DaveMac

When you see tombstones on the monitor, you pray the pt is a DNR/AND/No CODE, whatever your facility may call it. Cause when you see tombstones on the monitor, you can rest assured that this pt will be getting a real one soon.

The formula was suppose to be A : B = C : D if the : and D are put together her you get = >

.3 is 0.3 because .3 could be mistaken for 3. And 3.0 is 3, because 3.0 could be mistaken for 30. Most use the 4/5 split when rounding. The questions will give you the decimal they want or the instructors will. i.e. answer to the 2 decimal point. Another formula to remember is A:B=C:D or A/B=C/D. Both are the same. It reads A is to B as C is to D. Example: Order Rocephin 750mg IV. On Hand Rocephin 1G in 100ml 0.9% saline. Okay, a lot of numbers here. REMEMBER - ONE STEP AT A TIME. Your answer you are looking for is how many ml do you give. Now 1G (gram) is the same as 1000mg. SO 750mg is to Xml as 1000mg is to 100ml. Written - 750mg : Xml = 1000mg : 100ml Multiple the ends together and the middles together 750 x 100 = x1000 75000 = x1000 now divide 1000 into both sides 75 = xml 75ml This does about 95% of all your math in nursing. You may have to do it 2 or 3 times to come up with the final answer, but it is easy and helpful. Know this was long, but it has helped many a new student and even some "experienced" nurses who forgot their way in the offices. Good luck

First off, sorry to hear about the load that you had here. As many nurses will say, been there, done that. That does not make it better. I have left areas where this type of staffing have been the norm. With the units being so full, I can understand why the patients were on your floor. But at the same time, the load that you mentioned should have been covered by at least 2 nurses. :nurse: The cardio unit where I work we usually have only no more than 3 patients. There are times where we my go up to 5 for about 4 hours. Hope you find a good unit to work, it took me a few years to find one Don't give up and don't let them get you down. :typing

I agree with what you wrote with the differences between an IDN and an ICN (ICP). I have had one ICP tell me that they are the same, where I work, I feel that the floor staff think that I am both. :caduceus:

Congrats. I also have learned a lot this last year.

Seems like we work at the same type of place. Where you do InterQual every 2-3 days, I was directed by the CNO (DON) to do them every day of the week, including weekends. She has hired 3 nursing students to help on the weekends. They have other jobs when they are here also. The DONs mother was in a hospital in another city recently and the DON was told that InterQual should take less than 15 minutes, even for new admits. It takes longer than that here, 15 - 60 minutes for a new admit. Granted we are not computer charting anything yet and every thing is paper. My question is does this is taking me to long, if so, how can it be speed up? Still have to do the insurances, placements, DMEs, etc, etc. Monday :typing Wednesday :throcomp: Friday :crash_com Friday Night :beercuphe

ER nurses may know this one for broken bones - BATS Fracture - Broke All To ****. My favorite one is one I use in life also, learned this one while on Subs in the Navy as an ET in the Navigation Center - KISS - Keep It Simple Stupid. For those special patients - PITA - Pain In The A$$. When we could still use OS, OU, OD, etc, I had a hard time at first remembering left, right, and both. My study group in school was at AppleBees to study and as I poured my beer from the pitcher it foamed up. I looked at the student beside me and said that I had lots of SUDS. Then it hit me. - SUD - Left-Both-Right. That was in 93 and I still remember it that way.

The day after I posted the above, I was able to find my answer and got the wood out of the OR. The next day, I was talking with a couple of nurses from the hospital where the surgeon came from and reported that the surgeon does not scrub before, between, or after surgery. This bothered me and the OR manager came in an hour later and told me that here staff report the same thing to her. After talking with DON, I set up with the OR manager to do an observation during one of his surgery days. Well the hospital he came from was able to temp. reopen their OR after JC and DHEC shut them down. One way to get rid of a possible problem. But the problem is still out there somewhere.

Yes I would. I would have to make shift my own PPEs again. As fas as the government helping, in my personnel experence with the government, that is a joke. The government is not helping the vets enough as it is, so unless we are classed as a third world citizen, we will not get much help. But working during this will be for my patients not for the government.

