eak16

Yayyy!!!!!! I'm waiting for that on-air apology though

I felt the same way... nursing school just sucks sometimes. Yes, sometimes it is inconvenient for the patient to have two assessments. But that is the reality of training- nurses have been training just like you are for a hundred years, and if there were no patients willing to have students learn from them then eventually the supply of nurses would dry up. I often felt like i was doing more harm than good- especially in psych clinical- (when i had to ask eleven pages of questions to a person with a very painful past) Just one of hte many reasons why nursing school is uniquely draining and difficult. But trust me it gets MUCH better.

Hi- my parents got me a digital camera for nursing school graduation- a Nikon coolpix 3200- and it has been just great. I am NOT a techie at all, but figured it out no problem. It takes great pictures and is tiny and lightweight. They run about $200. I am acually returning the favor to my parents and buying them the same model camera for Christmas!

wow- change of shift meds! that had never occurred to me! Meds at my hosptial are NEVER schduled for change of shift for the exact reasons discussed above. And furthermore, if the nurse has a good reason why the med should be rescheduled (like the fosamax at 6 am when the pt is sleeping well) we can pretty much reschedule things within reason with no problems from pharmacy or management. Furthermore, I made a benign mistake that made me feel like an idiot last week- I discharge a pt without an order! Had talked to the doc and the pt about the discharge, thought I was doing quite well thank you, and then about two hours after the pt. left, realized I had never acutally seen an order! The chart was already in medical records, i had to fish it out, cal the doc, (who, thank God, was equally embarassed that he had forgotten to write it). He HAD meant to discharge the pt. that morning, but I still felt dumb. Med-surg is rough.We have to be a lot tougher than we look!

Sounds like a great idea if it is used appropriately. Our discharge pharmacy is extremely slow- on weekends it can take three hours to get discharge meds, and often this leaves an otherwise ok pt. sitting around to a while just waiting for meds.

I have run into lots of CRNA's at UW and Harborveiw

More often than not I have found that it is unavoidable things that keep people from dontaing blood who really want to. A blood transfusion saved my fathers life, so I couldn't wait until i was old enough to donate; The I got malaria (long story)- whoops, couldn't donate for three years One donation after that i got cancer now cant donate until 2008. Would have much rather gotten a tattoo :-)

University of Washington School of Nursing (ranked #1 in the nation, woohoo!) has the MEPN program, where people with a non-nursing degree already can take classes for three years and leave with a RN and advance practice degree. You get to choose the advance practice specialty, and they have a very good CNM program. The program is very new though (this is first year) and prohibitively expensive if you dont have good financial aid. Congratulations on choosing nursing!

Hi- relax, ok, i was being very sarcastic. I totally agree with you, in fact, thats the point i was trying to make.

another point, with respect to Allele's post, is that call lights are NOT ALWAYS a priority and dont need to be. If I am in the room of a high acuity patient who is gasping for air and whose Sat is 80%, do you think I am going to rush out to answer the call light of a patient who is alert and oriented x4, ambulatory, and has a history of calling to ask for extra sugar for their tea? Could this be the one in a million "true emergency" call for the tea person- yes it could. Am i sometimes willing to take that risk? yep. One of the great things nurses are trained to do is prioritize. Sometimes pt's call lights take a long itme to be answered becuase they nurse (correctly) prioritized their time to another patient. this is something that should be appreciated for the critical thinking judgement that it is, not harangued.

how about one CNA solely dedicated to call lights? I have noticed that sometimes when I am in a room doing a twenty minute dressing change or something, I assume that the CNA's will be covering my call lights, only to discover that they were doing a similar long task in a patients room... If there was one CNA who only answered call lights and performed simple tasks (getting water, blankets, simple bedpans, etc.), and then called other CNA's or RN's (everyone would have to have phones) for more lengthy tasks, then there would nearly always be someone available to answer lights in a timely fashion, and it would free up the other CNA's to do AM care, transfers, etc.

protonix heparin SQ docusate lisinopril oxycodone aspirin 81 mg oral Kcl calcium gluconate mag-ox (can you tell our residents REALLY like to replace electrolytes?) lactulose levothyroxine levaquin vanco and of course- your fav and mine- insulin

gimme 12's! I would much rather have the same paitents for 12 hours than have to come back the next day, have different patients, and basically start from scratch. I feel like once i kind of get in a flow with a patient, I just want to keep going. The extra days off doesn't hurt either

It can really vary depending both on the individual state's laws on the scope of practice of RN's, LPN's and CNA's, as well as the style of nursing at individual hospitals. Where I work, there are no LPN's, only RN's and a few CNA's. While the RN's here only have 3-4 patients on a high-acuity med-surg floor, there may be only one or two CNA's for 30 paitents, so VERY often we end up answering most call lights, putting patients on bedpans, etc. If you want to read a LOT more about this, search the threads for "team nursing" and "primary nursing"

