they could show/guide you? I was super scared to try an IV in the very beginning, but now I really like to start one and always up for the challenge. Good luck!
  9. TigraRN

    Needlestick accident

    I once had a needlestick with a contaminated (patient's blood) needle. That patient had a whole array of liver problems. I felt like I went through hell waiting for results, but will not make the same mistake again. Don't feel bad about the patient, they are probably already over it.
  10. TigraRN

    How Much Junk do you Keep?

    Remotefuse, I love this book! In my library it was available as "The life-changing manga of tidying up" which is a comic book. I literally had to stop myself from reading it further so that I could tidy up by category in real life. It's been at least 8 months since I read it and my house is still keeping up.
  11. TigraRN

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    Mandatory double verification would be helpful for paralytic as well. If we have another RN witness insulin, heparin, amio, why not do the same with vecuronium?
  12. TigraRN

    I don't feel like a real nurse

    It is ok to like your unit and not want to switch jobs. I feel like this is exactly how I feel as well. People came and go, getting into school and going to bigger and better things, but I am really just happy where I am. Why don't you get a certification or two that is applicable to PCU? I am pretty sure there are certifications/courses/you name it to improve your knowledge base without actually switching jobs. Or, have you thought of becoming a lead? What growth opportunities does your unit offer?
  13. TigraRN

    Charge Sheet

    At our facility, we only use charge sheets for foleys, c-collars, slings, crutches/walkers/canes, and other supplies. It can get tiring to fill out all those BG checks and blood draws, glad we don't have to use the sheets for that.
  14. Make lists of things pending for each patient and check them off as you go.
  15. TigraRN

    Dr Death

    Very interesting podcast. It is scary overall to go through any type of surgery and completely trust strangers in white gowns.
  16. TigraRN

    Getting into the Emergency department

    In our ER it is about 6 weeks for transitional nurses and 14 weeks for newgrads. If an orientee needs more time, they get more time. Good luck, I hope you like it! I would say the nurse is ready to get off orientation when they are situationally aware of all their patients, can discharge/admit within 30 mins, can speed up the process and don't hesitate to ask MD to dispo the patients. Safety first, of course, knowing your limits, when you need help, who is the sickest, and helping coworkers. It can be super fun. Especially when you get the unexpected through the doors.