twinjeep97

I passed the NCLEX last week and l started to apply to nearby hospitals. I got a call day after submitting application. In OHIO , new grads with BSN are being hired like crazy regardless of experience. However , on the job training and precepting allows "new grad nurses" to ask for as much orientation as needed..... My main concern is choosing the right career path. I have always been interested in Endocrinology particularly DM. Before choosing to work in this area can any nurses out there describe this specialty, additional certifications... EtcBtw this site has been so helpful while in nursing school. I truly appreciate the time and effort of so many nurses on this board!! You all rock!Thanks!!

Not sure what type of area you work in or your client load but I believe that this is bound to happen to anyone/everyone. Facilities expect no errors even with a client load of 10+. This just doesn't make sense. As a current nursing student I just feel that staffing levels are just unsafe. This is with the 10 hospitals I have been to. While hospitals are making cuts to save money they do not take in consideration hours worked, rest periods, stress, or outside issues. If staffing issues were competent then I guarantee errors would not occur. Magnet status or not, there must be over-sufficient staff. This is life and death, you would think state's would take this more seriously. Seriously being staff numbers, not by JCAHO coming in and pointing out minute errors. Hospitals like any other business pushes employees to the breaking point thus creating inevitable opportunity for errors. What do they expect? Wouldn't it be nice if employers/managers/supervisors/officials would actually take the time to explore the floor and ask staff about their mental/cognitive stress level? There needs to be a better system, period.

Thanks, I missed your initial explanation. So in other words, if I am hanging the 2nd bag on ATB (and it is same solution) no need to backprime correct? I guess my instructor wants us to get into habit of backflushing to ensure no compatibility issues. Also because if a shift change occurs, you may not be sure how long that solution has been sitting in the tubing.

whats a time waster? how do you do it? Id still like to hear ur input but will follow steps instructor tells me.

Yes that would be helpful. I need to invest into some skills cd's. But with original post, is that accurate?

well i just think with hanging bag and spiking, fluids may run out if the spike isn't all the way through when twisting. ITs also easier to grip when upside down.

Bc I want to make sure I am doing each step correctly in order to avoid asking clinical instructor repeated questions. I would also like to make a few notecards to review prior to performing each task.

yes why?

Hello, *With use of Baxter Pump* In this situation, there will be 2 bags, with the NS hanging below ATB. Another client is due for another 50mL dose of an ATB, so we must switch out the ALMOST empty secondary bag. When I go into room I will hit "stop." The connection from the secondary (portless) to main line is done by use of a "alligator clip." Once I hit stop, I will leave both lines unclamped and LOWER the 2ndary bag below the mainline bag. The lower the secondary bag, the faster the fluid will flow from mainline back up through secondary line into the drip chamber (hence bubbling). Once the drip chamber is almost full I will then squirt the collected fluid from the chamber into the old bag (clearly the line). I will then take spike out of old bag and spike new ATB bag UPSIDE DOWN while keeping clamp open on 2ndary line, then fill drip chamber to 1/3-1/2 full. Then would I program 2nd rate, 2nd volume, 2nd start, While ensuring drops are visible in the drip chamber prior to leaving room. At this time, the primary IV line should NOT be dripping (but will take over once the VTBI on 2nd pump is finished infusing). IS this correct? I really appreciate anyones input, suggestions, criticism. Thanks,

Hello, *With use of Baxter Pump* In this situation, there will be 2 bags, with the NS hanging below ATB. Another client is due for another 50mL dose of an ATB, so we must switch out the ALMOST empty secondary bag. When I go into room I will hit "stop." The connection from the secondary (portless) to main line is done by use of a "alligator clip." Once I hit stop, I will leave both lines unclamped and LOWER the 2ndary bag below the mainline bag. The lower the secondary bag, the faster the fluid will flow from mainline back up through secondary line into the drip chamber (hence bubbling). Once the drip chamber is almost full I will then squirt the collected fluid from the chamber into the old bag (clearly the line). I will then take spike out of old bag and spike new ATB bag UPSIDE DOWN while keeping clamp open on 2ndary line, then fill drip chamber to 1/3-1/2 full. Then would I program 2nd rate, 2nd volume, 2nd start, While ensuring drops are visible in the drip chamber prior to leaving room. At this time, the primary IV line should NOT be dripping (but will take over once the VTBI on 2nd pump is finished infusing). IS this correct? I really appreciate anyones input, suggestions, criticism. Thanks,

Thanks everyone I really appreciate the input!!

I have been researching and watching countless videos on Youtube of how to switch IV bags. Most youtube videos explain how to setup the initial bag and rate but not how to switch out empty IV bags. Can someone please help me with this, I would greatly appreciate it! -Lets say you have 2 IV's on 1 pole, 1 ATB and 1 1000mL bag NS. When changing out the bag of NS the line is already primed. So do I just need to tighten the roller clamp on the main line IV, flip bag over and empty remaining contents from drip chamber into old bag. Then uncap new IV bag, while maintaining sterility of spike then spike the bag. Then fill chamber, set pump, ad unclamp? Thanks!!!

I have been researching and watching countless videos on Youtube of how to switch IV bags. Most youtube videos explain how to setup the initial bag and rate but not how to switch out empty IV bags. Can someone please help me with this, I would greatly appreciate it! -Lets say you have 2 IV's on 1 pole, 1 ATB and 1 1000mL bag NS. When changing out the bag of NS the line is already primed. So do I just need to tighten the roller clamp on the main line IV, flip bag over and empty remaining contents from drip chamber into old bag. Then uncap new IV bag, while maintaining sterility of spike then spike the bag. Then fill chamber, set pump, ad unclamp? Thanks!!!

I just added vital signs and such to the sheet

Able to open and view it. Thanks a lot !