proudnurseRN

No way is your blood sugar 500 after eating a salad... where are you hiding the Skittles?

My husbands best friend, a well-built young man with multiple veins that I have eyed ever since knowing him, got into a motorcycle accident last year. After his release, during our first visit, and after our cordial "how are you feeling?" greetings I asked him "when you woke up, how many IV's did you have in you?" He said he couldn't remember, but he thought 3 or 4. He said it's when he realized he was in pretty bad shape, seeing all those IV's. I said "nah, they just did that cause they could.... they were probably making some kind of game out of it. Who can get the biggest gauge IV in..."

I'm trying to remember if I went to the ER as a child. My parents were poor, and didn't have health insurance, so I don't remember any trips to the doctor or ER until I was 17 for an abscess. Then, I did go a few times in my 20s (still no insurance) for a dental abscess, gallbladder, kidney stone and a couple of other issues I would have gone to the doctor for had I a doctor and money to afford one. The last trip I made was when our accu-check machine at work wouldn't read my blood sugar - just read "HI" and I wasn't diabetic (well, I was diagnosed that day). So yeah, I've been quite a few times in my life, but I don't think it qualifies me as a "frequent flyer." My ds has been for asthma as a baby and for an abscess. The abscess he had required an I&D and 3 day stay. In retrospect the asthma incidents could have been handled the next day but I was suffering from new mom syndrome.

Ain't nobody got the money for THAT!

The way our unit works- and as far as I know only our unit and only nightshift- on the 5 winter holidays Thanksgiving, Christmas Eve, Christmas, NYE, and New Years Day we place our order of preference down to have off 1-5. We must work 2 of them. This year it was arranged so that everyone had their 1st and 2nd choices off. The only "rules" to this system is that everyone gets their first choice off and if we are in a period of low staff you may be scheduled to work 3... but if that occurs you are the first to be called off after you have worked your 2 holidays. It works out well for us.

When I was in nursing school I purposely scheduled classes with a 1-2 hour break. That was the majority of my study time. Also, if I had a 10am class I would get to school at 7am and study in the lounge. Also, I am a visual learner... I cannot learn by lecture. So, what worked for me was to study during lecture. I would read the chapter that was being lectured on as the teacher was lecturing. I had the ability to also hear what was being said, so I didn't look ill prepared when called upon in class. I also didn't make it grossly obvious that I wasn't paying attention, but I was a consistent A student so I think the professors got it. Finally, I got side job as a tutor. It reinforced what I needed to know and in downtime I was able to study myself. I almost never studied at home. Sometimes it had to happen, but I would say about 5% of my studying came from the home environment. Papers, on the other hand, were usually done at home on the comfort of my own computer, chipping away 15 minutes at a time. That being said, I also co-slept, but was never able to study in bed. I always fell asleep.

That hospital changed their signs around a year ago so there was no longer a "30 minute" promise. Now I think the signage reads "Quick ER" or something similar. KateICURN- we must be coworkers.

That's ridiculous. When I was in your position (worked as a extern/PCA) I still received 5 weeks of orientation. Since then they've cut orientation from 6 weeks to 4 weeks which is still not enough IMO (specialized med-surg unit). Does your "mentor" have her own assignment?

The other day at work I had a series of small issues with a patient. First, I couldn't get the CPM to fit right no matter what adjustmants I made. So I brought in our floor "CPM expert" to help get it properly fitted. Then, the blocks started leaking. I got our block expert into the room to see if she could help me find the cause (as I suspected it was a defect in the line, nothing I could do about it). I told the patient, that these nurses were the best with these issues, and whenever possible I like to get another set of eyes. We have "experts" on the floor when it comes to IVs, Foleys, NGs... just about any procedure imaginable. So, that got me thinking about what my co-workers come and get me for. What my "expertise" is... and I suppose it's when people are going downhill. I am able to keep my head in a stressful situation and rattle off what needs done. I also seem to be the one who trusts the gut and can tell if a patient is going downhill before the obvious signs show up. I will chart in or right outside a patient room and when a coworker asks why I'm being anti-social my response will often be "I'm waiting for this patient to give me a reason to send them to the ICU." So, brag on yourself... and if you are so inclined share any tricks.

