Java Mama

Hi Everyone, I am 3 months into a nurse manager position at an independent living facility. One of the biggest problems I see with this facility is the narcotic shift to shift count sheet. I've looked on-line, but can't seem to find what I'm looking for. I want an area on the sheet that has a spot for when receiving medication from the pharmacy and a spot where you could subtract if sending something back (besides the other information that's on the sheet). Anyone have one they could share please? Thanks :)

Hello, I work on a busy hospital med/surg floor with-out telemetry (all other floors have). They are now turning our floor to a monitored floor in a few months and we all now have to take ACLS classes. The problem is, most of us can't read strips, let alone understand the complexity of irregular rhythms. Seems like this could be dangerous for the patients if you don't have experienced RN's that know what they are reading. We have ICU, IMC, PCU x2, surgical and OB's. Just reviewing "the basics" is hard enough to grasp, let alone this other material we have to learn. Can anyone give me some advice on the best way to learn this (a way that it's really broken down easily to learn)? Thanks :)

Hello, I work at a hospital on a very busy med/surg floor. Last week our floor manager handed out a new policy she will implement starting tomorrow. This policy is our new rounding rules. There is a very lengthy paper the nurses fill out on the even hours and the CNA's fill out on the odds and is kept at the patients bedside. Ok, it might not sound like much, but it is a whole paper. I always stop in the patient's room to see if they need anything, but I know I will not have the extra time for this. I run from the time I get there till I get home, so I am worried. They gave us a paper to sign saying we received this and will follow it because we realize WE are putting our patient safety at risk!!! NO!!!!...I don't feel that way, maybe the opposite. It also states that if we don't fill these papers out, we're subject to corrective action. I just don't know what to do.

Hi, I am a fairly new grad (worked 10 months in LTC) and am starting on a Med/Surg floor tomorrow. So, we had 2 days of orientation on Epic and I know it takes a while to learn, but it sure seems like a lot of information. Does anyone know of any links that could help a new nurse set up her day using Epic? Thanks :)

I am in the same boat as you. I am a new nurse and work at a short-term rehabilitation unit. The average patient load is 16 (and I know most are saying you're lucky to have only that many), but you have to remember, being right out of school...it's over-whelming. There is SO much paper charting, admits, discharges, etc. My average day is usually 15 hours trying to get everything done. I am so over-whelmed.

I ended up taking it and it seems pretty good so far. Thanks for all your replies. :)

Hi Elly, Yes, very expensive. I applied to every school in my area and it was a 2 to 5 year wait-list. Since I was 40, there was no way I wanted to wait that long. I can tell you, you will get an excellent education there but you will work your butt off. So I guess it depends if you are willing to wait for an opening in Michigan (not sure what the wait-lists are now).

Hi Everyone, I am a "very" new graduate (just got my license last week). So I have been putting out resumes at hospitals & nursing home/rehab. facilities. I had my first job interview yesterday and was offered a position at a rehabilitation center. I actually thought it was a nursing home, but they said it is short-term care rehabilitation center that centers on cardiac, respiratory and orthopedic rehab. It is a new facility and absolutely beautiful. I was surprised to learn that they said I would be able to place IV catheters, suction patients, wound vacs, etc. I thought that would be the downside (not being able to enhance my skills). They said I would be doing many of the same things as in a hospital. My question is, the shift is 7 pm to 7 am and every other weekend. That's fine, but they do not give any shift premiums for working nights or weekends and I know hospitals do. Did most of you jump on the first job or wait a little longer to see if you had any other offers? Thanks.

My drive was 45 minutes each way and I would have to go sometimes 5 days a week.

Hello, I'm also from Michigan (along with many others) lol. It is VERY SMART that you got all other classes out of the way before starting. Many people took other classes with the nursing classes and I just don't see how they could do it. I had it easy compared to others (jobs and young children). I only worked 1 day/week and my son is grown so I did not have a ton of responsibilities like some. I don't think you'll have a hard time getting in as long as you have decent grades. As far as the teachers, most were good. I think you'll always have some that are not so great. My advice to you is try and work as little as you can and stay organized from the start. The program is so demanding, you won't have much time for anything else. Mercy has an excellent reputation for preparing students to become entry-level nurses. Good luck and let me know if you get in!

I just graduated on the 15th this month. Anything I can answer for you?

Thank you SO much for all your wonderful advice! I am really looking forward to my first day Monday. A friend of mine said the instructor I have is suppose to be really nice, so that is a real plus :)

Hello, I just passed my nursing final and now am doing my final hours precepting in a psychiatric unit. I picked psych because I enjoyed that rotation in school and thought this would give me a better taste of what it's really like. It seems when you tell classmates what field you like, many can't believe I'd want to do that (I'm not sure why). I was just wondering what advice you would give someone that is new to this field. Thanks for your input.

