melanie1126

Thanks for the replies. I've gotten several good ideas that I'm going to bring up to the nurse manager. I didn't want to make it seem like I was the only one on the floor working b/c that certainly wasn't the case. All of the other nurses were busy, they were just finishing up their meds and sat down to chart and get chart checks done quickly b/c we had 7 empty rooms and we ended up filling all of those by the end of the night. It's just that I was the one who was slammed. It's a difficult floor, there are very few "easy" nights so usually we are all feeling like we are just keeping our heads above water. The team work on my floor is so/so. There are some who are really good about pitching in and others who only want to do their own thing. Our charge nurse on nights takes a full load, on day shift they don't take patients but sadly on night, yep, full load. I wish that acuity went into making the decision about assignments, and often it will as far as the order patients are assigned if everyone has the same #, but if you are down one, your getting the new admission no matter what other variables are in play.

Just curious as to how others are handling this scenario.... I work on a very busy tele unit in a large teaching hospital. My guess is it's a typical tele unit, high turnover rates b/c of higher levels of acuity with higher patient ratios than ICU. Many of our patients end up having to transferred to the unit b/c of change in status, or they were moved out of the unit before they were ready in order to free up beds and have to be sent back. We often work short staffed due to these issues. Anyway, long story short, last night I had a patient experiencing respiratory distress and I worked with him for about an hour pushing lasix, getting resp tx's, stat xray, ABG, getting MD to come up and eval, twice. I ended up transferring him to the unit and b/c he was one on one for so long, I was way behind with my other patients. Of course this happened right after shift change, so i was left scrambling to pass meds, assess and chart. Everyone was busy b/c we were working short with no tech, but a short time later, the charge nurse gave me a new admission b/c I now had one less patient than everyone else so my number was up. This happens all the time on my floor. I saw that other nurses were sitting down to chart, basically caught up and I, who had been slammed since shift change and was now playing catch up, had to take a new admission just to make the numbers on the assignment board "fair" b/c I was down by one patient after my transfer. Is is better to assign a new admission to another nurse who is not struggling but will end up having an extra patient , or is is better to assign to a nurse who is slammed, but the ratio will be even? It is sometimes obvious to me that the workload is the same or even more for nurses with less patients but my floor doesn't really take this into consideration. Has anyone come up with a system for assigning that works better without slamming a nurse who's down and not making the other nurses feel dumped on by having to take on a higher number patients?

In my school district run K4 school we follow DHEC childcare rules which states to exclude from school when the student has white or yellow discharge. If the eyes are red, with clear drainage we don't exclude as long as there is no fever.

You didn't have an xray available to you and based on your assessment I would have come to the same conclusion with no other signs of a fracture. I agree that sometimes you have to adjust your attitude on a case by case basis to cut down on the manipulation. If part of your guilt comes from the way you acted, then do it differently next time. We all live and learn.

I work as a school nurse in a school district K4 program so I have only 4-5 year olds. A little girl came into the health room after falling on the playground and skinning her knee. When she walked in I said "what happened". She replied," I hurt my leg elbow".:chuckle

Hi. I tried to post this question earlier but my computer froze up midpost so I aplogize if you've already seen half of a question from me earlier. Anyway, I was given an order today for Prolixin Dec 150 mg IM. I have only administered this drug once before and the order was for 37.5 mg. I have only been a nurse for a short time Also, my skills are mostly in med -surge, very limited in psych so I did some research online and in a couple of drug books and have come across a notation that "the dose should not be more than 100mg" . My first question is has anyone ever seen an order like this and is it common to give this much? Also, the im form of this drug comes 25/ml so I would end up giving 6 ml. I was taught in school not to give more than 5 mls in an injection. So is it right that this would have to be done in 2 injections? This is not the type of patient that is going to sit quietly and let me give this twice. I would appreciate feedback from a psych nurse or anyone else who regularly gives this drug in large doses. Thanks in advance.

I'm sure it's different from facility to facility and I've only been doing this for a month so I'm sure I'm not the best person to be giving you advice but here's what I like so far about my change to correctional nursing. My favorite part of this job is being able to address a person's medical issue and then being able to walk away. Like you, I was completely burned out by running around like crazy taking care of every little need of total care patients for 12 hours at a time. I was completely burned out when I got home and had nothing left to give to my family. i don't feel that way now. I take care of the issue, then NEXT! I'm not trapped listening to constant whining and I don't have to deal with family members. I also get to do a lot of different things. Some days you might do intake, some days pass meds, do sick call, labs, etc. I never get bored and there's always something new going on. I really am a compassionate person and I love helping people but it just seemed like I was giving too much of myself in acute care. I don't know if this is my niche but so far I really like it. Also, I was very hesitant at first to do this and lots of people told me not to, they said I was too nice but I'm learning as I go and have had a lot of support on new challenges for me like inmate manipulation and con games, etc. I wasn't sure about it but so far I'm glad I did it. Hope that helps.

