dano

Modified 10,000 times over, I think I finally have one that works for me!

Yeah, forget a clipboard. I quit carrying my extern manual around today because I got tired of losing it 50x every shift. Week to week we have the same doctors for our patients in different pods on the floor so I'm usually sure of who to get ahold of if need be. I edited it up a bit and added items that are part of the daily assessment that I can quickly do at bedside. Everything else can be done outside the room at the chart without having to talk to the patient, which SHOULD save me a ton of time. Today was crazy! One patient with gastroparesis had his vitals go to hell 15 minutes before I got off my shift, we had 2 stat lab orders but no tubes to send them to the lab on my unit or the next unit over, had a patient go #2 all over the floor and himself. Other externs were gone by 3 but I wasn't off the floor until 3:30, or should I say 1530 lol. I am quickly learning to take everything in stride and give 100% of my attention to the task at hand, or else I don't do it well at all. I did have a few staff members and patients tell me that I am doing great and have made great advancements in my few days there, that made the end of my shift a little easier.

Allergies, d'oh! I could change age to DOB. Date I could just write at the very top, no biggie. As for IV's, I'm not allowed to touch them as an extern I so I left it off. When I'm a II we can, then I'll have to include it. Thanks!

I started working for a well known local hospital as a nurse extern I (some places call them nurse tech's, I've found it's not very uniform across the country). I've been in orientation for 2 weeks and worked 2 8-hour shifts so far. What a mad house, but I'm loving it! It feels great to have a job that actually matters (used to work retail) and the pay is none too shabby on top of it. Anyways, I have noticed that most nurses run around with a blank piece of white paper and just scribble nonsense onto it (I'm sure it means something to them after years of experience). I used to find myself trying it during clinical and it was just a mess. I finally came up with a standard format I write out every morning, and after work today I turned it into a printable Word document. Obviously it can also be modified for other times. I work either 7-3 or 7-7 so that's what works for me. Has anyone else done this, care to post yours or tell me what you included? I'm also curious if there's anything I'm leaving out that YOU would have to have on there in order to make use of it every day. I've sat in a few collaborative meetings and my RN preceptor's used my sheet instead of theirs because it was so detailed. I'd like to include as much as I can without making it super huge. Right now I can fit 4 of those on one 8x10 piece of paper with some space in the columns. Thanks gang.

Look at all the subjective and objective data and focus on the area that seems to have the greatest number of issues. If you have two separate diagnosis' picked out, pick whichever one meets more of the major and minor defining characteristics. When writing your R/T, ask yourself "is this something a nurse can help fix?" If you can't find something to place after the R/T then your diagnosis is probably a poor choice and you should consider another. You might have two diagnosis' that meet all the major and minor defining characteristics, but when you start writing out your R/T clause then it becomes evident which one would be the best choice.

Nope, I'll be at the main Henry Ford Hospital downtown. I do have a friend that got an externship at Oakwood though, and I believe my psych clinical will be there in fall. I was born there too. :)

I almost forgot about that. In probably any one of your course syllabi, there is a ladder of command for you to follow when addressing concerns about instructors. If your school doesn't have one (I doubt it though), then go straight to the Dean of the College.

I live with my mother, 87 year old grandmother, 20 year old bipolar sister and my 10 month old nephew. This place is chaos. I need to move out. On top of that, I drive 1/2 hour every day to school. If I lived in the apartments that I'm looking at now, school and work are a 5 minute drive away.

Regardless of what procedure you have to follow, the way she handled repremanding you is unfounded. Do not just "suck it up" and finish out the semester. The longer you wait to tell someone the less it will appear that you are actually concerned about the issue. I would speak the Dean of the College of Nursing first and let them know that even if you were in the wrong, she handled the issue very poorly. If that goes nowhere, talk to the Dean of Students. With an attitude like she appears to have, I doubt you're the first or last person that has received the same treatment from her. Someone needs to speak up.

I got an externship at one of the largest and most respected hospitals in the Detroit area! The charge nurse of the unit I did my first clinical on (internal medicine) told us she was looking to hire some externs and she picked two of us for the unit. I'm finishing up my second semester of my BSN program and will be graduating in spring 2009. The externship is 48 months so that will work out perfect. It's a dream job for me. The pay is excellent, tuition reimbursement and you pick your own hours up to 40 hours/week. It also means I get to leave my crappy retail job that I've been at for almost 7 years. The one thing I've learned on here and from other nurses is that having a staff you can work is an absolute must. I love my charge nurse, the case manager is awesome, most of the nurses are amazing to work with (a few are grouchy but none I can't stand), and the nursing assistants are friendly and as helpful as can be. I'm even more excited because I'll finally be making enough money to move out my own. :w00t:

Post CVA quadriplegia would be correct.

I didn't really say that! If he was prescribed something he was allergic to and his record clearly stated the allergy, I wouldn't have a problem calling the doctor an idiot because that's just...well being an idiot. I approached him nicely about it, I would expect the same in return. Not to sure that's the way it goes though, this is the only time I've had to communicate about a patient thus far with a doctor.

Well someone failed them in their education. All I could think about was the what-if's. What if I said nothing and he ended up right back on our floor shortly after discharge for the same problem? That was motivation enough for me.

So if supposedly the wipes don't do anything besides clean the skin, what's more cost-effective to clean the skin with? I see boxes of wipes all over the place. I can't imagine using gauze pads + water or cotton swabs being much cheaper. Perhaps in the grander scheme of things that's why we use them, cost. JMO though, I'm running on very little sleep right now so this might not even make sense.

If there's one thing I've learned from listening to my instructors, it's that you have to really have a gut feeling that the order is not right before you say anything and I had that feeling. Turned out I was right. If I was not so sure I might have had a more difficult time.