kell1566

one more piece of advice....... its really helped me VOLUNTEER to take the enxt pt early in ur shift that way ur full:) then u have things done early and ahve all day to do it so that when someone comes in postop an our bf u leave ur already full :) plus they love love when someone takes initiative and volunteers good luck

all i have to say is wow to ur nights........ i feel like for me day to day its different one min i hate it the next min i have an awesome day where i really feel like i made a difference.... but i willt ell u that as a new nurse 8 mos they tend to kind of like "haze" the new nurses.... which seems like u get the harders pts and admits etc etc..... of course i want to learn and see different things but now while i have 5 pts goin on 6 and u have 3 no way.... i used ot be nice i really did haha but now i stick up for myself and ask why am i gettin them im at 5 they ahve 2 d/c and will be at 3. it usually works they dont expect u to speak up and when u do they dont know what to say hahah..... so if they kniow that u know what the floor is like and it IS possible for someone else to take the pts then say it....sometimes i have awesome nurses aides that can orient the pt to the room while i get caught up most of the time we dont tho its suposed to be team nursing truthfully but it seems like u know who u can ask for help and who will sit on their ass while ur runnin ur ass off... i dunno if its nursing or jus every job, when ur in it for u go to work and do u ......dont take on other things u cant handle say NOOO in the nicest way possible haha good luck!!

this is a long one..... oh wow jus what was on my mind....it was a weekend and they wanted to dc this pt with a bp of 200/120./...granted she was a dialysis pt but i kindly said to the doc (resident on call) im sorry i dont feel comfortable dcing a pt this hypertensive she could stroke ...could we please give her a prn dose and do a 24 observation....now per the dr i got "no way she is being dialyzed tomorrow this is normal for her were going to adjust her daily dose and send her home". Now this WASN"T norm for her, even if it was i wouldnt feel comfortable sending someone out like that, pt was uncomfortable also going home with that but didnt say anything bc of fear. I call the fellow tell him he still "no thats ok shell be fine ill give her some clonidine po and send her home.....i happen to see the attending on the floor ask him and he says oh nooooo way well have her stay and dc her tom after dialysis.....then the resident has the nerve to call me back "i pulled some strings shes gonna stay" more like i pulled some strings so ur pt wouldnt stroke and end up back in the ER.......... next day pts bps better pt ready to be dc'd same resident writing the orders and ups and disappears....... pt aggravated and ready to go AMA, i call resident to tell him and he yells "Im admitting 3 other pts now ill be up later" ok i say ill let the pt know, she wants to leave AMA again i call back now him yelling at me..... "FIne Ill come up there now"...comes up does his thing i kindly have EVERYTHING ready for him so its a quick thing ......hes done i say thanks so much im sorry for the inconvienence....he starts to say "you know what...." pt in hallway pt hears him and starts screamin at him hahah..... jerry springer style... "she was a great nurse it was ur unprofessional behavior u up and left blah blah dont u ever talk to a nurse like that again" haha gotta love patients lol..... so ever since he wont look at me anymore haha i never got an aplogy and for the record he never apologized to the pt either....... i always say im a patient advocate not the drs

this is the best thread for me right now... i came home today along with soooo many others at least 3/4 a week thinkin why am i doin this...... i love nursing and teaching and people and everything... but the interns not knowin much more than me is scary there is NO communication between mds and rns so guess what the pt doesnt know much more....... its jus awful.. im in medsurg 4-5 pts.... today i had only 3 and felt absolutely burnt out.. the patients families everyone pullin and pullin at me and i cant tell u nething bc the mds arent tellin us nething....... md: oh that pt is goin for that test today.... rn: yes they jus called to come get him and its ordered....... thanks for not even knowin **** about them!!!! right now i dont know if its the hospital, my floor or what but i dont feel like a nurse.. i feel like i push meds and do paperwork and thats not what i wanted out of nursing.... i have no idea what to do... its only been 3 months what to do what to do.. any usggestions let me know!!

