SoNan

Didn't expect those many comments. But thanks for all suggestions. I went to work that day, and back home as well. The snow was not as bad as I thoughts, most roads are cleaned when I leave work.

I live in New Jersey, and there is an anticipated snowstorm, the snow will be 8-12inch in the night. my shift is 3-11pm. There will be nothing at 3pm, but when I leave work at 11pm, I will be stuck in the snowstorm. I am live 40mins away from my work place. I personally feel bad to call out, but my family is worry about me driving home in the snowstorm, especially, I never drove in any heavy snow or snowstorm before. I need some suggestions.

Thank you for your comments. I feel bad because I did a procedure without enough knowledge about it. and I am worrying that I caused harm to my pt, which may lead the pt into code, hospitalized, or death. I will never perform any procedure that I have no experience in the future, and I will think twice before I perform anything, and ask for help.

Thanks for everyone's comment, althought some makes me feel more bad, I know I made mistake. Basically, I texted my charge nurse that I feel sorry, I don't know what I was thinking when she ask me if I removed PICC line. I told her the truth, and asked her if I need to write any statement or meet with someone to discuss this. PICC line removal, correct me if I am wrong: clean glove, sterile gauze, occlusive dressing, suture removal, alcohol wipe. 1. explain the procedure to pt, and need to avoid some acivities after removal . 2. tell pt lay supine, extend arm 3. clean the area around the catheter with alcohol wipe 4. remove the dressing and suture 5. ask pt to hold breathe, then slowly pull out the catheter 6. after removed, place sterile gauze, hold for few seconds and then place a occlusive dressing. 8. after placed occlusive dressing, pt can breathe normally 9. monitor pt for 24 to 48 hr 10. document date, time, pt tolerance of PICC line remove, and the length.

I just texted my charge nurse. And Im going to talk to DON tomorrow. I just hope the pt will be fine.

I am new Grad from May 2020. I got my job in subacute/SKF. My patient had a PICC line that needed to be removed. I didn't think about that much. While I was going to give him meds, I prepared to remove his PICC line. All I took with me is a clean glove, gauze and a Bandage. So, I told pt to lay down, extend his arm. Then I start peeling off the transparent pad. Once the pad is off, I saw the insertion site. I used my left hand to press the gauze on the insertion site, and with my right hand started to pull out the line. Then I realized, OMG, this is a long line! But I can't stop, so I just pulled it out, and threw it in the trash bag. I placed gauze then bandage on the site. Later, when the charge nurse came ask me if I already removed the PICC line, because she was planning to come with me to supervise me. I said I already removed it. Then she asked, if I removed PICC line before. ? I said YES! WOW!! Why I say yes! I only removed peripheral, regular IV line when I was in clinical! Then she asked if I have the measurement. I said no, I forgot, but I still have the line in the trash bin. She showed me the insertion documentation and told me I have to measure the length of the PICC line. It is a different protocol compared to the IV line. And she asked me again if I removed a PICC line before. I said YES, again. She asked, "Where, school?" I said YES, I just forgot to measure it. Thank GOD, the PICC line was still in the trash bin, and the length is the same as the inserted length. Now, after getting back home, thinking about what had happened, I feel guilty. I don't know what to do now. Should I tell my charge nurse tomorrow that I lied? I feel so bad! I also googled the PICC line removal protocol. I needed to don a sterile glove to remove it?! I needed occlusive dressing?! Because pt. is at risk for infection, bleeding, and air embolism, and blood clot! Sorry about my grammar. I don't know what to do now. I feel so bad.

thanks. I guess need to record how many hours I already learned, and save all the certificates.

Is anybody know where I can find how many CE hours I have learned for my RN license in NJ?

Thanks for your comfort. Yesterday, I was totally working alone with 24 pt in LTC unit, except there is an other nurse also with other 24 pts. He helped me a little bit when I do not know how to set up the tube feeding machine. my shift is 3-11pm. I finish all the meds pass about 11:15pm. then I start to do all the documents, which I finally end around 12:30 am. I arrived home around 1:20am. Then the whole night I was dreaming about meds pass. It is hard to pass meds when pt all on the beds sleep (after 9pm). I can wake up a few pts, and they will take their meds nicely, some pts semiconsciously take their meds. Some pts just don't wake up, or wake up very angry, or they wake up confused and only take half of the meds (crushed mixed in apple sauce) or just refuse to take any. I feel so bad to wake them up and ask them to take the meds.

