LauraMT

I don't feel dumped on by your comment, I actually appreciate it. That's the problem with the mellow ANM, no constructive criticism. And she also says, "Oh, that's just nurse's way. If you have a good shift summary he doesn't look for you". But shift summaries print 2 hours before end of shift and a LOT happens in that 2 hours. You are right. I was lucky! I don't want to be that kind of nurse! People have made fun of me before as I follow him down the hall trying to force him to listen to my updates, but until today I always ignored them. I wouldn't have done it with any other nurse. If it hadn't been a stable patient I wouldn't have let it go like that, and on our floor a stable patient doesn't mean crap. I can't even count how often I've come back the next night and said, "What happened to Mr Smith?" and find out he went into vtach or something and is now intubated in cicu or worse. Now hopefully this thread gets burried before everyone sees how dumb I was! I know I'll never be perfect but I ought to be able to avoid blatantly stupid mistakes!

I called. The ANM laughed at me and told me to go back to sleep. I'm such a dork. She said, "Nurse was late. Did you have anything to add?" and I said no so she said, "You're fine! Go back to sleep!" I could hear her eyes rolling from here. But I'll be reporting to anyone who will listen to me from now on!!

quick replies! See, that's what I thought. There is a written report on the kardex, but if no one HAS the kardex it's not going to do any good. Poop. OK, I guess I'll call. It was inadvertent, but of course still not ok on my part. At least I know I'll never let this happen again. I make new mistakes, but rarely make the same one twice.

I work the night shift and we have a nurse on days who does not care to take report. Let's call him nurse Anyway last night I had five patients and this morning I reported off on 4 of them. Then came nurse's patient, a person with an EF of 10% going for a new pacer/icd in a few days while waiting for their heart transplant workup. The only reason they are not at home is because our transplant team is the only one who will talk to them and they live 200 miles away. Nurse was not in the report room which is typical for him. If you have something to tell nurse you have to chase his butt down and tell him. You have to find out what rooms he has and have to wait for him to finish with the patient and then he'll come out and say, "I don't have any questions" and walk away and if it's really important you have to run after him and tell it to his back. So this morning I said to myself, "Self, nurse had this patient yesterday and knows him (i've abandoned gender non-specific language. HIPAA-schmipaa. I'm too tired) You've had this patient for 5 days and in that time you have gotten him tylenol for a headache once and gotten him a container of cranberry juice once and given him his spiriva 5x. Your carpool is going to leave you and you will have to ride the bus home and you know some crack-head will want to share your seat." So I left. But (this just registered in my brain) on the way out I saw a pile of kardexes and bridge worksheets on the table with a "nurse" sticky note on them. Maybe nurse was not there yet. Or maybe he knew all his patients and left his notes there. Anyway, did I break the law? The kardexes include the shift assessment as well as a narrative shift summary so if he shows up he'll know what's going on. The ANM in that shift is fabulous to new grads and mellow so I doubt I will get in trouble, but you know how things nag at your mind. I know in the future I'll be tracking his back down and telling it my reports so I don't have to be a worry wart. I guess if he really wasn't there the charge would have to hear report. Sorry to ramble so long (and sorry for the excessive use of parenthesis (it's an affectation)). Laura (parenthesis abuser/patient abandoner)

Oh, forgot to mention. Just call the hospital you're interested in and ask to speak to a nurse recruiter. If they dont take the time to call you back and answer your questions about orientation or any other questions you have they might not be a place you want to be.

I live in Eastern Washington (much different from Western Washington, I don't know where you want to go). We also have www.holy-family.org in this area which is also providence. Spokane also has Deaconess and Valley hospital, but they just got bought by a for profit company so I don't know how you feel about that. They actually pay about $4 less an hour too. Laura

My hospital would be in HUGE trouble if they demanded a BSN! On my shift I think I'm the only one with a BSN right now. Everyone else is an ADN, one person working on her BSN. Anyway, can you move? If you don't have a mortgage and a family you should go on an adventure! Go somewhere where you're appreciated and you like your job. I work telemetry in eastern washington. We have about 5 openings (even though there are better adventures elsewhere)!