we do 2 12's 2 8's and oddly enough i love stayin for 12s bc it seems like you have so much more time to do your work..... in 8 hrs u feel overwhelemd i mean you have ths same amt of work just in 4 hours less.... althought waking up on an 8 hr day and knowing ull be home fast isnt bad either haha!!

i definitely agree with the above post....we NEVER do the dressing postop the surgeon does it unless we have to reinforce it or its grossly leaking....then i usually call and ask.... you could peak tho I usually do. in regard to diet....... we need an order from the docs but they make the decisions based on our assessments of bowel sounds, passing gas etc.....one time this guy had a TURP and they had him on reg full diet 6 hrs postop....... i called and said dont ui think you wanna start him on clears....... well pt claimed he was sooo hungry so doc ordered house diet and not even within 1 min of eating.... projectile vomiting haha... maybe the MD will listen next time. definitely surgical pts are tough but its so exciting how diff people adapt after surgery and how some progress faster than others....i work on transplant floor for liver and kidneys and that is super neat!!! surgical is overwhelming but definitely awesome!! good luck for next time sounds like you did just fine today:monkeydance:

I work on a urology floor and we use nss for cbi and also for irrigation. I never thought of warming it. I don't know if it would be a good idea would think it could possibly burn. Hard to tell the right temp I guess...love urology though!!!

well first off good luck with nclex and the GN position!!! I started doing my GN after much debate one month after i graduated. I studied in that month before and on the weekends while I was working. You sooooo dont feel like stuydin when u get home from work. I was doin 4 days a week and definitely think that it helped me...esp the boring classroom orientation....only problem is like someone said before....real world nursing is nothing like NCLEX....so u cant think what you saw....but what they WANT to hear. For me I would do it again I think the GN helped.....but everyone is different....i would definitely say take it ASAP after graduation the earlier the better!!! Goood luck and btw....I passed first time 75 ques....dont sweat it!!! easier said than done haha

hey guys i wanted to see if the experts could help me wiht this.....i get on the inside the difference with the fusing vs graft; but can u tell the difference on the outisde by lookin at the skin....it seems like they all look the same? is there a way to distinguish if the pt wasnt sure which they had done? thanks

hey everyone.....i wanted to see if anyone ever had a sample nursing note that they used for reference in what they wrote? we have to do a DAR note in my facility and I didnt get alot of experience in school with doing notes....so starting my GN job i seem to forget things to include..... if anyone has a sample of a general note that they use + or - the add ins depending on the pt until I get the hang of it:uhoh3:...i know to go by systems but it seems like i end up colliding them somehow...if anyone has any suggestions that would be GREATLY appreciated thanks!!

hey guys good luck to all waiting and congrats to all those RN"S That finally did it!!!!! so i took mine today.....stopped at 75 questions....i do remember the last question and am not sure if i got it right....im almost sure but def not positive......if a question about pinkeye did me in omg lol....after lookin up what i remember i cant get definite answers for ne of them blah..... i couldnt wait to get to 75 i was soooo tired of lookin at that comp haha....i agree wiht the post above def so TIRED of doin questions im hopin it will be up sooner than later and i have to work the next 2 days....should i call in work omg i need to ill freak out....lord so nuts good luck to all!!!! ill keep u updated

Hey everyone.....I am feeling a b it overwhelmed right now with my new GN position and I was hoping that I could ask for some advice since Im sure you all know what Im going through.... AHHHH I wanted to cry yesterday when I got home from work.....It was my 5th day on the floor and the nurse gave me 3 patients.....no big deal right....... well it was nuts.....I think the problem is I was an extern on my floor and they threw me in the first day with 4 patients.....and I never had the chance to develop like a system and now I feel like Im forgetting things....doin meds late....notes not until the end etc etc.... Im not sure what to do....is this normal to have 3-4 patients your first week in.....first day even? I felt like it shouldve been hey let me go with u and help u do each step.....no way its like ok see ya later i mean they are there for questions but Im mostly doing everything myself.....IS THIS NORMAL for a GN orientation? Should I talk to my preceptor (had 3 already) and say hey let me start with 2 tomorrown get a system down then increase as im ready....btw on a medsurg transplant floor with 6-8 weeks orientation.....Please any advice would be GREATLY appreciated Im going out of my mind :angryfire

