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Neurovascular/Stroke Nurse
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karenrussell_rn specializes in Neurovascular/Stroke Nurse.

karenrussell_rn's Latest Activity

  1. karenrussell_rn

    When did you "Know" you wanted to be a nurse?

    I decided to go to nursing school after working in a hospital for about a year. Everytime I had to go to the Mother/Baby unit, I could literally feel the electricity of life buzzing all around me. It was then that I made up my mind to become a labor and delivery nurse. I veered off path slightly to obtain a year's worth of experience in Med/Surg, which I enjoy, but the "buzzing" in my ear is getting louder as the 1-year mark draws closer.
  2. karenrussell_rn

    New Job and pregnant!! Help

    That's a tough situation, determining when to tell. I'm with the concensus that thinks you should wait to tell the group. One exception though is the what-if of being assigned to a pt with shingles or meningitis or some other disease that is contraindicated for a pregnant nurse. Of course you can just ask another nurse to take the pt or you can let your manager know right away and be protected from that scenario.
  3. karenrussell_rn

    What's Your Best Nursing Ghost Story?

    Oooohhh, good one! I have to stand up for my manager though, he comes to work and rolls up his sleeves like he's a staff nurse! In fact, he's often solicited to bathe our modest, older, male patients!
  4. karenrussell_rn

    What is your biggest nursing pet peeve?

    When off service, consulting doctors come to our unit with no identification, in street clothes and get mad when we ask if they are family before giving any pt info!
  5. karenrussell_rn

    Did you ever think "Can I really do this"

    Tonya, I applaud you for the accomplishments you've made thus far. I am sure you have been an inspiration to a lot of other women! When I was in nursing school, I often felt like I couldn't or wouldn't be successful. One day, I had an "aha moment" where I realized that EVERY NURSE in the world had walked on the very path that I'm on now!! Once I had that realization, I would pull on that thought for strength. You have overcome some tremendous obstacles and I am confident that you will tackle this one as well! Good luck to you!!
  6. karenrussell_rn

    hourly rounding

    Our unit is broken down into 5 halls for nurses. The nurse-to-patient ratio is 1:5 on 4 halls and 1:6 on the other. There are 3 halls that the PCAs are responsible for. The PCA-to-patient ratio is 1:9 on 2 halls and 1:8 on the other. We have a 26-bed unit and typically our needs are 6 nurses and 3 PCAs unless our census is low.
  7. karenrussell_rn

    Pt./Family Comments that Leave You Speechless

    Two pts, two separate families: Pt A & Pt B. Pt. A was an 80+ yr old, frail lady, who was a full code and was going down fast! We thought we'd have to code her and that would have killed her. Pt. B, who was also old and frail, had a morbid stroke and was only responsive to painful stimuli. She was a DNR. Pt B's daughter was in the military preparing to go back to Iraq in a few weeks, who was already stationed in Washington State (we're in NC) decided against a PEG tube. As the daughter of Pt B is talking with the Hospice case manager, the family of Pt A, who we had to send out of her sister's room for getting in the way of the staff, overhears their conversation and says to the daughter, "you ought to be ashamed of yourself, starving your poor mother to death"!! Needless to say, we had to call security!!
  8. karenrussell_rn

    National Petition to Change N-CLEX Exam Process

    I, too am sorry that you didn't pass the NCLEX, however, I agree with the majority that there is nothing wrong with the test. Some people think that there is no such thing as testing anxiety, but it is real! I suggest you practice relaxation techniques, breathng exercises, and stop studying so much. I'm paraphrasing the old ballad, "if you don't know it by now, you'll never know it", meaning, you know the material, you've successfully completed the coursework, you're just having trouble with the exam. I never subscribed to studying 3 & 4 hours/day. I spent about an hour each day total; its not about how many questions you answer, but that you know how to process through the question. It's true that there are "tricks" to answering the questions because it IS a test, you are not standing at the bedsie of a patient, you are asked to identify the BEST right answer. In fact, I use those techniques now in my practice when I'm prioritizing my tasks. Someone earlier suggested to purchase a Kaplan study guide; that's what I used. I bought it just days before taking my exam and passed on the first time. Good luck to you and make sure to update us when you pass!!
  9. karenrussell_rn

    Advice For The New Nurse Entering Med-Surg

    At 3 months on the floor, it is perfectly normal to feel as if you are not ready to be out on your own. It is virtually impossible to be exposed to everything in your orientation that will equip you for the remainder of your first year of nursing. Unfortunately, most facilities are experiencing critical nursing shortages and pretty much rush new grads onto the floor for ratios; if you are able, ask for an extension in orientation.
  10. karenrussell_rn

