col3

Ahhhh....so i assume that the first dose is a larger stat dose --so the patient gets full benefit.

Nursechie. Again, the practice you describe sounds unsafe to me... 1. No med should be left in the tubing for two reasons. a) it is not getting to the patient, and b) it deteriorates the tube. Also, subcut doses are so small that 2-3 ml in the tube could be half the dose prescribed. Imagine the initial dose being 5 mls and 3mls of that is just sitting in the line for the next one to be pushed through. If i were in pain i would want all that was prescribed-not a fraction thereof. 2. Because it is common practice to use the same SC set for more than one drug (on your ward it may not be but what about casual staff ect), leaving a med in the line means a high risk of mixing drugs. Im afraid logic and best practice stipulates...flush drug flush.

"The tubing is primed before inserting, so there is always .3 ml of the drug in the tubing when you push your medicine. Our policy is to push only 1 ml per set, as it is very uncomfortable to the patient to displace more tissue than that. We never push more than one med in a set, and we never flush. There's no need to when it is used for only one med, and it is far more comfortable for the patient." So....as this reads (to me)....you prime your SC set with the ordered drug? Then push a medicine on top of it ? And whats in the tube when your drug is pushed? There should never be drug left in the tube(thats a dose the patient isnt getting). Something has to push that drug in the primed line through and it shouldnt be another med. Sorry, just trying to understand your method?

Initial prime with Saline....then drug then flush. ALWAYS. Our SC sets take 3 mls to flush....Yes, go with your instinct! :).......then when you go in again,,flush, drug, flush...... Also, HWRIGHT......how do you initially prime with a drug? How is the order written....I mean, if the order is for 5 mg morph the patient would only get 2mg as the rest would sit in the tube? Sorry, just dont understand how you could initially prime with a drug?

If i had a nurse that was willing to do what it takes- i would be eternally gratefull. If I caught a disease rather than die- I would be grateful. If I have ever been a new nurse- I would recognise and appreciate the nerves and inexperience she would have. If I had done the same thing in my past- nomatter what excuses i would like to put on it- I would be less judgemental.

Sorry lol....just laughing as i imagine a couple of our doctors performing some procedures on each other in the name of education..lol....honestly, no other profession needs to do 'their thing' on fellow colleagues before they can practice. Bathing a dressed mate will not prepare anyone for the real thing. Once the procedure is taught thats it. The first time and the 2nd and possibly third are all going to be odd experiences to say the least because 'washing' a fully clothed friend does not compare----its pretendies. If you cant percieve what its like to lift a heavy limp arm, or part someones legs and cleanse between each fold or retract a foreskin then nursing is not for you. If you believe a pretendy one off lesson in a lab has prepared you then you're in for a shock, maybe even bigger as you have a preconcieved idea of what it should go like lol. Nursing, like other professions requires a head full of knowledge, a heart full of love and compassion (ok, so other professions may not need this quality) and then it's all up to hands on experience.

I agree with the above post for sure. After all it is the first thing we learn in cpr....she must be a caring person- the sort we want as a nurse. Praise her for her dedication- teach with with good direction.

The common idea appears to be that one learns how a patient would feel. Unless the 'educational' test bath is being done in its entirety ie. naked, peri wash etc...then the argument is invalid. Any one with half a brain realises that this is a task to be done with the utmost care and dignity. The procedure itself does not require any disrobing-just mere acting out the scenario. Ive not met a nurse that has had to do anything like this, and ive worked with hundreds. Do we give each other a suppository so we can empathise better...NOOOOOOO. If a pt is so ill as to require a bedbath then undoutably this will be the least of their concerns.

Im so hoping by 'giving each other a bed bath' that you mean fully clothed? there is not one argument for any other way.

WOW. I was gobbsmacked reading this post. I have never heard of using fellow students as guinea pigs. Not for anything more than perhaps a volunteer to swing in the lifter. Occasionally you may have students who click together and get together to practice taking blood (this is not recomended practice though). I am in Australia and am a Registered Nurse having 20 odd years of nursing experience. This is just not a practice any university or hospital would use here. So, all i can say is that our training allows us to be buddied with an expereinced nurse who shows us hands on how to do what we need to do. I certainly do not feel that adding this personal experience to the curriculum would improve standards/make better nurses. In fact, i for one would not be a nurse if i had to let a uni mate catheterise me! As for us expecting the general public to allow us to bathe them etc, what can i say. I go to a doctor and expect them to do what they do, i go to a solicitor and expect them to do what they do...i would expect the public who come to hospital would be trusting us to be able to our job as well. As for empathy, well if thats not in your character you wouldnt choose nursing in the first place-surely?

