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Hello everyone! I just have a little question about Foley's. I recently moved to a med/surg floor so there's a loooot of those. I was just wondering: what are the signs that a Foley's balloon is misplaced? When you see some urine flow, should you advance the catheter more or inflate the balloon right away? Would the catheter still be draining urine or only blood? Pain during inflation must be a sign, but could the inflation be uncomfortable even though the Foley is at the right place? Thanks to all of you!!

Hello everyone! I'm writing here tonight because I thought of a patient I had last week and have a little question. The client was in for abdominal pain and turns out her stomach was full with 2 liters of liquid in it. Doc ordered to place NG tube and the patient to be NPO. It was the first time I had a patient with a NG tube,and I know there's often NPO and strict NPO but.. I did not think of clarifying that with the M.D on my shift because I thought we wanted to drain the liquid and give her stomach some rest. Not refill it with food and other liquid. Now I think I made a mistake assuming we had to give her meds!! (and be sure that next time I'll think about that twice) So I was wondering, in this type of situations, when the patient is not waiting for surgery or any procedures, do we usually give meds to patients who have NG tubes?

Wow, some of these are so bad:( I'm so sorry for everyone who had to deal with such horrible shifts! I see that mine really is nothing compared to that!

I'm a new nurse working on a med/geriatrics unit since july and I just had the woooooorst shift ever today!! Got report in the AM, saw that I had a lot of anormlal labs, so a lot of phone calls to doctors.Plus, I had 8 IV's to give between 9-10h AM! Like okay I can do that no problem. 3 of the IV accesses I needed were infiltrated.First was a man who constantly tried to pull it out. Got a new one, started the IV just to see that he had cut the IV tubing with his teeth like 10 minutes later!!!!! Another was a lady that just could not have an IV access on her right arm because she had a breast surgery a few months ago. But her left one was swelling a lot she was a really hard stick. Another patient could not had his blood test done during the night because he was too aggressive also had to be stick and was a success thanks to my wonderful colleague. By the time all of this is done, I have 15 files with new consults and orders and doctors asking me various things. I felt that I could not help my coworkers at all this morning because I had so much work myself!! I try to help with patient hygiene every morning but just didn't have time. By the time I had to go to lunch I was able to get everything done and was hoping that I could start to chart in the afternoon! Big mistake! As soon as I came back from dinner, a woman became hysterical, pull her IV out, started screaming, crying, etc. Had a lot of trouble to give her some Haldol to calm her down and had to send someone start a new IV. The same aggressive patient that we had to stick in the morning and tried to hit us everytime we touched had fever. Doc called, septic workup was ordered (so a lot of manipulation agaaaain for this poor man) and eventually done. New orders just started to pile up on my desk, but had to give my afternoon IV's, write down report and actually start to chart! WELL, eventually I got out of work (almost 1hour late!). Charge nurse told me to write overtime, but I felt like crap. I feel like I needed so much help today and felt overwhelmed most of the time. Never happened to me before! A doctor even asked me some questions about one of my patient and I actually just did not know what to answer because my head was so full of everything I had to do, write down, etc.! I can definetly say that this has been the hardest shfit I have ever worked on. Felt good to vent, and I was wondering about you, nurses of allnurses, how was your hardest shift?

Yes I am being trained to both places but I honestly feel like I'm going to work only there because they lack of staff so badly (last weekend, 1 employees were absent!) And one of my friend told me she was going to be trained on my floor, because she couldn't work at her's since school is starting back and her shift were days only.

Hey everyone, I'm writing here because this week I got really bad news. I'm a new grad and I was hired at the beginning the summer on a geriatrics/medecine unit and i just loved it! Not a too heavy workload so I have time to learn most of the time, but still pretty busy, I love the patients and the team! Everyone is just amazing and I felt I could not be on a better unit. but this week I learned that I was going to be oriented in LTC center of my hospital. I do not have anything against LTC nurses and they do an amazing job but going there just makes me so depressed I've been crying everyday since I learned I was going there. The reasons are that I was à CNA for a year there before graduating and I was completely exhausted from this place I just could not bear it anymore. Also, I'm really afraid I am going to loose a part of my skills which were already hard to gain for me (I never had a trach, ng tube, and I still have trouble with drawing blood sometimes.) The skills that LTC nurses do are for the majority foley's and wound care where I work. The problem is that in Quebec what you learn in wound care is the basics only. You have to go to university to have a complete class on that. I'm starting uni this fall but cannot take that class until next year?? Îm also afraid I'm going to be incompetent on that part. I just feel like Im not going to be happy there especially since I was so happy to leave this spring. I'm not saying I'd never go to LTC, I was even considering that at the end of my career because I love older people. It's just that it's not the best place for new grad who wants to work in a hospital most of his life. I'd like to share my worries with my charge nurse and ask if the hospital needs staff somewhere else, but does that make me picky? Am I a big baby for thinking all of this? I know what not being happy in a job feels like and i do not want to live that ever again I'm just really scared:( What do you all think? (sorry for the long post I really had to vent)

