man23SN

Any other takes?

My facility's O2 protocol reads "O2 to maintain sats >90%". Do you see any potential liability in discharging a patient home (in this case nrsg home) while right at 90% while on room air? Several of my cohorts think O2 need only be applied if the pt drops below 90%.

I believe so, yes.

We had a 65 year old female admitted to the floor with a chest tube that the CTS just called a chest drain. It was connected to -40 suction for several days and then he ended up connecting it to a JP bulb. A ways above the bulb there was a little blue clamp that can be turned to off or opened back up. I know JP drains are considered closed systems but since this drain was connected to her chest shouldn't the blue clamp be clamped off before you open the jp to drain it so air doesn't enter her chest? I don't know if all staff caring for her had been doing this.

Hey guys, sorry if this is a silly question! I just passed the nclex-rn last week and got my license application in the mail today so I signed it and send it out. But I have a question for you.. A job listing just appeared today that I've been waiting for and there is a section under licenses/certification that I'm not sure what to put. There are 2 sections with boxes that I need to choose. Thes are the questions: 1. Are you currently? Registered, Licensed, Certified, or None. 2. Are you eligible for? Registration, Licensure, Certification, or None. I'm basically license pending right now so which would I choose? Also, when you got hired for your job did they do a physical on you? Whenever I get a physical my HR and BP go way up, i've had that happen to me since I was a little kid. Could this keep me from getting a job if they think I have hypertension, etc?

Just to give an update, it was delivered and I got the pop up "Our records indicate that you recently scheduled this exam. Please contact your member board for further assistance. Another registration cannot be made at this time." This is a GOOD SIGN!!!

Thanks for your responses, and giving me hope I really appreciate it! With the way they lock you into the testing center and herd everyone in like sheep, it felt like i was in prison!

Ohh bummer, so it gives the message I got to everyone who has just finished teh test then? NOO I was thinking I may have passed...

Hey guys, I just took the nclex and I felt like I failed and ended on an easy question which is NOT good! I just did the pearson vue trick and this is the message I got, "The candidate currently has an open registration for this exam. A new registration cannot be created at this time." This sounds like a different msg than others have been getting. Do you suppose it means I passed?? I'm really neurotic at the moment!

Hi everyone, thanks for taking the time to read this. I graduate from my BSN program in 4 days and we're moving all the way from Nebraska down to the Carbondale, Illinois area due to my wife getting a job there. I'm not at all familiar with the area, much less the hospitals down there. Can you please fill me in on the reputation/work environment of the following hospitals? Also any idea how they treat new grads? Memorial Hospital of Carbondale - carbondale, il Herrin Hospital - herrin, il Heartland Regional medical center - marion, il St. Joseph Memorial Hospital - murphysboro, il Department of Veterans Affairs - marion, il As I'm sure many of you have experienced, this is a stressful time moving to a new part of the U.S. with a completely new job after graduating. Please share any insights you have experienced or heard through the grapevine!

Thanks to all for replying. You are right m/writer his allergy was not listed in his chart, and we did chart that we gave the full 10 mg. We also charted the reaction that he had, and that benadryl was given and that it neutralized his reaction. I will always be more careful from this day on, and i have been hugely humbled by this experience. The nurse I was working with was being so nice and trusting me, and I feel like a huge idiot for making this mistake. The last thing I want is for other nurses to think, "That guy's a lawsuit waiting to happen."

I agree with you about filing the report, but the nurse said that it wasn't technically an error because it was the right med, and it read that the patient could receive 10 mg. However, the 10 mg was probably not to be given all at once..

So I'm supposed to graduate and march in 2 months from now. I'm currently doing my critical care rotation and I had a 7 hour observation/clinical experience in the ER tonight. The nurses were great, they were letting me start IV's (I was 1 for 2) and give meds with little to no supervision at all. I didn't feel like an outsider and the observation was going super. So one of the nurses told me I could give an IV push of morphine, and the order read 1-10 MG titration. She told me to go ahead and give him 3 MG, and that the full 10 MG was in 2 ML. So I was good to go, she left the room and I started to push the morphine and for some reason while I was pushing the med and talking to the patient, I was thinking that the 2 ML was 3 MG, not the full 10 MG So, around 10 minutes later the nurse comes up to me and asks if I dumped the rest of the morphine out, since she told me to give 3 mg. I was like ohhh crap, I gave all of the morphine, and she started freaking out, but she said she would just tell them that we gave the 3 mg and dumped the rest out. Side note: the patient broke out into hives and we found out he was allergic to morphine, so she gave benadryl and it fixed the problem. I then told her, "Should we file a medication error report?" and she said that she was afraid they wouldn't let me graduate if we were to do that. I then told her that, "Shouldn't we be okay, since the order said up to 10 mg of morphine is ok to give?" And she was like, ohh yeah you're right! You're right, we have nothing to worry about since the order does say to give 1-10 mg titrated. She also said that if anyone asks why we gave so much, she'll tell them it's because he was a big guy, and he uses meds all the time at home (which is true). I feel TERRIBLE, and i've been beating myself up over this since I just got home a little over an hour ago. On one hand, I feel like I could have killed the poor guy, and on the other hand, I'm afraid the nurse is going to say something to another nurse and it will get back to my program and they'll kick me out or something. The nurse reassured me that I have nothing to worry about, but I worry about everything.. I have learned my lesson on the 5 rights of meds and I will ALWAYS remember this day. Please feel free to respond and advise...

Hey folks, well I am more than halfway done with the first semester of my senior year, and halfway done with my mental health clinicals. Unfortunately, my first patient got discharged so I got assigned a new patient today. My main concern is this: I am a male student nurse, and my patient is a woman who was committed because she fell in love with a handyman who was doing plumbing in her house. Keep in mind the man has a wife and children. Anyways, she became obsessed that they were in love and has been found on occasion stalking the man, and his wife. She has also had thoughts of killing his family because they are getting in the way of their "relationship". She still has delusions and when I was talking with her today, she said "she just misses him so much". Should I be worried? I have a wife of my own and I don't want these same things to happen to me once the patient is discharged. She is 37, and I'm only 23 so I would think maybe that would lessen the chances of it happening, but I wouldn't put anything past this individual. My instructor thinks there is nothing to worry about, she just seems to laugh at the whole situation because her past history does sound comical if you were to read it on paper. However, it makes me feel more than uncomfortable. Am I blowing this way out of proportion?