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mia

mia

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  1. mia

    In a pickle

    :uhoh21: I hope that someone out there can give me some advice. Here is the situation. I have been working at a small hospital for about 7 months. We do both acute and chronic patients. Initially there were only 3 nurses to share call and care for our chronic patients. Our patient census dropped dramatically and there was talk of floating us to the floor. I really did not want to do this so I started to explore other career opportunities. I applied for my "dream" job not really expecting to even get an interview. It turns out I not only got an interview but was offered a position. This is the job I have wanted to do since nursing school! Now the problem...One of the other nurses I work with was also interviewing elsewhere and accepted a new position. She gave her resignation last week. That leaves me and the senior nurse who has been really, really good to me. In fact, its because of her that I am even qualified for the dream job I applied for. If I take the position I would leave her alone with all the patients and all the call. To make matters worse she is scheduled to have some surgery in about 2 months. I feel guilty that she may have to delay her surgery if I leave. I really want this job. What would you do in this case? :uhoh21:
  2. mia

    Need info on PD

    Can anyone give me information on Peritoneal Dialysis. My manager has offered to train me in this specialty ( I currently do HD). Is it mostly teaching? Is there alot of acute care? I would like to gather some info before I accept the offer. Anything you can tell me about PD would be greatly appreciated!! Thanks, Mia:)
  3. mia

    Please help new Dialysis RN

    Thank you all so much for taking the time to answer my questions! I have taken everyones advice and I feel alot more comfortable now. Even better is that I have been offered a hemodialysis position in a peditric hospital. The staff seems really supportive of new nurses and I have been promised a precetorship with a seasoned dialysis nurse. I think I will really learn ALOT working with this team!! Im so excited!! Thank you all so much for your support and advice!! Mia
  4. mia

    Please help new Dialysis RN

    Please help me. I am a new RN who is working in an outpatient chronic care dialysis facility. I have so many questions that I really need answers to. First, how do you maintain sterility when hooking up patients with subclavian catheters?? I can do it for the dressing change but when I am hooking up without assistance it is almost impossible without changing my gloves over and over. The nurses in my facility say "I don't know why they say its a sterile procedure, it is really just clean". Is this true?? If not how do you do it?? Next... What do you do when you have a catheter that you can not aspirate the dwell from?? In my facility as long as you can push a saline flush through you go ahead and hook up and give the treatment anyway. This scares me. Is this safe?? ALso if the arterial line on the catheter won't pull they just switch the line and make the venous the pull instead. How long can you do that for (in my facility I have seen them do this till the catheter is not functional anymore)? As a new RN such practice makes me very nervous...Am I just acting like the "super novice"? Lastly (for now) many of our patients have very prolonged bleeding times (and they bleed alot). To compensate the nurses and the techs just cut the heparin dose. I feel uncomfotable consistently doing this without the MD offically changing the dose. Am I being overly cautious? What do you do when this happens? Please someone advise me . I think the staff is getting irritated by my constant questions but I really want to make sure I am being safe. In nursing school we really did not cover dialysis to a large extent so I am really in the dark here. The last thing I want to do is develop bad habits. I appreatiate any comments, advice and tips you can give me!! Thanks so much!!! Mia:confused:
  5. HI! My name is Mia and I am trying to ellicit the adive and expertise of all experienced RN's from all speacialties. I will be graduating from a BSN nursing program in December. I was recently offered a position on a unit that I really want to work on. The only draw back is that its a 7P-7A shift. Personally, I don't mind this at all. However, I am afraid of being really tired during shifts. I have worked late nights before but not in a field where it was so imperative to have clarity of thought ( a good nights sleep!). From my previous late night experince I know that usually I can sleep through the day but sometimes its just not happening. I am especially concerned because I am a new grad and my skills still need to be developed. I will get 6 weeks with a preceptor and then I am off to the late nights with lots of insulin drips. What do you all think? Is this doable? Any suggestions from late nighters on how to ensure sleep during the day.? Any advice will be thoughtfully considered but please respond soon. I need to either accept or reject the offer in about a week. I reallly, really want it but Im not sure if it is wise.
  6. mia

    Bilingual nurses?

