ShortStackRN

Never refrigerated...in fact it specifically says "Do NOT refrigerate"

I would not have covered it. Yes there are some medications that you should have an MD permission to hold but your nursing judgment and critical thinking should come into play here. Several of you have stated that you will ask an MD before holding anything...does that mean that if your patient has a BP of 90/60 at 1am you're going to wake the MD up to tell him that you're going to hold the med? If so then I imagine you have a lot of upset docs on your hands. In my facility we use a barcode scanning system which gives you an option to exception off medications with reasons like "clinical decision, Low/Normal BP, Low BG, etc." My thought process on insulin is that I do not administer if it is like your patient at 153 if the patient is NPO ESPECIALLY if it's a high dose algorithm. You could be asking for a major drop. Of course as many have stated you can administer D50 if need be, however by doing this you are a.) compromising your IV site and b.) their blood sugar is going to rise dramatically and it will become a vicious cycle. I also work on a diabetic floor so we deal with this day to day. Hope this helps.

It is! Had the preemptive interview with HR today and it went great. It's the area I want, it's considerably more money...only problem is that while it's only about a 20 minute drive it's in another state. Now my concern is finding out how it works paying taxes in two states...yucky...

I have PF with extremely high arches...so far the only shoe I have been able to wear consistently with very little pain (except for the inevitable after 3 hard nights) is Sketchers Shape Ups. They keep my heels off the floor and allow your foot to rock when you walk so as to keep pressure off the balls of your feet and heels. Also, it doesn't hurt the calfs and bottom either

When I first started working nights at my hospital I got kind of the yucky schedule because I was new. I would consistently be scheduled one on one off one on one off one on...it was a nightmare. I was unable to stay awake so I just kept myself on the night schedule as if I were working. At first I tried staying awake on my day off and after about 3 months of that I ended up not being able to sleep at ALL...it was nightmarish. You might want to consider working at least two in a row with at least 2 days off in the middle. I work 3 on 2 off 3 on then 6 off now and it's great. Good luck! Listen to your body...if it's asking for sleep give it what it needs!

So....I got a call back today FINALLY...I have a meeting with an HR rep Monday morning...fingers crossed. It's so aggravating because I have emailed directors in my facility where I'm trying to transfer directly and to no avail. I mean I didn't even get a response (which I also find kind of rude...even if you aren't interested). Hopefully something comes from this interview Monday! It's another facility but it seems like a good opportunity!

Thanks so much for that AWESOME report you gave me about how you just checked on them and everything is great and the patient was telling you how awesome you are. Crazy how somehow 5 minutes after report when walking rounds I found the patient drowning in tube feeding and had to call a CODE BLUE...I so appreciate it! I'm sorry you had a bad day...I really am...but I'm not going to do your work for you because you got an admission at 1pm and it's now 7pm and they patient doesn't even have orders on the chart. If you don't feel good...please call in. You are actually making my life harder by coming to work and spending the first 2 hours sitting at the desk complaining about how your toe hurts because I, as charge, end up doing your work for you. Just because I'm sitting at the desk doesn't mean that I'm not doing anything. While I have been running around taking everyone to the bathroom, changing people, bathing people and getting them ice, drinks, snacks, etc...i have also had to pass meds, do assessments and NOW I need to chart these things. This does not give you an excuse to say "Make the nurse do it...I have to go take vital signs" (meanwhile you have already had your lunch break and time to sit around and gossip for the last 4 hours while I've been doing both of our jobs. If you're going to ask me things like, "Should I stop a tube feeding before I draw labs?"..."Can PCAs do a portable chest xray?"...and tell me your patient fell because "I didn't put the bed alarm on because the doctors order say up as tolerated"...IF you're going to ask me for help which i sincerely hope you do...please do not argue with me when I tell you the correct way to do things. I love you but you are a scary nurse. All things said, I love and appreciate my coworkers. But at the end of the day we are like a family (as we spend more time with them than our OWN families). We all get annoyed with each other from time to time...but once we can vent we can get over it!

