futurenicunurse2008

Could you tell this to my hospital. We do medical detoxes on my dual diagnosis unit. We are not monitored and I have had patients come up to the unit in DT's. Their BAC will be 0 and they are stumbling around with no idea where they are. Hallucinating. BP off the charts are med floors tell us we can handle it. We do po/im ativan.

[Another example is charting "patient was turned q2h" when they were turned maybe twice in the shift. Another big one is entering in a CIWA assessment for a sleeping patient. I'm sure there are lot of excellent nurses out there who wake their patients to perform CIWA (which is what you are supposed to do) but most I know will not wake up an alcohol withdrawing patient in the rare moments they can be found sleeping unless absolutely necessary. Yet, they all put in the CIWA assessments on time. I could go on and on, with people charting that saline locks are patent without flushing them, non existent pain reassessments, and so forth. Do you encounter this often? And being as honest as possible, have you or do you do it? Do you feel that you have much of a choice? Actually I work at a facility that does medical detoxes and we DO NOT wake them to perform CIWA. Sleep is essential for these pt to recover. They often dont sleep for days which can add to the delirium. I have linked an article from vanderbilt University that actually states in their protocol to NOT WAKE a patient , but hold meds and assess when awake. Have you ever had somebody climbing furniture thats been plowed with 20mg of ativan + haldol FINALLY get to a point to sleep. Why would you wake them in an hour to give more medication? https://view.officeapps.live.com/op/view.aspx?src=http%3A%2F%2Fwww.mc.vanderbilt.edu%2Fdocuments%2Fsss2%2Ffiles%2FDT_VPH_Alcohol_Withdrawal_Delirium_Tremens_Protocol.docx Also sometimes no matter how many medications you give the pt will still go into DT's I have had pt who received 22mg of ativan in less than 24hr as well as 15 of haldol and still went into severe DT's. My unit isnt monitored either so that can be scary. Just thought I would share, some units protocol is to actually let them sleep. I have had many pt IMPROVE once they get a few hours of uninterrupted sleep. I still assess breathing,sweats, even vitals but I dont wake them to ask if they are seeing things. If they are sleeping then they are probably not actively hallucinating

Can someone pass the popcorn please

I graduated from an ADN program in 2008. Should all of my credits still be good and able to transfer to a BSN program?

"my cna" is lazy what do I do?

I am right there with you after years of being told i was "depressed" I finally had a doc suggest FM. nsaids and alternative medicine is how I treat there are days I hurt so bad I can barely move. it sux ((hugs))

mine is always about charting.lol im forever charting and doing admissions with lots of charting

I am pro-choice but this article makes me sad I respect her right to choose but it feels wrong. Maybe she should have thought of these things before impregnating herself,especially when she had older children. I guess it felt very selfish to me. Its not like she was medically in danger at that point. Again I am pro choice but I dont think it should be treated like a commodity. I dont know it made me uneasy

I think its up to each person and depends on where you live. Where I live 20 is pretty much what all the new grads make. Ive been an RN for 2 yrs and without my night differential only make 22. So its all relative I make fairly decent pay for where I live. Also I feel ok about what I make because I have spent part of my life making 7 an hour at best so Im making alot more now than what Ive ever made. Like I said its all relative.

the program involves alot of self teaching and it is hard because of the accelerated pace but its doable. I graduated there with my RN in Sept 2008, passed my boards the first try and have had no issues finding work. Hope this helps:)

I know some are going to think Im crazy but I hate the hours at my job I work 3pm to 11:30pm 5 days a week. A lot of people have said they envy the hours I wish I had my 12's back . I work in a detox unit and even though it's not what I originally wanted to do I have found that I really enjoy it. I just hate the hours and Im not the only one. My job as actually seen quite a bit of turnover for that shift. The problem management will not budge on the schedule even though the rest of the hospital has 12's they wont go to it. I feel bad because I just started a couple months ago thinking the hours didnt sound too bad. I HATE THEM. I never see my husband who is in school all day. and I work every other weekend so I feel like like I only see him every couple of weeks not mention I dont get to spend as much time with my kids either. I dont know what to do. It seems to early to try to transfer but I really miss having more days off and being home more.

I agree I am not trying to be a nasty person and I understand making mistakes but there is such a thing as personal responsibility and thinking about the consequences of your actions. I see this sort of thing alot in our out pt program (im an addictions nurse) we have pt fail test that are on probation and end up going to jail because of a lapse in judgement or giving into peer pressure. THINK BEFORE YOU ACT. It will come back to bite you.

personally I dont see the problem with the language as long as it is on breaks. However the thing that bothers me is the cliquiness (sp) thing. I see this everywhere regardless of nationality. There always seems to be those one or two nurses that are just left out. That can be very hurtfull and create an unpleasant work environment and the make the person feel they are alone instead of part of a team, also leaving anyone on the floor should be a nono what if she were in a pt room and there was an emergency or even just a call light noone can take care of the floor by themselves.