I def agree that its not abandonment if you have someone covering your patients just like if you ran down to the caf for break......but i dont think anyone should be sleeping on their shift....i know that i would not be able to function after i jus woke up let alone give meds etc. I dont see anyone sleeping during day shift on their breaks, so why should the night people.....sure its nighttime.....but we get up early too for day shift and you have to make sure you get sufficient sleep.....whether it be during the day or at night depending on your shift!!

thanks everyone for the replies!!! i am so glad to be able to use this site and ask questions....we learn something new everyday!! well overall im glad i questioned it bc ive always learned in nursing school that dont jus give it bc somoene else did the day before....i kno this may not apply in the real world...but im going to try and uphold it!! congrats to everyone else graduating.....its been a long haul~~~ but the learning is gonna continue!! good luck in the future!! thanks to everyone for your posts!! nothing wrong with takin a few mins to call and ask the MD and pharmacist so Ill keep that in mind!!

hey mommy nurse a quick question in reponse to your post....i did read somewhere that angiotensin receptor blockers are used more now d/t decreased SE and are more tolerable......but my main concern was that the pt was Allergic to ACE inhibitors.....(in my mind thinking like anaphylactic shock bc there were no documented reactions) rather than being intolerable to it (in my mind like a undesired SE or it wasnt working for the pt). In your findings, did you happen to see pts getting it if they were actually allergic? Im still pondering it and wanted to see for further situations what to do if I ever come across it again...thanks!!! love this place!!!

Thanks so much for your quick replies!! well it wasnt my pt, i was the team leader but I felt like it was my question so I should find the answer. If it was up to this student she wouldve given it. I talked to the pharmacist, then the nurse and she said she would call the MD to verify. The pt was 86 and confused, so it wad difficult to get info from her. After talkin with the nurse, she talked to the doc and he ok'd it bc she has been taking it for yrs in the nursing home. But I think they had a hard time finding the info from her about her reaction to it,and just simply had the info from the transfer report from the nursing home. The pharmacist said that alot of times people c/o cough and say they are allergic to ACE inhibitors, which I know I haev heard before about other meds, but it didnt state anyehwere that that was her reaction, so thats why I made sure to question. Im not comfortable with giving meds if I have an instinct not to, so we let the nurse know, she got the OK and she gave it, not the student or I. I just was writing to see if anyone ever had a similar situation with this allergy and another med that was prescribed for replacement. Or has anyone ever still questioned an order even though the MD ok'd it and not given it?? Thanks again just lookin for some advice before we don't have an instructor to go to!!

Hey everyone!! im a student nurse who is graduatin in may 07. I have a question about a med that i was concerned about administering, any advice would be great!~~ My last clinical day I was team leader and overlooked 3 students with a total of 6 ortho/trauma patients. As team leader, my instructor allowed me to check the po meds, while she had to check the injections, IV etc. Anyway, this one patient was getting cozaar for her BP. As i was looking at her kardex, it noted an allergy to Lisinopril in one section, then further down it said allergy to ACE inhibitors. I was concerned about the allergy and wanted clarification....was she allergic to ALL ACE inhibitors or just lisinopril?? And if she was allergic to ACE(angeiotensin converting enzyme) inhibitors....was it risky to be giving her a angiotensisn II receptor antagonist? I understand that angiotensin is already present in the body but there was no documentation about what she was allergic to within the ACE inhibitor or what S/S she had to call it an allergy? So who knows if whatever she was allergic to could also be present in cozaar. As a student nurse, we learn to always check and this rang a bell in my head and I said that I wasnt comfortable giving the student the "OK" to give it so we talked to the instructor that was thankful i caught it and advised me to contact the pharmacist, which I was already in the process of doing. The Pharmacist said if she is allergic to ACE inhibitors ----no way do not give Cozaar...tell MD to clarify allergy.....then another said that as long as she was having a cough and not angioedema it was fine to give it.....esp since she had been gettin it everyday while at this hospital....for me i dont care how long she was gettin it it doesnt mean im givin it unles I know its ok.... I was just confused could anyone shine any light on it?? Overall.....if the pt was allergic to ACE inhibitors.....would they give Cozaar instead??Thanks ...sorry for the long post~~:monkeydance:

