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KellT1203

KellT1203

Med/Surg RN
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  1. Hello,

    I am planning to take the exam. please, could you share the questions to me? 

    thanks

  2. Hi! I can across you post about the Med-Surg certification questions I was wondering if its not of any trouble if you would be willing to email me them as well. Thank you!

  3. Hi. I recently came across your post about med/surg certification. Do you mind sending me a copy of the study questions?

    thank you

  4. KellT1203

    Quick Head to toe?

    Sent!
  5. KellT1203

    Med-Surg Certification

    I have around 200 or more study questions and a study guide recommended from the hospital I work at if you'd like I can email it to you. I am working on a resource binder for the nurses on my ward. I was the second to be certified and more are to follow now!!
  6. KellT1203

    Quick Head to toe?

    These are my assessment questions, head to toe. Any headaches, neck aches, neck pain, stiffness? (look for glasses or hearing aids). CP, shortness of breath, cough, palpitations? Look at their breathing, NOTE* sometimes they will say no cough but yet you will hear them cough (mostly post surg or pts with lung issues) When was the last time you had a BM? N/V/C/D? (last episode) Pain or burning with urination? (asses color of urine, or ask aid if poss) Falls in the last year? Assistive devices? ( assess extremities, check for edema) Then ask the patient if you can listen to their innards (I like to be funny)? (listen to heart lungs, abd). I am constantly assessing every time I look at my patient. Looking around the room. It only takes 5 minutes, maybe more depending on the patient to complete my assessment (charting is MUCH different, but we all know how that goes). While you are doing their skin assessment (they are walking to the bathroom or turning in bed - look at their back side) look for IV, bruising, wounds, surgical site. I could easily be asking them while I am doing my med pass. I am not always able to get all of my information at the same time so I rely on frequent contact with the patient. If I don't have part of my assessment complete I at least start charting (when I can) and fill in the blanks later. I do have an awesome assessment sheet I use that helps me to remember so I don't have to ask the patient again or go back to reassess. We use COWS, so I am able to make notes as I go. If you would like to check it out let me know. I would be happy to email it to you. You can make changes to it as well, tweak it to your specific needs. Kelly
  7. KellT1203

    CMSRN

    I did it. I studied my butt off, took the test on Friday and PASSED!! So excited to be a part of the CMSRN world. Such an exciting step in my career. Now I sit and try to patiently wait to find out if I have been chosen for the Evidenced Based Practice Fellowship. Keep your fingers crossed!!! Kelly
  8. KellT1203

    CMSRN

    I scheduled my test for August 3rd but thinking about pushing it out two weeks. I did horrible on a practice exam of 75 questions. I got around a 57%. Anyone have any advice? I have horrible test anxiety. I made the mistake of telling a lot of my colleagues and now I seriously can't fail, which puts me in even more of a panic. Any advice on this would be so helpful.
  9. KellT1203

    CMSRN

    Thanks! My employer doesn't offer to pay for the test but they do offer to pay for the refresher course. It's & hours long for 2 days. I'm not sure I can handle a course that long. I have a short attention span í ½í¸¬
  10. KellT1203

    CMSRN

    Hey everyone! Hope you all are having a good start to your weekend. I have almost met my 2 years on med/surg. I have been a nurse for 8 years now! I plan to sit for my CMSRN. I was hoping some of you could give me some insight, what to expect for the exam? Thanks, Kelly
  11. KellT1203

    Waste of Insulin

    I know this is super delayed. I haven't been on the site in MONTHS. Thanks for all of your input. A couple of things. We keep unopened bottles in a med room in the fridge. In that room there is a chart that helps calculate when to date the bottle AND our labels!!! Some nurses don't label the bottles. We do keep them in a locked drawer near our insulin syringes once the bottles have been opened. We have non-diabetics who receive insulin post surgically to keep their blood sugars under control to help promote healing and prevent infection. They are on a sliding scale and don't discharge with insulin so it wouldn't be cost effective to keep the insulin in locked boxes for everyone who is on insulin during their hospital stay. I almost wonder if maybe we should send up bottles for those who are on insulin at home and have them go home with the bottle. Keep a very small amount of insulin bottles on the ward for those who are on insulin short term during their stay in the hospital. I still haven't figured this one out and yet again, just two weeks ago I found another 2 bottles of insulin (aspart being one of them) full and unlabeled. Our supervisors talk about it during morning minute but nothing ever changes :'( Makes me mad. Hundreds of dollars are being thrown away and it is coming out of our budget. Its not like enough crap gets wasted. I get so mad!!!!
  12. KellT1203

    Home Health burn out, advice welcome.