Seriously lets not argue we all can admit that there are lazy people in the job place PERIOD regardless of title. I have had cna's ignore call lights and not turn patients when I am extremely busy and overwhelmed (i worked on a stepdown unit for awhile) Instead they are socializing or complaining but I have also known nurses who sit at the nurses station playing on facebook and expecting others to do all their work. and leaving all the turns to cna's or other nurses. We have to work as a team in order to get the best patient care. However there is a heirachy because I am the one who has a license and am untimately responsible for the safety and well being of my pt. I have never delegated a task that I am not willing or have not done myself but when I do delegate its because I am not able to do it at the moment and it needs to be done. We all need to learn to work to work together and stop bickering like we are in highschool because ultimately it is the patient who suffers...and I am just not ok with that/ Off my soapbox now :)

I would love to be a patient whisperer lol. So even the worst withdraw detox patient who is freaking out pacing the room I can just walk in and instant calm :)

it may not even be what you think... Hate to say but there are politics in nursing. I had 3 different interviews with a position once and then they ended up going with a close friend of the NP that worked on that unit. Come to find out she didnt even make it through orientation. so it may not have been you they may have met someone with more experience or they may have known someone there....It happens

This is usually I am as well I feel a sense of loyalty plus training a new nurse is not cheap....Its so hard though to imagine walking away from what Ive always felt Ive wanted to do.......I have to admit insurance will play a factor in this I have a medical special needs child one of her specialist is covered no matter which I would go with, Im not sure about other 2. As far as other insurance issues Im pretty sure my pcp and OB wont be covered either way so it will be about deductible and out of pocket maximums. I dont know I have alot to think about if another offer comes across the table. I just want whats best for my family.

Ok heres my thing and I may be jumping the gun here but cant help it... I just got hired at a local hospital in the addiction recovery unit where lies much of my experience, however as you can tell by my screen name I have always wanted neonatal. I received and invite to come in for an interview at childrens mercy in the NICU pretty much my dream job. However I know how slow they are with their hiring process and chances are I will be working the new job before they would even make a decision. I dont know what I am going to do if I get an offer. On the one hand the ARU job is much closer to my house, better hours,decent pay and a less acute atmosphere. On the other the NICU is pretty much a dream position for me. What would you do it seems like it would be rude to work a job for a short period of time and then leave if I got another offer. I know Im prob jumping the gun I may not even get an offer but Im thinking about it now because I dont think its a decision I could just make on the spot if I did get an offer.

My hubby gets annoyed with me when I put out all the mistakes on tv medical shows....(shocking a flat line is my biggest pet peeve)

I currently work on a very busy, very stressfull stepdown unit. While it is not my dream job, I feel like I have learned alot and developed my skills. However, I am worn out. The hospital is having budget issues so we are now taking more pt with less help, without any incentive. We are not even getting our raises this year. I feel so tired and stressed all the time. The patients on our floor are very heavy and often have psych issues along with the medical issues. At least once a week I am getting hit, scratched or kicked by a combative patient the other nights I am putting confused people back to bed or restraining them to keep them from pulling out lines or catheters. I am exausted, Most nights I dont even want to come to work and I wonder why I chose this proffession. Again this is not my dream job, I really want to work in neonatal or OB. I realize this is a stressfull area also but its more where my heart is so I feel I will enjoy it more. I feel like I go home beat up night after night. I feel burnt out. Is this normal to feel this so soon into my career Ive been working for 10 months now. My husband thinks I should look for another job but there isnt really much out there in the area I want to be in and I know I should just be grateful I have a job. I just wish I was doing something I actually enjoyed. I have nightmares about this place. Thanks for letting me vent.....

actually the start is now 20.80 for new rn and the bonus is 500 up front then 1000 every 6months for 2yrs i just started last december and this is what it is for me

Ive been working 7 months now and I have to say what you said is so true I have actually had pt 2 and 3 and so true about families.....funny post:yeah:

My thoughts exactly, the point is they were students and clinicals are there to learn. It also matters where they are at in the process....Were they LPN students in their very first clinical setting?? That can make a difference. Your first clinical experience is scary and overwhelming, think back to when you were wet behind the ears. We dont all know everything while we're in school, if we did we wouldn't need to be there.

Really???? Thats quite curious, where do you work? Because again, I am a BMC grad and trust me sweety I know how to bathe a pt along w/many other things. I passed my boards first try. and am working at an area magnet hospital, and my co-workers find me to be quite competent. Try not to judge based on a handful of students.