mia

: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:

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:)

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

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:

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?

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!!