    RUN! And run FAST!! I did home health for just under 3 years. I stayed with it because of the autonomy I had and because I had such a love for my patients. I was seriously getting burnt out, mostly because I kept getting more and more pressure from my management and no help. My thoughts on this is because I was one of the better, more organized nurses who actually got her work done. We had one nurse who would sometimes be a month behind on charting and pulled out of the field to catch up, and still get paid. I had very little morale of the company when I left. I didn't have any emotional attachment to my or coworkers when I left. I was seeing my last patient on my last day (3 years ago yesterday in fact) sick when I got a call from my former boss stating a patient was just discharged home and needed a resumption, that day. I told her I was done, headed to the office and shouldn't have been seeing patients anyways because I had a horrible (HORRIBLE) cold. She was pissed and now I am no longer re-hirable to the company (which is a whole other story - and absolutely ridiculous). I actually left my home health job and worked at a clinic, with little direct patient care for a few months and got laid off. I took a total of almost one year away from direct patient care. Gave me a break to regroup. Home health is very hard. I found myself unable to shut off. Always charting, always checking and replying to emails. Lots of anxiety. Having worked so hard and with all the stress it has really taught me how to let things go and not be taken advantage of. I can totally leave my work at home now. I couldn't do that in home health. It also had a lot to do with starting a family while I was working for the agency. I felt like my job took a lot of time away from my daughter and put stress on my second pregnancy. Good luck!!!
  13. KellT1203

    Planning route for the day

    I did home health in a large city. Because of traffic I would start with the patient who lived the farthest away afrom me and worked my way back home. I would try to make it so that I didn't have to do much back tracking. For those patients whose homes I hadn't been to before I would map my day out the night before, even make my calls to set up my visit time the night before. Most times I could finagle with my patients a little bit saying hey I am going to be in the area at such and such time, is it ok to stop by at X time. Most of the time I got a good response. If not I would ask to come a half hour later than I had wanted to and it was ok. I used that half hour of time to grab a snack, find a place to go to the restroom, eat my lunch or catch up on my carthing. I was a case manager so I always had A TON of charting to do. I did have to back track at times for various reasons but I found mapping my day out the night before was very helpful. Things can change pretty quickly if an admit came my way. This would make it easier for me to change my schedule. It took me almost a year to get a good routine while working in home health. And I was a very green nurse, with around a year of experience, most of it was in ALF.
  14. KellT1203

    Waste of Insulin

    Hey everyone! I work on a med/surg floor. Most of our patients are post surgical and then we get the overflow of medicine patient. We have a HUGE amount of insulin that is wasted d/t nurses not properly labeling bottles, bottles scattered all around the floor (in COW drawers, med carts, pockets). New bottles are being opened all the time, almost full bottles are being thrown out. About two weeks ago I found a bottle which was probably opened during the day shift (I work nights) that wasn't even labeled!!! So incredibly wasteful. I am going to work on a little project this year to help us (hopefully hospital wide) cute down on our insulin waste. I am getting a team of a few other nurses together so we are just in the beginning stages. I am trying to brainstorm ideas of how to cut down on the waste. The only thing I can think of is that rather than having bottles opened as a community bottle the bottles be sent up with our patients and designated to just the patient. Some of our patients are only on insulin post op and do not go home on insulin so this wouldn't save on cost BUT the bottles for those who are diabetic would end up taking the bottle home. Does this make sense? So! I am making this a longer story than needed. I am wondering if some of you nurses could share what you do on your floor with your insulin. I could really use some help with the brainstorming of ideas for this. Something has got to be done. A bottle of aspart is around $100. I plan on talking with our pharmacy to see how we can track how much we use and how much gets wasted but this may be a difficult task. We may have to do chart audits for our diabetic patients. Like I said. This is just in the beginning stages. I am just now trying to pull a team together for this. Any help and information would be greatly appreciated. Thanks!!
  15. KellT1203

    IV medication that can not run fast

    Phenergan. It can cause tissue necrosis and lead to amputation. Just after learning about this in nursing school I ended up in the hospital over night with a gallbladder attack. I was given Phenergan for the nausea. Freaked me out! It was administered IVPB in I believe 50 mls of NS.
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