I got a job in an LTC/SNF, even though my main unit or I prefer subacute unit, but I was told I may float around in LTC as well. So Friday (9/11) was my last day of orientation. The nurse who should orient me called out. And it is an LTC unit. I will care about 24 residents. I thought I will be fine because I just take vital signs, and pass meds. However, it is much hard than I thought! First of all, I took temp and pulse ox on all my residents, and BS on some that required, it took me around 30 to 40mins to finish. Then I start to pull all the meds, some need to crushed, some don't, and some need BP, some do not, so I have to go to the pt get BP before pulling out some med. Then some people have fever, I need to report to the supervisor. some residents are not in the room, I need to go look for them, some resident asking what meds they are taking, and I have to explain. Sometimes the BP cuff does not work, or the BP is way too high or too low, I need to redo it. I am super behind the schedule. Finally, after I finished the 4-6pm meds, it is almost 8:30pm. Then I had some water, then went back to the laptop to do some document, and prepare for the 8 to 10pm meds. I guess my supervisor cannot suffer me being super later, so she helped me to pull the meds, and I pass those med to the pt, do BS, BP as needed. And she also helps me to set up IV, antibiotics infuse for the pt who has fever. Finally, we finished pass all the med around 10pm. I sit down to do all the documents. Then I found out, I miss some BP, so I went back to the Pt to get BP. Some people are on the nebulizer tx, I forgot to recheck them/stop the machine, so I need to go back to turn off the machine and reassess them. Then again, I found there are two pt need wound tx. So I went back to see if the pt still awake, one already sleeps, one still awake. So I did one of them. Then back to my laptop continue doing documentation. Finally, I finished everything around 12:00 am (my shift end at 11:00 pm). I cannot believe I did not cry. I do not know if I can do LTC or not.

Good afternoon, I am a new Graduate RN from May. Currently, in an LTC facility, I am on my 8th day of 10-day orientation. I did not get an orientation checklist until the 8th day, and I find out I still have a lot of things I haven't been oriented yet, such as admission from the hospital, transfer to acute care, discharge, Expiration... etc, I am not sure if the DON will help me to fulfill that information in the next 2 days or not, if not, I do not know if I can start to work on my own. Also, overall I feel I did OK with the orientation: pass med, documentation, assessment.... However, during my 7th day, the DON told me to fill a paper regarding what I saw and did about a pt in the LTC unit that I had orientation on my 2nd and 3nd day (tudesday and Wednesday), because that pt was found out have a fracture on Saturday, and it is not reported or documented. so I just wrote what I did and saw about that pt when I was orienting in that unit. Then on my 8th days, the DON told me regarding I held a pt's BP med (I have no idea who the pt is, because I am super bad at name, I have to see pt's name or go to pt's room to figure out who is who). the DON told me that I documented I held the med because the pt has low heart rate, I did not document what is the heart rate, I did not call the doctor, or do anything about it. And the DON told me next time call the doctor and document the specific heart rate. I said OK. I did not say anything because I did the documentation then if there is a problem it is my false. I also do not want to make the DON feel like I am pushing the blame to other people, even though I believe if the pt's anything is abnormal, I always tell the nurse who oriented me, and nobody told me which medication I should notify the doctor if I hold it and which medication does not. Today is my 9th day, I feel overwhelmed to start work on my self next week, and I also nervous to show up today and the DON grab me again to tell me there is a other problem. I feel OK to do the assessment, med pass alone, but if there is a situation comes up I do not know if I can handle it or not. I don't I should get more orientation or not. Because all I did in the past 8 days of orientation is assessment, med pass, documentation, which I believe I can do it alone. the most things I am worried about is when the pt has abnormal findings, admission, discharge, and transfer out. During orientation, I have back up and reference. I am afraid when I start to work alone, I have no backup and reference.

Thank you for all the comments?!

I am a new graduate, first time working as an RN. I just got a job in a rehab and nursing home facility. The person told me that I may be placed in the subacute unit. Tomorrow is my first day and also the first day of the 10-day orientation. I am not sure what to bring with me I will wear my scrub, a watch, a few pens, a highlight, few notecards to write, a penlight, my lunch, and of course my stethoscope, and scissor. I am not sure if I should bring a drug book, and is there anything else I need to bring?

Thank you. My school emailed my transcript and letter of completion again to BON today, and I also email BON to tell them to look for my transcript and letter. If they reply to me they do not have my transcript and letter again, I may think about filing a complaint. I hope the filing a complaint would be helpful if I have to do it.

Hey guys, I do not know what is the problem right now, and I do not know what to do despite waiting. I took my NCLEX 6/22 and Passed it according to the quick result. However, I am still waiting for my license number. A lot of my friends got their license number 2 days - 1wk after their NCLEX (other states, I am the only one getting NJ license in my class). I emailed BON, they told me they are still waiting for my transcript/letter of completion. I do not understand, my school mailed them once and emailed them once before I got my ATT. If they do not have my transcript how come they can complete my application and give me ATT and allow me to take NCLEX. Has anybody received licenses from NJ recently, or is waiting for NJ license as well? I received a call from an LTC regarding my resume and application last week, and she told me to wait after getting my license number and then call back. It was the first call I received after I applied so many places. I do not want to lose it.