congrats to everyone!!! it was definitely a hard test....some say harder than nclex.....we will see i take mine in a few months hopefully the first date they have then start wokrin june 18th!! does anyone have a job yet??

last semesters graduating class took the hesi and only 9 of like 30 passed it the first time..... then teh second time alot more passed it ....we have 3 tries to take it and we have to get an 850 to pass if you fail the second time u cant walk on graduation and need to take lke a kaplan at ur own cost......this time around we took it our graduting class which has like 75 people and i think only about 10-15 passed it first try..........dont get me wrong hesi is super hard but if u put ur mind to it and focus u can pass!!! some people dont care or have a bad day and get nervous but it is passable....good luck!!

thanks so much for your help!!! I hope to give me class a basic day to day for the correctional nurse. what shift do you work/pay? what does a typical shift look like?? how many inmates do you care for? is an officer there with you at all times? did you need any previous experience or classes that were needed for your position? what issues do you see here that may differ in a hospital setting? how closely do you work with the MD and local hospitals? thanks for all of your help!!! this will be great to introduce to my class since we dont get thsi experience in clinical!! :monkeydance:

hey everyone.....i am so glad that i saw this specialty link ...I need to do an interview with a correctional nurse and am having a hard time finding one in my local area that is willing or able to talk. I just have a few questions about your typical day, your educational preparation etc. Please pm me or respond to this thread if you can be of any help at all!!!! Thanks in advance!!! have a great day;)

hey everyone.....i am so glad that i saw this specialty link ...I need to do an interview with a correctional nurse and am having a hard time finding one in my local area that is willing or able to talk. I just have a few questions about your typical day, your educational preparation etc. Please pm me or respond to this thread if you can be of any help at all!!!! Thanks in advance!!! have a great day;)

First Pam I want to send out my condolences to you and yours. Im really sorry for your loss and have been through a similar situation. 5 years ago I found my dad in bed Im assuming had passed at that point. (hx of 2 heart attacks years ago) He stayed home sick from work with jus a cough or so and hours later I came home to find him in a horrible state. This was before I started nursing school at 17 and had no idea how to help him. I started CPR called 911 went to get a neighbor and everything and couldnt do anything. The paramedics sent me dowstairs they didnt want me to see him be shocked and told me mins later that he had been dead for hours. I guess I will never know what happened or if I could have helped him but I do know now that I did everything I could. I even blamed myself and thought pound on someones chest taht is havin a MI is that nuts?? But after everything learned that was ALL i COULD do. I have to admit that it was the scariest site EVER and I wont even get into details of what I saw but I hope that as a soon to be nurse in MAY that I will be able to help someone in that position next time around. I definitely did not take the grieving time that I needed and rather tended to my mom who also lost her best friend so unexpectedly. But that got me nothing but severe anxiety years later. So I can offer advice that you NEED to talk to someone and take care of yourself ASAP. If you need to talk to someone who does get it, PM me dont hesitate!!! I will keep you in my prayers

what is the TEAS?

im sorry guys i forgot to mention jefferson in the Philadelphia!!! I didnt know there was one in Pittsburgh-- learn somethin new everyday!!!