    hourly rounding

    We call it Empower Rounding at our hospital; 4 P's and an E: PAIN, POSITION, POTTY, POs, ENVIRONMENT. Basically we go in every hour, PCAs on odd hours, nurses on even hours. Sometimes we flip, but the nurses must always agree to which hour they'll round. The nurses take 5 pts each on a hall of 10 pts, but the PCA has all 10 pts. This eliminates the PCA from spending their entire shift just rounding on pts! (In the event you can't do your round, let the PCA/nurse know and they'll do it for you: communication!!) The nightshift gets the day's initial vital signs at 0600 so the dayshift PCAs can get quickly get started with their 0700 round. The most important step, we've found, is communication between the staff. PCAs get report from each other, then they immediately get report from the Nurses. It really makes the morning go by so much better when everybody knows who is who and what pts require what. When the PCA does the initial round, they put the names of the caregivers on the dry erase board and ask the pt if they have a goal for the day (if pt is confused or unable to communicate, we give them a goal: skin care, turning Q 2hrs, etc). They also explain the rounds for new pts. As far as the actual round itself, we ask if they are having any pain and if so where & how bad. (After I give pain medicine, I write on the board the next time the pt can get more medicine. I've had so many pts tell me that it relieved them to know when they could get the next dose of something). We suggest going to the potty rather than ask because we've found that asking a pt only gives them the idea that they've got to go after you leave the room. We ask if they are comfortable in their current position and if not, we help them get comfortable. Environment and POs usually go hand-in-hand, where we straighten up the room, make sure the trashcans are within reach of the pt, move the bedside table back to the bed, make sure the water pitcher and cups are within reach, and place the call bell and telephone where the pt can get to it. All of this can be done within a few minutes. Before leaving the room, we explain that we "will be back in to check on you in about an hour" and ask if they need anything else before we go (the video suggested adding "I have time" to that question, but I think that's too cheesy). We no longer say to the pt and/or their family, "call me if you need anything" because that defeats the purpose of doing the round in the first place. So far, we've seen a tremendous decrease in the number of call outs and if we get them, the pts states that they hit the button by mistake. It only takes a few minutes to do and it increases pt satisfaction overall. For me, I actually have time to take the 15 minute break that is being taken out of my paycheck regardless, I can complete my assessments in the computer, catch up on work emails and any staff education. Even our secretary talks about how bored she is!!
  11. karenrussell_rn

    Advice For The New Nurse Entering Med-Surg

    I have been on the floor for 5 1/2 months, including my time in orientation. For various reasons, I worked with several different nurses, besides my preceptor, during orientation and it was a great learning opportunity. One perk was I got to see how other nurses do things like organizing their day, setting daily goals, and prioritizing patient care. Another great thing was I got to know other nurses and they got to see how well I was grasping what I learned so far and could fill in any gaps if necessary. That was a tremendous boost to my confidence! Of course, I have my days and feel as though my job only consists of passing meds or that I'm not being challenged, but overall I have valued my experience thus far in med/surg. One bit of advice I'd give all new nurses is to make sure you have a day, at least, to shadow the Medical Unit Secretary!! That was one aspect of my unit I was not fortunate in learning about specifically and I have had to play "catch-up" to find out what to do. Although, I feel more comfortable now, I still joke with our MUS whenever I have a question by saying, "This is why I needed my day with you!" By the way, I work on a Neurovascular/Stroke Unit.
  12. karenrussell_rn

    What is your biggest nursing pet peeve?

    *To "Grant Morgan" on the pt with Medicaid* This was before I became a nurse, I worked as a diet tech and one of my floors housed the Behavioral Health Dept. There was a pt who used to complain about her food and said that she "paid our salaries" because she was on Medicaid. It took everything out of me not to reply, "yeah, but my taxes fund your SSI check!!"
  13. karenrussell_rn

    North Carolina Roll Call

    Oh Ok! I'll be on the Neuroscience unit, 7th General at FMC 7a-7p. I'm about like you! I worked for 3 years on 3rd (Fri, Sat, Sun) and I promised myself and my family that I would NEVER work nights again. I'll be there on the 28th, with a bright and smiling face !! About the t-shirts,they are in office. I had been bringing them to the NCLEX reviews in hopes that I'd see anyone that hadn't picked theirs up. I only had 3; yours and two December grads. Have a great vacation!
  14. karenrussell_rn

    North Carolina Roll Call

    CONGRATULATIONS to you too, Dixie!! When I got up this morning, I went to the NCBON website to see if I was 'official' yet...and I was!!! Where will you work? I'll start orientation on the 28th @ FMC! Take care and I hope to see you soon.
  15. karenrussell_rn

    North Carolina Roll Call

    Greetings everyone!! I have had an active nursing license for all of 2 days, LOL!! I am a native of Winston-Salem and I'll be workling in the Neuroscience unit. I am married and we have 1 daughter and 1 dog!
  16. karenrussell_rn

    Winston Salem State University

    I think with any nursing program, you'll have your share of disorganizatioin. In support of WSSU, we're one of 3 4-year institutions, not to mention the large number of community colleges that graduate ADNs and they all receive their clinical training at WFUBMC and FMC in Winston Salem at some point. To that end, WSSU has to juggle scheduling issues with those facilities and the other schools to ensure that their students get what they need to satisfy NCBON. For example, FMC mandates that only a certain number of student nurses can be on a unit at any given time. On the days that we went to pick up our clinical asignment for Adult Health I, we had to go in pairs because the ADN students were in clinical and anymore students on the floor would be violating that policy and the school would be penalized. As of today, July 2, 2008, WSSU has a 100% pass rate. That includes the ABSN, December '07 grads and the handful of May '08 grads that have already sat for the NCLEX. I would venture to say that a few instances of 'disorganization' is an equal trade for receiving a exceptional nursing education.