Mags_RN

At my facility, there is no RN-RN report anymore for patients coming from ER (only ICU does, and that's because the ER RN moves the pt to ICU personally). Yeah, no report at all, you are to look at the information in the computer EMR before they come up. you do get this computer generated report that's printed out by the ER rn (includes cc, last vs, rn triage note, meds given, iv access - nothing that the ) and tubed to you ~10min prior to pt arriving to your unit. so if you're sitting around and available when the charge assigns you a patient then you might have a chance to look up what kind of pt you are going to be receiving but if you're busy in a room and the charge calls you and tell you you're getting an admit and the report was already tubed to the station, there's always a chance you will be meeting you're new admit in their new room without knowing ANYTHING about them. It kind of sucks. i guess if you want to speak to the er rn you can call him/her. we (floor rn's ) keep trying to fight this method but the er wait times have improved greatly and i guess no sentinel events have yet happened so it's not going to change.

Here's mine! NOCreportsheeTpdf2.pdf

ugh... i hate politics....

on my unit we give report at the rn station and then do walking rounds with the oncoming shift, then we can point out the drips/tubes/drains/sores whether pts breathing pattern or just the way the pt looks is new or not. but what administration wants us to do is completely different: they want us to give the complete report in front of the pt, absolutely everything in front of the pt. this has definitely not been happening. can you imagine " pt aox3, very anxious, on the call light every five min, family demanding, kind of lazy, poor prognosis ect.."

no motivation and lack of responsibility to our patients because in the end its always the rn's responsibility and the rn is the one who has to fix the problem. i see this happen all the time with bp, rr, especially I/Os because if i refill the water pitcher twice in the shift and tell the pct, i still see an intake of 200 for my shift even though the pitcher is 800! ugh this is frustrating.

This article answers your question. Highlights_of_HIPAA_for_nurses.2.pdf

We do diagnose : Nursing Diagnosis.

I'm a new grad, got my license in June so the horrors of rn school are very fresh in my mind. my sister just started her rn schooling this past fall and they aren't even doing rn diagnosis anymore. they were told that rn diagnosis do not really correlate to nursing practice in acute care so they are focusing on medical diagnosis and the care that correlates to specific s/s of diseases and conditions. i thought that was kind of surprising...

i started as a new grad on a telemetry unit just this September. I passed my nclex in july. And i really love it. I have worked on this unit for the past 3 years almost as a PCT prior to being an RN. What really helped me become more comfortable with this new position is just going through orientation and taking care of different scenarios of patients. As with cardiac monitoring, there are protocols for everything such as rhythm changes, cardiac gtts, and best of all there is the support of your floor - nurses working beside you, your charge nurse, nursing educator and google at times. know your antiarrhythmic, bp meds, know your heart anatomy (its helpful when you get report from a cardiac cath rn to know where exactly they put in stents), know your rhythms strips, know everything about CHF. And a pt being on a tele unit doesn't quite mean that their main concern is cardiac, theres plenty of psych/overdoses, renal failure/htn etc. but mostly chf, afib, and syncope. and of course mainly the elderly. you'll learn your institutions protocols and things will just be much clearer then. but most of all, it just comes with time and experience. If I'm not sure of something or something just doesnt seem right I ask the nurse sitting next to me, and i always think, if this was happening to me , would i want my rn to worry about my condition. if your have spare time offer help getting lights or helping another rn that is really behind passing meds, completing her admission or discharge, helping others and working as a team is what makes an enjoyable working environment. everything things take time. enjoy orientation, ask billions of questions ( my favorite question was "is there a protocol for that" and usually there was ) and fall back on to your preceptor when you need help. Good luck! Tele is awesome!

Was Texas Tech on online program? I cant seem to find that online on their site.

at the hospital were i currently work, they will not hire a rn from ltc that has been away from an acute setting for more than 1 year, unless s/he takes a refresher course - which is pretty much an 8 wk course through a local community college's rn program which includes class time and a clinical portion at the hospital. so i guess it all depends on the facility.

i once wore my light green scrubs and happened to be in the elevator with a family with 3 small children who kept on asking me if im a doctor. I said no and told them im a nurse. and then the girl told me " no you're not, you're wearing green and have that thing on your neck" - my stethoscope :) it was so cute

I work on a medical telemetry unit that is 4:1 on days and pms. 6:1 on noc. places like this do exist.

in addition... i work on a tele floor too. we also push plenty of lasix solumedrol bumex dextrose diazapam benadryl famotidine heparin lorazepam meperidine reglan phenergan ... to add to your list :)

I usually dilute everything in 5-10 ml of ns and push over around 1-2 min, unless its something that i know i have to push over a specific amount of time. but.... i looked up these meds in my drug book for actual recommendations and I found specific instructions/ answers to your questions. i have the Davis' Drug Guide. Good luck.

