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Sewbusy~RN specializes in Orthopedics.

Sewbusy~RN's Latest Activity

  1. I feel for you. A while back I had a drug seeker who was angry I diluted and pushed slowly. I made an agreement with her that I would wake her for pain meds through the night. She was getting 2 mg dilaudid IV q 4h. I woke her twice and asked her if she wanted her pain meds, did the whole five rights and pushed it slowly. Both times, she called me 20 minutes after I gave it, asking if she could have her "pain shot". The first time I told her I had given it to her and she said "oh" and went back to sleep. The second time, she went all crazy and irate and started accusing me of not giving it at all, and then she started accusing me of taking it myself. I have never been so upset with a patient. I still don't know if she was making it all up or if she really didn't remember me giving it. Either way, her accusations made me wary of treating pain patients the same way. I see them now as a threat to my license. I'm scared they will stop breathing, I'm scared they will do what this creep did, and I'm scared that they will do worse things to get their fix. I'd rather have a confused patient trying to jump out of bed than a drug seeker.
  2. Sewbusy~RN

    Medical Charting in Family Practice.

    I don't think there's anything wrong with what you charted. The important thing is to be objective and honest and just state what happened, when it happened and how it happened. It is what will be used in court so it better be as factual and accurate as possible if you are the one under fire, in my opinion. I know you can never chart it when you do an incident report, but I've never heard that you can't put peoples names in there if they made a decision that directly affects the patient.
  3. Sewbusy~RN

    Good Recommendation Letter

    If you are getting letters from your instructors, they will know exactly what to write. They probably already have a letter saved on their computer that they just insert your name, and a couple specifics, and print it off for you. My advise would be to get as many as you can, and put the ones that are the most specific to you on top.
  4. Sewbusy~RN

    And the results are in....

    Ouch. Where do you live? I hope its somewhere that pays nurses well!
  5. Sewbusy~RN

    Ever Think Nursing Might Not Be Enough?

    I agree with what everyone else is saying. Work for a while. Let your "student brain" go and get on with the process of actually learning what it is to be a nurse, which is not taught in school. Let go of all that theory BS and forget about nursing dx/care plans, no one cares about those in the real world. In the hospital it's just another annoying piece of paper you have to initial as you're walking out the door because you didn't have time to be bothered with it when you are actually taking care of patients. All that aside, other than being crazy busy all the time, being an MD is nothing like being an RN. As an RN you are the one looking at the patient and figuring out what he/she needs. Your job is to figure that out and then, figure out how to get the doc to do what you already know needs to be done. I love being a nurse and you couldn't pay me enough to do what docs do. From what I have observed, the hospitalists have 80+ patients at a time, don't know the majority of them, and they spend their shifts answering pages, doing five minute assessments, writing orders and dictating practically in their sleep, and running to codes and such. They are mostly grumpy, unhappy overworked people, and I've only seen a handful who really seem to enjoy it. No thanks. but this is something youll be able to know for yourself soon enouh. Give yourself a year of bedside nursing and then see how you really feel about it.
  6. Sewbusy~RN

    Foley Catheter Removal for SCIP Core Measure

    We also put stickers in charts, bright orange labels on the foley bags and on the front of the Kardex. In addition, foley removal is now a nursing judgement where I work, but we don't touch them without an order if it is a neuro or GU patient, and a few other situations.
  7. Sewbusy~RN

    Feeling Flustered

    That's a ridiculous shift schedule, unless they are paying you a ginormous shift differential for working nights AND weekends! It is standard to work every other weekend, maybe less if you've got seniority/work part time or if the hospital has a weekend only staff (my hospital does and pays a very high shift differential for those who work all weekends) I work 12s, 3 a week. They rotate so generally it's 2 on 3 off, with 3 shifts in a row twice a month at the most.
  8. Sewbusy~RN

