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You actually did the patient a favor by sending her to ER. First of all, if you had suspected a UTI, you'd be on the phone trying to get a hold of the doctor for an order to do U/A with C/S. Then you'd send it to the lab and probably get it back the next day. If her UTI was severe, another day could had led it to Urosepsis, you never know especially at that age. Sometimes the Doc will see the UA results and choose to wait for the pending C/S results, further delaying treatment. Another thing, it was a change in condition. Severe pain should be enough to send a patient to the ER for evaluation. Great job on getting her on ABX sooner.

Which ones are charging 20k? The ones I've researched are charging around 35-40K for the entire MSN program online!!!

Lifestyle: a 25 yr old been a nurse for bout a year. Whats the 1st thing she buys? A CONVERTIBLE MERCEDES. Now thats the lifestyle of an RN.

Hi, I recently joined Intermin as well partime. One of my co-workers works with Interim, she referred me so I went in for the interview. It was more like a meet n greet and having your questions answered about home health. When I walked out, they made me fill a time card. I asked em for what? They said "SO YOU CAN GET PAID FOR TODAY?" I was surprised.... WOW, I earned already? Most of the time spent was on learning the paperwork. I think I oriented about 6 hours on paperwork and 2 visits to open cases, and I was on my own. Its pretty easy to pick up as long as you learn the paperwork. We already have the skills, just need to learn organizational skills with paperwork and schedule visit times. As for your questions: 1-What does orientation consist of? Paper work, a few visits (make sure you go to OPEN a case). Don't go on a follow-up visit because all you do is the skill required, vitals and charting. If there r any changes, u call the doc. When you open a case, thats when you do 80% of the paperwork. How long is orientation? It depends how fast of a learner you are, but they'll always be auditing your work very carefully in the beginning. 2-Is the pay hourly or per visit? Pay per visit. You get extra to open a case. Claim your mileage, gas, and vehicle expenses in taxes... more in return vs re-imb from Interim. Good luck

oh by the way, after reading this post, i'm going to go have a beer for all the stressed nurses out there and enjoy it... to all the hardworking nurses out there... cheers!

I'm going to have to disagree with that. It takes a lot to be a nurse. You should consider yourself real special to be a nurse. We learn to deal with a lot of adversities throughout our nursing careers and learn to deal with them. If you are a good nurse, you will know how to deal with them. I'm not being offensive here, so don't misunderstand me, but if you can't deal with the adversities, maybe you are not cut out to be a nurse. Then you just push yourself putting yourself at risk for stress and depression. Saving a life, caring for the ill and putting a smile on their face, pretty much makes up for all the stressful situations I deal with in a daily basis on the floors. I got to give "HEAVY PROPS" to the floor nurses for being in thick and thin and caring for the patients. WE ARE THE BEST! God is watching us. I'm excluding all those lazy nurses sitting behind a desk or do jobs like chart reviewing. Okay I might have gone off topic, but I don't consider depression among nurses is due to work. If it is, CHANGE YOUR CAREER. Or you can just ruin your health and continue being depressed and stressed.

It depends by which home health agency you work for. Some agencies give you a schedule for an 8 hour day. You can finish that schedule in less than 4 hours and get paid for a full 8 hour day. It all depends on the agency I guess.

I just remembered my 2nd semester of nursing school. During our IV sessions, my partner (NOW WIFE) had a field day practicing IVs in me. Obviously, I was being sweet and told her that she can practice on me as many times as she'd like. Boy did I regret saying that. After 3 days I could had easily been assessed as a DRUG USER!!!! Anyhow, she got one in an artery once. We didn't know after until she dc'd the cannula and blood was squirting out of my arm with every heart beat. On top of that, she dropped the gauze and had to get a new one, so my arm was basically squirting for about 10-15 seconds every second or so. Ahhhhhh I miss those days...

Yes, exactly. Make sure you flush. Did you check placement first? Always check for placement prior to administering.

Tony, What qualifications do you have? Degrees? In what field? What sort of work have you been doing your entire life? Its important to know all those factors in order to decide what part of medical field will be best for you. Be more specific and we might be able to suggest you a few options that might just work out for you.

How about "If you fail, you won't be able to come to America to make the big bucks". Is that inspiring enough?

The bum bum is still the best site to give IM shots. VL is the best in the little ones. In my experience, most patients report that VL shots hurt like heck as compared to the bum bum shots. Bum Bum = Ventro or Dorso

I don't think it would make a difference. Its not like you have a measured amount of fluid in your gut. It all mixes down there. If its bitter, give it a little more mixture. I don't think there is any restriction with foods while taking Vanco PO.

Ativan is a thick medication. Why do we Dilute it giving IV? So we can administer it with ease. Ever tried pushing it undiluted? Good luck with that. As for IM, There is no need to dilute that Ativan, just make sure you use a larger gauge needle when administering it IM, say 18 gauger? If you want, you can also dilute it. Just make sure you use the same amount of saline. For example, if you are giving 1mg/1ml, add 1ml of saline to dilute it a bit for easier IM administering.

