jaxnRN

I got my Illinois license (also was a second along with my Iowa license) and I had mine done at the police station. Done the old fashioned way...ink finger print...ink finger print...etc. Made me feel like a rebel. You are SO right. It is truly a hassle. I am not sure if it is any different now because I did this a few years ago. It cost $10 for the prints to be done. ~Jackie

Can I also have a copy of these worksheets? I am in the same boat.

I am the staff development RN at our LTC center. I was asked today to create the yearly skills fair for the nurses and CNA's. :typing I have been a participant in countless skills fairs but have never had to organize one. If anyone can help me, this is what I need: I have a few topics that are necessary for our facility. I am doing the research with the policies and procedures. I have taught a lot of new nurses and feel that I do have great talent in teaching. BUT, I would like some ideas on the presentation. We don't have any resident models so will have to use "real people" for demonstrations. Any ideas on how BEST to present this? I need the basics. I have heard of Jeopardy games to play for inservices but wondered if there are any pre-made outlines. Trying to keep it fun but I want everyone to walk away with some new knowledge and skill. Our facility does not have any previous "copies" of how these have been organized in the past so I am starting from SCRATCH!!!! Any and ALL help would be SO greatly appreciated. If anyone knows of any websites or books... Any past experiences you could share? Thank you one and all for at least reading this. I didn't word everything on this post as good as I wanted but needed to get this question out there to all of you wonderful nurses. This is my pool of knowledge. I have a month to organize and I am just anal about organization. Help me....... Jackie, RN

That's great that you want to work OB. I worked in OB for over 15 years and NEVER thought that I would want to work in any other department. In the last 5 years I have taken my career to Home Health and LTC and Hospice. I had several doctors who would kid me that I worked opposite ends of the life cycle back to back! :heartbeat The hardest part of OB nursing for me would depend on the day. It can be the BEST department to work in or the WORST! The reason being of course because not EVERY situation has a storybook ending. The BEST part is being a real part of the birthing team. You form a bond with the moms that can last FORVER!!! I see moms in the stores out in public and they do remember you. Your name. What you said to them during labor. The little things that you did for them. It is so important to remember that you will make a lasting impression. My dad is an OB/GYN and I pretty much grew up knowing the lingo and the great hours!! So it didn't bother me to be on call. I really had a great advantage in that area as far as knowledge was concerned. I used to read the ultrasound books and labor/delivery books that he had on his bookcase when I was in the 2nd grade! My mom was an OB nurse for her entire career. I remember hearing her stories and how BAD her legs ached after working double shifts. Almost every day. So I guess the OB thing is in my blood. And yes, many babies have been delivered without the doctor there. Depending on the facility you work in there may not be a doctor in house 24/7. The nurse that trains you will be invaluable. Listen to everything she has to tell you. Don't base your nursing advice based on your personal experiences. Know that one size doesn't fit all. Just because something happened during a mom's first delivery does NOT mean that it will happen again. Anything goes. A lot of new nurses on orientation like to tell personal stories. There will be time for that. When you orient, make sure that you do much more listening than speaking. Questions are good but I'm sure you recall nursing school theory when EVERYONE has to share what happened to them. Get as much information during your training as you can. Go to as many deliveries as you can as a student or new nurse. Don't be afraid to tell your nurse preceptor that you are not comfortable with a skill enough to do it independently. Make sure you DO IT with help and then DO IT with someone observing you. Be comfortable and confident. I'll stop rambling now. And as with any nursing specialty you will learn MOST with experience. And you can't rush that. One day you will just FEEL like an OB nurse. Experience is truly the best teacher.

My mother-in-law is recovering from a ruptured aneurysm (abdominal). She had an exploratory laparotomy and the spleen was removed. Received 2 units of blood. She is doing well and on the road to recovery. It is her 3rd post-op day and the doctor told us today that she has a "bruised pancreas". All I can think of re: a pancreatic contusion is resolution on its own, with time. Does anyone else have any info on this? Such as possible complications or residual effects? I wasn't there when the doctor delivered this news so I didn't get to ask any questions. I know that this is the place to come for answers!!! Thanks for ANY help.

You are ALL so very awesome. This is the best resource I have ever found during my nursing career. Thank you to everyone! ~J

I did not know this! Something I need to look into. Thanks for the info. ~jackie

wow! this seems like a very simple question but sometimes the fine details are not clearly recalled. especially when you get to be as old as i am. i have a question regarding inhalers. what is the proper time interval wo wait between giving two different inhalers? i remember learning 5 minutes but is this wrong? has it changed? thank you for your kind responses. i feel like this is something i should just know. but in teaching a new nurse, i want to get it absolutely right.

i would love some input for inservice ideas. the audience intended for lpn's and cna's. topics could include safety, medication errors, pain management, communication..etc. obviously i and wide open to any suggestions. it seems that our ltc facility lacks the creativity to make inservices educational but also interesting. i've done a search on this site but have found nothing specific. i am very interested in providing some much needed updates for our staff. thank you for any help.

