JazzyRN

CNMC. worked in the pediatric ICU. it was grossly understaffed with high pt acuity. nurses would take 3 patients regularly and it was very unsafe. you rarely got lunch. coworkers were all so busy, it was hard to get help or relief. i would feel sick and anxious prior to each shift i work and found myself praying to make it through the shift. luckily it was only a travel assignment with and not a real job for me. i pray that things are better over there now for the sake of the nurses and their patients.

Have you ever had a patient .... So full of energy and life that you looked forward to caring for them whenever they were there? That was so brave in the face of illness, they never let it get them down? Always kept a smile on their face and their sense of humor when they were feeling sick or recieved bad news? You would negotiate to change your assignment in order to be their nurse that day? That could make you laugh/smile and instantly improve your outlook on your day? That felt like a member of your own family? That traded in their wheels for wings so unexpectedly it stole the breath out of your chest? I lost a patient this week that was so kind, caring, funny and unique that I will never forget him. Try as we might to maintain a professional relationship, once in a while a patient slips through and leaves an imprint on your heart that can never be erased. I learned so much from you J.M.C. about loving life and staying positive. I am so thankful that I had the opportunity to care for and get to know you. You will never be forgotten. R.I.P.

I think it would be extremely difficult to get an accurate answer to your question. Med errors occur both day and night and are grossly underreported. I think more important than trying to figure out what shift is reporting the most, its more useful to understand the underlying elements that can set people up to make mistakes. Things such as poor staffing, fatigue, distraction, systems errors need to be examined and corrected. I think medication errors are great learning experiences and make better nurses out of people.

Yes I found a preceptor, actually 2 great preceptors, one PNP and one pediatrician. Thank you guys for your help and concern. I'll finally be done this December!

I think it really depends on the situation and the reason why you do not want to work with a patient. But since you can't be more specific, there isnt much else to say

seizures are pretty simple. just ensure that there is oxygen and suction in the room. although they are rarely needed. just time and observe the seizure, ensuring the patient is safe, with enough padding around them so as not to injure themself. there isnt much to do. If they do not come out of their seizure within a couple minutes, then draw a whatever PRN med (usually ativan) is ordered for their seizures. dont bother trying to get vitals with a GTC because they are often hard to obtain and inaccurate. some will throw oxygen on a seizing patient, because they may desat a little but its usually not necessary.

i think you should let her go to school

I'm a PNP student in my 2nd semester of my program. I am looking for a great PNP preceptor in primary peds practice 2 days/wk for the short 10 week summer session. I am looking in the Washington DC area, including Prince Georges, Montgomery County, Howard County and Annapolis. I would really appreciate any suggestions. Thanks.

I just wanted to inquire about finding a preceptor. My school has encouraged us to find our own PNP preceptors for summer session if we would like to have clinical closer to home. I would really prefer a PNP instead of a pediatrician. I looked up a few of the pediatric practices I know of on the internet and found a few PNPs. I was just wondering if anyone had any tips on how to approach or inquire about a preceptorship from these complete strangers? Has anyone else gone through this? I am looking the in the Washington DC or Prince Georges/Montgomery county area, let me know if you have any suggestions. Thanks.

We used a similar form in my old job in NYC. It was called the protest of assignment form. People would still take the assignment, but where it becomes useful is if a bad outcome or event occurs, it should save you from personal responsibility and the hospital management will really have some big explaining to do. I think its great. Most hospitals in NYC have nursing unions, so there is no way someone could get fired for that.

We all make mistakes, don't beat yourself up about it. However I must say, if you are busy and don't verify a med with the MAR, that med should never be an insulin. Insulin is prone to making errors and can end up killing patients. In time you will recognize these drugs such as insulin, KCl, digoxin. One must come out of autopilot then review the 5 rigths and get a proper double check. Mistakes make us better nurses which is a positive that comes from that.

turbulent blood flow causes that vibration, perhaps your patient has some peripheral vascular insufficiency/disease. if this patient has some atherosclerotic changes in the vessels of this hand, then you occluding the vein with the tourniquet added an additional obstruction causing a greater turbulence which is the vibration felt

This letter is crap. So we are to believe that every evacuee is an alcoholic, drug abusing, ungrateful, disrespectful neglectful parent. There was no one that was a normal citizen down on their luck due to their homes and belongings being destroyed? This is really sad and just highlights how much racism and classist thinking exists in this country. I have a coworker in the US Health Corps that spent 2 weeks there helping out and had alot of encouraging and positive stories about the teamwork and the lovely ppl there.

if you think its not right for you, chances are that you are right. Listen to your intuition on this one. I was told as well, that I must do my one year of med surg to be marketable and its not really true. The nursing shortage is such that a lot of places will accept and train you on their specialty unit. I graduated and went straight into peds. i have friends that went straight to ICU, PICU, NICU, ER, hem/onc without that year of med surg. So I say get out there and interview on a less hectic unit. Good luck!

Yes there is we gave babies a formula called Alimentum, when they can't tolerate soy or milk formulas.