ARRR10

I have one more question:D So, if I do go active duty, do I get to choose the base I want to be assigned to? Reason I ask is that I live in Alaska and there is an airforce base nearby. Thanks.

^^topic^^. I have a nursing classmate who is in COT as of now and I am strongly considering the airforce as a possible life experience pathway before I hit the 30 year old mark. I graduated with my Bachelors and already have 2 yrs experience in ortho/surg. I just need to ask a couple of questions to all you military RN's out there. Will I still be able to practice ortho at the same hospital once I am finished with COT or would I have to work on the military base hospital? I am aware of deployments and I have another question- Even if I'm an ortho nurse and if I were to deploy- Will the airforce just float me to whatever department needs nurses? Thanks.

It is really that bad. Started out on an ortho/surgical floor just b/c i know my patients are going to get better and that there was a little bit of med/surg involved. My first year was hell (constantly running with pain meds, being yelled at by MD's, making mistakes that were totally unavoidable, being yelled at by patients/family members, etc.). Then after working 6 mos- I was required to float to other floors where most of the floors that I floated on would just dump you with the worst patient load. In addition to having to deal with the patients that the charge RN's would dumped me with when I floated- I had to deal with RN's that were just pure evil beings...I HATED WORKING WITH THEM SO MUCH! THEY WERE JUST PURE EVIL. Even with all the floating I had to do to other departments- I still haven't found my niche. I made it through my first year and wanted to quit, but when I came on to this forum and read some posts on how most jobs wanted at least 2 years of acute care experience- I decided to go ahead for another year. Last week is my 2-year anniversary working on ortho/surg. I love the staff I worked with and I have good rapport with them- I just don't feel I am being appreciated at all from management for all the work and sacrifices that I have to make... The only thing I get from them is like a $5 gift certificate when it is my birthday ::gag:: Now that I'm browsing through this forum, some RN's are saying to have at least 3 years experience....pffttt.. I'm going back to school to get my Bachelors in something else b/c I'm really burned out...

The hospital is super busy and I requested to work extra ONLY on my floor tonight if they needed me. I just contacted the charge nurse on my floor (ortho) and with all the discharges and no surgeries, there will only be 5-6 patients and there are 3 RNs working tonight. So, I contacted the House Supervisor to cancel my extra shift and let's just say she didn't take it too well, but she did cancel it. If I didn't cancel my shift, I would end up working tonight on my floor and two of the RNs scheduled to work tonight would float to the most undesirable, worst place in the whole hospital (its med/onc)- everyone hates floating there due to all the bad staffing, the attitudes of RNs that work there, and the way the charge RNs split the assignment (you either get the front, middle, or back of the unit... the charge RNs do not split the assignment to where the floats get patients they can feel comfortable handling). I mean, I shouldn't feel guilty right? Its the facility's fault for not having adequate staffing due to the hiring freeze we're experiencing, right? I already worked an extra shift last week and in the middle of my 3-day off the house sup calls me in the middle of my sleep asking me if I can work extra and I am like "umm, uhh" and ended up signing on again for an extra shift because I feel bad if I say "no". Sorry if my post is too long... Just sharing some feelings.

What does "cya" and "NSTEMI" mean? also, yeah the labetolol parameters were ordered by the surgeon and the labs were ordered by the hospitalist. Apparently there were conflicting issues going on between the docs about the pt's diagnosis. Thanks for the replies!!!

I work nights at a hospital and I had a patient who was having issues with his blood pressure. There were orders by his surgeon to give labetolol if systolic is >150 and diastolic >90 and to give HCTZ daily. Throughout my shift, my pt's BP stays around the 130s/60s and the only issue he had for me throughout the night is a critical H and H drawn from his CBC- I called the hospitalist (who was being consulted) concerning the low critical H and H- no further orders. I learned today from one of my coworkers that the surgeon was angry that he wasn't paged about the high blood pressures and he wanted to know the nurse that took care of his pt that night (which was me). I had one of my coworkers double check the BPs the night I had him- his VS appeared to be stable; however, prior to working my shift and the night before he had a BP-150's/90's (this was taken during days) and another one 180's/90's. Our unit prints out rounds report showing all documentations (VS, I&O's, etc.) backtracked 24 hours. So, I'm all stressed out about the situation, but I don't see what I did wrong. Do you guys think I should be blame for this?

By August 3rd, 2010, I will have my one-year experience working as a registered nurse. So, I just wanted to know if its too early to switch from full-time to part-time? I'm thinking about maybe going back to school to get another degree just as a backup, or maybe finding another nursing specialty. Another question, I want to get at least another year in working as a nurse (I work on Ortho), but I just wanted to know if changing my work-time status would affect my experience as a nurse (like 2 years working as a nurse on ortho)? Geez, as i'm typing up this thread, I still can't believe its been almost a year- just thinking about all the mistakes I made, the bad stuff I had to put up with, and all the stress... WOW....

Here is my issue. Back in august 09' I had an abscess on my hand that got infected and needed to be drained. I missed a week of work, because I was not allowed to work with a draining wound. The wound got reinfected back in January '10 and I had to get surgery recommended by the infection control specialist at my hospital and by my surgeon d/t the possibility of osteomyletis. As a result, I had to miss three weeks of work. Then in February 10' I got chosen to be part of the jury during the jury duty selection process and I had to miss another week of work. Then two days ago while I was getting up to start my three day work week, I collapsed on the floor while getting out of bed and started having severe nausea and vomiting. I was sweating profusely and my room kept on spinning around me. I wasn't able to walk, so my mom had to call 911 and I was diagnosed with severe vertigo and was told by my doctor not to work for 3 days. I am getting better, but I am still having trouble staying balance while walking. I'm just afraid that all these abscences that I haven't even done intentionally will result in me being terminated. I'm only eight months as a new nurse in my first nursing job and its just a pain that all these unpredicatble situations are coming up. I just need some advice.