Thank you so much for your kind words, I really needed that right now! :)

Hey everyone! I recently made a post during my first days of orientation expressing my concerns about being an RN. Now that I just completed day 8 on my own, I realize I'm having problems with something else. I know I need more practice with skills like foley's, IV's and blood draws but there's already a progression. The main thing that I am struggling with is that on my days off, I start remembering things that I forgot to do! Before I leave at the end of my shift I take 5-10 mins to review all my patient, what I have done during the day to see if there's anything that have to be completed, but I still remember things 1-2 days after. For example, I forgot to sign a STAT medication that I gave (even though I wrote in report that it was given),I had a blood transfusion too and started my note and everything but completely forgot to finish it and to write the post-transfusion vitals on the sheet (even though they were taken and normal). This happened on friday. Staff called me to see if I had given the stat med and told them yes, but I thought of the incomplete transfusion paper on saturday. I didn't call or anything, because I thought I'd just have to complete it on monday. Should I have called? I also realized that on my days off, I start doubting almost EVERYTHING that I have done!!! It's becoming irrational. Like today I changed the dressing and caps of a PICC line, but now Im starting to ask myself did I removed the Heparin before flushing one of my two lines? Was this line clamped when I changed the cap? Im pretty sure everything was fine, im comfortable with PIClines, but there's this constant irrational doubt making me imagine the worst scenarios like a bleeding or an air embolism. This makes me feel sick before I have to go in to work, scared that I will learn that I made a mistake without realizing it Any tips on how to be able to relax? Anyone also went through this when they first started?

I had 5 days of orientation, 4 evenings and 2 nights!

So tonight I've had my fifth evening off orientation and it was my first bad one. I came in to work to know I forgot to give one pill last night (it was ferrous sulfate so it didn't had any consequences on the patient). The worst is that I signed it on the MAR but got distracted and forgot to give it and didn't even notice! When others go on their breaks at 6PM, I am alone with 1 CNA and 1 LVN for 32 patients and sometimes it's just crazy? Like yesterday a super confused and agitated patient just walked into another patient's room and hit another patient with his cane? And today the same patient walked into another patient's room, pulled down his diaper (sorry I don't know which emglish word is more respectful for elderly people) which was full of feces, sat on a char and started putting his feet in the feces and made a big mess. While I had to handle this, there were many bells, a patient who needed supervision to walk got up and went to the bathroom alone, it was chaos! I probably looked like a headless chicken to the others. For the first time I had to start parenteral nutrition and the pump just kept ringing and I couldn't figure out why. Turns out the tubing was just misplaced. Had to get the other nurse to figure this out -.- Finally, I was alone for passing meds and installing half of the 14 patients for the night and wasn't done at all when everyone came to help; we were 6 in the room to install/pass meds for 3 patients and I almost started crying because I felt so slow and incompetent.. Now I'm scared that next time I'll go to work we'll tell me that I forgot to give a med or something else, or that I did something wrong :'( I know this is a normal feeling but I've only been working for 5 days and made my first med error, I'm just a little down, needed to vent.

Yeah, I live in Quebec and everything here is paper! That leaves more place for mistakes, gotta be extra careful

So I am a new grad who just started orientation (wednesday) on a med/geriatrics unit (exactly where I wanted to be!). Each nurse here has 16 patients. The first two days went pretty well, but those were calm days. My coworkers are amazing and soooo kind with me, I already feel like I've been there for 3 months! The only thing is that I realized that I had issues that could compromise my orientation. First, is that I absolutely suck at drawing blood! I can start an IV most of the time, but drawing blood even with a butterfly has been an impossible task. So far I've had about 20 attempts and I can count on one hand the times I got it. Everyone tells me it comes with practice and I understand I should give that a little more time. The biggest issue is that I really have trouble focusing on one thing at time. Like if I am charting my assessment on a patient and an order for another patient would come up I'd take care of that thinking Ooooh it will only 2 minutes. It's like I constantly have my head in the clouds and I made my first mistakes yesterday. After a doctor made an order suggesting something, we have to call the patient's doctor so they can say whether they agree with the order or not. If they do, we have to write Ok, Dr. X, on the order so everybody knows they've been informed. I called the doctor but forget to write okay on the order so the evening nurse called the doctor again and he was mad we kept calling him about this. I also got an order to cease all Dilaudid for a patient and new orders of Morphine. Ceased the regular and PRN between regular doses, but didn't see there was PO Dilaudid. I just noticed that I forgot when pharmacy sent us back little stickers to show us what's in their system now. Yesterday just before shift change we received an IV antibiotic to give STAT to a patient, so I started it but completely forgot to sign it before I left. I went back this morning to sign it. I just feel like I shouldn't make such mistakes since my days were less busy than some of my friends who started at the same time as me who are on CRAZY units with 10-13 patients too. I needed to vent, but I was also wondering ; did any of you had similar issues when you started? How did you get over it?