Some nurses might find themselves in situations where they've given into inmate manipulation for something small and then basically been blackmailed into continuing the behavior. I once heard of a nurse who was bringing cigarettes in for money. Once she'd crossed that line the inmates started demanding narcotics etc., and threatening to rat her out for her past behavior. It's a lose/lose situation.

Thanks for the suggestions. I brushed up on all of these points over the weekend so I feel much better. I'm just worried about the interview being successful. It's hard to feel confident when you're in foreign territory (for me anyway) and I'm not good at faking it. But they have my resume and are aware of the areas that my experience lies so I'll just keep pressing the fact that I'm a really fast learner and hope that helps! Thanks again for the support

I've been working nights on telemetry med/surg floor since graduating from nurisng school in 4/05. I have an interivew on Monday with a Pediatric Physician's office and I do not feel prepared at all. I suspect that I may have to interview with the doctors (which I've never done, just the NM on the floor that I work now). I really want to do well on this interview b/c I need to work daytime hours now and I'm tired of all the stress/politics, etc at the hospital. Does anyone know what kinds of questions I should prepare for or anything I should look up. I'm a little nervous b/c everything will be different compared to what I do now. Please help!

This month marks my 1 year anniv. as an RN and when I graduated, I came to my tele/med/surg floor along with several other new grads. Most of us went through the same program and were taught the same way. I've seen several people change their practice from the way they were taught, and one situation pertains to chart checks. We were all taught that when we come on shift we were to check the Med Sheet against all the Dr.'s orders on the chart. I am still checking ALL of the orders but I have also noticed that I am always the last to finish my assessments & give meds (which sometimes doesn't make my pt's very happy). I've talked with several of the nurses about this. One or two say they still check them all, some say they go back a few days, some say they go back a week. (Our stays range from 3 days to a month) The nurses who don't check them all say that at some point you have to rely on the other nurses to have caught errors during previous chart checks to catch mistakes b/c there simply isn't enough time to check 6-8 charts, then give meds and do assessments b/c the patients want to go to sleep (I work 7p-7a). We were told in school that we were being taught Ivory tower nursing in an ideal world but there would be things we'd have to give up in the real world. Just wondering how some of you check your charts.

I graduated a year ago and in my nursing class of 31, with the exception of 4, all were going into nursing as a second career. Most were in their 30's and we had several in their 40's. We've all gotten jobs, no problem. Good Luck!

I remember lying on the ledge between the back seat and the rear glass. My brother & I would also play "bridge" - we'd have our heads on the back seat and our feet on the headrest of the front seats, suspending ourselves over the backseat. I can also remember riding in the back of a pickup truck. Yikes! :uhoh21:

Thanks for the advice. I called the NM and let her know that I was interested so the ball's rolling. Our hospital does not have LDRP. We have LDR, then pt is transferred to Mom/Baby. We have a high risk OB floor and then we have gyn surgery in another area. Thanks for the encouragement about my dh's deployment. It's a little unnerving to be planning such a big career change at the same time he's going to be gone. Also, we have a 2 year old so it's going to be a big adjustment for me. Our house was alreay on he market before he found out he was going so I'm thinking of moving in with my parents while he's gone and waiting to buy a new house when he gets back. They've offered to help watch our daughter. I think I'm about to find out how good my coping skills actually are!

It's probably both. I went off of orientation in July and I was terrified my first night alone. Luckily for me I had supportive staff at night as well and they didn't mind my constantly asking questions. If I remember correctly, it took me several weeks to get used to working nights, and you will get used to having to sleep days as well. I have a DVD called am/pm yoga and I do the PM portion before I go to bed if I need to unwind and relax. That seems to help. Also, try to cut out the coffee after 3am if you're a coffee drinker. I found that I was wired at 7 when it was time to go home. As far as your mistakes, you're going to make them while you're learning. But don't put pressure on yourself by trying to fit into the same timeframe of more seasoned nurses. Allow yourself to be OK with slowing down some and take your time. It's more important to do it right. It will get easier! Good Luck