grneyes676

I have been reading sample narrative notes and soap notes online the last couple days, which has made me wonder.....why would you write a narrative note including all the data that should be on your flow sheet and in your shift assessment? Don't you risk making a mistake by charting the same things in 2 different spots?? Where I work, we chart our shift assessment on the back of our flow sheets.

I am still undecided. I have things I like and dislike about each of the concentrations Walden offers.

I have been going back and forth about going back to shcool for a MSN degree. I really would like to advance myself, but I cannot decied if I shoud do the Walden route or online classes thru a brick and mortar institution. I kind of feel like I will not be taken seriously with a degree from Walden. Not that it should be that way, cuz I have heard it is a hard road!! Any opinions on this??

WCC has a great program!! I graduated from WCC in 2002. Being that it is a tough program, my biggest advice would be to focus. Dont let other things interfere with going to school. It really has to be your number one priority. Good Luck!!

Currently there is no extra pay for being in charge or precepting!! I belive that thare should be...our contract is up next year and I have heard that this subject is going to be brought in durning negotiations.....

Most pump tubing can be ran just as gravity...just dont put it in the machine. It depens on what pumps you use, but there is some sort of clamp that is on the tubing part that would go into the machine, you use that just as if it were a roller clamp. I prefer to run my boluses by gravity if it is a PIV, that way the run at there own rate, not with to much pressure, less chance of blowing your IV!!

I love my Dansko's too!! The store I purchased mine at has a bump and scratch pile, nothing wrong with the shoes, just a scratch in the leather or something similar....I purchased 2 pairs for $80!!!!!

I do not remember where I learned to waste meds...I dont think I haver ever seen a written rule anywhere....I always put the meds in the sharps container, wether it is a pill, in a syringe, or if I squirt it in there....if someone wants to go dig in the sharps container to get an oxycodone they can be my guest!!

Most doors where I work lock at 6pm...I belive the main enterance locks at 9pm and security is there. There is a door in one of the parking structures that is open 24/7 with security sitting there and they call up to the floors if there is a visitor to ask if it is ok for them to come up, the ER does not let anyone in for visiting....employees can not even come thru the ER!! We have to use our ID's in the card reader to get in at night, but like someone said earlier....you open the door and 5 people come in after you!! I try to not let people in at all and explain to them that they have to go thru security! Also security is highly visable all the time. A few years back we had someone come thru the ER, he shot and killed one of our docs!!

This debate drives me crazy!!!! Each shift is busy, just a differnt kind of busy!! but here is how my shift goes....... I work 12 hour nights. We hit the floor running. Once we get out of report about 730pm we have to assess our patients and maybe to vitals (depends if we have an aide), then it is time for tpn/lipids to go up, by the time those are up it is time for 9pm meds (working on a transplant floor there are tons of meds) in the mean time the OR admits are all coming at the same time, while the docs just did afternoon rounds and none of the new orders were tended to, they usually consist of blood trans. or e-lyte replacements, oh and dont forget the patients need to be up and walking at least one more time. Hopefully I get this all done before report at 11pm when I pick up a couple more patients. Then 9 times out of 10 we dont have an aide so at MN I get all my vitals and assess my new pt's, start the new 24hour flow sheet, chart checks, MAR checks, while answering lights and doing Q 1 hour urine dumps on my fresh kidney transplant with cc/cc replacements, also answering the phone and pulling orders since there is no clerk, updating the kardex (yes that god awful old system..LOL), then at 4am it's vitals again along with drains and boy do our pt's have tons of them, then of course everyone has low urine output ....then the paging the docs for the low UO and hanging boluses, btw, got to have the pt's looking top notch since rounds start at 630am so there are what seems like a million docs on the floor all asking a million ?'s while you are trying to button everything up for the end of your shift!! Shew.......sounds crazy when you type it all out.......Im sure I forgot to mention something...(like the sundowning pt's.....) any way a glance into my night at work!!