Where I work, yes we need an order to place oxygen on a patient. If a patient is in obvious distress and oxygen saturation is low, I'm not going to wait for an order, thats your "nursing judgment", and call the doctor once I stablize the patient and use my assessment skills to figure out what caused the drop in oxygen saturation. Watch out for those COPDers, you have to monitor their oxygen use, you don't want to kill their drive to breath.

I'm 6'2'' and I workout and am in good shape. Working at a med-surg floor when I started as a new nurse took a great toll on my back. I always use to think that it wouldn't happen to me since I am in great shape, but its all about BODY MECHANICS. I always make sure I use the correct body mechanics as they keep on drilling you with during in service and injury prevention fairs. But the best thing that helped me the most is wearing a BACK BELT. Its the same belt I wear when I lift weights. Boy, did it make a difference. I never ever felt a stress on my back while working everytime I wore my weight lifting belt. They have them for all size and shapes. I would highly recommend you wear that back belt and trust me, it will make a difference. Make sure you use correct body mechanics. Start working out your quads, arms and abs. Those muscles are heavily used with patients and it will take most of the stress off your back. Take care of your back. I did.

Not familiar with "HIT" term, but I know CPT means chest physio therapy. Bottom line is, you need to grab the policy and procedure manual at your facility and read it regarding Trach Care. I'm sure it should answer all your questions. Here are my 2 cents: CPT is done to get all that excess mucus in the lungs to move around in order for oxygenation to get better. I don't think HIT will be much effective if all that mucus is sitting there and clogging the passages. Saline neb will definately loosen up the mucus and facilitate better movement. I would loosen the mucus, do some clapping on the back, suction and HIT. Keeping in mind that the patient doesn't suffer any resp. distress throughout the process. I guess these patient can't take it deep breaths to expand their lungs, theirfore we give them deep breaths with an ambu bag. I guess its the same when we listen to their lungs, we hear some rumbling and we have them cough a few times (moving mucus, facilitating oxygenation) and listen again... usually does the trick. Hope that helped, and make sure you read the policy at your facility and let us know the correct order.

I've worked with 3 different PCA pumps. Even though I feel like I know how to work the PCA pump, I've always made sure I had the proper training via in-service and was checked off. This is a high alert infusion, so you must be trained properly. So make sure you have your manager schedule you an in-service, and get checked off to make sure you know everything. Whats that popular saying? "WHEN IN DOUBT, DON'T DO IT. ALWAYS ASK".

I think ACLS is great even though you only work on a regular med-surg floor, especially for nurses that haven't experienced a code and are afraid how they will perform during a code. So if you don't need to take it, I'd rather have you take it to prepare you better in case a certain situation should arise. I don't think its required for other staff members to have ACLS training. It is waste of time and money. Its not even in their scope of practice to push meds during a code, unless you are an RN, NP, or MD. Anyone ever took ATLS? I'm enrolling in the class with one of the doctors I work with. It should be exciting.

You are a new grad, so I expect you to do that, keep it up. But in a few years, you will understand why I said what I said.

Knock on wood and pray to god... Haven't really met my PCP yet. Hope it stays like that for another 50 "healthy years"

:banghead::banghead:

Let me give you a great example. One night I receive a call from a nursing home that a patient had chest pain but it went away after nitro x1. The nurse said the patient has frequent bouts and it usually goes away after nitro. So she decided not to send the patient to ER. I work at an urgent care clinic and have to follow up on all urgent matters with the nursing homes. I call the nurse and request her to send the patient to ER, she says that it really wasn't chest pain. She was testing my patience so I just told her, if the nitro relieved the chest pain, what does that tell you? She really didn't say anything, I just wanted her to realize it was a cardiac problem. So I made sure the patient was tx to ER for further workup... Cardiac enzymes were elevated! Bottom line is, the nursing home nurse wanted me to be held responsible since she made me aware of the problem. If I hadn't forced the treatment, they could had said well, so and so didn't give us any orders. I didn't know the patient so I'm not going to agree with anyone's assumptions clearly when the nitro relieved the pain so it was indicative of cardiac problem. Better safe than be sorry. So what if they go to ER and everything is negative. You wouldn't had known any other way. Just because EKG is normal, doesn't mean there is no damage to the heart.

How many days a week do you work? If you can, put those days together. On the last day when you go home, take a little nap, and stay up the entire day until you are dead tired at the end of the day. It is your work day anyways so why not use the rest of the day as an off day? Then you should be able to enjoy your days off. When you go back to work, try to take a little nap before work so you can be okay for your 1st night back. Its usually easy to do a first night without much sleep since you know you will be sleeping after work. I've been working nigths for 3 years now, Its pretty easy to convert for nights to days on my days off. I work 5 straight a week then 3 straight the next week. I usually go sleep early, right after work. But on my last day, I go to sleep late and wake up right before coming to work so that way I am more fresher when I get off and enjoy the rest of the day with a little nap in between. A lot of nurses think we don't do nothing at night and get paid extra. Only if they knew how much we sacrafice by working nights with family, friends, and how hard of a time we have on our off days to convert from night to day and then go back to night come work time.