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Content by RNNPICU


    so lost

    I definitely would take it. This is a good opportunity. You might be able to go back to the ICU later. I don't think you would be eligible for rehire as an external candidate.

    Pt advocatcy

    I don't think you need to worry any more about the situation. Your manager told you it is being handled. You don't know nor need to know her remdiation plan. Although I can understand you wanting to know more information, you have as much information as the manager is willing to give. Unfortunately you just have to let it rest now. I really don't think reporting it again to others will change anything, Just focus on providing the best care possible for this little one that is now under your care. Best of luck.
  3. KatieMI: I am glad to see there has been some resolutuion. I realize that since she was a minor (although 17 is really close to 18) her level of culpability is different, nonetheless, I am glad she will have some ramifications of her actions. I wonder if in 10 years from now if she will finally realize her actions.

    CoWorker using a patient's medication

    OP if you witnessed and observed her using, why did you not stop her? The BOD could very well ask you why you did nothing except stand by. All of us have done bonehead move at some point and regret it, not usually worth a call to the BON. How do you know with absolute certainty that the hospital may have done something. Your strong desire to contact the BON for this nurse makes it seem like there is an ulterior motive behind it. While I agree this nurse should not have done something like that, I would much rather have the hospital handle it. You too are complicit in this event as a bystander and you did not intervene.

    Preceptor has 1 and half year of work experience

    Not that simple. The OP has had 6 shifts on the unit and her ideas and perceptions of her OP could easily be clouded by her newness. OP stated her preceptor was loud and cocky personality. What I am also wondering is what is the OPs personality? She very well likely will be getting a new preceptor but I think asking for one when she has only had 6 days on the unit will not bode well for the OP.

    Leaving New Job after only 4 months

    Many times you have to be in your role for at least 9 months before transferring. Check with your HR policies. Remember orientation does not count towards months of experience. You will probably need to wait some time.

    Preceptor has 1 and half year of work experience

    Just to put some things into perspective. You now have two weeks of being a new nurse on your unit. It is often easier to find fault and nitpick on others if you are also being corrected. As for your preceptors experience, I think it is a good match for your skill set. As for her "yelling" at the patient, what was the full story, was the patient violent and yelling at her, was she "yelling" at the patient because the patient was inappropriate and she was trying to get some help or to let the patient know the behavior was inappropriate. Although it is difficult in text to interpret tone, it sounds like you are being overly critical that the preceptor did not know how to insert an NG tube. You are making it sound like she should have known... perhaps the floor she works on does not use them frequently. Your preceptor sounds like she was smart enough to know to get resources - Charge RN, and she did not proceed in an unsafe manner. The Xray is always done for placement. You are on an orientation journey and will be learning and observing new things. This preceptor may have been told ways to precept and she is also learning, just like you.

    NCLEX RN repeat test taker

    I think a bigger block for you may be the long period of time without testing for the NCLEX in the US. For the foreign eligible RNs, many require the TOEFL to ensure you are proficient enough in English to pass the NCLEX and work in the US. You would need to check on the BON in each state to check on which one does not require TOEFL or another similar assessment of English proficiency. It is possible you may need to do a refresher course as well.

    Finish the Toon!

    Davey Do.... So nice to see you!!! So glad you are back

    Finish the Toon!

    Looks like we are in this together. Let's create a checklist of symptoms.

    Doctorate in Nursing or Health?

    I think the decision between the DNP or a Ph D in health science depends on what you ultimately want. The DNP or PhD in Nursing is strictly focused on the nursing practice... you would be influencing nursing practice either in a role as an NP or many other related areas to nursing.. The PhD in Health Sciences is a broader health science.. You could influence research as a nurse but in the field of health sciences. Although they are similar there is a difference. The difference between a PhD and a doctorate is the type of culminating work you would do. PhD tend to have a dissertation while doctorate tend to have a huge capstone. It also depends on the program as well. Think about if you want to be a nurse influencing nursing health care or be a nurse working in healthcare bringing a nursing persepctive.

    Paramedic to RN

    One thing to also consider is that you will likely need 5 years as a NICU RN before working as flight RN. It is not an impossible path, but just know that there are steps to be taken prior to working as a flight RN, especially as NICU flight. Often at trauma centers or Level IV NICUs, they have their own flight team, so you would work in the NICU and once positions are available, you have your NRP\, Stable, and likely other certs and courses under your belt, you would be eligible. Others have mentioned salary. Even though you are a paramedic and have years of experience, you will receive a new grad RN salary that in almost all cases in non-negotiable. Good luck with nursing school and your future career.

    Let me hear your perspective...

    Just a few more thoughts.... I am not convinced that "the ball was dropped". There is a lot of time where you are not sure what happened. It is unlikely that nothing was done and no one monitored the patient for hours on end. The ER may have been waiting for the affect of the drugs to wear off for a better assessment. The drugs could have been masking her true underlying condition. Althoug you did mention that MRI was recommended, it may not have ultimately been orderee due to other factors, a recommendation does not automatically equate to an stat order. Perhaps other labs came back that indicated something else, perhaps after further reading of the CT scan they realized the bleeds were old bleeds and since she wasn't recovering, that she needed in-patient monitoring. Before futher judgement on inappropriate care I would love to have known what other labs, medications, consults, GSC scales were. I think it is hard to know what was her previous baseline status without the influence of drugs. While there are lots of reasons why she presented on your unit they way she did, there is lots of gaps in information to truly determine if she received inadequate care. If your team feels this was a potential deviation in care, is your team allowed to do a Root Cause Analysis? This way everyone could see the timeline and providers involved could explain the assessments and reasons why MRI was ultimately not ordered, again, the MRI was only a recommendation not a STAT .

