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shiccy

shiccy

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  1. I'm throwing this out there, also, but at our facility adenosine is actually not able to be pushed sans MD present at bedside (and in ICU, and with the patient attached to the crash cart). This being said, I might have missed it but the original poster didn't say anything re: what the rhythm actually was (afib, or SVT). Most of the time when we get orders for a tachy rhythm like this we will try either cardizem, lopressor, or give a loading dose (or a few) of digoxin. This is, of course, after fluid balance and rhythm is identified. Keep in mind that . I've also seen IV verapamil and amiodarone gtts, but those are more rare. Verapamil actually worked well for a patient that had been in an accelerated ventricular rhythm (and asymptomatic) for a while with no response to other meds. Also, amiodarone has a ridiculous half-life of 58 days (range is 25-100 days).
  2. shiccy

    termination for expired acls

    We had an instance of an RN that was put on a final for documentation reasons. Per HER account (I wasn't involved, but heard it second hand) she filed a grievance, was sat in front of the manager(s), CNO of the entire hospital, HR, etc. and the writeup was removed from her account and she is still working with us. This being said, good job on not signing the writeup, and file a grievance with HR ASAP. Lawyers help, too, obv.
  3. shiccy

    Patient Abandoment

    Wow I think you need to find out what your max hours for shift is. I'm in OH and it's 16 w/ at least an 8hr break between shifts. I would NEVER imagine this happening to somebody. I personally would write an incident report on that person stating that she made threats of patient abandonment if she did, indeed do this as it's #1- blatantly against the law in many or most states #2- unsafe for patients to have a nurse for 20 hours straight #3- Unethical behavior. I'd also recommend possibly taking this issue to your director as she should know that this happened. She/he will probably not be pleased.
  4. shiccy

    15 yr old misdemeanor a thorn in my side!

    I had been terminated from a job in my distant past. I'm truthful about this. I don't get into details on paper, because if they don't meet you they'll never know what kind of person they'll get or skip over. I've been truthful about this and have always gotten an interview regardless. On my applications I always put, "Please ask". This way you will get the interview, they'll meet your personality, and can go from there. Each new job I've gotten SINCE then *have* asked "When I was reading your application, I saw 'please ask' under ........ Can I ask what this means?" I actually got very detailed about what had happened, and then TOLD THEM WHAT I HAD LEARNED ABOUT THE SITUATION. They were very appreciative, and the interview continued. I've had 5 jobs that I've interviewed for, and haven't had a difficulty! "Crimes" are a bit harder to deal with, but I would do the same approach. "Please ask". Stick with the positives of your experience. What did you learn from it, etc.
  5. shiccy

    when to report/notified....

    FWIW in our facility the RN is the only one that is able to call a physician. I do not know if this is a "State Law" issue, or just hospital wide. I would assume that it'd be the latter b/c aids, even if trained properly are NOT allowed (even though state says they *are*) to place foleys. I have no problem with either. I'm sure there was an issue earlier on in the company history that made this issue a necessity. I'm in Ohio if you were wondering.
  6. Agreed with Lori- Some people might be able to assist if you actually had a ASN/BSN from the Philipines, but some ed here and some ed there is a hard one. I honestly would have to say that the credits PROBABLY wouldn't carry over/transfer, but I could be wrong. If your transcripts are not English based, it will behoove you to translate them before turning them in.
  7. shiccy

    bullying at work

    Were these personal sneakers / shoes? That's downright nasty. I agree with the others, if there's another place you can go, PLEASE get out. Also, please document EVERYTHING said and done. Pictures are worth a thousand words, as well. If they cut your shoes, I'd definitely invest in a lock for my locker (if you have one). If not, I'd change my shoes at my car. It's not the most convenient especially when it's cold, but it's something that has to be done so they don't waste tons of your hard earned money. After you have sufficient "evidence", you can consult legal advice and see what to do about it. Finally, sometimes it takes you having to confront the offending people before things stop or at least slow down. Saying something along the lines of, "Have I done something wrong to offend? I feel like we aren't seeing eye to eye, what can I do to resolve this?" Please don't make "you" statements as this will almost always offend in a confrontational environment. Finally, good luck. PS- I wouldn't file for a hostile work environment until AFTER you find a new job. While they won't fire you outright right away, they WILL scrutinize everything you do from there on out and find a way to do this.
  8. shiccy

    To call or not to call....

    Sounds to me like you should continue to look, but continue to pester. That being said when I put in my application at a national restaurant many years ago they pulled this with me. It took my pestering for the better part of a month and a half before I started working. Keep pressuring gently, usually once a week but sometimes more frequently, until you hear a definitive "no". May SURE to put in there, "I hadn't heard anything, so I thought I'd just follow up a bit."
  9. shiccy

    Air in the line!!! What am I doing wrong?

    1. Open your bag of fluids and hang it on the pole. 2. Open your IV set and CLAMP it BEFORE spiking the bag. 3. Take the tab on the IVF off, remove the IV spike protector. 4. Spike your IVF, fill the chamber 5. UNCLAMP the IV tubing. When the fluid (it doesn't matter WHAT you're running) reaches the portion that is continually compressed by the IV pump, INVERT the tubing so the air flows in the distal direction of the IVF bag. 6. SHAKE the tubing with one hand above and one had below the inversion. This ensures all air is expelled. I used to have this problem. After I switched to this method I've NEVER had a problem. Don't put the secondary tubing in place until AFTER this is done. Clamp the secondary tubing before connecting to primary, connect, unclamp, and then put in a dependent position and remove spike protector. Replace protector when the chamber fills, reclamp until you're ready for its use
  10. shiccy

    when to report/notified....