You are so right. As I stated in an earlier statement, I was assigned as an LPN supervisor over several RNs. I felt uncomfortable in this role, and left that job within a few weeks. As was said by someone else, it is the state boards nurse practice act which controls this. Some of the best nurses that I have learned from have been the LPNs. Many know more than some of the RNs that I have worked with. Here RNs push meds, hang blood, and mix meds here our state will not let the LPNs do this. Some of my friends here here are LPNs and work in another state like I do, can do more there than here. It makes it hard for them when they bounce back and forth. As far am myself, there no RN vs LPN war. We work as a team and make sure all the patients are taken care of. And don't leave the aids out of the team, it takes a village to care for the patients. :dancgrp:

I was working several years ago as a part-time LPN in a nursing home. On my 3rd day of orientation on the 3-11 shift, I was approached by the DON on my way to the unit I was assigned to. She told me that I was being pulled out of orientation and made the evening shift house supervisor. I told the DON that she could not do that. She thought I was saying I couldn't supervise. I explained that I almost 18 years as a supervisor, it was the fact that I did not know the facility that well and there were RNs working that could do the job. To make the story short, I ended up having to supervise again in a nursing home with RNs under me. At the time I felt like it was wrong and I still do. Most state boards state that LPNs are not supervisors. I do realize that in most of the nursing homes around here there are usually only two or three RNs, one being the DON, and the LPNs have to carry the load. But in a hospital setting, this should not happen. Even thou I was an LPN at one time, I don't think a RN should have to work under a LPN as supervisor. There is just too much that the nurse practice act will not allow them to do. If the fecal excrement were to hit the revolving oscillator, then it would be the RN who would get the fall out. I would pray and think long and hard about taking this job. Good luck in your choice.:redlight::thnkg:

I know this is late, but may help someone else. I am working toward getting my CIC (Certified Infection Control). UNC Chapel Hill has a two week course which is very good. It is done in two one week classes. Infection Control Part I and Infection Control Part II. Part I is done in the spring and Part II is done in the fall. They also have a one day course for the RNs who have two years experience to take to help prepare you to take the certification board, which cost a few hundred dollars to take, so you want every help you can get. I was lucky, I was helping the case manager here and when she left, I was asked to take her job. Well Infection Control was one of her jobs. My turn over was about 5 minutes, here is a list of what I monitor, good luck. Well it turned out that she was not doing even 10% of what was suppose to be done. I ended up rewriting every IC policy and learning from the ground up. Thankfully I had some exp with Navy OSHA and 14 years as a nurse to pull on. As far as going straight into IC straight out of school. You could do it, but I would not recommend it. You need to know what the different lab results mean, how to know what an imaging reports says, C&S reports, what needs to be reported to public health and how fast, what requires isolation and what type of isolation. If you can attend Chapel Hill, this will give you so much information it will make your head spin. The more I do IC the more I like it. What you need is to find a job that needs an assistant to help with IC and you can get some exp and then move on up. Good luck and don't give up.

I was stopped this morning by one of the plant service men and he asked me if it was okay to have a wooden table in the OR. I told him I did not think so and not to build the table until I got back to him. I asked a couple of ICPs in other hospitals and they told me no. I have informed the OR manager, the CNO, and the CEO that it can't be there. I need something in black and white to show the surgeon in case he balks at this. He uses one in the OR he came from while they are shut down. I know some say that the wood can be steamed but this does not go deep enough to get it completely done. Any one know where I can get an article on IC dealing with this? Thanks in advance.

It sounds like the patient might have pneumonia and a gram neg infection. They may need to be placed on resp. isolation and get IV ABTx for this. Infiltrates can mean different things to different docs. Sounds like it needs to be monitored due to the bld cx.:bugeyes:

I have ADHD and I feel like I am doing well in Nursing. Since 1977, I have always been able to be able to do my work on my unit and go to other units when called to assist. Many look at me like they can't believe that I stay caught up. With ADHD, multitasking is second nature, so as far as nursing goes, you have a leg up. Now about the big bucks. Excuse my while I LMAO. At the start, the pay is not so good, depending on the hospital you are at. When you first hit management, expect a loss. I work full time in a community hospital and as an agency nurse one day on the weekends, 2 or 3 weeks out of 4. I have to take manager call for a week every 3 to 5 weeks. The money can be made, you just have to give up your life at the start. THINK LONG and HARD before you go into nursing. When I precept a new nurse, one of the first questions I ask is "Why do you want to be a nurse?" If they tell me money, I recommend that they find another profession. We want and NEED nurses who want to help and not just to have a job. Being a nurse is more than a 7 to 7 job. It is 24/7. It not what you do, it is who you are. You can't turn it on and off as you feel. It is always on. You see someone in need in the mail, you respond without thinking. You see a car on the side of the road and someone on the ground, you stop and assist. So think about it and pray about it. Good luck in your choice. And yes, C=RN. What do you call the RN or LPN/LVN nursing student who finished last in his/her class and passes the state boards? Nurse, RN, LPN, or LVN,:caduceus::cheers:

Being overwhelmed seems to be par for the course now. I work in a small county hospital. I am a one man department. I do Discharge Planning, Utilization Review, Infection Control, and Employee Health. I am also expected to also help manage the nurses, take nurse manager call, take patients and/or assisted the floor, ER, and OR/Endo if the DON feels it is needed. How am I to get my work done. I gave up with being caught up months ago. It takes till 10 or 11 to get done with insurance. By this time the hospitalist is on the floor and he hords the charts so I have a hard time doing InterQual on every patient (DONs orders). To top this off, The DON will call meetings at 1530 0r 1600. Now I start at 0700. There are also regular scheduled meetings through out the week at either 1300 or 1400, about 3 times a week. When I mention that I could use another nurse, I am told that our census is too low. Sometimes I feel like I am being set up to fail.