Here's a thread that goes into exactly what you are asking Format for handwritten lab values - allnurses.com

During my clinicals, at a particular hospital, we had read-only access to all information. We were able to chart only vitals, simple I/Os, Activity. If we wanted to chart assessment information, we had to do it with our nurse preceptor: she would sign in and we would chart with her sitting by our side checking everything over as we did it. When we did chart anything by ourselves (vitals, i/o etc), we were to let our nsg instructor know at the end of our shift so she can go back into the pt record and there was an option for her to check off that she had double checked the information we documented. Charting medications was also done with the RN. The Pyxis was accessed by the RN or the instructor and we were not left alone with the machine, ever.

Figured it out ? I'm a new grad and i realized I need lots of reminders of what to keep track of for my patients. Book1cadjustments5pdf.pdf

just graduated in may, suburb of chicago.... $24/hr, with $4 pm diff, $6 noc diff

the hospital where i work now just till this may was offering sign on bonuses. i was hired in august, go figure. 2 years ago there was a $17,000 2 year contract, the following it was 10,000 3 year contract and now ... big fat zero! im a new grad (graduated this may) and im just happy i have a job let alone a bonus. i also remember going to a job fair for rns 2 years ago, as a nursing student, just cuz i was curious, and all the reps were taking and asking people for resumes. This year i went to this same job fair, now as an rn, and no rep wanted to take any resumes, they weren't even giving us any information on the positions or what their facility was looking for. most reps were just saying that they aren't hiring but i can still fill out an application online for their future reference. ugh, i printed out 10 resumes and came home back with the 10 still in my folder. most of my graduating class doesn't have jobs and those who do either had connections at the hospitals they worked at or are just continuing to work at pct/cna.

i believe these are the same ones my institution uses ( they have a barcode thing in the front of it). they get kind of sweaty too if you spend a long time in the room moving about, especially when you add in the gloves and a face mask or even worse, a n-95 . Coincidently, today, I found out that on average, it costs $7 to rent this gown. I dont know if I believe it, it sounds too expensive. We also have the blue plastic one-time use ones. I mainly see the physicians put them on, dont know why.

I would love to show you the one I came up with but I can't seem to figure out how to add an attachment.

Wow, great job. That is enormous dedication to study with so many resources. Congratulation RN!!

I, too, had many priority questions and they were tricky. I prioritized pt's by: (in this order) 1 - ADPIE (nursing process) - always assess first, if you dont assess the situation then you dont know what to do or if anything is needed to be done anyways 2 - Maslows hiarchy of needs: PHYSICAL -> Breathing Circulation (body fluids) Comfort (pain, nausea) nutrition/fluid/electrolytes SAFETY -> physical (back up to maslow) bacteriological (immune issues, isolations psychological (not suicide-thats physiological safety) 3 - communication - always focus on the client's feelings (the client is not always the pt in the scenario: if the son of the pt comes to you because he says that his father is in pain and he doesnt know what to do, you dont just walk away from the son and go get the meds for the pt, you have to acknowledge the son's feelings -even for a second-and then deal with the pt because at that point the son is your client.... 4 - teaching/learning : which is admissions and discharges [this doesnt apply to trauma admissions] example: 1. you have to administer these meds to one pt but you can only give 1 (dont question why that is) which one would you give: steroid, anticholinergic, antibiotic, anticoagulant. ...... answer: anticoagulant because it is dealing directly with circulation. example2: you have 4 pt complaining of nausea and vomiting, who do you go medicate first with an anitemetic: pt with a peptic ulcer pt with a side effect (the nausea and vomiting) of a different med pt who is receiving chemo pt wiht a brain tumor answer: the pt with a brain tumor and n/v becuase the n/v will increae intracranial pressure which inturn will decrease respriation (ABC's), then you would go to the peptic ulcer which will have a circulation issue (any body fluid shift is a circulation issue whether blood, urine, diarrhea) example3: ER RN, 4 pt come in at the same time, who do you assess first: pt bleeding with stab wound to chest pt bleeding from the head from a fall pt bleeding with a gun shot to leg pt who is 30 wk pregnant and has moderate lady partsl bleed answer: ...this order exactly, chest wound-breathing issue And NEVER ask yourself "what if ", if they haven't' included that information that you're trying to guess then it must not matter in answering that question appropriately. Hope that helps :) GOOD LUCK PS. I just took the NCLEX-RN this friday and I passed with 75!!!

oh wow, i didnt know they changed everything already. sorry for the misinformatio then.