Snickerdoodles

Hmmmm.. You are also putting your license on the line by give the medication if it is outside a safe level. Would you give Diovan or lopressor a low b/p? Why is it any different to "hold" this medication? I guess we will agree to disagree on this one.

"I just wanted to add that you probably could have pulled up a dictated consult from the neuro doc" Not test result. Consult report. Consultants will record a consult usually the first time they see a patient. Thats what I was talking about. = )

I would probably agree with giving the Lantus. As was said that is likely why their glucose is controlled. But it also depends on if this is a new dose/dose increase of Lantus? What is their D5 going at? Has their glucose dropped the past couple days? Is this poor appetite thing new? Are they getting solumedrol/prednisone? Are they one a sliding scale that can give coverage if they are elevated tomorrow? Better to correct a slightly elevated sugar than have it drop overnight. There is not always a clear cut answer. I do not agree with having to call the doc for a hold order. In most cases that is your discretion as a nurse. Our facility will also let us give a half dose of Lantus, like if the patient is going to be npo for testing in the AM. Again, up to the nurse. Trust your schooling and skills you have learned, this is why you went to school!

We give over 30 minutes but with 6 hour frequency. Of course if you give over 4 hours it will be therapeutic longer. Isnt that true with any med? Just like if you drink your case of beer over 4 hours you will be theapeutically tipsy longer. But my question is why dont they change to an abx with a longer half life? Or increase the freqency of zosyn? I didnt notice how often you infuse. Sounds like just a huge inconvienence for the nurse to have to schedule meds around it or start a new IV site and the patient to be hooked up to the pump for that long...

I am not sure if they will know how many times it took you to take the pass. Just because 6 months pass does not mean they will know if you took it once, or twice. Also, I know plenty of girls who couldnt even get a test date that they could make it to until 4 months after graduation. If its a year or something, I am sure it will come up in the interview what happened. Not sure if you have taken yours yet but one thing I read the day waiting to take my test was, "96% of American educated students pass the NCLEX on their FIRST try." That immediately calmed my nerves, and I wished someone had told me that 2 years sooner! Good luck!

I hope my supervisors dont hear about this! I could absolutely see them instilling this into our routine! At one point they had papers hanging in the room to sign during hourly rounds. Everyone just signed them at the end of the night!

you guys cant look online?!? In IL we can look online after 48 hours for about $15. Otherwise you wait for your letter. Did you type your name in the license registry for your state? It will pop up there before the 3-4 days the letter takes to get through the mail. Hope you hear soon! That was the longest 48 hours of my life waiting for my RN, couldnt imagine waiting 7 weeks!!

I work on a cardiac floor and I swear you were writing this from my own unit! It is a very mundane task. We also have to have the discharge paperwork checked by our charge nurse. They have new system that we are introducing that will have 2 columns, one with medications the patient received in house and the other one with the home medications. It is supposed to cut down on us having to call, and those errors of forgetting the ACE/ARB. Or policy is only if the EF is below 40%. Is this also the same at your facility? Either way it can take an hour to do these discharges and then you have to wait for the charge nurse who may have 2 other ones ahead of yours! I agree the docs should have more liability on this. Our pharmacy does random checks on the CHF patients, but it is not on every patient so it doesnt really help.... wish their was a better way!

Although I am fairly new myself, I am grateful for my ability to multi-task. But I see this alot in other nurses. I try to step in and help them when I can. I think when I am having this problem sometimes you just have to say, " I can come in and talk to you about that in a few minutes." Sometimes I have noticed doing patient teaching the whole time you are in the room, about plan of care, safety, diseases process, and meds; just basic things, stops the patient from asking those inane questions like that. Sometimes I think they want to know what is going on, and arent sure what else to ask! Again, this will require some multi tasking but it will become second nature to do that, the more you do. I had a great preceptor who was great at this. It doesnt give them a chance to think of those useless questions and helps you do your job as a patient teacher! hope that helps!

I just wanted to add that you probably could have pulled up a dictated consult from the neuro doc rather than trying to read that page! You could have given the doctor the info and saved yourself the embarassment of him being a jerk! When you are waiting for a specific doc ask a seasoned employee what he looks like so you can be on the look out. Then when you meet the doc introduce yourself and explain you are new to the company (you dont have to say new nurse!) and next time I bet he/she remembers you. I can honestly say the majority of ourr doctors recognize, know thier names, and he personal lives of our 3 male nurses. So you have an advantage there. Even saying hello to them gives them a second to notice you and reminds you to notice them. Some nurses are so task oriented they run up to the doc ask for orders and thats it. They are your co-workers, so treat them as such. Another tip is to befriend you unit secretary. If you are courteous to him/her, offer to watch her phones while she runs for coffee or stop that family member who keeps bugging her because shes the only one sitting there; and I guarantee she would have spoke up and read that page for you or pulled up the consult if she overheard what was going on. It is hard to learn all the new staff but that is what they do 8 hours/day read and identify docs. Hope that helps!

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I live in IL and CNAs start around $12, a little more for tele techs. $16 or so I believe. Check out salary.com for ur area. I worked as a CNA, unit secretary, and a tele tech for a couple years before and during nursing school in a hospital. I currently work as an RN on a cardiac floor. Although the tele experience was great, and made me more comfortable, I dont think it was the most beneficial. If you end up working on a cardiac floor or a critical unit they will teach you the rhythms. If you thinking you want to work in ICU it will make it easier for you to interpret the rhythms. It will look good on a resume. A dual role would be great if you can get hired on a tele unit! It was great experience to come in and have different experience everyday. Working as a CNA makes you more comfortable with the patients and the general health care setting and routine. If you have never worked in healthcare that is probably your best choice. And if you go into ICU it would help because you will be the primary caregiver. Dont downplay working as a CNA, or glorify a tele tech. Both are hard work, just different types; and both will give you good experience.

It sucks to work during nursing school! I worked 2-3 days/week and it was hard to keep up with homework and studying. And I was never someone in high school, or through my pre-reqs that needed to study. I worked 35/week all through high school and made honor roll. I was able to do some studying at work (maybe 2 hours/week) during nursing school. Depending on the job you have it might be ok. I had a couple friends who worked full time ( I still dont know how!) but the majority of the students didnt work at all, or very little part time. Especially those with families/children. It depends on your job and you studying habits. Nursing school was so much more stressful than any other classes I ever took. And I heard that a hundred times before I started, but you have to be there to know what I'm talking about! Work now as much as you can, get some dough in the bank! My advice is not to stop after your LPN. You will have a hard time getting a job in a hospital. One more semester is worth it! Good luck with everything! I hope that helps!

I think the "new grad" term applies to your experience, not your actual calendar year out of school! But either way remember it is your liscense, and if you are not comfortable on your own, or with the work load you are being started off at, speak up! Good luck finding a position!

I am wondering how your superiors found out about this incident? As a new grad and hospital employee for several years I have learned that you have to follow the "don't ask, don't tell" policy with these experiences. Sure, most hospital employees in training for another position get the opportunity to practice techniques not in thier current job scope, but you also can't run and tell everyone how cool it was! Not to accuse you of doing so, but I am assuming that you told people since at the time you didn't think it was wrong since the doc was there. Nurses and docs all used to learn by doing and now with everyone being sue happy, these experiences have changed. The nurse who was caring for this patient may have just wanted to cover her own behind and felt this should have been addressed! It is hard to say, but in the future I would either not put myself in this situation, or keep it on the QT. Good luck!