Triddin

I've always had to give 4 weeks notice

It takes a while to fit in with new coworkers. Give them time and I'm sure you'll be considered part of the team. I don't think it's recommended that one goes into travel nursing with so little experience. What support to you perceive that you're lacking? Is there an educator or manager you can discuss this with before deciding to leave?

It actually stresses me out how long it takes them to get on the chest in a code situation. Instead of cpr, the just stand there talking

Try other provinces? Under served communities?

Any local food banks or shelters

I'm curious as the clinical reasoning behind keeping the patient supine as this is not a drug I'm familiar with. Could you have turned the patient to their side? No longer an aspiration risk

Your story raises red flags with me, and I don't think it confirms the point you were trying to make, but its partially it's because we don't know your background and experience. Were you icu/ Er trauma trained at this point? Had you cared for vents/ post arrests before. If not, that was a very unsafe assignment to accept as you would have had a huge knowledge deficit. I disagree that you shouldn't move a patient before the ett is confirmed, but every hospital I've worked at has a portable X-ray team. Had the X-ray been done already? Why couldn't the Er doc have confirmed the X-ray then and there. I would argue that delaying the patients arrival to icu is far less safe than waiting for cxr placement. At least in icu, you are surrounded by resources and supports for your patients: nurses who are familiar with the drugs needed, intensivists etc. My experience is that even if the intensivists have written orders down in ER, unless it prevents the patient from crashing, ER just doesn't have time to implement the interventions, including targeted temperature management, I would be concerned about delaying interventions such as these. I agree that doctors will sometimes ask us to do things that are outside our scope of practice, or against policy. But often explaining what the policies are is enough. With this story, I don't think the resource nurse was outside her scope of practice to escort the patient. It as when she received an order for a medication she clearly wasn't familiar with and gave the wrong one and wasn't aware of the required monitoring afterwards that the nurse decided to practice beyond her scope and this event unfortunately happened. She made several errors including not doing the basic rights of medication.

It was a horrible event and the nurse screwed up, but I can guarantee you that every error made is from not doing checks or having a momentary lapse of judgment. You will make errors, which may or may not have severe consequences. Your level of anger towards this incident makes me feel uncomfortable, and I hope when you make a mistake, you are treated in a kinder fashion.

Vandy patient dies after nurse gives lethal dose of wrong drug; puts Medicare at risk - NewsChannel 5 Nashville I'm curious why the hospital didn't report the error

I wouldn't as its outside of the scope of the job youve been hired for

I personally like my young lightly roasted and sprinkled with salt before eating them personally

I wouldn't say infection is a current priority based off the evidence offered. It sounds more like a " risk of" at best. Low hgb really has no bearing on infection, neither does liver cancer, unless he is being treated with chemo and has become immunocompromised, and you would expect end to be elevated if there was an infection. Your #2 and 4 are essentially the same. How does obesity cause poor tissue perfusion? I don't this it provides strong evidence. Same with number 5. I don't think you are providing strong evidence there is low perfusion, I would expect to see hypoactive bs, decreased motility as evidence. With the minimal information given, I would focus on nutrition, effects of liver cancer, low hgb to be priority problems, how is his cardiac stuff since he's been cardioverged? And kidney effects from being obstructed? I feel those would likely be more pressing problems

Many hospital policies leave me wondering why; however, the fact is either you accept their terms or not work for them. However, think of it from the organization's perspective. An employee gets sick with the flu, because they couldn't get the vaccine and refused to wear the mask. They still have to pay for the costs of the employee getting sick.

Before I call the doc, I've learned to have done an assessment for the pertinen details and I've written down what I think I'd important for them to know (I swear I have the memory of a goldfish sometimes) so I have my pertinent points. Some doc's want all the details, some dont but it's always better to have the information available of its requested.you don't necessarily need to do a full assesebt. Often focussed ones will work. I feel like being able to give the pertinent data (and know what is pertinent) comes as you develop critical thinking, which is an ongoing process in all nurses. I also think we've all been there, having a doctor call us out on not having all pieces of information they want. I ever calling a doctor about a high k and they asked me about urine output and I honestly couldn't tell them. I had to put them on hold to check. It sounds like you've done some good reflection. Could you take this information and present it to your work in form of a learning plan? It shows them you are taking this deficit seriously and are being proactive to find solutions. Might help. Also writing down valid strategies to help you improve can help you direct your own practice. Best of luck.

Is it a union job? All union jobs should start at the same wage

I would not want my patients to have my personal phone number for several reasons. I'm surprised the hospital doesn't give you a work phone

Will Ontario allow you to work as an RN and an NP? I know some of the NPs I work with state they miss bedside, but have to go to different provinces to work as an RN as the BCCNP won't allow the dual roles.

Canadian here. Since weeds been federally legalized, our BON and employers policy is essentially to maintain ones fitness to practice and not come into work impaired. Granted our drug culture is much different than that if the US. I've never had to undergo a drug screen, nor is it common practice for entry to school, new job etc. I know of many health care professionals who would smoke on their own time but never showed up impaired so it was a non issue.

You see it a lot unfortunately

You sure you didn't walk into a hotel by accident?

I wouldn't accept a verbal order from her, and would make her document it on the order sheet. To my knowledge, it isn't an arrestable offence if you report her, often what happens is a fine is posed to the individual and a notice on the BONs website says "x" is calling herself an RN and she isn't. Honestly, I think you'd be doing her a favour; she is setting herself up for litigation if she makes a mistake, and she won't be covered under any insurance as she is practicing outside her scope.

I would report it to your bon after talking to her and reminding her nurse is a protected term

I feel alarmed that you are bored in ICU. As a new grad, you will get easier assignments and more stable patients, but the majority of ICU work is critically thinking: why does you patient present like this, what factors are involved, do you give x med because their qtc is increasing, what could go wrong, what would I do if it goes wrong. Making a running dialogue such as this will help you develop your thinking and realize what you don't know. Then you can research what you don't know. It takes time to make friendships, on the ward and off. Moving away from friends and family is hard. Honestly, maybe your coworkers are picking up in the vibe you are sending out that you are bored and don't want to be there. If you can, I would stick it out if possible, it takes atleast a year minimum to feel comfortable and be competent in any ward, much less iCu. Of course only you know you. If you're rather teach, go for it. Just remember there are consequences if you choose to come back as an old new grad with minimal experience. Best of luck in your decision.

I've never heard of flushing an art line with heparin. Is that a standard practice?

I maintain it's a valid question as she hasn't been practicing as a nurse for 9 years. I know my BON requires a refresher course if you have less than x amount of hours in so many years. The scope of a CMA, as well as the critical thinking is different as a nurse. At any rate, congrats and best of luck