Surgical_RN08

i have recieved my 1st eval. and it was great!!! we even had a "new grad no more breakfast". i can personally say this year presented many learning opportunities (did i forget to mention it was hard as heck). i am not so overwhelmed anymore and can really say that i am really glad i chose my unit. it really is true that the first year is the hardest. i am not so task oriented anymore (which is normal for a new grad) and i am critically thinking more. my mgr told me she recommends that i start studying to be certified, but i have to wait on year two to take the exam. for those of you just starting out, just stick it out, it will get easier......

its been a year since ive helped contribute to this thread....i thought it was soooo helpful...so those of you coming out of school...study hard every day with a set schedule and congrats to those who have recently passed the nclex. wow i am sooo glad this thread is still going....nursing is great and i love love love it!!!!!

i have a question. i am a floor nurse and dont know very much about this. i had surgery friday and had loads of anesthesia i.e versed, fentanly, diprivan, etc. i think it was one more but i cant think of it. anyways...the day before surgery i had an extensive bowel prep and was npo after midnight. the day of surgery i was so dehydrated the crnas couldnt get any iv access on me. so they did a ej or a central i cant remember but it was below my subclavian bone. i also had an arterial line. when i woke up they pulled a nasotrach tube from my nose and immediately put me on a nonrebreather because the said my sats wouldnt stay up (85-88%). the pacu nurse told me that my body "held on" to the anesthesia and they had to give me narcan and bagged me some (then they put the tube in my nose). well my temp went to 101.6 and my cxr showed pneumonia "it was a small area of consolidation on the right lower lobe). so i stayed in the hospital for a couple of days and was on zosyn, levaquin, unasyn, and vanc until my blood cultures came back. my cultures were negative and i was discharged on one pill levaquin. so my question is does levaquin actually help with aspiration pnemonia even if my cultures were negative? and do i have to keep taking it since i was on all those strong antibiotics for so many days? sincerely, fresh postop, nicole rn:confused:

i have a question. i am a floor nurse and dont know very much about this. i had surgery friday and had loads of anesthesia i.e versed, fentanly, diprivan, etc. i think it was one more but i cant think of it. anyways...the day before surgery i had an extensive bowel prep and was npo after midnight. the day of surgery i was so dehydrated the crnas couldnt get any iv access on me. so they did a ej or a central i cant remember but it was below my subclavian bone. i also had an arterial line. when i woke up they pulled a nasotrach tube from my nose and immediately put me on a nonrebreather because the said my sats wouldnt stay up (85-88%). the pacu nurse told me that my body "held on" to the anesthesia and they had to give me narcan and bagged me some (then they put the tube in my nose). well my temp went to 101.6 and my cxr showed pneumonia "it was a small area of consolidation on the right lower lobe). so i stayed in the hospital for a couple of days and was on zosyn, levaquin, unasyn, and vanc until my blood cultures came back. my cultures were negative and i was discharged on one pill levaquin. so my question is does levaquin actually help with aspiration pnemonia even if my cultures were negative? and do i have to keep taking it since i was on all those strong antibiotics for so many days? sincerely, fresh postop, nicole rn:confused:

the latest i stayed over....the shift ends at 0700 so i ended up leaving at 0910 because i was still charting. but lately its been 0730 at the latest and its mostly because some of the nurses dont get there on time to get report (some are even new grads, you would think they would be trying to be on their p&qs because it is our first year). they always show up at 0655 or later which gets on my nerves because report time starts at 0642-0645. if i give report on time i am out of there by 0705

you shouldnt quit nursing but you should think about going to another area to work (maybe in the hospital or outside like a doctors office, community health etc.) 6 wks orientation isnt much at all by the way (i had 12). if you dread going to work everyday then it really is time for a change. a nurse should have some good days in between to make that balance. just try another field of nursing because youve worked to hard to get to where you are now.

