KBRN413

The RN's are obligated to obtain their own vital signs at my facility. I would rather do this for myself; I can get a conversation started and start my assessment at the same time. Sometimes, I do ask a CNA to do admission vitals for me and every time, the RR is 18. I go meet the patient and check for myself! Many on my floor are on PCA's, and there RR is 12-14! Scary, but they should know how to do the basics! Many however, are wonderful and do a really amazing job!

I always check before giving diuretics. We administered IV lasix at 0800 and 1600 here, I do routine vitals at those times anyways, but even before a one time order, I always check. Just to make sure!

Congrats!

That is just an example, not an actual order!

My facility now has strict orders that basicall read: percocet 2 tab q4hrs prn for pain 1-4 hydromorphone 0.5mg q4hrs prn for pain 5-7 hydromorphone 1mg q4hrs prn for pain 8-10. That way we are not prescribing a medication. It is there for us to use as a guide. I work on an post op abdominal surgical floor, so everyone is usually on a PCA with toradol. But after the PCA is discontinued, we have that scale to go by.

We do all of our charting online now. We have a section in our nursing shift assessments that states "nursing education". We talk about what we taught the patient and family, if they understood the teaching and if reinforcement of that education was necessary.

We get between 0-5% increase depending on our merit review. Last year we didn't get anything, but we did get a bonus at the end of the year.

Your floor should provide manual BP cuffs. We have them in every patient room! Ask your supervisor! :)

Ughhh! I completely agree! Our floor actually started this as a Unit Counsel Project, and now it is hospital wide. Yep, I round on my patient hourly, most of the time, more then that. I hate the fact that I have to stop and sign a piece of paper....c'mon! DOn't tell........Sometimes I initial it at the end of my shift, if the CNA hasn't done it. It's completely meaningless!! At least I can have a conversation with my patient while I do it. I believe our hospital throws them away too, so honestly.....what is the point? WASTE OF PAPER! GO GREEN PEOPLE! lol!! :D:D:D:D:D:D

I'm extremely greatful that my facility has online documentation. The only note we have to write is based on our care plan, and even that is online. Our shift assessment is classified as our nursing outcome summary. Definetly a lot easier! With this new law, I think all facilities have to go paperless before 2012. Am I wrong????

i'm a relatively new rn. i've been out of school for 3 years. i have been working on a med/surg/telemetry floor. i have learned an extensive amount in my 3 years there. i was also very fortunate to have a new graduate recidency program at my facility. i had a class once a week for a year and was refreshed on a lot of things and also learned a lot about my facility. i highly recommend a med/surg telemetry floor to gain experience! appy everywhere! you will be happy :)

do you have an sbar form?? at my facility we use an sbar form for report and throughout our day. it helps keep me organzied and allows me to give a very throuogh report. i also recommend that throughout your day, when things happen, write them down in the appropriate areas on the sbar form, that way you know exactly what has changed and what you did. much easier to give report and keep track of your day!

it is completely opposite where i work. the day shift 7a-7p medicates throughout the day. does all the treatments, handles mds, family members...etc..etc...etc. nights seem more quiet. i have done quite a few nights for overtime and what a difference! much less to do! not always slow at night, but the majority of the time, i spent just doing paperwork and rounding on my patients. maybe you should talk with your manager regarding the huge difference in obligations! nursing should be a 24hr/day job! things should be getting done when there is time. if they have time to take 1 1/2 hours breaks, then there is no reason why things can't get done during the day!:typing

You are a very rude person. I also agree with above that you are definetly looking into this for the wrong reasons. Nursing is a blessing. I love my job. Yes it is stressful, but I wouldn't want to do anything else. As far as your analogies, I'm sorry you feel that way. All I was implying was that you seem to be making assumptions of things you don't understand. Being rude to someone who was replying to something that YOU said is wrong. Please, if this is something that you REALLY want to pursue, think of the people who you will be caring for. You CANNOT be like this with people who are sick and dying. Compassion.....it is a must have for this profession. Doesn't seem like you have this capability.

how could her daughter do that to her mother??!?!?! knowing what she wanted!!! that makes me sick! my parents would come back and haunt me forever!

i can't even begin to tell you how familiar this sounds! we have had a young girl on our floor for almost a month now. she is a frequent flyer for dysphagia and abdominal pain. she had a gastric pacemaker placed and is here for tube feeds and pain control. she has been here for a long time and is receiving iv dilaudid, zofran, ativan, anzemet and benadryl. we are in that room every hour medicating her with something. it is rediculous. the nursing staff feels that she is addicted. she is always complaining of a lot pain yet, she never shows it. she writes the times that her meds are due on her dry erase board. the nursing staff have talked with the mds, psych, social work and the nm. they are finally starting to have conversations with her regarding tapering her medication. but, before, she would complain and get what she wanted. it is not helping the patient. we as nurses are patient advocates and need to step up and make the necessary phone calls! we have to push for things to get done. she should have been tapered and home with services a long time ago! its amazing how the mds will give patients what they want so that they stop complaining!!! ughh so frustrating!

yes, you can't give 12.5gtts. it would round up to 13..

where i work, we all have our sbar's attached to our orders and we clip them to a clip board that our nurse manager gave us. i have my assessment, pmh, admission diagnosis, and meds on my sbar for individual patients. i write things that need to be done and put a box next to it and highlight it. i then check off the box when done. i also write changes and things that i have accomplished on my shift. i use this when writing my notes and when giving report to the next rn. it definetly takes time to get organized and you will find your comfort zone! it took me a little while to get comfortable and find what worked for me.

:heartbeaton my first day, i basically "shadowed" my preceptor. i did what she did. i got a tour of the floor and learned her routine. on my second day, i took one patient and then gradually went up to 5. taking one or two patients at first allows you to really concentrate on all the aspects needed to give nursing care. as soon as you learn a routine, it is easier to provide care to more patients. taking 3 or 4 patients on your first day is horrible! you don't know anything yet! easing yourself into your position slowly is the best advice i can give! worked well for me!

ok, if you walk into a room with scrubs on....most people will know you work there! :chuckle if you have a name tag, most people can read it. and most people introduced themselves when they walk into a patients room. so, wearing the same uniforms really doesn't make sense. at my institution, we can wear anything we want. i feel bad that some of you have to wear white shoes!! i havent worn white shoes since nursing school! i hate them!

:yeah:many facilities have nursing intern positions where you work directly with an rn. i know you have to be in the nursing program at your school. look around because it is an excellent opportunity.

my sister is a dental hygienist and she makes at least $11 more an hour then i do. i understand she works hard, but, i just think that rn's should make at least what she does! we work hard!!! (no offense to dental hygienists!!!!)

if i were you, i'd try to get back into the hospital you were happy at. i also have a long commute to work, but i refuse to leave because i love it there. most of the doctors are great and very observant to the nurses and their needs. i don't want to chance leaving and being unhappy somewhere else. i know gas prices are through the roof, but, i'd rather be happy at work and drive an hour then be unhappy and hate my job.

good for you! that place isn't worth it! if they are willing to fire you for doing the right thing, then you shouldn't work there! sorry about the bad experience :uhoh21: everything happens for a reason! you'll find something much better!

if you really want to pursue nursing...do it! don't let anyone hold you back! my sister is a hygienist and she makes great money... i'm jealous at times because i feel nurses don't get paid nearly enough as we should! i mean, look at the job we have! we have patients lives in our hands! my sisters job is very important...don't get me wrong! getting back to the point (lol, sorry) i love my job. i go home everyday feeling that i made a difference in someone's life. there is no feeling better then that.