    Hey Kim! Its ironic that you would inquire about a Spanish class for nursing students. My good friend and I were just talking about taking such a course last night. The local community college (which has an ADN program) does have such a course in its continuing education curriculm. The university I attend (BSN program) supposedly offers such a course as well, but not every term (and truthfully I have never seen it listed in the schedule of classes). Anyway, my point is check out other schools besides your own to see if they offer such a course. Look in continuing ed as well as credit course listings. Also, do some research on the internet for such programs ( they are out there, I know because I looked ...but I dont remember the actual sites). If the demand is high enough in your class for such a program there may be a way to bring such a class to your school. Find a supportive member of your nursing faculty to help facilitate this. It can be done! Good luck in your pursuit!! Mia
  7. Dear Bobbi Jo and Patty Jo, Thank you so much for your responses! I have to tell you that since I posted last, I took a job as a psych tech. Unfortunatly, I am even more confused and concerned now. I have discoverd that I really enjoy working with the patients. I feel there is such a need in this patient population for good nurses to act as patient advocates. In addition, I especially enjoy the large education component associated with psych nursing that I learned about in school and even experienced in my academic clinical rotation. However, I have to tell you that I am not seeing this in the facility I work at. I don' t know if Im just in a really bad hospital (there is some strong evidence that this is the case) or if this is just the way it is everywhere. I am not trying to be judgemental or offensive, Im just stating what I am seeing at this hospital. The nurses rarely ,if ever, come out from behind the nurses station. They totally depend on the techs (or I should I say "tech"..... sometimes 1:17 patients) to interact with the patients (which is very difficult to do effectively when your trying to do checks every 15 minutes,serve meals, take vitals and fill out your own bit of paperwork on each patient). They then use the information provided by the techs to give report. I do not know what the nurses are doing, but they look very, very busy with paper work. Is there really that much paper work associated with psych nursing that the nurses do not interact with the patients (except when they give meds...from behind the nurses station)? If so, then maybe I don't want to do psych nursing. Or is it possible that to interact with the patients the way I would like requires certification or higher education? Can you advise me? Am I just at a bad hospital? If not, then can you tell me what the expected duties of a psych nurse are? I really appreciate the time you have taken to answer my questions! Mia:)
  8. mia

    student nurse has a question

    Hi, I was wondering if any of you could answer a question for me. I am a student nurse who will graduate in December. I am really interested in Hemodialysis. I am also interested in eventually becoming a Certified Diabetes Educator. From what I understand, to get the certification one must provide a certain number of hours of patient diabetes education. Can you do this in Hemodialysis? I know that a large population of patients are on dialysis as a result of diabetes. I was just wondering if I could prepare for my CDE while working as a dialysis nurse. I have tried to contact the American Diabetes Association for a answer but they were very vague. Can anyone provide me with an answer or refer me to a source that could? Thank you so much for your time!! Mia:)
  9. Hi! I was hoping someone out there could help me. My problem is that when I try to take a blood pressure reading I have a very difficult time hearing. I don't know if I have some kind of hearing impairment or what but Im really concerned. I feel that a better stethoscope may help but Im not sure which one to get. Can anyone advise me about a good stethscope?
  10. Hi, I am coat tailing on a previous post from Molly J regarding the limited response by psych nurses to information requests.Psych nurses do not seem to respond to posts like the other specialty nurses do. This is especially troublesome for student nurses (like myself) who are interested in pursuing a career in psych nursing. It is not just on this site either. I have approached quite a few psych nurses to get emloyment information and they have all been very tight lipped. What is the big secret????? I personally just want to know how you like your job, what kind of career opportunities there are for psych nurses, is it better to get an advanced degree as a clinical nurse specialist or as a psychiatric nurse practitioner or is there no benefit to getting an advanced degree? Is there really such a position as a nurse psychotherapist and if so how do you become one ? Can they prescribe meds? Is the pay for psych nursing comparable to other nurse specialties? Is there a high turnover rate for psych nurses? Do you recommend getting some Med -Surg experience first? Some body please break the code of silence . I would REALLY appreciate it. Thank you so much! Mia :)
  11. mia

    Advice from psych nurses to others?

    Hey Molly J, I am sorry I just kind of intruded on your post. I will go ahead and post it again as a new topic. Your concerns take priority over mine. Mia :)
  12. mia

    Advice from psych nurses to others?

    Hi, I hope this does not come across as nasty but I agree with Molly J. Psych nurses do not seem to respond to posts like the other specialty nurses do. This is especially troublesome for student nurses (like myself) who are interested in pursuing a career in psych nursing. Its not just on this site either. Ive approached quite a few psych nurses to get employment information and they have all been very tight lipped. What is the big secret????? I personally just want to know how you like your job, what kind of career opportunities there are for psych nurses, is it better to get an MSN as a clinical nurse specialist or as a psychiatric nurse practitioner or to not pursue an advanced degree at all? Is the pay comperable to other nursing specialties? Is there a high turnover rate for psych nurses? Do you recommend getting some Med-Surg experience first? Somebody please break the code of silence. I would REALLY appreciate it. Thank you so much! Mia :) :)
  13. mia

    New nurses poorly educated

    Im really glad that this is coming to light. I will be graduating in December from a BSN program and let me tell you I am really nervous. I know I have not attained the clinical skills of my predecessors who attended diploma programs or even associate degree programs. At my school the emphasis is definitly on paperwork. When I express my concern to my clinical instructors they usually say, "Don't worry you'll do all that when you start working." My thoughts are , gee, I would rather practice some skills now . I know Im going to very embarassed if after I graduate I must tell my preceptor that I never started an IV . I know that it must be difficult on our clinical instructors to make sure that everyone graduates with a certain degree of technical skill, especially when you attend a large University. Still, I feel somwhat cheated. I mean, I did pay for my education. I just hope that our future preceptors are empathetic to our situation and will be patient with the newbies. Just give us a chance and I promise we will learn as quickly as we can!!