That was my main strategy for preparing for the NCLEX and I passed with 75 questions and in 30 minutes. I felt I was very well prepared, but I also researched each question I missed and would even read further into it. Seriously, 100 questions if done right, should take a couple of hours to review. Sometimes more, sometimes less.

I'm not an ER nurse, but spent a few weeks doing a stint in the ER. We had a MVA and the doctor asked the same thing... "Anyone else have any ideas?" I think it's a matter of respect and making sure everythings been covered. Only experienced it once though.

I work with post op joint patients and other fresh surgeries, some have standard care paths and specific post-op orders. Orders for the degrees on a CPM, and whether or not it's even used, is based on the doctor and the patient situation. Some patients come to the floor with catheters, some keep them in until the following day. We also get pts that will be going to surgery. We have a checklist on the front of the chart that includes questions such as "Is the history and physical on the chart?" "Is all jewelry removed?" and several other questions. We recently had a policy change that only the surgeon is to mark the operative site. Anyway, I'm not sure if any of that information is helpful. If you would like more info just pm me.

I cannot sit to chart until all my physical work has been done. I have to check the last 2-3 pages of orders before doing anything else... I hate surprise orders at 2am. A couple of weeks ago I was too busy to do this task and found a stat potassium ordered at 1700 that wasn't done... and it was 2300. I cannot sit and take a break or chit-chat while a co-worker is running around like crazy. One of these days that might change, because it seems some days I'm the only one that feels that way, but I can't stand to see someone stressed out.

In 2002 I was working at a well known company, making decent money for a single girl, doing a job I hated and was slowly but surely getting shipped overseas. At the same time, my grandmother became seriously ill, and was transported from FL to IN on a med flight. She was expected to die and was placed in a nursing home. I went to that nursing home everyday. I got to know the staff and the patients. I visited so frequently that I was one of the few people that could decipher what her roommate was saying (stroke) and would interpret for staff. In 2003, major changes were happening. I hated my job. I was looking for something where I could use my brain, work with people, and wouldn't get shipped overseas. I decided nursing was my best bet. At the same time, my grandma was better and ready to move out of the nursing home, but wasn't quite prepared for independent living. She tried living with my dad, but it didn't work out well. By 2004 she had bought a house and agreed we (my husband and I) would live with her rent free while I attended school and we helped out with cooking, groceries, yard work, etc. So, that was the moment. I went through several stages of areas I wanted to work in through nursing school... ER, peds, psych. Right now I'm in ortho and while I love it, I feel like I will have to move on soon to stimulate my brain further.

I graduated there with my BSN... but I don't know anything about their on-line program

Oh, and I do understand the difference between comments and orders. Once there was an ortho surgeon, friendly doc, when asked about a constipation issue with the patient..."Ask the medical doc. If it doesn't have to do with his foot I don't want any part of it. He's an *******. Give Milk of Mag, Miralax, a Gallon of Golightly for all I care..." I laughed, but did not write that as an order.

Good answers and they are all over the place. I can count on one hand the times this has happened, and I've actually initiated the order before. It was a patient that wouldn't be happy with her pain meds until sedated, and I told the doctor just that. My words were along the lines of "Doctor X, you are going to have to give me what you are going to give me and tell me that is all she is going to get." This was a patient that was demanding A LOT of pain meds. What made me wonder about it was I did write the order about a week ago because I didn't think the MD was taking the pts pain seriously. I called twice, and without getting too specific the pain relieving measures for someone complaining of an 8/10 pain was ridiculous. The next day he addressed the order in the progress notes by saying she was fine earlier and the nurse had called twice regarding pain. He signed it off. So far nothing else has been said. Anyway... thanks everyone.