Hi, Our teacher posted some math problems and I have no clue how she got the answer. Could someone please explain this to me? I've never seen an "mu" before either??????? Pitocin Give Pitocin at a rate of 4mu/min Available is 20u in 1000ml LR Answer 12ml/hr

Thanks for the breakdown! Great example to print out and carry with me so I won't forget. :) Thanks everyone, I really appreciate all the help!

Thank you :)

So the PCA questions are back this semester...if someone could take a look at this and see if it's correct, I'd appreciate it. A patient has a PCA. It is delivering 3mg as a basal rate. The patient can have 1mg every 15 minutes on demand. What is the maximum amount of Morphine that a patient can have in a four hour period? 3 mg/hr x (4 hours)=12 mg 4 mg/hr x (4 hours)=16 mg Answer=28 mg/4 hours

If you have a child with juvenile arthritis and Down's syndrome, which one would be more likely to get cancer? I would think that that since juvenile arthritis is an auto-immune disease, it would be more likely to happen in that case than a child with Down's syndrome. This was a discussion in class and some of us feel we were right. I tried finding information on any website, but am not having any luck. Does anyone have a website that would have this info? Thanks.

Hi Everyone, I had to do a clinical day with a school nurse and I have to write a paper on my experience. I have some good ideas, but one of the questions I have to address, I'm not quite sure what to put. Could you tell me what this means exactly? Apply concepts of the teaching/learning process in designing teaching strategies in achieving short and long-term goals in the school-age population. I assisted the nurse with an educational program that day. She played a video on eye protection and we handed out certificates that they completed this course and also gave them some pages to color. I think I need to write something like...ways to protect your eyes to prevent damage (..........)??? I guess I just would like some help wording this section so it sounds professional on my paper. Thanks for any input.

Hi Everyone, I'm going into my 2nd week and I am really stumped of what would be the easiest way to remember where to get these numbers and where to put them. I know some of the info is self-explanatory but from "maximum concentration" to "do you need to stop or decrease main IV line" is very confusing. I know some of the info will come from the doctors orders, but just looking at these med sheets we need to fill our every week is totally over-whelming. Can anyone give me an easy explanation? EPSON001.PDF

Well, after reading this thread, I thought I needed to say something. I just got my exam grade for GI/GU and failed. This is how my semester went (I'll post my grades since no-one knows me :) )...first exam--84 second exam--78 third exam--82 fourth exam--98 and my final--77. The real kick in the teeth was on the 3rd exam I didn't turn the paper over and missed 4 questions on the back! That was 8 points there!!! The tests are weighted 18% and the final 28%...that leaves me with a final grade of 83.12%. I just feel sick to my stomach. How do you go from a 98 to a 77? I studied the same way (recorded the lecture, blah, blah). I just wish I could REALLY figure out what I'm doing wrong. You can't be below an 80% or you fail. I have gotten B's in my previous semesters, but I just couldn't figure out what the teacher was going to ask this time. I have 1 more year to go and am always worried that I can make it each semester.

Thank-you both for your replies. We don't have to do any type of presentation or anything like that, you are basically the instructor's assistant for the day and they want to you to be able to prioritize. I know the basics (I think), regarding who should get their meds passed to them asap that morning, but you are also suppose to help the others chart and make sure everything is completed before leaving for the day. I just wanted some ideas to make things run smooth. They gave us a guideline and it really isn't that hard, but helping the instructor with 8 people will be a challenge to get everything done correctly. Thanks again for your input, it gave me some great ideas! :)

Hi Everyone, I'm a 4th semester student and each week at clinical, we all rotate to get a day as the "team leader". I know some basic things I should do (besides helping the instructor), like prioritizing who needs their medications first (ex: diabetics), help with charting...but I was trying to come up with a good plan to make things run smoothly. I don't have a patient that day, it is all team-leader duties. I try to stay organized, but since I have not done this before, I would appreciate any tips. Thanks :)

Hi Everyone, I am in my third semester and am taking mental health. I failed the first 2 exams (there are 4 and a final), "but", the teacher gave the class an extra credit project, so I am just passing the class right now with an 82 (you need an 80 to pass all nursing classes). I passed the first 2 semesters with a B, and had to study very hard for those grades. I use the disk from our book and do each chapter, the Saunder's NCLEX and ATI modules. What the heck am I doing wrong? If anyone that has taken psyc yet and can give me some others hints to improve my grades, I would really appreciate it.

Ok, I think I am starting to get it. Thank you all for all of the help, I appreciate it. I'll keep practicing them until I get it right. :)