    There's two views on this one. I worked with a guy that was an LPN. He would alert us properly and put that in his charting, which is totally fine.... HOWEVER this does *not* mean you can wipe your hands clean of this patient while the RN "fixes" them... We may intervene with a med, but you're still primary on that patient. I know the LPN was just kidding when he would tell us, and he would sometimes jokingly say, "Yeah ... Well ... RN NOTIFIED!" He totally DID notify us, but saying that was kind of like *jab jab jab* Maybe they think you're not trying to trouble shoot / intervention with the patient enough? In the end, you are CYA (covering your a**). I wouldn't let them get you down. When they call a doc and say, "This person's glc is 50 an asymptomatic" ... If the doc didn't give any verbal orders, I'm SURE they would right, "Physician notified, no new orders received" ... It's the same deal. You're following the chain of things, and if they don't want to do anything, great. If they do, great. Either way you're doing your job, and you're charting what you did and who you notified.
  11. shiccy

    no cell phones no personal phone calls at work

    When I am at work, I do have my cell phone, and it *is* in my pocket. We have a strict no cell phone rule, HOWEVER, my phone is also my PDA. It has the ability to do calculations including BMI's, unit conversions, etc, as well as being my own personal portable always on and highly searchable PDR. My phone is ALWAYS on airplane mode until I sit down for lunch, which then it goes on for a while so I can see what new things are happening w/ e-mail and txting. Afterwards back off it goes, and either back in the pocket or in the bag for the rest of the morning (rarely need it after my HS med pass)
  12. shiccy

    Safe Harbor situation?

    I'm from OH, and unless I've just not come across it, I'm fairly certain I've never heard of a "safe harbor" situation. This may be a regional/state only thing? As far as the hitting is concerned, I'm sorry that's happen(ing) / (ed) as it's never fun. I'm wondering myself if he does this to everybody? If NOT, I wonder if it would be beneficial to attempt dress casual clothes (SUCH a PITA, but ...)? For no reason at all some mammals are infuriated by certain things. (ex: some dogs go after cars/wheels, others after people in uniforms especially mail man and utility workers) Could this possibly be the case? Does he do it to docs as well? In addition to the wrists I would recommend the restraint alternative mittens that prevent people from picking at their IV/dressings. This way when he punches he won't hurt as bad, and he can't GRAB ... any man would attest that this is a fantastic idea, especially if the patient is being turned TOWARDS said man ... crushed manhood is not a fun thing, either. BTW I'm not comparing your patient to an animal, I'm just using a crude example...
  13. shiccy

    no cell phones no personal phone calls at work

    Food for thought. You are required in most states BY LAW to have a 30 minute NON-PAID break. During this time you have full right as you ARE NOT ON THE CLOCK to do whatever you please. As long as your patients are being watched and you're available if absolutely needed, they are NOT allowed to tell you what you can and cannot do on your break. As long as your break activity is not breaking local, state, or federal laws, they cannot touch you. Also, FWIW if this is a floor or unit specific "rule", unless this was told to you prior to accepting the position or was in writing, this is not an enforceable rule in many places. They can get you on insubordination, but more than likely this would be thrown out if taken to HR. If I were a nurse that was being isolated in a locked psych unit for 12+ hours at a time, you better be d**n skippy I'm going to have SOME form of communication with the outside world, if for nothing else than to dial 911 when your local security staff members refuse to help you with a patient that is a danger to workers, other patients, or him/herself. Believe me from experience this HAS happened, and thus they can go suck a gobstopper up a straw manually for all I care. WITH THAT BEING SAID ... USING YOUR CELL PHONE WHILE ON THE CLOCK, ON PATIENT CARE, AND ON DUTY IN MOST PLACES WILL GET YOU AT MINIMUM A ONE STEP DISCIPLINE.
  14. shiccy

    When do you intervene when food is lodged?

    Or cause spontaneous amputation of said husbands finger
  15. Ultimately these stats are completely ridiculous and cra*. That said, the rationale behind the first time passage of NCLEX rule is related to the fact that these places are suppose to be educating you to be nurses from the get-go out of nursing, and it wasn't happening to most state's satisfaction. The rationale in my mind is that most people will study for NCLEX, sure, but will NOT take extra courses/spend extra money the first time around for things like in classroom NCLEX reviews. I'd say probably a good portion that take it a second time have subscribed or taken in class nclex reviews or at least bought a few more testing packets from the store. This means that the school didn't do their job properly in preparing you for your licensing exam
  16. shiccy

    GRRRRR...why no phone calls?

    Here's my way of working: Call once a day every day until you hear from them. Right now is prime time to go on vacation. My director's taken at least one or two extended ones this year. This makes it difficult if not impossible at times. If you don't hear anything in approx a week from this person, find the HR number (call a unit, operator, etc and ask for HR) and say, I'm having difficulty getting ahold of the director and was wondering my status for the job. Finally, it's been my experience that if you've not gotten calls back or promises have been made and not kept (and you've not even started, yet) RUN AS FAST AS YOU CAN. Think about it. They're short staffed and thought you were an excellent candidate. Instead of rewarding you with a prompt call back, their lax views/personalities are not calling you back. What does this mean for you? Well THAT is the person you go to in order to file a complaint, send ideas to to make the unit better, etc. If they're not calling you back right now, I can only IMAGINE what kind of response you'll be getting when the time to get things changed comes for you.
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