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AriRN36

AriRN36

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AriRN36 has <1 years experience.

AriRN36's Latest Activity

  1. AriRN36

    Hospice Inpatient Units

    How often are you getting multiple admissions at once? How many nurses work on that unit each shift? Your intake department should be setting you up for success by staggering admission times.
  2. AriRN36

    HIS - Shortness of Breath in an unresponsive patient

    I'm a skeptical person, and I truly don't think that's the reason she wanted me to chart that way. So - assuming that was not the reason - what's your opinion? Does it make sense/not make sense to chart an assumed SOB? Thanks
  3. Hi all, I just started at a new hospice and don't agree with the way they want me to fill out the Hospice Item Set questions about Shortness of Breath. For those who use Netsmart/McKesson, this focuses on the Respiratory assessment and HIS J2030A. Situation: I admitted a GIP patient onto hospice services yesterday for metabolic encephalopathy. He has no history of O2 use, but was currently on O2 for comfort when I arrived. My preceptor told me to mark the box for "shortness of breath" and "shortness of breath while talking or eating or performing other ADLs" because it is ASSUMED that he would have SOB while performing those tasks. She also stated that if I were to click the "None" box, that would have a negative impact on our HIS scores. In my opinion, an assessment is what I know and see, and I don't know that he is SOB. His respirations were WNL and were not labored. Would you chart SOB or not? Thanks!
  4. I think some people have great ways to phrase questions that are uncomfortable for patients. What are some ways you ask patients about if they are incontinent of bowel or bladder? Thanks!
  5. AriRN36

    Scripps New Grad Residency October 2018

    Question for the people who have heard back: - did you have your CA license at the time of application? - did you have any prior experience (obviously less than 12 mo) as an RN? - do you have ACLS certification? I am applying from out of state, so I have no idea what they're really looking for despite their job qualifications stating that you don't need your license at the time of application. Thanks!
  6. AriRN36

    Weird actions that are out of nursing scope

    Thanks everyone for that info. I figured something sounded off, but again, don't want to lose my license over something that could easily be avoided if I only knew. I also should have corrected - by children I did NOT mean young children. Her kid is like 18 or 19. Sorry you couldn't read my mind.
  7. AriRN36

    Crying when you need to talk about something serious

    Thanks for sharing - I've never gotten choked up at clinicals, but I also have never really had a serious conversation like that. Recently I observed a conversation this great nurse had with a family who had unrealistic expectations about the patient's condition. She was very calm, but was essentially confronting their misconceptions and stating that she's concerned about the medications he is requiring, the doses, etc. despite our efforts. On my drive home I tried to repeat some of the phrases she used to myself as if I were talking to the patient and it made me teary. I will also run through the DNR conversation in my head sometimes and even though there isn't even a patient involved it can make me teary. So that makes me worry that it's not about letting out emotions. I just want to be able to be strong and concise for my patients, so it's frustrating to thing this may affect my conversations.
  8. AriRN36

    Weird actions that are out of nursing scope

    Ha - okay, glad to hear it. So what about with things like a friend or family member asking you about symptoms they have? Is it out of scope to tell them what you think might be the cause, what meds might benefit them, etc...or is this just another example of me overthinking things?
  9. Hi all, I just passed my NCLEX and will be starting on an acute care unit next week. I had a teacher tell me that if her children have friends over who have a headache that she can't give them ibuprofen because that's considered "prescribing medication." That sounds suspect to me, especially because she is in her own home and that medication is over-the-counter. However, if she is right, that makes me worried that there are other seemingly innocent actions out there that are technically considered out of scope and that could put my license at risk. Aside from the obvious parameters in a nurse's scope of practice, how do you learn what's okay/not okay for a nurse to do in strange situations like this? Is this something most nurses know or is it something that comes with time and experience? Thanks!
  10. I just passed the NCLEX and will be starting work on an acute care unit this month. For a few years now, whenever I think about or talk about anything that's even remotely serious I get the urge to cry and you can tell by my voice and face. I have no idea why it happens because a lot of the topics don't truly make me feel sad in that moment. For example, I was trying to explain who "the righteous among the nations" were to someone (non-Jews who helped the Jews in the Holocaust). Another example is when I was sharing a story I heard about a nurse during Hurricane Katrina who discussed how important it was for her to rely on her knowledge when the generators failed. Even just bringing things like this up triggers the response. My concern is that this will likely be happening frequently on the unit when discussing things that are urgent and/or serious, like a DNR, during a code, etc. Does anyone have a similar experience? How do you handle it? *I have also been told in the past things like "you get used to it" or "it's alright to cry sometimes," but those aren't really the responses I am asking for. Over the years I have not gotten used to this response because it doesn't actually have to do with something that's truly sad to me. Thanks for any input you have!