well a doc got pretty upset with me because i called him in the middle of the night for an order. situation: my pt had a temp at the start of the shift 100.1. i encouraged him to do pulmonary toileting, plus the pain med he had already had tylenol in it (percocet). i mean this guy ambulated, used the incentive spirometer etc. so around 10:30 his temp was 103.8. i then called the doc on call and explained all that i have been doing for him, the med he is already on etc. he gave me an order for extra tylenol. so the next day he went to my mgr and told her that i called just to get tylenol order and that i should have tried other measures first. so what else was i suppose to try? my mgr also said i could have wrote the order for the tylenol instead of waking him up and she also stated "you will get to know the doctors and whats okay with them". i told her i refused to write an order for any med (i am only 2 months out of orientation). even though she is my mgr its still my license. i told her what if i wouldnt have called it still would have been my ass for not letting anyone know. it seems as the docs always win and we the nurses always lose in most situation. why do we always have to bow down to them. if a doc is on-call then its his job to answer the phone for a serious situation...well i thought the temp was serious enough. was it not????????

a nice stethoscope always comes in handy or a pocket organizer to keep scissors, pens, etc.

okay we do have lexi-comp which replaced our micromed....i will explore around with it when i get back to work to see what i find. thanks guys.

hi all, i do call the pharmacy at work when i have questions about this. i know iv nexium and invanz are not. i am trying to make a list. is there a book or website i can get this information from. thanks in advance.:typing

i just recently had my eval after getting off of orientation and my manager said it is quiet "normal" to be task-oriented at first as a new nurse. she also says as time goes on the critical thinking we spent so much time stressing in school will start kicking in more than task-task-task. only time will tell.

its a two stick max for any person at our facility new or seasoned. wow she trys that many times before she asks for help. if i try once and know that i cant get it on the second try i will find someone else.

hi all, i graduated on May 18, took boards july 7. i started working on a 27 bed mainily postop surgical floor (but we get medical pts too). i love this floor because it will help you to get organized because of the high patient turnover and everyone seems to be in pain (so you really have to be on top of things). at the moment i am taking 5 patients on night-shift and next week i go to my full 6 patients. my preceptor says do you think you want to come out of orientation early? i was like no thanks i need all the time to learn as possible before i am on my own lol! basically she has 1 patient and doesnt have to do anything for mine. i come out of orientation October 3. i think i am learning alot!!! hope all is well with everyone else.

i think i am in the same boat as you guys. i am trying a few different things. i write down the patients room numbers across the top of a piece of paper. then draw lines down to divide them. i write all the things i do (as i do them soon after i come out of the room) i.e give pain meds, initial assessment, ambulate, started an IV, consults, even if i turn the patient: then write the time next to it . i put a check mark next to it when i have charted it. if there are any new orders, our charge nurses will make a copy and bring them to us (but i check often anyways). if its something very important i need to relay to the next shift i will highlight it or star it on my brain sheet. soooo in report i give the basics (past hx, surgical procedure, name, doctor, fluids, incisions,etc.) from the kardex then i scan down the list "brain" as i am reporting to make sure i am not skipping anything. then i read from the new orders. as far as the meds, when it is 6p i scan to make sure all meds are caught up. but if it is 645p and its time to give report and things got a little crazy, i will tell the next shift that i am overdue for this such med and what time and why. i mean things happen and we are not perfect. i try not to let it happen to often. it only happened once since i started orientation and i also went up to 4 patients that day. i do still forget to write down the simple things sometimes, like education or doing a transfer to the chair but time is sooo crunched...oh well you all get the picture. sorry to ramble:typing ps. dang! i forgot to chart that IV i started today. lol!

my preceptor put hemostats and tape clipped to the side of my pants. we keep flushes and wipes locked in the pts med box inside the room. one multicolored pen in one pocket but i always keep a few wipes in my pocket just in case, and my hospital phone. scissors and miniture calculator in the other. my keys for the PCAs and med box are kept on my name badge. i also have a miniture keychain sharpie on my badge. i always buy everything miniture if possible.