I probably wouldn't. Actually who knows what I might write depending on what else is going on. Writing it as a nursing note is probably a better idea. CYA... and the MDs don't read the nursing notes. And really, if it came down to it, I would call back anyway if I had to for the patient. Or I've also been known to call another MD consulting the case if appropriate and there was a good relationship with that MD. Just wondering how others handled the "do not call back order."

I have had this happen a few times, most often due to pain meds. Pts pain out of control and I've called a couple of times for orders and they have said " she can have this and/or that and nothing else. Don't call me back." I do write the order. Something as "MD notified of pain 8/10. MS 2-4mg every 2-4 hours prn pain. Do not call back regarding pain control issues. MD will see in am." Is that appropriate?

I had a stone left over after my gallbladder surgery also. It hurt worse (and I didn't think it was possible at the time) then what lead me into the initial gallbladder surgery. I called my husband home to be with the baby (6 weeks old at the time) so I could die. I wouldn't go to the ER because I couldn't imagine waiting in one of those ER chairs when I was going through something like an exorcism on my bed. He eventually called an ambulance. One ERCP later I was also much better. Childbirth, gallstones, kidneystones, fistula repair surgeries, oral surgeries... the above instance was the most painful experience of my life and what I base my "10" on. Anyway, sorry no advice to your original question, but thought I'd share my bile duct stone experience in our ERCP bond.

Good for you. Not too long ago I had a pt arrive from OR onto the floor who just didn't seem "right". V/S upon arrival were WNL, so I just kept an extra close eye on her. Kept her door open next to the nurses station and paused every time I walked by to peep in. Within an hour I noticed her breathing was more shallow. Went into the room to assess pt further starting with respirations...9/min. Took pulse ox... 55%. Called respiratory stat, got on the phone with the MD, and got that pt transferred to ICU real quick. She ended up being re-intubated, recovered, and came back to our floor (primarily ortho) within a couple of days.

I am able to take care of my $35,000 loan payment fairly comfortably being the sole supporter of a family of three. I'm not able to save huge amounts of money, don't drive a new car, and home upgrades are aways off, but I do have enough to cover the mortgage, utilities, loan payments, put a little away for retirement, have had several medical expenses, have to pay for kindergarten, and going to Disney... but it can be done. We don't go out to eat often, my shopping fix are yard sales, and I'll drive my little gas saving Saturn until I can't anymore. A lot depends on your area. When I made $20,000/yr and was single I felt rich. However, there was a period during nursing school and my husband was laid off that we made $9,000 that year (with a new baby). Now that was tough times. I still live like we make $9,000/yr for some things, which makes it much easier to budget. You can do it.

I understand. I have an embarASSing issue that has required several interventions... colonoscopy, outpatient repair, colonoscopy, outpatient repair...I'm only 32. Fortunately have been able to get away with only doing FMLA once and have been able to schedule vacation... not really painful as much as embarassing. It sucks. I feel for you.

We don't have any night shift daycares around here. I think it would be invaluable, and I'm not sure why we don't, but we don't. Nurses aren't the only ones that could utilize after 6pm childcare... surely there's a demand?

My true love is my son. I never knew it was possible to love someone so much until I held that boy in my arms. I would jump into a lake, run through a fire, do whatever it takes to keep him safe. Nothing else comes close to that kind of love. Really, he is the #1 problem I have with working. Most of the time it's not that I don't like my job, it's that I'd rather be home with him. Maybe some will look down on me for this... but in second place is tie between my step-daughter and husband. They have both been part of my life for 10+ years. My husband and I have had some serious problems lately, and it may not have a happy ending. However, unlike my first marriage, I do believe he is a good friend. Just possibly, bot a good spouse. Enough of that though... happy thoughts. For material things I like money. I used to work hours upon hours of OT before my son was born- more for the money than anything else. I can't bring myself to do that as much anymore.