Just a question? Dont you need to have two nurses sign for Warfarin? We do at my hospital. Also, Orientation here (NSW Australia) means a nurse is on her first few weeks training. Definately giving warfarin would not be done without supervision. Also, on our med charts the warfarin is written up daily by the doctor only once he knows the INR result and has signed for the next dose to be given? Either way, drug errors happen because of a fault in the system. We are then encouraged to report errors - not for humiliation or punishment- but so that the entire unit can see where and why errors happen and can be fixed. I reckon everyone will make an error in their lifetime of nursing- even ommitting a drug is an error. Regards, Colleen

Wow...This thread is an eye opener to me as a new grad in her 3rd week. During placements and even in the last few weeks I have seen Professionals all around me...new grads and especially the seasoned RNs. I have been so lucky where I am and am astounded as I drive home that I lucked out with my peers. They are all supportive and even though I am in a critical area they realise that uni only taught me the basics. My first year is to learn how things all go together. I do remember during study that there are two issues relevant to this post. 1. There was a lot of information on how 'Nurses eat their young'. When I left uni I was prepared mentally for a bunch of mean hospital trained nurses that thought I was not good enough and.. 2. Research shows that the new grad does not have the experience and knowledge to be able to pull everything together. They are task orientated. After 3 weeks I can say this is becasue we are trying to learn time managemnent skills, get the drugs right and learn the routine. At this stage my brain doesnt even have time to really comprehend all the reasons behind my actions. I can imagine a new grad thinking she was following the med chart and giving the Warfrin as scheduled. This is where he/she needs to be aware of what she is giving and why! This is her responsibility. Having said this, if the person she was having to ask advice off was a little unsympathetic to her needs I can imagine that she may just concentrate on getting the job done as she sees it. Either way, it all comes down to the attitude of both parties. As for point 1....As I mentioned earlier, times must be changing because I have not felt inferior or been roused on once! I am confident I can freely ask questions and have been encouraged every step so far. Thank you for the girls on my ward....RNs, EENs...they are worth theyre weight in gold! There are bad eggs on both sides. Part of my self directed learning has been to do two reflections each week. One on a patient case and one on a personal experience. If I get told of a mistake then i would for sure go home and consider this. Id throw it around, research it and find out how I could do things better and try and understand the advice given and the rationale. Meanwhile....Im dying to get back to work...when I am there I feel "home" and wish I could just pull up a bed and stay there! Have a terrific day everyone. Colleen

Hi Claz... Im in NSW, but did my degree with girls (and guys) from all over Oz. It is my understanding that Public hospitals now pretty much offer the same program. In NSW you apply online to the health area and then list your preferences of hospitals. From their u usually get an interview at the first preference- if knocked back u may get an offer at your second preference. Go to the Victorian Nurses Board site to find exact instruction as to what u need to apply here and be aware that the uni u attend here may not accept the units you have already done and you may need to repeat. This is common changing from one uni to another- even with in Australia- and drives many students to despair! Maybe our new National Registralion (which begins next year) will force unis to run the same program and simplify the whole process! I am working next to a UK girl who is on her new grad program and she is coping well, I believe she is still awaiting a visa that she thought would be here by now but she must have a certain time clearance. If I see her I shall try and get her to come here and offer any suggestions. Good luck, Colleen

Hi everyone, This course must be different from the Master of Nursing I was looking at. The one I am loing at is 42 units over 1 yr (ft) or 2 yrs (PT). This course is a post graduate course and does not lead to nursing registration. I think I was looking at UNE or it may have been Charles Sturt. I cant remember but it was only a few days ago. As for the paid graduate 'course' mentioned earlier. No, the new graduate 'program' is for those who have completed their bachelor of nursing and are registered.

Hi Lucia, Having just started my 'new graduate program' I can tell you this... The first three years are at Uni- with 'placements' spent in the hospitals over this 3 years (not much- say, 6-10 weeks per year). After this 3 yrs we are RNs. Then the recomended way is to apply for a new grad position which lasts 12 months full time. This is where I am at now. I am workng in a cardiac unit in a hospital in our public system. I had one day orientation and shown around the ward. An educator assessed my skills then the next shift I was given my patients. I panicked the first day and then realised that questions were ok to ask, the staff are very supportive and the environment is great for learning. At the end of 6 months, i move to another area and complete my new grad yr there. After this yr I am able to apply for a position where ever I feel i may like to try. You are registered before this post grad yr however it is hard to find a job before you finish the program- you are encouraged to do the program so as to gain competency in your clinical skills. Hope this has been of some help and Good Luck :) Colleen