BertinaRN

I am a floor nurse on Med/Surg. I am in my eighth year and I still love it. I love seeing different diseases, ages, and surgeries. I am also a preceptor for my Alumni College and a trainer for newly hired nurses. I hold a position on a few committees. I am still a part-time student at Cappella University in the ADN-BSN bridge program, and will graduate in 2016. I would love to continue my education towards Master of Science in Nursing with a nurse educator focus, but I do not want to educate out of a job. My employer doesn't offer much room for career advancement. Have a Great Day, Bertina

I work in Med/Surg in an area that has a high volume of drug addicted, ETHO, suicidal,mental illness and so on type patients. We do not have the resources in this community to fix or help these patients. I always review previous admission documentation, H&P, discharge summaries, I verify the home medications as best I can with the information they provide. If the MD prescribes the narcotic and the patient states they are having pain, I give the medication as prescribed. I know that I can not fix them, I always hope that they are quickly discharged, but while in my care I make the best of the worst.

I worked part-time during school. It is really just making sure you set your study time, and never put it off. You have to make it more important than everything around you.

I work a busy Med-Surg unit normally but last night I was sent to CCU. Talk about being a fish out of her tank...LOL. Anyway I had a GI bleed pt which for me is second nature, but then they asked me what should have been a simple question, I later found citical thinking is truley my friend. "Why do I have to drink this when every time I pass stool it is nothing but blood, is the doctor trying to make me bleed to death?" After a long discussion and some re-assurance that the doctor's goal was only to prepare for a colonscopy my patient did begin the prep. They were on hemogram draws every six hours so when lab came I requested they wait until after a few BM's. Before the start of the prep the Hgb was 11.7 after two BM' s I called lab, results showed the hemoglobin went to 9.5, I had to notifiy the MD, thank goodness I asked lab to come back or there wouldnt have been a way to catch the drop, the next blood draw would have been long after the prep started working. Anyway the patient received 2 units PRBC' s and they were fine, but then I had to hear "I told you the doctor is trying to kill me" for fifteen minutes. I know that it is important for the colon to be clear, but I also understand why my patient with a GI-Bleed was scared to start the GoLytely prep. My patient finished the prep, had tons of stool so I hope they did well through the night. It was my first time in CCU. I have only been an RN since July of 2008, but it was one of those rare nights when I felt confident as a nurse. Even though I was the fish out of its bowl. Just sharing my experience, have a great day everyone. Bertina

We also do the peri-anal in some cases, and I have never had to do one on a patient who had a negative result for nasal, they always screen the nasal first.

This is very common on my unit, many of the people admitted are elderly and have no idea what medications they take, when or the dose. I ask for the pharmacy they use. We have 1 24hour pharmacy in my town, I work 15-2330 shift, so if they utilize that one I am usually able to have the med reconciliation form complete for when I call the admitting doctor for orders. We also have a 24 hour policy that allows us to complete the form in case of complications such as their primary not being the admitting doctor, and such. As far as screaming doctors, you always have the MD's that think they are some how better than everyone else, like they could ever do our job...lolso Joint Commission has decided to step in and create abusive MD's and even nurses into a Sentinel Event http://workplacebullying.org/press/clinrev011709.html http://jcahohospitalpolicies.com/JCAHO-Phenomenon-Bullying.html http://search.jointcommission.org/search?q=yelling+doctors&site=All-Sites&btnG=Search&entqr=0&ud=1&sort=date%3AD%3AL%3Ad1&output=xml_no_dtd&oe=UTF-8&ie=UTF-8&client=jcaho_frontend&proxystylesheet=jcaho_frontend Hope the links work, I found the material very interesting. Bertina R.N.

I graduated from Gateway, I really enjoyed the clinical rotation's. I enjoyed my third semester experience so much that I inquired about a position and was offered a full time nursing job before I had even finished school. I feel confident that I received a very well rounded education especially when speaking with other graduates from different colleges. Hope this helps, Bertina RN

Lately we have had an influx of drug seeking patients on the unit, most of them are frequent fliers, and seek pain medications. I even had one pt who told me straight to my face "I might as well feel great while I am here, and man these drugs are great". I felt as though I should some how inform the MD of the statement so I did, and we slowly weaned the pt off, the pt became enraged and really did become a HUGE problem, the total stay was 23 days by the time of discharge, three specialists, 1 psych MD and the pt was self pay, so you know who took the bill for that. Those are the pt's I have a hard time treating, because I have other Pt's who really are in pain, and the MD is afraid to prescribe anything worth taking, when they deal with the drug seekers everyday abusing the system, and the medications.Thankfully I only have 1 out of 6 like that at any given time. I have learned to research symptoms, diagnostics, and how they relate to pain. I use the faces scale more than the numbers with those types of patients to try and have an accurate rating for the MD, and I unfortunately sometimes have to discourage Md's from increasing doses based on the research, and prior pt history in the facility. That is the part I do not like, I was taught to never doubt a patient when they say they are in pain, but when I have a pt smiling and laughing while they state their pain is a 10, I just have to follow my instincts.

We have to have another RN or pharmacist witness, but there is no reminder from the computer, it doesn't know what you give so I make sure to have a witness right away so I do not forget, other wise when you go to chart the med given in the computer it will show a discrepancy between the two and pharmacy is notified. Bertina R.N.

Some helpful tips I have learned just in the last 3 months Read the H&P on your pt, learn why they are there and their past medical Know their labs, xray results, UA results, ct results etc. before you call the MD Know their allergies,your MD may not have that information available when you call them and ask your pt what medications they have taken before that worked, some pt come back over and over for the same problems, get to know what works so you can recommend. Don't take it personal if an MD starts yelling, swallow, and continue, you are your pt voice, and besides I heard that Verbal abuse form a doctor is soon to be a sentinel event through JCHAO, which will include how they speak to us, along with their pt.:) If your pt does not remember their meds/dosages find out what pharmacy they go to, the pharmacy is usually very helpful , have their personal information ready. Just adding to the knowledge base, hope someone benefits. Have a great day, Bertina R.N.

At my place of employment I had blood work, ua, and a complete physical, which included weight, lifting ability, vision and hearing. Then when I was on the unit, there was more, I had competencies that I neded to be checked off on. I finally finished the last of them. Hope that answered your question. Have a Great Day, Bertina

I am in love with MOBB brand, they are comfortable, they have lots of pockets. https://cheap-scrubs.com/ They are great for me. They are a little pricey, and it takes about 3 weeks for them to come via snail-mail. I did buy a few of the other styles and the sizing is way off the pants just fell off they were so big, but this style really seems to be sized well they fit great.

The unit I work on we have three nurses with very bad asthma. They let everyone on the unit know, my supervisor inforces the no perfume rule, and we do not use the santiation wipes around them. I would just be upfront with your co-workers and supervisor about your asthma on the unit you get hired for. They do not have the right to ask medical history during an interview so if you are worried that you may have difficulty you would have to tell them. Have a Happy Day, Bertina

I work med-surg. Passed boards in July have been on the unit full time since. We have the 6-1 ratio and is it really busy all the time. I am second shift which made the transition from graduate to RN a little easier. I have had a great expierence, it is never the same day twice, I am amazed at how much I learn every night. I am also very lucky because the girls I work with are really wonderful.

Just wanted to let everyone know I did pass state boards, I am offically an R.N. Thank you for all of the support, Bertina:yeah: