core34

Any St.Joseph's students from Massachusetts doing clinicals? I am told they aren't accepting Mass residents because the Department of Higher Education hasn't approved preceptorship in the state. Any insight?

Our boss is implementing a "no-sitting" policy, we are not allowed to sit at the nurses station to document - we are only allowed to stand at our computers out in the hallways. We are only allowed to sit during our breaks. Some union reps have posted a Mass "Right to Sit" law on our floors, but I can't find any information for myself. Has anyone else come across a similar situation? Was it resolved?

This lady partsl bleeding could as be a side effect of chemotherapy. Did she receive any palliative chemo recently (specifically Cytoxan and/or Ifex)? This lady partsl bleeding is called hemorrhagic cystitis, the drug Mesna is typically used for this side effect.

I was just offered a position at Anna Jaques (med/surg)...I have been working as an RN for the past 6 months in geri/psych at another hospital but I'm still considered a "new grad."

Hi there -- I'm coming up on my 6month mark and relocating soon, so I decided to put out my resume to see if I could 1)get something closer to my new house & 2) get into something more medical (I'm currently on a geri-psych floor). One place responded "Unfortunately I do not have anything to meet your needs at this time." I obviously suspect my lack of experience, but I'd like some insight into their thought process. So my question is -- would it be appropriate to ask for the reason I don't qualify? Can I also ask what, in the future, WILL qualify me?

Correction: New grad at Mt Auburn 29+/hr Eve diff 2.25 Night diff 3.25 Weekend diff 1.75 Weekend night diff 5.00

FYI: Nothing ever came of it. Turns out she was being very manipulative, etc etc -- and had been saying it about every male caretaker. We have all covered our bums and do care in pairs:) Thanks for everyone's response! Great advice--I have a lot to learn!!!

Great question! I would love to hear what other people are doing out there! I currently work on a Geri-psych unit and I struggle with this daily. We have a basket of clothes to fold as well. We also have a bin of nail stuff for the ladies. Some of the women would be preoccupied with their nails for hours. We have a wide range of patients and I never feel like we successfully address dementia patients' needs. A lot of the activities are geared towards oriented patients -- and most of them can't tolerate/comprehend group activities. I've tried looking stuff up online -- but I haven't turned up much! Hope this thread will shed some light for us!

I'd like to know if there is a protocol at other facilities for situations like this. Currently, there is none in place for mine. Here's the scenario. Patient "Ed" is admitted from home with a bag full of bottled RX's. Some are controlled. At my facility, all we do is label them and keep them in the med room w/the other small belongings (i.e. glasses, dentures, etc). They are not locked away but merely keep in a bin. Apparently, when discharged, "Ed's" full bottle of Ativan went home with him empty. Mind you, we don't use patient's own meds (unless they are on a different formulary the hospital doesn't have). How does your facility document meds that come in from outside? Where do you keep them? How do you document when they are sent home with the patient (given they continue on those meds)?

I'm sorry you had to experience that. I'd be upset too!!! If it were me -- I'd show up for the next scheduled shift, head high, keep to myself, bust my butt to show I'm valuable and can handle these situations, etc. Then I'd go to my NM and let her know it was my last shift. I'd let her know that I wasn't staying til the end of the schedule b/c I didn't feel comfortable in an environment that didn't support MY needs when I was trying to support HER needs. I wouldn't get into it, I just leave it at that. Don't apologize for leaving her hanging. Let her scramble to fill up the schedule -- that's her job; and if she did her job correctly and justly, she wouldn't BE scrambling to fill up a schedule, she'd retain good nurses. Sounds like she spends more time pleasing the needs of spoiled brat RN's who throw hissy fits/temper tantrums then keeping good staff. I truly hope your new job works out for the best. It's saving grace that you can see the end in sight. Take some time off in between! 2 Full time jobs at the same time???? phewww! Good luck with everything!

I have "New Grad" Bipolar disorder.:o

Ok-- I'm pretty disturbed by this. I hate confrontational situations. I work on a Geri-Psych unit and something happened last night that upsets me. 11-7, one of our patients became pretty upset -- unsettled, anxious, etc, around 130am. She NEVER sleeps, she just lies there all night eyes wide open, somewhat catatonic. But last night she became very upset & hyperverbal. There are 2 RN's and a counselor overnight. This particular patient was not my assignment, but I'm very familiar with her. So anyway. The other RN went in to check on her and figure out how to help her. And she made this statement to the other RN. PT: "He hit me....that black guy" RN: "Who the counselor? PT: "Ya" RN: "Why did he do that?" PT: "Because I was yelling and wouldn't stop.....he's not gonna get away with it." There were 2 "black guys" on the unit last night. One was the counselor and the other was a 1:1. However, neither were ever in physical contact with her last night!! I can't say 100% but I'll say 90%. We do 15min checks on the unit, so she would have seen the counselor. But there is no hands on contact unless needed. Summary of events: 1100-0045, the counselor, the 1:1 and both RN's were busy with 2 patients (other than the accuser) who were becoming agitated. The 1:1 then went into a separate room with both doors shut and he would've had to walk past the RN station. The other patient fell asleep in a chair in front of the RN station. 0100-0120, this accused counselor and I went to this Holiday dinner thing at the cafeteria so we were off the floor. The RN covered the floor and the checks. When we got back I covered the 1:1 so he could go get food. 0140, this is when the RN gets the statement from the patient. There was very minimal time for the patient to have interaction with the counselor. Also, she NEVER screamed, yelled, spoke loudly OR rang the bell etc. If she had, both nurses and the counselor would have checked on her TOGETHER. We do 15min checks on on all patients and we answer all bells, bed alarms TOGETHER, always. This never occurred with her last night. It is highly possible that she is having a delusion or hallucination, or some sort of flashback of an abusive history. But no one can tell for sure. This is a serious accusation and I will feel SO BAD if something happens to this person's job. I truly believe this person is innocent and I will certainly speak up for him if needed. I just have such a horrible feeling. It makes me nervous too!!!! I mean what if someone accuses ME of abuse unjustly one day???? I can see that it is a real possibility. Has anyone ever encountered a situation like this before? What was the outcome? I am very upset about this. I'm nervous to enter this patient's room alone for fear of her focusing on me. Ugh. I don't even want to go in tonight and hear bad news. How can I protect myself against accusations like this?:o:o:o P.S. I am a new grad, so this is still all very new to me.

