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  1. neonn965

    Religion & ectopic abortion

    This is pretty cut and dry to me. The baby is simply not viable. The mother is viable. The two options are to terminate the baby or terminate both persons. I don't see how any religious beliefs could even logically go against ectopic pregnancy termination. ETA: Atheist, pro-life
  2. Meticulous attention to detail, thorough charting, adherence to policy and evidence based practice, and collaboration with the team will not go unnoticed if you simply do it quietly. I know it seems like the recognition does not come quickly, but nurses that follow you notice that they do not find errors in your charting. They notice that all meds are given, tasks are completed, and all outstanding issues were addressed. Doctors will notice these things and trust you as their ears and eyes. Managers will trust you and utilize you as a valuable resource on the unit for new nurses and even old nurses. And the best part is, people will not think you are annoying and boastful, they will simply respect your work.
  3. neonn965

    D20 and a 1.9 fr. PICC Occlusions

    I also am curious if the D20 was heparinized. We would never run a PICC line KVO without heparin. We would also never run D20 for KVO purposes. We actually would never run dextrose for only KVO purposes. We run heparin 0.5u/mL in 0.9% NaCl or something similar. Were there sugar issues or something?
  4. neonn965


    But that's not actually getting time off. I truly don't understand what is going on here. If you are working your full time hours Sun-Tues, then what are they paying you any PTO for? That's how I take "vacation" when I'm not actually using any PTO. Sun-Tues and then Thurs-Sat the following week. I have 8 days off, take no PTO, and work my full-time hours. Basically, the cap is annoying but you just need to use your PTO. How much PTO are you able to schedule per year? We can schedule up to 144 hours per year. There's a difference between requesting days off and having them off, and then using PTO.
  5. neonn965

    Non productive overtime

    Do you have anything to support this? It is 100% definitely illegal in my state to come in off the clock and read through patient charts that I am not caring for.
  6. neonn965

    Non productive overtime

    Think about this scenario. If a nurse comes in early and starts looking at charts based on what the assignments might be, and then before that nurse's shift begins something occurs where the charge nurse needs to change the patient assignments and that nurse is no longer going to be assigned to those patients, then looking through those charts was a HIPAA violation. I would not work somewhere where I needed to come in early and/or stay late and be in patient charts off the clock. I don't look at charts before I clock in and officially take over my assignment. I don't look at charts after I clock out. Ever.
  7. neonn965

    Least "demanding" nursing Jobs?

    I gave you legitimately helpful input. If you do not want a huge learning curve, I would not seek employment anywhere in the field of nursing. The input I gave is also helpful towards society and patients in your geographical area.
  8. neonn965

    Night Shift & Eating

    I don't understand your post either. I thought you were going to say you were worried about losing weight. Regardless, I and all of my co-workers just bring for lunch what we normally would and eat anywhere from 12AM-4AM usually. I don't eat a ton on night shift either. Dinner before I leave and lunch at work. I don't eat in the morning or right after I wake up. I try to bring leftovers from dinner for my lunches (chicken and veggies, beef stew, etc), but if not I pick up soup/salad or something along those lines on my way in.
  9. neonn965

    Just grin and bear it!

    I get that it is frustrating but it really doesn't matter if the rest of the team is on board with comfort care if she is the one that has legal decision making rights for the patient (I'm assuming she does as health care POA?). It's really one of the biggest issues that I think nurses face in health care today. All you can do is educate and make sure they understand everything and then move on with the treatment plan. There is no getting through to some people though and to them, any and all levels of quality of life are better than the loss of life. I know you're venting, and these situations get old for sure. It is just one of those things you see so commonly you just have to let it go eventually.
  10. neonn965

    Being Mandated

    Never heard the word mandate on our unit. We do use on call though. And if that fails, our managers work in staffing, night shift, weekends, doesn't matter, if staffing is unsafe.
  11. neonn965

    Nursing specialties for the moms out there.

    Management or LTC would not be where I would go if I were looking for what you are describing. Outpatient/clinic nursing is probably what I would seek out. You are there for a set number of hours, the workload is reasonable, and you clock in and out and leave your work responsibilities at the door for the most part. In peds outpatient, nurses spend a lot of time doing phone triage, and then obviously vitals, immunizations, updating charts, etc. That to me seems like the ideal low stress job.
  12. neonn965

    Least "demanding" nursing Jobs?

    In August you were complaining about taking an OB course, and suggesting that it should not be part of nursing curriculum, and now all of a sudden you are interested in postpartum because it's "easy"? Also, as a side note, you do realize that normal newborns will start to seize, experience respiratory distress, etc. while under your care? And that a mom can suddenly have a pulmonary embolism or uterine hemorrhage and need transfer to ICU? All areas of nursing, chill or not, require you to take your orientation seriously so that you can manage your patients appropriately.
  13. neonn965

    Difficult conversations in the ICU

    Last thing, if I really feel a family doesn't get it, I don't try to make them get it. I go back to the team and say hey guys, this family does not understand and I really think you need to sit down and talk to them. Either they will be surprised by that and have another conversation with the family, or they will tell me they have talked to them at length and they just don't think the family is ready to accept it. I feel like it's really not my job to spell out poor prognosis for a family like that. Only to assess for understanding and reinforce if that makes sense. But yeah, if they don't get it, I involve the docs/NPs and pass the baton.
  14. neonn965

    Difficult conversations in the ICU

    To answer your question OP, I typically don't present a whole lot of information regarding prognosis. If they want to pay me an MD salary I would certainly be willing to present that information. But I can tell you what I do with families when I know that their baby will die and they are not open to comfort care or anything but aggressive treatment. I will often ask an attending physician what they think about the family's level of understanding. I ask them what was told to the family, etc, so that I have a baseline to start from. Then I will ask the family what they have been told and if they feel they understand the baby's very critical status. Generally that opens up the conversation in a non-threatening way. I usually say something along the lines of "this is your story, not mine, and my role is to support you in whatever you choose to do, and I will support the decisions that you make, but I need to know that you understand your options and your baby's condition". Something like that so that they know that I am there to aggressively treat and sustain their baby's life until they change their minds or the baby passes. I really do support their decision and feel that I can do those things ethically as long as the parents really GET IT. I will sometimes remind them that at any point they can change their minds about treatment options and that at any time they can decide to hold their baby/pursue palliative options/withdraw care, etc. I usually say something like "I only am explaining this to you because as your nurse it is my responsibility to make sure you understand all of your options at this point, and I totally understand your choice to continue with aggressive treatment". These are the types of conversations I have with families AFTER they have had them with the physicians/palliative care etc. My role in my eyes is to reinforce these conversations, make sure they understand the baby's condition, make sure they understand options, make sure they understand they can change their mind, and make sure they know that ultimately I support their choice and am there to support them in a very difficult time. ETA: I don't have these conversations every single time I care for a baby like this. If the baby is maintaining their status and the family is well aware of their condition, I don't just randomly bring this kind of thing up. It's usually when I feel like we're reaching a point where it becomes relevant again. Say we get a crappy gas, or we have to start an epi drip, or something changes in some way, or I take over when the baby is having a particularly crappy day. That's when I'll kind of sit the family down towards the beginning of my shift and just say hey, I know this is a tough conversation and I just want to get it out of the way and make sure we're on the same page. Usually people are really responsive and very appreciative of this approach.
  15. neonn965

    Least "demanding" nursing Jobs?

    Glad you are taking your RN role super seriously. Lol. Good luck. Probably the best area of nursing for you is unemployment. Any other area requires the ability and openness to learn and grow in the RN role.