    Break in sterile technique

    OP: Also something to consider... if the patient is having an emergent bedside procedure a potential break in the sterile field is likely the least of the patient's issues at that time. Also, are 100% positive they used the drape you may have accidently touched? Are you 100% positive that the drape you may have touched was one the chest of the patient near the open chest? Someone obviously saw you open something and then instructed you to hand it to the tech. Likely there was something underneath the wrapped item that was sterile. Emergent bedside procedures have that risk since they are done in a non-sterile, non-controlled environment. If the patient develops an SSI, there are so many factors that it could be contributed to, primarily the bedside environment which would be the most likely potential cause. PLease don't beat yourself up anymore, take time to decompress from a very stressful situation. You were not the only role in this emergency, there were many many many other chiefs as well.

    Dobhoff med administration conundrum

    I would not take the word of the CNA. What did the other Nurses on the unit say. What did the orders say? Sometimes the order may have specific instructions on how much to dilute the medications or if to mix with formula.

    Are boundaries ok?

    I think it is okay to say no if it is happening all the time. However, every once in a while, a co-worker may have a real reason or emergent reason to need to leave. I once had a co-worker who asked me to come in 2 hours early because there was a last minute change in a child-care snaffu. Since I was going to be getting her assignment, it didn't matter. It was something that happened maybe twice a year. I said yeas, because I knew my co-worker needed a helping hand and was not a staffing or anything issue.. If she had repeatedly done it, I think it would have been a bigger issue. Thankfully, I never needed to ask anyone for this favor as I know it was really hard for her to ask.
  17. tony1234: I think there are two issues here. 1. We pay the school, not an individual instructor for education. The instructor serves as a guide, imparter of information, resource, and, role model. The instructor has many tools to use to give information, some of that learning is from direct lecturing, some could be youtube videos, some could be reading materials. There are so many ways to learn and to help students gain the information. Some of that is independent reading, some could be supplemental readings. This outside work the student must do is homework, also teaching students how to use resources outside of a single lecture. 2. Instructors responsibility is to teach the students in the best way possible, this includes using all available resources. Instructors are not meant to just spit out information to students and only test on that. Instructors also want to give students different ways to learn the information. Only testing on lecture materials really does a disservice to everyone. I would much rather have an overview lecture where an instructor highlights the main points of the topic at hand and then give me other materials or videos that s/he selected to best illustrate their point.

    Patho vs Pharm

    For me, Patho and Pharm were the hardest nursing classes. After I struggled with Patho, I refocused my way of studying for Pharm. I still struggled with Pharm but had a better approach to studying and thankfully passed.
  19. Just think about this, your lectures are the highlights of the day's lecture/material. There is simply isn't enough time in a day to review ever single detail of the materials that will be on an exam. If the instructor handed out readings, etc, always consider that they might be on the exam. If the instructor did not think that these materials were important, they would not have handed them out. Another possibility is that the instructor is also providing a different format for learning, some are audio, visual, and kinesetic learners. Written materials are a good format of learning for some. For this next exam, approach it from the concept that every paper the instructor has given you is fair game. I am glad the instructor is kind enough to help those students in need. Not every instructor will do this. It is not a recognition that the instructor messed up or anything like that, it may just be some points to help out those in need. However, you still have to do well for it to help your grade. Good luck

    Live in lpn

    Especially since you are POA, it would be a conflict of interest.

    Help w/job decision?

    I agree with all of the other PP. Stay with the job. Perhaps if you start taking more advantage of your time off, please think of how to truly utilize your time off, you deserve it. Taking vacation, enjoying your hobibie are great ways to balance out the stress. And, you may find that that is the difference, having a better work/life balance and really enjying things you like to do.

    Confused and Depressed about Performance

    Perhaps others are watching and reporting to her. It could be that you are appearing to not be managing time effectively even if you are. See if you can draw out specifics. It could be she has a specific way she does things that is different from you? Is there anything with prioritization? I think simply giving your perspective of the shift, and then ask what ways could you have been more efficient. I think her talking time management at the start of the shift is actually a good idea. Try plotting your time out and telling her what your plan of the day looks like, this not only lets her know about your time management but it also shows your ability to prioritize and organiza time between patients, charting, cares, etc.

    Quit my CNA Job ???!

    Unless you have another job, keep the CNA u til you start PA school. You also have no guarantee that another job won't be short-staffed and overworked... it is health care afterall. Also, why rock your boat more than it needs to be you know the unit and the flow of things, plus have likely accumulated vacation, sick days, and some seniority, why wreck that.


    You do not need Chemistry to make you a smart nursing student. It is nothing but a class, it does not make you smarter than those students who did not take chemistry. Since it is not a requirement, be thankful that you do not have to take it. If you stress out now about your future classes you will set yourself up for failure. Are you 100% certain every single other student who you will be starting with had a 100% in Chemistry class and is exceedingly smarter than you? You do not need Chemistry to pass nursing school. If you did your school would have had it as a requirement. Take it easy on yourself, you would not have been accepted to nursing school if the admissions team did not think you could handle it. Let Chemistry go for now.

    Considering ICU.... among several other options

    Wuzzie: I think this area that I highlighted is what speaks the loudest. Most nurses choose to leave LTC, not asked to resign. There likely is some larger underlying issue. And I agree ICU or any of the other places the OP listed are definitely not the place to try.

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