hahhaha, seriously!!! no blow over 11-7! we're working on the BM but she's been dehydrated and this is normal for her. we'll see what happens when i go in tonight. i'll prob end up being the lucky one!!!!

Update: 12/15 K+ = 5.4 , 12/17 K+ = 3.5 and still no BM. Worked like a charm!

Hi there -- Quick question. In order to lower a high K+ level with Kayexalate, does there need to be a successful bowel movement (i.e. is the K+ excreted with the stool) The reason I ask is that we have a patient w/K+ 5.4. She is receiving Kayexalate 15gm Q6h. Since she started (2 days ago) she has not had a BM yet (no cramping, Abd SNT, +BSx4). When we notified the MD, he said she did not have to have a BM for the Kayexalate to work on the K+. The other nurses and I were under the impression that there needed to be a BM in order for the K+ to drop (thinking as in Lactulose + Ammonia). Could someone clarify this for us? (Mind you, this is a Geri/Psych unit to we don't see these things on a regular basis) Thanks so much.

I worked for a few private duty cases and the highest I was paid was $42/hr. I'm also a new grad. Although this figure seems high (especially for a newbie) you have to figure in how much to take out for taxes. When you work Private Duty you are considered an "Independent Contractor." So taxes don't come out of your paycheck -- you pay for it during tax season if you don't prepare properly. So while $50/hr seems inflated, figure a third of that should be put away to pay taxes at the end of the year.

all those courses will go towards a nursing degree so it can't hurt either way. for your science electives i'd suggest microbiology & chemistry (some nursing programs require chem, mine didn't but one i was applying to did). i'd like to reiterate what east texas said. if it takes extra time and money i would avoid programs like these. if your focus is nursing, take all the pre-reqs you can to get into the program. it will take some time if you're fresh out of high school anyway so you will have time to make a decision. i'd also suggest volunteering or getting a job in a hospital/nursing home/etc as a nursing aide/PCA so you can observe RN's as they work -- as well as get some experience on a floor. good luck!

I (luckily) found a job in Boston w/an ADN in Nursing. Graduated in May, started my search in January and began in September. It is not my ideal floor (Geri-Psych) but its a starting point/foot in the door. I just talked to my friend who graduated with me. She was accepted into a New Grad internship at a hospital back in August. That hospital is now entering a "hiring freeze" and although she will have completed the New Grad training in a few weeks, they are not able to offer her a position!! As well as all the other RN's who went through the training! How awful is that??? I would def. suggest sticking it out down in FL for a year to get experience. It is very hard to come up around these parts. I've noticed most ADN's who got positions at good hospitals worked there as CNA's/Tech's previously and they were hired as "Internal Applicants." Boston hospitals can afford to be picky with so many schools in the area.

5 nights is really tough. say goodbye to those 7 days off. the thing with working 5 8's is that you can barely switch with anyone either. if you haven't done 5 11-7's, i would advise against it.

25/female/2

lazy my ass. LAZY is being able to push IV haldol when a patient acts up at the drop of dime on a medicine floor when they already have a line in. MINUS ALL THE PAPERWORK. i'd love to hear someone call me lazy after 4-pointing or chemically restraining someone who is 4x my size and following up w/buttloads of paperwork b/c of it.

You always acknowledge patients who undergo trauma, that what they did in the situation was the best thing to do. They may have suffered physical/emotional injury, but being able to live through it is the ultimate victory. If you confer that there were better alternatives, patient's will have to deal with added guilt and remorse. Ultimately, any outcome is unpredicatable and if they are safe now, then they did the right thing.

We practiced injections on special injection pads. And once we passed on that we could do it in clinical. Inserting IV's or drawing blood was not taught in school. Around here (MA) you learn on the job if it's required. Most hospital's in Boston have IV teams to start lines and the PCA's draw labs.

12's!!!!!!!!!!!!!! I work 5 8's and it's very disorienting. I don't always get 2 days off in a row and if I do, the 1st day is usually wasted. I have to do 5 nights in a row if I want 2 nights off which can be sooooooooo draining. And one night off is not enough to ever feel "normal." Unless you have friends, family in the same boat, def. go for the 12's. I wish that were an option for me right now!