jodi_cmsrn

Our hospital policy actually allows for parents to administer medications that were prepared by the nurse, in the presence of the nurse.

As a person that gets bored easily, med-surg has been a great fit for me because you just never know from day to day, hour to hour, minute to minute what will happen next. I love the variety of patients, illnesses, and never ending learning experiences. I have been a med-surg nurse for 6 years, and have just moved on to house supervision but still tend to migrate to med-surg when everything gets crazy. There are any number of specialty units, but med-surg combines them all - we get peds, cardiac, post op, cancer, gi, geriatric, bariatric, urology and anything else that comes along....

I always try to thank whoever I am working with for their help. Just the other day, I thanked an LPN that I was working with, she literally kept an eye on 8 of our patients while I spent a great deal of time with a family of a patient that we were sending home on hospice to die (her last wish) If not for the wonderful co-worker, I would not have known that everyone else was okay. Teamwork is not always abundant, and greatly appreciated when it happens.

[i can tell you from personal experience that one should never underestimate the pain (like you're on fire) that undiluted phenergan can cause] I totally agree. I came in one morning and went to medicate a patient with phenergan and found half of her arm was black from the last person that had pushed phenergan. The patient told me she told the nurse to stop it hurt too bad, and the nurse told her "Phenergan always burns, it is okay." Our policy is now to dilute any IV phenergan dose in 25cc normal saline and run over 20 minutes.

I have been out of nursing school for 6 years, and have been a preceptor to new grads for the last 5 years. I love helping the new nurses adjust to the culture shock of floor nursing from being a student. This year has been the hardest year for me though, because the new nurses seemed to know it all. When trying to explain any new procedure to them the reply was "I know." When asked if they knew how to perform any procedure it was "Oh I read about that." - even if they had never performed it. And my personal favorite, when asking about a patients assessment is "But the book says this problem presents with these problems". I have mentioned to more than one new nurse this year that their patient has not read the book that says what their symptoms should be. I like nurses with confidence, but if you don't have the skills to back it up, that is a whole different story. While on orientation is the time to ask questions, not to know everything. I still ask questions when something new happens, and am not afraid to admit it. Good luck to all the new nurses, we can sure use them.

I just signed up. Thanks for this.

Thanks for posting the above link, however when I clicked on it, all it showed was a Microsoft Outlook Express sign in page. As a nurse in PA I would really take advantage of this. Between the new state requirements and my Med-surg certification requirements, I take advantage of all the free CE's I can get. Thanks again.

Thoughts and prayers to all as we remember this day in history. Thank you for sharing the link above, it was AMAZING!!

I have my med-surg certification from the Academy of Med-Surg Nurses (CMSRN), and although it doesn't directly mean more money at my facility, they did pay for the certification, and it counts towards our "Clinical Ladders" which are achievement levels we can earn that are worth $.50 or $1.00 more an hour.

Thanks for the reply. We are trying to prevent the RN's being run ragged, and unfortunately are REALLY short on CNA's, so someone has to pick up that piece too. We are just looking for ideas at this point.

Our med-surg unit (22 bed) is considering switching from team nursing (1 RN and 1 LPN for 10 - 12 patients - sometimes one CNA for all) to some form of primary care system where hopefully each nurse will have 5 - 6 patients. Our biggest issue is how to utilize the LPN's the best way possibe. Just wondering if anyone else had experience with this, or how your unit does it? Thanks for the help.

I was also a non-traditional new nurse (mid-30's), and was scared to death when I started. It does get easier and you will become more confident in your assessment skills. As for knowing when something is wrong, there was more than once that I have called a Doctor and said this person concerns me but I can't give you anything specific. Most doctors will ask questions and can sometimes help figure out what's wrong. Sometimes it is nothing, but just last weekend we caught an occluded leg graft and saved a women her leg. Good luck and hang in there.

Remember that even though you read the books in school about what the patient should do or look like because of their diagnosis, the patient has probably not read the books. Trust your instincts or the patient that says "Something isn't right"

Sometimes changing shifts can help too. I was pretty stressed last fall, and was asked to help cover some shortages on night shift for a month . . . nine months later and I am going to go back and try days again . . . our unit and patients are a completely different world at night.

Have had several surgical procedures at the hospital where I work, and one unrelated inpatient admission. Everyone treated me wonderfully, and I wouldn't have wanted to be anywhere else.