I agree with that comment. Most definitely. I was just wondering about the actual written LAW. There are many LPN's much more knowledgable than some RN's. That works both ways and we all have our strong points. That's why it's so important to work together as "nurses" and not seperate the title when it comes to working for the better good.

Okay. I see. Is Illinois required by the state to have an RN on site/nearby?

What do you mean that u are in trouble if what happens? Having an RN THERE or NOT there? We have our DON and ADON to call if needed. But when I am not working, there are no other RN's on duty. ALL the other nurses are LPN's.

the really stupid thing that doesn't make sense to me is that i actually checked the mar before putting this on! we write down the location of the existing patch so that we will be sure to find it and rotate sites. i saw that it was put on just a day ago! i looked at it and still went ahead and did it! ! we also write directly on the patch our initials and date and time. i have oriented a lot of nurses through the years and stress to them that you have to pay attention and not just go through the motions!! we even are enforcing a policy not to interupt nurses during med pass unless it is something urgent! it's way too easy to get distracted on some days. i am glad that something good came of something bad though. we did find that the order should have been routine and somewhere along the line it got changed to as needed on the physician order sheet. i cringe at that fact that the physician i have to report this to really frowns on med errors. one of the least understanding of them all. and as you know, we have all caught med errors that physicians write. we are all human. thank you all!!! :bowingpur: i love nurses who really understand. :redbeathe: and support each other. you are all awesome!

Oh yes! I know too well of the error that I made. That's probably my point. I KNOW better! I absolutely LOVE having students and orientees. When I had nursing students with me in Home Health and Hospice I think I tried to teach TOO much! I was lucky to have worked for a physician for many years who was an awesome teacher to his staff. He would explain anything to us and share unusual occurences in the OR. Experience is the best teacher. And that takes time!!!!! In 17 years of nursing, I can honestly say I learn at LEAST one new thing every day!!!! And if I don't know the right answer, I always look it up! My boss calls me a walking encyclopedia! But this is also a great place to come for info. Love this site!

i attended a hospice conference last fall. the speaker, a very high ranking nurse in her field, was talking about ltc. she mentioned that in iowa, medicare is going to require an rn to be on the premises 24 hours per day. she told everyone that "yes, it is coming soon. within a year." i have not heard anymore about this. i can't find info online. while working home health our lpn was taken off of her duties as case manager as she could no longer supervise/evaluate cna's, which was a weekly duty. she could still do home visits. this change came from our state (iowa) nursing newsletter. our home health was county based. she was "demoted" in a sense from something she had been doing for over a year or more. so, has anyone heard about ltc requiring an rn to be on grounds 24/7? wish i could find my papers from that conference and be able to contact the speaker. she was great. thanks, once again, for your answers!

yes, in my 18th year of being an rn i am still so hard on myself. i was "raised" by a very, very, very serious surgeon who made me the nurse i am today. details. details. details. i guess it just seems like a huge deal to me and even my don told me "don't worry about, everyone makes errors. i know you are an excellent nurse". it's just like "ugh!" how dumb of me! it was clearly my fault. thank god it didn't hurt anyone. i have worked some high stress jobs that required fast thinking and acting and i guess i should be thankful that i haven't done anything worse than this. yet.... :) thanks you guys. we all need to have each other's backs!

you honestly will be fine...depending on how busy you are. the busier, the better. the 4 a.m. to 5 a.m. hour was always a sinker for me. no matter what, i would get that empty, out of fuel, yet restless feeling. it passes. drink a lot of water!:smiletea2: you will sleep on sunday. just make sure you go to bed and don't try to get the house clean, do dishes, laundry etc. go to bed!!! take a nice warm bath and lay down!!! you may not feel like you will be able to sleep but trust me, you will. remember, you are not alone. there are many (if not most) of us who have worked the night shift and didn't think we would make it through. i know a lot of nurses who would never work days! it might be your thing! so don't be negative about it. sounds like you are already counting on feeling like crap. you might just surprise yourself! i don't suggest reading on your break, if you have one. take a protein snack and some crunchy things. remember how important your job is. feeling "off" is normal at first. and some nights will be easier than others. it helps to have good co-workers. let us know how it goes!!!

