MidnyteRaine

Hi all, I'm just feeling a little blue tonight and am wondering about my options for the future. I'm 24 years old and I've had Crohns disease for a little over one year, never had to miss a day of work because of it, but I have a feeling things are going to change. I still have inflammation even though I'm on Pentasa, so next month I have a f/u appt where I'll either start 6mp or Remicade, both of which will likely lower my immune system and may even make me neutropenic. I work on a surgical (primarily ortho) floor, but we also get telemetry and regular med surg patients. We also get all the chemo patients and I'm chemo certified. I have a BSN so I know leaving the hospital for something else is a possibility, but I really love my job, my coworkers, etc. And really, anything where you work around people will expose you to lots of infectious diseases. Heck a walmart cashier is exposed to lots of fun stuff. I'm not sure how to handle this. I'll get blood work done regularly to monitor my wbc levels, but I'm sure many of you have had patients that they've taken care of for days and then 4 days into their hospital stay find out they have cdiff or mrsa and get moved to a private room. By then a person could already be infected. I also don't want to be a carrier if I am susceptible to bacteria and pass things on to my patients, especially my surgical or oncology patients. Is it enough to just be extra careful w/ handwashing and wear a mask around any patient who has a cough or if my immune system goes low to wear a mask and just tell patients I'm getting over a cold and don't want to share it with anyone? Can I switch patients with people so I don't have neutropenic or infectious patients? Who do I need to talk to? Should I mention this to my manager, to the employee health nurse in the hospital? I mean, it's not definite that I'll become severely immunosuppressed, so I don't necessarily want to make a big issue out of something that may never come to be. Any suggestions? Does anyone else have any experience working while on immunosuppressants? I know there must be nurses out there on Prednisone, Remicade, etc for various conditions. I'd like to hear your experiences. Thank you to all! Ashley

Hi everyone, I started orientation for Med/Surg/Tele on June 6th, now I have one week of unit specific orientation (they go into detail on setting up a PCA pump, hanging blood, they have the new GN's pass some meds, do all the IV starts on the floor, etc), then I start the real orientation where my preceptor and myself have 5 patients. I alternate between being excited and thinking I can do it, to being a nervous wreck :chuckle . I orient on evening shift for 10 weeks, then I have 2 weeks on nights (no preceptor, but was told to use the team leader who has no patients for help), then I'm on my own with my regular schedule of 2 8-hour night shifts and 2 12-hour night shifts. I can't wait to get to nights, I hate evening shift! But I feel that the length of my orientation is pretty good, so that makes me feel better (helps make up for the fact I have 4 different preceptors, lol). Like the OP, I'd like to talk to other new grads too. Really, only other new grads and nurses can understand what we're going through. My other friends, as wonderful as they are, just can't completely relate. I'll give my aol screen name here for anyone who actually has the spare time and desire to talk to fellow new grads- nyte185. Good luck everyone! Ashley

Ahh, so my math is right, I just read the bag wrong sheesh. Thanks!

Hi all, sorry for the math question (who wants to do math when their not at work?!), but this is the quickest way I know to get an answer from experienced people :) I'm a student nurse doing a preceptorship, and one of our patients a few days ago was on a Cardizem drip at 20 ml/hour for afib. The order said to titrate the drip to a maximum of 20mg/hour. The concentration was 125mg/150 ml. When we came on shift we were told her heart rate was still in the 130's but she was maxed out on Cardizem. I think I'm doing the math right, but wouldn't the maximum rate for her be 24ml/hour? I didn't ask the nurse I was with because she wasn't my usual preceptor and didn't seem to want me around, plus the doctor came in shortly after and wrote new orders. I just thought I knew what I was doing when it came to figuring out the rate, so I'd like to know if I should drag out the med calculation book and review! Thanks to anyone who feels like doing math and helping out a nursing student! Ashley

I don't graduate until May 2005, but I have a trip planned to Sedona, Arizona for me, my sister, and my mom. All the tickets are bought, the reservations are made, and thinking about it is one of the only things getting me through this last semester!