I have been a med-surg nurse for about 5 years and I have no intention of going anywhere anytime soon. Med-surg nursing can be hectic, frustrating, and overwhelming, but it can also be rewarding, fulfilling, and educational. I have worked both 7a - 7p and 7p - 7a and both shifts have there ups and downs. When working 7p 7a I get to spend some time with my patients while helping get them ready for bed, giving back rubs, etc. Perhaps one of the biggest benefits to working night shift, is that it is a lot less political. THere are less people around fighting for time with your patients. There is no physical therapy, no case managers, no physicians making rounds (usually), and less time that your patient's are off the floor for tests and procedures. However the downfall to that is there is often less staff around if something bad starts happening, and night shift can get just as many admissions as the day shift. Also, contrary to popular belief (by some day staff people anyway), not all of the patients sleep from dark til dawn. Hope this helps, and I hope you truly enjoy the med-surg experience. Try to keep an open mind, and remember that you will have good days and bad days, but you can make a difference in the lives of your patients.

I also have tested and passed the CMSRN through the Academy of Med-Surg Nurses, but that does not automatically make you a member. Membership dues are an additional fee. I have often thought of joining, just haven't done it. As for the test itself, it wasn't really anything like NCLEX. My test was on paper, and alot of case study scenarios. Hope that helps.

Our facility offers new nurses the opportunity to spend a day in our ambulatory surgery unit to have exposure to starting a large number of IV's in a short period of time. Perhaps you could ask if this could be done in your facility. These nurses are often able to provide tips and tricks and maybe even identify what you could do diffferent/better to improve your skills and your confidence. Hope this helps.

Thanks for sharing this. This sounds like a wonderful project that could help promote a wonderful sense of normalcy for a lot of diabetics, particularly the teenagers that don't want to have an adult around all the time, as well as that little extra sense of security for the parents of these same teenagers.

We have used foley catheter's as a type of "comfort measure" for our end stage patient's who due to pain or shortness of breath can not tolerate being turned or assisted to the commode. The catheter prevents the pain, shortness of breath, or increased anxiety related to this whole process.

As a new nurse starting out, I remember learning multiple new things every day. Our facility has a couple physician's that are legendary for their temperments. I have always been the type of person that wants to understand why I am doing something, and would always ask why? Why are we doing this? Why are we doing this like this? Why is this going to work? One day I was preparing a patient for an angioplasty and the patient had a critical high potassium level. Upon notifying the physician (and expecting a kaexylate order), I received an order for an amp of D50 and insulin. After asking every nurse on my unit, and looking in all the drug books I could find, I still didn't find the answer. I gave the medications, rechecked the patient's potassium level as instructed and sure enough it had improved. When the physician arrived on the unit later (of course one of the famous temperments), much to the surprise of my co-workers I simply asked him, "Why did we do this, and why did it work?" He happily explained it to me, and actually thanked me for asking. He also told me it was refreshing to have a nurse want to learn and has continued to go out of his way to show me new things, and actually praises me to patients, co-workers and physicians. Don't be afraid to ask "Why?" You just don't know what you can learn.

These are the reasons I LOVE med-surg. Boredom doesn't happen, and I really like being challenged with the diverse issues of my patients. I have been a med-surg nurse for almost 5 years now, and although I know the day will come that I physically don't want to do the job anymore, I am enjoying each day while I can. When I was in school, I had no desire to work med-surg, but was interested in psych. Being a rural area, I was limited to where there were openings, and that was med-surg. I now can't imagine working anywhere else. The ratios aren't always great, some days you think are going to do you in, but I wouldn't give it up. Hope this helps from the other perspective.

The graded compression stockings have made all the difference in the world. I would also suggest trying different brands to find the ones you like best. I recently went from Jobst to Juzo and can't believe the difference.

I am from Pennsylvania What I am looking for specifically is: Are you using PICC lines? yes, we use them regularly Has your use increased in the last two years? Definitely Who is inserting your lines--IR, PICC team, etc.? We have a small group of nurses that are trained, and are actually having another class soon to train more, as many have left. Have there been any changes in re-insertions or infection rates? Not sure. How soon after admission do patients receive a PICC line? Depends on the patient, the doctor, reason for admit, etc. Do you have any particular assessment tool in use for PICC line candidates? No, but would love to develop one. Hope this helps.

Student loans were the only answer for me. Will be paying of 20k+ in loans for a while, but I made it and it was the only way.