During a stint in Africa there were a few things that really helped me: cleaning wipes- any and all kinds- individually wrapped for toting around, packs of baby wipes for cleaning flavor packets- you can usually find tomatoes anywhere- a pack of salsa seasoning makes them special magazines little hygeine things- CHAP STICK! nail clippers, these tend to get lost every few months :-) a mix CD of whats on the radio here now a little stain removing pen, or Shout wipes. handheld games- loved Bop-it, and could share it with locals (no language needed) a mini-tape recorder, reporter type, to save the sounds and language remember bottles can and will explode on planes so double seal- found this out the hard way when my economy packs of Purell hand sanitizer baptized all my clothes :chuckle

Funny, I was wondering the same thing this morning. Had a patient who could have had morphine but wanted Phenergan instead. Go figure! It must be good because I've heard it feels like fire going in and has the pH of around 2.2. Goodness knows i wouldn't want that in me. Question for everyone: are you allowed to give it IV push in a peripheral (diluted? Undiluted?)? I had heard this was REALLY bad but everyone does it on my unit, and there is no policy on it.

Can't answer the CIV questions, but I can tell you that PICCs are peripherally inserted central catheters, they are usually inserted in the upper arm and the line stays in the vein all the way to the caval-atrial junction. Because there is so much line inside the vein, the main risks are migration (tip of line moving into another vein, usually in the neck), thrombus formation, infection, and rupture (usually from a nurse forcing fluid through it when it is occluded). They can stay in anywhere from a couple days to a year or so- a year is the longest I have heard of them being in, and that was with a very compliant home-infusion patient. It has been my experience in my short career as a nurse that in a month or so most PICCs get occluded or infected and have to be pulled. PIV I'm assuming stands for peripheral IV.

there is such a thng as a certification in wound and ostomy care nursing. The wound and ostomy care nurses at my hospital have both an advanced degre (MN) and are "CWOCN's" (certified wound ostomy care nurses.)

yeah, gosh, I wish all non-educated people would just learn to know their place and accept poverty as god's will for them too. WHAT THE HECK??????????????????????????????????/ I strongly suggest you read "Nickled and Dimed" by Barbara Ehrenreich. there is a section in that book about maids I think you would find interesting......

There was actually an article in the American Journal of CC about perceived futility in care r/t job stress in the ICU. There was quite a correlation between the two (I know you're shocked). I think it contributes heavily to ICU burnout as well. I was just going to mention this article- it is a must read. I am a floor nurse myself, but I did a very involved case study in nursing school on the effects of a patient such as described above on the atmosphere of an ICU. Case was very sad- had been in a coma for several years after an accident, was coded several times, last code before I saw her, the resident was in the midst of calling time of death when a MED STUDENT THOUGHT he felt a pulse, so they resumed compressions and she came back, albeit even more brain damaged than before. Talk about frustrated ICU nurses!

I agree- this is one of the things you just need to take into account when you CHOOSE to be a nurse (or cop, EMT, etc...). Also, I am always surprised when people feel they deserved more holidays off because they have kids....just a pet peeve. Single people celebrate Chrsitmas too. Not saying you are saying this, just an attitude i have noticed a lot. We all pull our weight, thats what makes nurses so close knit and special. Who do people think runs the hospitals on Christmas, elves?

FIVE twelves a week- no prob here. Have a friend working two 68 hour weeks in a row so that she can take a week and a half off without using benefit time. We do self schduling so this is possible.

It totally depends on the facility. Some hospitals use "team nursing" (look for recent thread on this) where the RN may only be doing assessments, certain treatements, and charting on several pt's. Here I do primary nursing, so I usually do EVERYTHING for my 3-4 patients (with the help of some wonderful CNA's that are shared between several RN's.) Everything includes AM care, peri care, keeping the family up to date, peripheral lab draws, organizing transport, pleading with dietary to bring my patient the right food.... lol

Interesting- just today I switched shifts with a fellow RN so that she could vote on Tuesday (I am voting by absentee). She was very grateful, and I'll be watching the elction returns from peeks into patients rooms!

I just started working as a new grad two months ago. Honestly, the main thing I looked for was low ratios. You do not have time to learn if you have six patients! My preceptorship lasted only five weeks (with an option to extend) but now that I am on my own with 3-4 patients, I acually have time to ask for help when I am not sure of something. I also looked for a floor where there are a lot of recent (past five years, maybe) grads. There are a ton of relatively new nurses on my floor, so there are a lot of people asking simple questions and debriefing over lunch. A nursing school friend is working on a different floor- same hospital- where the majority of nurses have been there 20+ years and are VERY cliqueish. Even though this friend is in her 40's (the same age as most of the nurses there), she still feels excluded and friendless. Good luck in your decision!