^^topic^^. I just got back from nightshift and I am kinda freaking out that I removed the staples on one of my pt's surgical site (total knee replacement) on postop day #2. Generally it is 10-14 days for staple removal, but the MD specifically wrote to remove staples on postop day #2. I checked with my charge nurse and she said to go ahead and remove the staples, which I did. The incision site was well-approximated and intact after removal of the staples. Is it common to remove staples from a surgical 2 days after surgery? Did I do the right thing? Am I going to get in trouble?

Sad thing is, I'm only 6 mos into the job and I am not qualified for FMLA until I work at least a year at their union facility. Good thing I always come early to work.

I had an abscess that was drained on my hand in august (developed unexpectedly during my first week of classroom orientation) and couldn't work for 3 shifts during my orientation due to infection control policy (if I have an open wound and it is still draining=no work). The abscess came back in the middle of December and I was scheduled to see a hand specialist the following week. Due to certain circumstances (insurance wise); I was referred to another specialist. Luckily, the abscess burst unexpectedly (probably r/t when the specialist was pinching the abscess) the following day and I was able to see the other specialist right away (my original appointment was scheduled the end of January). The specialist made an incision, drained it, and packed it. Furthermore, I had the option of getting hand surgery which involved irrigation and debridement. I had to miss 3 shifts again d/t infection control policy and the infection control nurse recommended getting the surgery since it's so near the joint (near the thumb) and the risk of possibly developing osteomyletis. Also, I knew I was going to miss more shifts due to the draining and I really didn't want the abscess to develop again. So, I notified my manager to let her know I was going to get the hand surgery this week and and told her what the infection control nurse of our facility has stated. The physician stated it would possibly be 10 days till I can go back to work. The nurse manager seemed kind and understanding, but I just can't get the feeling that this situation is my fault (is it?) And I am getting the feeling that I might get fired? I don't know I just have this bad feeling? And what is really depressing is all my vacation and sick days will all be used up for this situation. What do you guys think?

I have about 2 more weeks left of orientation and I'm also in the same position as you are. I'm taking care of a full patient load, but have yet to call the doctor (the opportunity did not come up yet). I already did an admit, but as you've stated, it was also my preceptor who entered all the orders, prepared the chart, etc. My preceptor is really nice and I learned a lot from her, so what I think I'm going to do is just voice out how I am feeling and if it would be okay if I can put in orders and stuff (I only have 4-6 weeks of orientation). I think after orientation you're never really are ready because you're still new to everything and to me its like you have to experience every mistake you did as a learning experience (but what really bothers me are the mistakes that are like life-threatning). Just always ask questions (especially the resource person on your unit) ALWAYS ASK, ASK, ASK, because your new and for me its like my right as a new grad to ask. Whenever I make a mistake, I record it on my notepad, go home, and examine why I made the mistake and what I am going to do next time to prevent this from happening. I try not to be so hard on myself and I always say to myself that this is a learning experience for you and you'll get through it. I don't know, I heard from so many nurses that the first year is the toughest, but I'm trying to keep a positive attitude and I tell myself that I am new and I am not expected to be like a super nurse that knows everything, because its impossible. Its great that I have staff that are always helpful and nice. You've already been on your own for two months and it seems like your doing great. I would also like to hear opinions from other experience nurses. Good luck to you.

Excellent points! I was in the same boat as you are right now 6 mos ago. I kept filling out applications but never received a call back. Some of the replies I got back stated they needed a nurse with experience. So my friend told me to dress up, print out a whole bunch of resumes, and go to the nurse managers in each of the hospitals in my city (at this point I was desperate just to find a job, so I would take any position that was offered). One hospital wasn't hiring, the other hospital again needed nurses with experience, the public health clinic hired a nurse with over 10 years experience in this type of field over me. Then the last hospital I went to commented on how I came in in person to hand in resumes. It showed I was assertive in getting a position. The nurse manager actually looked over my resume, and scheduled an interview the following week. I am now working with great staff and management. Keep your chin-up and keep applying.

One of my patients that I was taking care of was in for ETOH abuse, ascites, and cirrhosis recently passed away. He was living in a assisted living facility where I was working at and based on what I got from report, he came back to the facility the previous night intoxicated. The last time he was seen alive was today at around noon where he asked to take his lunch back to his room. When the health care provider told me to go to the patient's room stat (this was around 7 in the evening), I found him not breathing, on his side, his face swollen. We called 911 and I tried to perform CPR on the patient, but his muscles where stiff and I couldn't separate his arms (it was fixated in a overlapping position). I then attempted to open his mouth, but it was tightly shut. I couldn't even barely get him on his back. The paramedic on the phone told me to keep on doing chest compressions until the paramedics arrive on the scene. I'm still in shock by this incident (I am still a new grad nurse also working at a hospital) and I can't believe that this patient that I've been taking care of for months actually died (this patient had a very friendly and caring attitude to everyone), so yeah, I'm in the dumps right now. Sorry I got sidetracked, but I was researching online on rigor mortis, because I am assuming that this is the condition the patient was in when I arrived to the scene and I just wanted feedback if my actions were valid in this situation?

UPDATE: My gosh, I brought bagels w/cream cheese, coffee cake, and muffins and all of it was nearly gone by the end of the day-. I was able to develop rapport with the PTs, other nurses, the nurse manager, supervisor, and the CNAs. I guess this was a good way to integrate myself to the unit:wink2: