drew9319

we have a gym in the basement. i go running for 30 mins then shower and come back to work. if i have a heavy patient load and cant do that, i run for 4-5 miles as soon as i get off. the perimiter of our hospital has a 2 mile walking trak that i run around 2 -3 times every morning that i get off. you just have to make time.

try nursingcrib.com they have searchabel careplan samples. for nada, nic and noc..you'll have to buy the books

use very much so. we usually use hr for the pulse or just P. the unapproved abbreviations is a whole other coversation :smilecoffeecup:

the temp i saw was 37.8 C. the PR of 102 i though was the pulse. that was my take anyway.

no trouble. if you read the posts here this happens. alot. nurses disagree on how to do things all the time. its just the way we are. everyone brings their own flare and methods to the game. if you make it through you will too.

you can disagree if you want. thats your right. never said you had to hand him the answer either

yes i have heard of the term hint. he is being resourceful. while doing his homework ect he is using a very good resource. which is this board. we should be helpful to those who come after us. not just give a hint and hope that they a) find what you expect them to find or b) understand what your telling them in the first place. its better to give a hand and bring them along. give him a link to follow or something. its called mentoring. i appreciate the fact that you are attempting to help him as i am. i just think we should be as helpful as possible.

you cannot diagnose the patient. sepsis is a medical diagnosis. and yes the pt does meet the criteria. but i doubt that his instructors would expect him to know that at this point. from what i am seeing i would assume that this is a 1st or second semester nursing student? were you able to identify sepsis then? if you were good for you. but most nursing students dont get that till critical care later in their studies.

acute pain related to infection of wound on the right foot is the one i would go with

the dm will cause it to take longer for the wound to heal. thus you can use potential for delayed healing r/t dm. the anemia means that he also has the potential for decrase nutrient and or o2 carrying capicity due to low hgb. thus imparing healing. you could also use risk for pain intolerance r/t wound infection or something along those lines. you have to adress the pain aspect of it

he si febrile(mildly), wbc elevated. hgb low thus the anemia. elevated wbc in urine indicates a urinary tract infection or inflammation of the urinary tract. need a urine culture. rbc in urine is a sign of renal damage. the crit on the cbc is good. the diagnosis i would use is potential for bleeding due to anemia. i woulnd use the potenetial or risk for infection b/c he already has one. use this link to do your care plan and to see your diag. http://www1.us.elsevierhealth.com/MERLIN/Gulanick/Constructor/index.cfm?plan=32

we use the artic sun blanket here to induce hypothermia. but you can do it with iced saline and ice packs. that is only in an emergency though(ie malignant hyperthermia) the reson you really should use a cooling blanket is because you want to control the rate of cooling.

unfortunately thats the way is is done. we do not have a choice in the matter. i usually take longer when turning over to a new rn who has not had the patient before. we try to avoid this be keeping the same group as long as the patient is in the icu. 8 pts. i wouldnt take that long to give report. we could get it done in 15 to 20 mins. as well. i would even have time to tell ya what color toe polish they had on and what times they went to the head.

keep this in mind as well. when the heart stops. we only have a 5% chance of recovering a pt. if the cod ehappens outside the hospital. it doesnt increase that much inside the hospital from the outside. when the heart fails and the o2 in the blood runs out. thats when the brain starts to die, as well as the heart. research has show that we can reduce the incidence of anoxic brain injury by inducing hypothermia. here is the link. http://content.nejm.org/cgi/content/short/346/8/549 hope this can help increse the knowledge we are sharing great thread

well yall would hate me. my report is short sweet and to tha point. but it is head to toe withe every system covered. it takes about 10-11 minutes a patient. but then we have to review all orders written during the shift to verify that i updated the cardex, then we look through the progress notes to make sure i wrote a simple care plan and what the outcomes where. its ok in the icu but when on the floor with 5 patients its a bear. me i like a through report. system by system. drips ivs all of it. i have a habit of going in and seeing the patient before report to see if they are giving me the good scoop during report. but i do have those that during report will be looking into space and off in another galaxy. then at the end of report will ask a question on what i just said, or ask to repeat what i just said. so i will state to these individuals that they need to pay attention i will only say this once. it seems to work ok..

stick with it. od not think that you are dumb. you passes nursing school. that in and of itself is an accomplishment and you cannot be dumb and do that. dont worry about others. it will just drive u crazy:banghead: i also woked in the south befor i joined the navy. i started out in the icu and did float pool for the ed and the ed holding area. i understand that you cant jump in and order things. i have been there. but i would say this, if you have to wait for the doc to fill in the the order to follow a protocol then something needs to be corrected with that. a protocol is there so that you can take care of business in an emergency ie cp, acs, dka, ami. you facility needs to look at that. thats just my opinion and thats how it works here and how it worked at my facility in LA. if trauma is your passion then get some experience by moonlighting or using some off days to work overtime to get that exp. thats how i got from MICU to the CCU and how I got to the or. If you show some initiative then you will get noticed. if you feel that you will not get respect or the chances you want where you are at then maybe you need to look elsewhere. i hope i dont sound like a recruiter or nothing but the Navy needs new nurses. we would be glad to have you. and you get to do alot more here than anywhere else. but i do hope that things get better for you.

i wish you the best in your future career. i have a sheet that has been used at multiple hospitals. i work in the icu/sdu. we are a combined unit. we can have from 2 icu patients to 3 step down patients. anyway my sheet has the following: its divided into 3rds. top third: pt info, consults, dx/sx, code status, med/surg hx, contact precautions? restraint orders, fall precautions, skin integ, calls to md reason and time, critical lab results, mrsa swab date. middle 3rd: neuro, pain mgt., card/tele, advanced directives, flu/pneumonia vac, med recon, pulmonary(o2/ett/vent/trach/mode, rate, fio2, peep, ps, tv), radiology stuff, tests and followups. bottom 3rd: gi: tubes and drains, diet/tube feedings, accucheck, gu, dialysis, vascular, ivs(drips, critical drips, iv sites) misc notes. on the back i have the times every hour for the 12 hr shift. in these i time my interventions. meds, accu check, pca checks, bath, lab draws ect. hope this helps you. best case find one that works for you and your situation, then make it for yourself.

Nahhh, rather keep it the way it is. Let people think what they want to. Some people are just happier when they can put another down and who am I to take away their enjoyment. just let me be clear. I was not trying to put anyone down. your statement was "Now, in the South, if I do what I described, I would be up before the BON for trying to practice medicine without a license. Can't even start a line in most places without the doc giving me a VO." that was a blanket staement. thats what i was responding to. i do not doubt that you are a good nurse. but if your going to cover everyone and every institution you had better be sure that what you say is correct. the way it has worked in the facilities i have worked in is that there is a set of protocols for everything. yes you will need a DR order for these things as you would in any state I hope, otherwise you are practicing without a license. but the protocols of the intitution gives us as nurses cober to make decisions and use our judgement. because if we cannot use or own judgement then our practice act is worthless. but back to the issue, the institutional protocols tell you what you can and cant do. i would suspect her er has a set and that she could do the ekg and the ce set w/o having to ask the dr. she probably didnt know that due to her time in the ed. but that will come. i hope that she doesnt let this experience tait her view of nursing. we all develope thick skin after a while and she will too. hope all of you have a good night. it time to go take care of pts and familia

the last post seems kind of critical of the south in general. did you work in every er /hospiytal in the south? if you did then i would wonder how you acheived that particular feat in only 4 yrs. now as to momvick. dont let the docs get you. be assertive. its ok to doubt yourself. that shows that you care about what you are doing. it allso will cause you to later go back and review.(thats whats going to make you better). If the staff you work with tells you that you are doing good, then take it at face value. dont worry about the other new grads either. you focus on what you need to work on and thats all. develope your skills and the respect from the docs will come. it will just take some time. keep your head up:smilecoffeeIlovecof

i would say that you should follow your dreams. i was an enginner b4 nursing. now i am serving my country in the navy as a nurse and love it. i also worked in the civilian side as a nurse too. no problems there either. there are always those that say its too stressful. well, they are the lazy ones. nursing can be an adreniline junkies dream..;-P

Most of the drug books state .18mg/min or 180mcg/min is the max dose for sever hypo or sepsis. Go by your hospital guidlines. That will be your best bet, and it also gives you cover if anything comes from the death of a pt. It is always best to follow the hospital protocol. Hope that this helps. Navy Nurse Corp

i went befor the navy selction board on jan24th... still no official word on my selection. was told that first they lost my package but then they found it, it is because of the new system that they are using. i call once per week just to check, say hi, and let me recruiter know i am still alive. i am very frustrated at the lack of progress here. i hope that this goes away once i get tha word....i was told i have been penciled in for a school in may. that is not the same as saying you made it...all i need is a yes or a no....any ideas on what i should do next?????? bummed in la

get tested. that is the most important thing. hiv is not the worry here. for hive to be spread through the blood it would have to be a more substantial amount than that delivered by an insulin needle. the worry is hepc. i say that only because hep c delivered sq or not, the amount on the tip of the insulin needle would be enough to give you hepc. hepb you should be ok if you have had the hepb series. as you know hepc no cure. here is some contact info for you to report accidents, unsafe working conditions, or safety & health violations: contact the osha office nearest you, see map of offices, or, contact our toll free number: 1-800-321-osha (6742)... tty 1-877-889-5627. call 1-800-35-niosh hope this helps, and find another place to work if possible. i have been stuck as well and know from personal experience how scared you must be...hope all is negative for you on the testing side. good luck

i have 1.5 yrs as an icu nurse and 1 yr as an or nurse. how does the navy determine what job i will do? also has anyone been stationed at NAS Jax? and do they have an icu? its one of the three places i put in for. pensecola and portsmouth being the other 2.