I motivated myself by registering for a test date. I graduated on may 6th and took the nclex june 20th. I had a study buddy and here is what we did: First we did the kaplan strategy and saunders comprehensive alone. 1. The Kaplan strategy book--just worked all the way through it 2. The Saunders comprehensive review. We did the quizes first (I think this is pirated from Suzanne's plan that we never actually got around to signing up for so we just read the stickie) and if we did ok on the test we didn't read the chapter. We did read all the rationales though. We looked up things we didn't know the answers to. Then we got together with the saunders q&a and cds from other books and did at least 200 questions today. We would talk over why we were picking each answer and look them up if no one knew the answer and just teach each other. We really only studied for about 3 good weeks. the rest of the time we sort of studied. During that 3 weeks I quit my jobs and put my kid in full time daycare. The night before the nclex we made our husbands take us on dates. We were both in and out in 75 questions and under 30 minutes. Just practice and use those strategies!

A lot of nurses where I work have dog tags (not military tags, actual tags like you would put on your puppy) zip tied to their stethoscopes. I don't because I don't want to be a copycat, but my stethoscope is engraved. Another nurse wanted to get his engraved and said the place he went to refused to do it because it would mess up the sound, but mine seems fine.

I got a patient up from ER with an IV in the artery once. I called IV therapy and they were not concerned. I dc'd it and started one (in a vein), documented and never heard anything else about it.

I just had a week off of my job on the nightshift on a very busy ACU because my husband was out of town and I had no childcare. Tonight was supposed to be my first night back but I called in because my Daughter and I have been sick with a really nasty cold and I felt like I needed one more day. Plus I hate to leave a sick baby. Also, my last scheduled day I scored an LCD and had just had a few days off. So I have weaseled out of work since the 5th. Anyway, I keep thinking--maybe I shouldn't go back. And of course I will, but I still wonder. I've been working since the end of June but I still feel like a big phony. I work on a busy ACU floor. We have lots of post-opens and a healthy sprinkling of mechanical hearts and transplants. I am terrible at reading EKGS--especially 12 leads, make sure I have it right side up if you ever see me trying to read one--and the emergency orders are a mess in my brain. Thank god for the monitor techs. If I'm ever the first one to a code I feel like that person will be as dead as a doornail before I figure out what the heck is going on. I passed the dysryhythmia test and the emergency procedure test, but that was while I was sitting minding my own business in the library. No one's life depended on me. And I'm starting to get MORE scared because almost all the nurses on my shift are pretty new and there is no one to run to for help. If the one nurse with experience is sick we are in trouble. Tomorrow I am supposed to precept someone too. And she's going to know more than me, so THAT should be pretty embarrassing. Well, poor sick baby just passed out (ok, she's 3, but she's my baby), so I'm going to crack open the EKG book so I can feel better. At least I'm TRYING to learn!

I'm not on the CICU but on the stepdown unit and often feel overwhelmed on my easier unit. So I can imagine how overwhelmed you must be! I have an organization sheet similar to WeeBabyRN's. I just made it on word. On the top I have names, room #, diagnoses, activity and diets. I have spots for vitals so I can see changes easily. The rest of the shift is divided into hours and I write the meds due and anything else that I need. There is also a spot for Is and Os and a little spot where I mark off everything I've charted. It feels really good to mark stuff off and it feels even bette to chuck it in the shred bucket at the end of the shift. It took me about 6 months of asking every nurse I saw about their brain sheets" before I came up with the one that worked for me. And if the unit is just too hard for you at this time take a little break on an easier unit and go back. They'll be glad to have you back I bet.

I've been working since June and at my hospital everyone orientates on days then switches to their shift for some more orientation. It was good to orientate on days because you do things on days that you rarely do on nights like discharges and certain procedures. I'm on nights now and I think my stint on days was helpful--and now I know I NEVER want to work days.

I just signed up for weigh watchers on line since I am getting all sorts of Chubby from working all the time, eating junk and not exercising. This morning my friend and I formed a plan and step one was to join WW online since the meetings in our town are made up of this one weird click of stay at home moms (that will never talk to me and my daughter) and octogenarians bussed from the local nursing home. Is this program working for anyone? And if anyone is doing this or any diet, when do you eat the biggish meal of the day? Step 2 is tomorrow. That's joining the local universities fitness center. For $110 a year you get to use the fitness center with the pool and weight room and raquet ball and everything. For an additional $95 a year you can use the circuit training and get an exercise physiology student to train you. I think that is probably cheaper than other gyms. Thanks for any input and is anyone interested in maybe starting a weight loss/healthy living thread?

Amidarone, Cardizem, Digoxin, lots of other antiarrhythmics. Lots of diuretics. We have heparin and insulin drips that get titrated on sliding scales. Tridil drips (nitro) for chest pain. Tons of potassium. Everyone has htn, diabetes and hyerlipidemia. I work nights so I don't give as many meds as a day or evening nurse but I still look up all the meds people are on so If something happens I know if a med they got earlier caused it.