This nurse is now one of the house supervisors. Go figure:confused:

I went to the DON one day about a nurse who was 15 - 20 minutes late every shift. Would talk about every patient she had and other peers. It seemed to the aid and I that she went out of her way sometimes to say or do something to cause conflict. The DON told me she was aware of the problem, but she was "a body" to fill a hole.:angryfire A body to fill a hole. Please. Give me a couple of good aides to replace her and the patients would all get B/Bs, ADLs, feed, VS, etc done and The nurses would be able to get their work done and out on time. But now the aides do not do vitals, I/O, draining foleys, this now falls to the nurse, along with drawing all labs and everything else. The hospitalist stays on the floor from 1000 to around 1700-1800. One of them keeps the charts with him most of the day, so charting becomes another problem. Nuff said, thanks for the vent. I do agree, it is enough to start looking at my old job of electronic repair.

Since I was a young child, I have suffered on and off from a red raised rash that comes and goes. When it comes, it also itches. Prior to being a teenager, the doc put me on a 10% sulfer solution. Needless to say when the teenage yrs started, it was not a good smell. I quit it. Later I was given pills, lotions, etc to take. Nothing helped. A few yrs ago I was told to use medicated selsun blue 2 or 3 times a week. Wow this work. About two weeks ago my wife got some tea tree oil to try. The itch is gone, the rash is gone, and it feels good. Yea it smells, but not that bad. I am a beliver also in tea tree oil.

You said it. There are good workers and lazy workers in all areas.

was i ever an aide, yes i was an orderly back in 1977. i have also been a mental health tech, rehab tech, unit clerk, transporter, and have also done the jobs while in the navy of house keeping, plant management, and emergency response, both nuclear and regular. i am one of the biggest supporters for aides, cnas, pct, tech, what ever name is put upon them. during the seminar class while i was in adn school, the instructor did not believe in aides. she felt msns should be directors, bsn managers, adns floor nurses, and lpns doing patient care. no cnas. my paper for the class was on using patient care techs to help fill the nursing gaps. there are many areas where they can shine. my reference to it being a war may not be the best way to word it. for the most part the aides will do work for me that they won't do for others. when they have a problem with a nurse, i am the one they come to, to talk it out with. what gets me is when the dons say that aides are a dime a dozen. last time she said that, i and one other manager reached in our pockets and handed her a dime each. this broke the tension and she agreed that was an understatement. the don we have now let all the aides go except for 2 on days. 1 worked 12 hours on m-w-f and the other worked t-th. she had to work the floor one day and now they are looking for new aides. i did not mean to sound like i was talking down about aides. i have worked as an tech more than once since becoming a lpn. adn, & bsn. any nurse who will not help in this area is missing a big chance to get to know their patients.

do you ever clash with your aides? several times. what about? patient care - hiding, not answering call lights, refusing to do the job. who "wins"? usually i do, sometimes they win the battle, but the war is mine. do you have friendships among your subordinate staff? what about with other coworkers? yes and yes. have you ever had an aide tell you she's refusing your direction to do this or that? yes. have you ever called your supervisor for back up? yes. what happened? some have said that is just the nature of the beast and some have called the aide to the carpet. how did you cope with it? i just explained how they would "follow my orders". once as an lpn, i was charge with a rn working under me, she refused to be in charge. i had an aid who was only working for 4 hours. we needed an aide in the dining room during supper time. well she refused to do this easy task, also had an aide with 2 rib fxs working and i also ask her to help get her patients up. she through a fit and went to the rn and complained. the rn came to me and told me what she said. i confronted the aide about this and when she started her mouth, i told her to clock out and to meet me in the dons office at 0800 the next day. i called the don and told her what transpired. she told me that i did not have to be there for the meeting. well the aide did not show at 0800. when she arrived at 1445 to clock in for her shift, the don was waiting for her at the time clock with her pink ticket. she released her on the spot. nice to have that kind of backing. were you made to feel at fault somehow? they tried. are you in a long term setting or acute care with quick patient turnover? hospital now, have done different areas. is your staff pretty stable or do you have a frequent load of new staff who don't really know the job yet? not at the moment, usually are.