rkitty198

Oh that's funny! No cookies for you!

I love the specifics of the policy that helps, except the juice and cookies! Geeze. No complex carbs or protein in that. Peanut butter or protein powder added to the juice? That sounds like a quick way to up the glucose but a quick way to drop shortly after.

Must be a case of patients metabolic needs outweighing the food/insulin ratio.

I do know d50 is not long acting, an hour at most. Regular peaks at 1.5 to 2 hrs. Did the patient eat? Could they eat? I think the langue dose needed to be looked at as well as omitting the regular insulin dose. I wonder if she gave the insulin before/after the sugar check?

Probably should have been on some sort of a dextrose drip after one amp. I would have called the doctor if the one didnt work since I have never had to give more than one in 11 years as an RN.

I have never seen a patient require more than one. If it still continues to drop there must have been an overdose of some fast acting insulin given. Sugars don't just continue to drop on their own unless a fast acting insulin was given. Or these amps were given over a period of a long term and sugars were checked over a long period as well. Insulin given exongenous can result in this rapid drops of sugars and will need treatment like this.

"Will she be flat as a board?" I would respond "well yes, just like your chest" The sugar comment "does she eat a lot of sugar?" "Yes, sugar can cause cancer just as your crap comments lead to your nasty personality" "You don't remember my mom has stomach cancer? Mmm I am worried that your dementia is progressing." I say these things to myself for the amusement factor, it helps me to deal with people

We are talking about the legal rights of women who pump at work, but what about the legal rights to standard lunch and breaks? I watch your patients while you pump and you watch mine while I take a break. It's called teamwork- no resentment however, it sounds like some of these nurses are taking advantage and not reciprocating. At that point I think the manager should get involved, because ultimately it is the employers duty to give the nursing mother the time not the staffs responsibility.

Like in what way? I have never asked the ED for anything and I work PCU/MED/SURG/ONC and now do one day a week wound care I LOVE the varied things I get to do. The multitude of conditions. Some people see an adorable baby in a stroller and say "how adorable is that baby!" As they make kissy faces. Well personally I see a patient who is 80 and up and say "how adorable are they!" The older the patient is the better! i also started doing wound care once a week. It's so fun being a part of a speciality that dr's rely on YOU for your knowledge. It's very rewarding seeing a wound change and heal over time.

Can I like the above a million times over?

Not to dig the knife deeper, why didn't you just check the blood sugar at the end of the shift? Sure it was very late, better late than never. You learned your lesson. The only way the board will find out is if your employer tells them. They probably won't, the firing is probabaly punishment enough, unless you live in Texas

You don't need IV certification, what you want is a practice/refresher course? If so you just practice on site. Practice during your orientation, out on the floor.

I had a male patient in his late 40's who started to pace around the room, he was sweating. I asked him if he would sit down because I started to worry. He sat down, picked up his phone and called his mom. He had his mom talk him through the "shot" which ended up taking several minutes before I could even administer it!

You cannot accept a sputum sample collection with partially digested food.

I challenge them to put one on me! Go for it! Why don't these morons just follow me for a 12 hour shift and see what it's really like, then go from there, scared?

Then how are you supposed to utilize it as the tool it is meant to be unless you just click click click? It gives you basic intervention ideas, but not all of the interventions. To me all it does is cover cms quality guidelines for quality care/charting for reimbursement. I honestly would love to know how to utilize it in my care/charting to make it more meaningful.

Wow! I see flies on the surgical oncology floor. Just last week I had a patient in hospice with a fly, doing its fly thing around the head of the hospice patient it was just so nasty and unsanitary. I tried to get it out of there, but there was so many family members. I couldn't just tell them all to leave so that I could um get the fly to leave their dying loved ones head and open mouth. I even tried using the yaunker. I told them I needed to clean the patient but alas the fly left, and then came back a few hours later! Grrr!

The key part is washing of the hands.

I don't know for sure, but family members do it all of the time in home settings so I don't see why not with the proper training. Good luck with the job. You could always check with your regulatory body. I would be surprised in Texas because when I worked there it was very strict compared to other states.

I took it prior to nursing school. I thought it helped me to feel more comfortable with the bls process. It also had good teaching regarding basic wound dressings-wrapping techniques. Other than that it was geared more towards first responder. I work in acute care so I am not the first responder at the scene but it allowed me to see what happens on the scene before the patient gets to me. I was glad I took it. It did give me that GPA boost I needed too.

I would sum up why you are a valuable asset to the team. I love what you wrote. I can't imagine you going to work and saying "oh I hope a patient falls today" it is obvious by your actions you want to help everybody, to the point where it wears you thin. Keep your head up. You are valuable. If not to your current workplace your next workplace will have a stronger smarter nurse because of this experience. Keep us updated. Wishing you luck and hugs.

I don't know about your state but in Washington we don't use paper licensing. It's all online. Your future employer is going to check your state licensure as well as nursys for your credentialing anyways. I wouldn't bother the BON for that sort of thing, they are busy micromanaging other important nursing business haha. Congratulations! ������ (these are emoji balloons, but they aren't showing so you get this instead- my intent is good )

This is falsifying documentation which is fraud. Hospice gets paid based on the admission assessment per the RN and their admitting qualification criteria. Since this said nurse did not partake in the actual assessment it is fraud and she is falsifying documentation. You can perform and chart your assessment and she can go in and RN verify, meaning she can double check and oversee the documentation is correct. In no way should another nurse chart and assessment they did not do.

If every nurse who had a fall lost their license we would have some major problems!! It's so hard to make the right decisions within a split second and much easier to make the right decisions in retrospect. I would tell your managers what happened, what you should have done, and what you plan to do right the next time. I would also add that your priority was to prevent the patient from falling as well as her privacy and dignity. She was trying to get up from her chair in the hallway soaked wet with urine. Either way this patient was a fall risk at the desk or in her room. What if she were at the desk when you went to help the patient with their tray? Who would have been there to assist her then?

They probably won't give you an extension. If they felt you were improving (based on their assessment) then they would consider it. Let's face it, they probably don't want to spend anymore $ on your orientation and it sounds like they have made a decision already. I would quit, or ask that you be transferred. I think it's probably a blessing in disguise, probably would be a unit from hell to work for. Don't give up on your dreams. Find a job where you can get a new to speciality orientation. I wouldn't work for Kaiser anyways, unless it was the only hospital or clinic near me and I had to work there, that's based on personal reasons.