    Getting blood on your hands

    Well I usually put gloves on immediately when I walk into a patients room, but accidents do happen. I've has urine splash back from a catheter when I was clamping it in to the bag and pushed too hard (gross), I've had a patient projectile vomit on me. I've had blood spatter across the wall from a patient that pulled his own drain out. In the winter my knuckles crack and bleed from the dry air and from washing them hundreds of times a day. I use special soap from employee health, I use creams and lotions, but I can't ever get it totally under control until spring. It worries me sometimes I guess. One thing to remember is that gloves are actually slightly porous and they do break, so you can't really trust them 100%. I actually double glove when I give suppositories or clean feces, so I can quickly take off the outer pair when it becomes contaminated. Blood and other bodily fluids are just job hazards you deal with as an RN, and at some point it just doesn't really worry you so much. I just follow standard/universal protocol and pray :)
  9. Sewbusy~RN

    first code

    I have seen a couple and helped out in one. I actually really enjoyed it, that probably sounds callous but I liked how the doc just stood there calmly with her hands in her pockets and told everyone "let's push this, and do that..." and we had plenty of people who all helped and we had the patient stable and transferred within about 20 minutes. We don't have many codes on my floor, and when someone does call one it's usually not a real code but someone jumping the gun. For the most part we use rapid response and get our patients off of med surg and into a higher acuity unit when they start to go downhill.
  10. Sewbusy~RN

    Tips for a good shift!

    1. Keep in mind that nursing is a 24 hour job and you can't and don't have to do everything. 2. At the start of the shift, sit down and write yourself a skeleton schedule; include when you expect to pass pain meds, do dressing changes, pull catheters etc. Highlight things that are your highest priority. 3. Pee if you need to pee, for goodness sake! Your patient can wait three minutes. Two bladder infections taught me this lesson. 4. Have a roll of paper tape, a couple 2x2s, alcohol wipes, stat locks, IV caps and flushes in your pocket at the beginning of the shift. The first 4 hours are usually the busiest and the last thing you need to be doing is running back and forth to do minor things you notice need to be done during your initial assessment. 5. When you have an older confused patient that keeps trying to get out of bed or pull lines etc., take the time to do a bed bath if you can! Then cover he Pt with a couple of warm blankets and turn on some classical music if your hospital has music therapy. This usually puts the patient to sleep and almost always is more effective than Haldol or Ativan. However, if your patient is pulling lines/taking a swing at you or jumping because of withdrawal, go with the meds, lol! 6. Gain the trust of your patients right away, by doing what you say you will do, and little things like wiping their bedside table down with an antiseptic wiper giving them a warm blanket. If they can see you care and want to make them comfortable, they will generally stay off the call lights. Caution: this can backfire at times so be sure to assess your patients psychosocial needs as well as the physical when you first go in the room. 7. Accept the fact that you are only one person, and it's ok to ask for help. You are not super man/woman. 8. Realize that some shifts you will spend the entire time putting out fires, and you won't be able to do any of the things you want to do. On those days/nights, just let it be what it is and remember the shift WILL end!
  11. We give them six hours too, then bladder scan and call the doc for orders for straight cath or foley.
  12. Sewbusy~RN

    "unlearning" med surg habits?

    We "scrub the hub" on my unit, and it is taught on all m/s units in the hospital I work at. We also use those Curos to cap off all ports on all central lines.
  13. Sewbusy~RN

    Full Circle, My First Year of Nursing

    I know this is old but I just found it and it made me cry. Thanks for so perfectly articulating the roller coaster of the first year as an RN, and for reinforcing my reasons for applying to transfer to the NICU.
  14. Sewbusy~RN

    "unlearning" med surg habits?

    Thanks! Great idea, I'll look up neonatal CEUs tonight!
  15. Sewbusy~RN

    nurse to patient ratio orthopaedic floor?

    California- 4:1 all shifts, but occasionally take a fifth if were short. At night we have 1 tech and 0-3 aides, depending on the unit census. Days usually has 1-3 CNAs (by census again), a secretary and a tech, plus volunteers are available for restocking, dropping off labs/picking up blood, etc.
  16. Sewbusy~RN

    Pregnant New Grad Starting Ortho--Advice?

    I worked through my entire last pregnancy on an ortho unit and it worked out fine. Some shifts were better than others. You have to be willing to ask for help and realize that some people will resent you for it but you have to accept that it's their issue, not yours. Just do everything you can but ask for what you need and most people will be telling you to slow down and jumping in to help before you even ask. It may be a little harder going in to a new job pregnant though, since you won't know people so you won't know who ask that will be nice about it. Im sure youll figure it out pretty fast though. Good luck, and congrats!