Hi everyone (and happy holidays!) I'm trying to decide where to do my senior practicum at and I was hoping some of you guys could help out. I'll be on a med/surg/tele floor when I graduate, and I'm trying to decide between a regular med/surg floor and an ortho/neuro floor for my senior practicum. The floor I'll be on after graduation gets its fair share of TKR's and THR's and since I'm not too comfortable w/ post surgical patients and I have no experience w/ traction I was thinking the ortho/neuro floor might be good for that. However I'm not sure if I'll get experience with other things on that floor such as NG tubes, tube feeding, TPN administration, decubitus ulcer dressings, etc. So, what kind of patients are on an ortho/neuro floor anyway? The Total Knee and Total Hip patients are sort of obvious, but what about on the neuro end? Will I get experience w/ skills there or is it too specialized? Should I stick w/ the regular med/surg instead? Any opinions would be great, I have about a week to make up my mind yet. Thanks! Ashley

MLOS, you suggested something so simple that I had to laugh that I didn't think of it first --> asking the professor if I could take a 3rd patient. I'll do that if it seems like there's time...I think we only take 2 because it's too crazy for the professor to supervise meds and treatments if we'd take more than two pts. I'll have to see if it seems like the professor would have time and be willing to let me have another pt. Manna, yeah, I did have an externship in med/surg over the summer, it was an excellent experience and I loved it, I even signed on to work there after graduation. During the externship I was up to 3 patients...granted I felt a little disorganized and flustered sometimes, but I know I can definantly do it. So going to 2 patients seems like a step backwards : ) Thanks to everyone who answered....I just can't wait until nursing school is over with, lol. Of course I know that during the first few months of working I'll be wanting to retreat back into the safety of nursing school :chuckle Good luck everyone with school this year!

Hi everyone, I don't post much, but I desperately needed a break from school work. My eyes feel like they're going to dry up and fall out of my head from all the reading, I'm sure some of you can relate! I'm in my senior year now, very very happy about that, but I'm a bit disapointed with my college's program for senior year, especially with clinicals. I wondered how yours' compared with mine. This semester I have clinicals for 2 courses, Peds and Med/Surg III. There are a total of 11 clinical days for Med/Surg, 6 of them are observational experiences (PACU, OR, ER, Cardiac Cath Lab, Express Admissions Unit, etc) where we can do procedures we were checked off on, but can't give any meds. The other 5 days are on the floor. Since we're using new hospitals, the first day in each hospital we only get 1 patient. Then we advance to 2 patients, but we don't give meds everyday. There are about 6 ppl in the clinical group, and only half give meds on any given day. We already worked our way up to 2 pt.'s last semester, and will continue to take only 2 this semester, doing both the aide and nurse's job. It just doesn't seem like we'll be getting much experience, especially with meds (we're just starting to give IV meds this semester too and giving meds 6 times over a month and a half isn't enough to get comfortable doing so). Clinicals for Peds is similar, one to two patients, when we have 1 pt. we always give meds, but we don't always give meds when we have 2 patients. Here we have about 6 real days on the floor and 5 observational experiences (PICU, NICU, Perinatal Unit, manning the phones for Project Child hotline, etc). My class will be graduating in one year and it's scary to think in January, with one semester to go, we'll have only got up to 2 patients at a time. It seems a bit ridiculous. I love my instructors, but I'm beginning to dislike my BSN program and respect the diploma programs that are out there. Sure, I'll know about Leadership issues, historical figures in nursing history, but the diploma grads will be more comfortable on the floor! We have the highest NCLEX pass rate in a BSN program in the area, but I'd gladly switch that in exchange for feeling competent when I graduate! I'll stop before I switch into ranting mode :) Is anyone else's program like this or is my program suckier than I realized? Geez, this turned out to be a small book, sorry about that! Hope everyone's first weeks are going well! Ashley

I got something from them in the mail too, I tried finding infomation on them on the internet by typing in the guy's name who signed the letter, the address, etc, and came up w/ zippo...tossed it in the garbage...I figure if it was legit I'd be able to find some info on the internet. Then again, I did think that if it WASN'T legit I should see something about it along the lines of "Beware of scholarship scams" or "companies not to trust" or something, but I didn't feel like taking any chances.