i made a medication error. i was filling out the form and need some input. working in a ltc on monday, and the nurse who was reporting off to me and counting narcs mentioned that it was "patch day". which means that in the hall we were on it is the day to change the duragesic patches on residents. (actually two residents). well, i signed a patch out for each resident so that i could apply them that morning. this is a very busy hall and a lot of acuities for ltc. i had one resident in severe distress and several others with acute serious needs. not that it is an excuse, i am just trying to paint the picture in the real world. the nurse that told me that it was "patch day" is an excellent nurse and i can never remember her making errors herself. so, i applied the patches and then went to put them on the medication administration record. i then read that it is not "patch day". patch day was yesterday. :doh: so, in reality i had removed the existing duragesic patch and replaced it with a new in 24 hours instead of 72 hours as ordered. the order for the patch reads: duragesic patch 25mcg q72h as needed!!!! first of all, we never write these patches as needed. so, at least looking back at the order i did catch this pharmacy error. but, still changed it too early. anyway, the duragesic patch is a continuous release. this error would not be considered "double dosing", right? and when the patches fall off or will not stay adhered for whatever reason we replace with a new patch. no med error occurence has ever been written up for that! my don isn't upset with me at all. i am upset with me. when i worked with home health and hospice if the patches fell off we were to tell our clients to apply another. i am just so frustrated that i could have been so busy that i made this error. when filling out the medication occurence report i tried to logically think about how this is an error. of course, it was put on too early. but that doesn't increase the dose. plus, the pharmacy and the physician's order for the month actually states to use as needed!!! this resident is never in pain so either the duragesic has done its job or we need to decrease the dose. there is no documentation that the pain patch is needed. so, it's actually a good thing that this happened. it definitely made me slow down and it revealed the pharmacy/md error for prn dosing. for a couple of years the dose was q72h routine. and the med was listed on the medication administration record under the routine meds when it even reads "as needed". :zzzzz if you are still reading and following me, my question is this: how would you word this error? there were no adverse effects. does changing this patch in 24h actually give a med dose error???? i've been working way too many long hours. :stone:smilecoffeecup: thanks for any input and ideas. sorry this was soooooooo long!:redbeathe: i just feel really stupid for making such a dumb mistake. :urgycld:

Always answer call lights. Wouldn't we all feel guilty just leaving them without responding? Just like an I.V. beeping at you down the hall. After all these years I still hear "beeping" in my sleep.

i feel your pain. remember that there are some nurses that are considered to be "territorial". some may be threatened by you. i really think that all institutes should have a customer service class that addresses all issues. the issues being communication, problem solving and being friendly and open to everyone that walks in the door. maybe you could talk directly to the next person who seems to be "mean". it can't hurt. maybe that person got am impression from you that you didn't intend to send. but when it comes down to it, all you can control is you. "no one can make you feel inferior without your consent." ~eleanor roosevelt make your day happy. you might find that you influence other people who feel the same way that you do. remember the younger nurses coming into the field. get to them before they get a bad impression of nurses. be open. and like many have said here, women will be women. bad stereotype but it's something that will never change...unless we are all aware of it and make things better one minute at at time.

This may be a really dumb and wishful question...but I am itemizing my taxes and using Turbotax. There is a question there that asks about vehicle insurance. I was a Home Health/Hospice Nurse for the entire year and used my personal vehicle for work. I put on a LOT of miles and wear and tear on my vehicle. I didn't take any of this off of my taxes last year. I'm in the process of still figuring out the mileage deal. Turbotax states that the mileage rate is 48.5 cents. Although I read in another post that it was 50 cents. So, if anyone knows about using insurance as a "write-off" let me know. Thanks so much!!! I paid so much out of pocket this year and still can't make ends meet. I've been an RN for 17 years and at our agency we are making LESS than new grads are getting on average nation-wide. Glad I'm not in this profession for the money. :icon_roll

OB nursing chose me too. My mom was an OB nurse for her entire life. She worked double shifts, in TWO different hospitals in Cleveland. She used to come home and sleep on the couch while I played in the living room. I remember how exhausted she used to seem....but now I GET IT!!!!! My step father is an OB doc. Delivered babies for 35 years. That's a LOT of sleepless nights in a solo practice. I grew up at a dinnertable filled with conversation about placentas and inductions. It's in my blood.....I wouldn't be settled anywhere else in the hospital. I would be wondering what was going on "up there" all the time. It's my spot.

Thank you very much for that info. I read the application but actually thought that the fingerprint info was for foreign applicants. That is something I am going to have to get right on top of. Wow. Also interesting that there is no mandatory continuing education requirement. We are right next door to Missouri and such different policies. I am now wondering what the difference in the pay scale is going to be. I am looking in the southern half of Missouri. I work in OB. Will be interesting. :)

Hi. I am considering a move to Missouri. I am currently licensed in Iowa and was wondering what the usual "waiting" period is for the endorsement into Missouri as far as getting my license for work. I printed my application tonite so I have that ready to fill out. Does anyone know? Thanks in advance!

Well, I gained weight on nights. Of course, in OB, it is feast or famine, (pardon the pun), so when we were busy of course, I wouldn't eat at all. The danger came in when my 12 hour night shift was over. I had to get the energy to drive home, get my kids ready, drive them to school and stay awake to drive home....safely. I would eat to get myself awake and that called for mostly quick energy crap, like Snickers! I am being honest here. I ate like crap. I slept VERY little, and on my days off, I really lacked energy since nights did not agree with me. I am NOT a night-shift worker. I tried it and it didn't work. I think I might have gained about 25 pounds or more. I don't know for sure because I REFUSED to weigh myself. I was a fitness-aholic, and lifted weights and did cardio each day, but when I went to the 12 hour nights, I didn't have the energy for it and lost my incentive. Since then, I have gone to days, got back into working out 6 days a week. I sleep at night and have dropped the weight. It scares me to do a per diem night shift because of all of the above. I asked the same question you are asking about a year ago or so. I got mixed answers, 50% gained, 50% didn't. Each person is so different. Good luck. My best advice is HAVE A PLAN!