Freshman RN

the problem with any job, especially right now, is that everyone is on edge. the coworker problems are always there no matter what job that you have. our just happen to be rude doctors, surgeons and nurses. patients will always complain no matter what the service, and usually about stuff that really doesn't matter. my MIL once complained that following surgery the nurse came in to wake her to make sure that she was still breathing at 0300, (sorry siding with the nurse on this one) this is something that she complains about today. people tend to forget all the good care and remember small things. dr's are a strange group, just do your job, document and limit contact. negative coworkers: limit that contact to. they are negative in nature, they don't change from the time they get up to the time they get to work. there is always a large list of complaints( the dog the car the weather) it is where they live and where they like to live. thanks

our school based it sole on gpa, credits and A&P

her tank was full, we bolused her for the pressure originally and the decrease in urine. normal osmal is 275 to 295 so the 305 not really to far away from normal. flushes were with every shift and we did get the 60 back. is there a reference for the diurectic phase, i am looking and cannot find any info. thanks

serum osmolality 305

I recently had a patinet that came to us from the nursing home. she had been obtunded for 6 hours, BP 50/30, diabetes. comes to the icu, blood sugar 110, b/p 90/50. foley placed-hardly anything out. had to pull with syringe and then like vanilla pudding. urosepsis dx. - arf - etc... u/o 320 over next 12 hours then nothing for 2 days. irrigate x6 with 60 mls. pt repositioned hourly. iv filuds going at 125 with bolus for 2 days then 30. After 2 days of nothing for u/o, soaked bed & 1300 out. b/p back up and continued to put out. End result death after 5 more days. :confused:any thoughts on the copious amount of urine??

"The question I am trying to determine is whether to report that nurse to the BON, or does this fall under the minor incident rule which states you can make 5 errors before reporting to the board." I have never heard of the "minor incident rule, but this is a major error, what if the insulin wasn't effective?? what if the sugar isn't checked in a timely manner? Do you have a 2 person check in place for insulin?

"I'm still a student, so I'm not making any accusations or anything here so please don't get upset, I'm simply curious. This seems to me like taking a HUGE risk. If something does happen, and an investigation is carried out, how many of you think that MD will actually back you up? Do you really think they would?" The doctors still have to sign behind you. Are you sure that there isn't a list of standing orders?? There is in someplaces an "accepted practice" if someone is on a vent, you apply scd's ng, foley get a ua with the placement, wounds get e would culture, PT etc.... And there are "accepted parameters" PT( who writes dressing orders), Respiratory therapy( who changes the vent), pharmacy( who makes or changes dosages) who act and write orders based on their job. my advise Know your doctors, your hospital and your nurse practice act.

Patients have 5 rights. right patient, right med, right dose among them the fact that they are outdated is the wrong dose/ med and 5. injections to 5 people is 5 med errors. the only combining that you can do is combining the wrong dose/med with the person given it to.

such a good point! get a letter from the dean! i am still at a loss why put that you are bipolar on facebook. I have nothing against mental illness, but I think facebook is a bad place to let that knowledge out there.

" "That is a highly unusual arrangement, and would not be permitted in any of the states I've been in over the years." "why would or should a hospital allow its building/equipment be used without compensation????" our hospital does it so that those students will be hired at the hosptial after graduation. Grow your own.

did you read the article to the side of the page?? New HIPPA laws may protect you in this case. A pt will have to be notified if a hippa violation happened. What about the state nursing board?? I mean before you pay a lawyer, have the state nursing board and the HIPPA compliance committee do the work for you.

small amounts of stress are useful. Nights like these can only be chalked up to learning days. kudos to you for giving all you could

hr 110 to 32

talk to your doc

What did they ban you for? The HIPPA or the bipolar. I certainly would make sure that I knew. Isn't there an HIPPA person in the hospital that has to follow a paper trail. If the hospital accused you they are liable for the fines. I am sure that there is paper somewhere?? Ask for it.

1. How about you try working in a nursing home before making a judgement call. I find your post very confusing and insulting. I did work in a nursing home, and all nurses should know that you cannot find a diastolic blood pressure without a systolic one. that is basic nursing 101. To report this by a nurse to the paramedics is laughable. 2. The systolic in the bag was a joke, you cannot put a systolic bp in a bag, that is also nursing 101. 3. "I've also seen some people post on this very site, posting things that don't make any sense with horrible grammer and exhibit no intelligence whatsoever... yet they're nurses. How the hell does that happen?" https://allnurses.com/general-nursing...ce-417892.html Maybe the person who posted this worked too many hours, didn't drink her coffee, and didn't proofread! She'll probably wake up tomorrow morning and think what the #*$) did I post? I'm not really sure how 2 misspells makes someone a person with " horrible grammer and exhibit no intelligence" I woke this morning with coffee at side and still laughing about the previous day. This is why yong nurses think that we "eat our young" I wonder if you and i met in person, would I be a person with "with horrible grammer and exhibit no intelligence". this kind of comment could make me have a bad day. It was a jike, if you didn't understand go to the next post. 4. She meant, "here is a funny story and I kept this story 'in a bag' to tell someone to make them laugh on a crappy day'" thanks, I also love the posts, they are great, people are so passionate.

npo doesn't mean no iv and what is procedure?? I would be way more concerned about bowel surgery in a pt with alow whit count than a healthy young lady have an d&c

is your question the cost? or the concern for the pt?

I think this is a case of a flawed system. is ems required to transport? isn't each admisson a new dnr??

no you cannot just be a competant nurse, these are the nurses that as sued and complained about. Fake it!

One thing I have learned is that you job should be the easiest part of your life. You should be able to go, do your job, and go home without any thought to it after you leave ( for the most part there are those that you think about outside of work) Every place has negative people and cna/nurses come in 1 of 2 kinds great or lazy. be good to your cna's they will be good to you, noone like a rn that tells them that they ( the rn) are better than you either verbally or nonverbally. Jobs are alot like marriage, you can't just decide that you are bored and walk away. What if this is the best job that you have( after you are on your own). I know it sounds like i am saying leave and stay, i'm not. I am saying that if this job if affecting your physical health give it up but if you just "want to be happy all the time" then you are being selfish and unfair to those who gave you the job. Newer Nurse ( 5 years) but old Wife ( 25 years)

:typing I recently got a patient that had come from the nursing home. The paramedics were told ( by the nurse sending the patient to the hospital) that he was unable to obtain a systolic blood pressure but did manage to get a diastolic one. :chuckle I later relayed this to my supervisor at the hospitaland he brought it to me! I kept it in a bag in case we need it sometime, we know just where it is. Additionally, my patient had been obtunded since noonish, and was sent tot the hospital at 1840, but a quick check of her medication reconcilliation, showed our dilligent nurse had given her all her meds, even her trazadone!

fraud? because if you are charging for a tele bed and not providing that service by competent staff wouldn't that be fraudulant??? We can't charge patients for meds or procedures that we don't do and we can't charge patients for services provided by housekeeping if they fall under medicine. What if medicare audited,found one incident and looked further and found out this was the practice?

Isn't this fraud of some sort? we just had this dicussion, if we are charging for this service shouldn't we provide it?