I have tried applying within my facility but the problem is that there aren't many positions open (as this seem to be a problem everywhere these days). Right now I'm looking to go into critical care. It's always what I have wanted to do and I was lucky enough to have a 3 month practicum in critical care. I decided that med-surg for a year was the best route for learning and experience and because I couldn't get a job straight out in an ICU or the ER. I have recently applied for jobs in the ER (which is my first choice) and in CVPACU. I'm just sitting around with my fingers crossed that someone will call on my transfer. The other problem that sticks in the back of my mind is that I work in a facility where everyone knows everyone. My NM made a comment to me after I told her about my transfer request (which I am required to do) that she really couldn't lose me right now as our floor is almost completely staffed with new nurses, coulnd't I just stay until January...basically I'm going to do whatever I can to keep you. I'm just HOPING that this hasn't been discussed with any of the NMs in the areas I have been applying. While I appreciate the flattery, I feel like this is my career, my education, my license and if my heart isn't it then I shouldn't be trapped here. It's so frustrating.

Definitely The Ramones-I Wanna Be Sedated

We give IV paracetamol a good bit in my facility. It's hung just like albumin and you must be sure it's vented tubing. It's basically a fast drip. We use it mostly for unresolved fever or fever related to blood transfusion reactions.

We had a patient come to our floor one night with orders for a continuous bladder irrigaition (which is usually sent to the urology floor, however they were full). Our ANM had no experience with setting this up, as most of us did not either, so there were probably 6 of us in the room...counting drips...manipulating things...etc. While we waited for the ANM from the urology floor to come and save the day...making jokes about "how many nurses does it take to..."...the little 80ish lady is laying there...spread eagle...she was pleasantly confused thank goodness...the one male nurse in the room happened to be standing closest to her...she kept grabbing his hand and saying, " I love you mister...you're so soft mister...please don't let them hurt me mister"...we were all about to blow something trying not to laugh. This has become an almost every day joke for us now...every time he's working we walk by him and rub his arm, "You're so soft mister..."...lol

I graduated May 2010. I like to think that I'm a strong nurse as I have been working on a 38 bed MedSurg unit with a very high acuity, taking a 6 patient load every night, and also serving a charge nurse in the last few months. I am ACLS certified, I have extensive work history in the medical field even before becoming an RN. I am ready to move on from med-surg....I can't even get a call back!! I feel like I'm trapped. I guess I'm old school in that I prefer a face to face, door-to-door job application rather than just being thrown into a stack of resumes. It's very frustrating...does anyone have any advice?

I work night shift so I typically don't work with many students unless they are shadowing or about to graduate and are in a preceptorship role. However, I have pet peeves all the same. When you arrive in the morning, PLEASE do not crowd into the nurses station. We understand that you need to receive report from your nurse and that you would like to hear us report off to each other (as well you should), but please wait until we begin to walk rounds on the patients. I am ready to leave and I need to be able to get to a computer to chart, etc. and if you are just sitting there chatting with your friends you're really in my way. When I was a student, the instructors at my school would have had a cow if we had ever gotten in the way of the nurses, doctors, PCAs, case managers, etc. Also, please tone down your makeup, hair and jewelry. We understand that not all nursing programs are teaching you to look as professional as possible, but this is just my personal advice to you. Would you want a sloppy looking nurse with bright pink eyeshadow and huge earrings clanking around your ears taking care of you? Or someone who is well put together and professional looking? At the end of the day we do love having students. We are all teachers or else we wouldn't be nurses. Just try to remember that while you get to "chart" and perform duties during your clinical, we are ultimately responsible for our REAL work so we have to get our jobs done. Try not to take things personally when you are in the clinical setting. It wasn't that long ago that most of us were there and we still feel your pain. But it won't be that long before you are where we are you will begin to fell ours.

Drawing blood from an exsisting IV site is not done for several reasons...the two main reasons being that this poses a huge risk for infection and also when you draw back from the IV site you are more than likely going to lose the site causing the patient even more pain by starting more IVs. Our facility doesn't have phlebotomists either...only nurses and specially trained PCAs are allowed to draw labs. And we are also not ever allowed to take blood from an IV site unless it's a new IV start.

I've been an RN for just a little over a year and I have been on night shift. I worked as a PCA during school on rotating shifts and got to experience days and nights. I've noticed that in every hospital it seems to be the same...Day shift sometimes has a lot less teamwork than night shifts. For whatever reason night shift co-workers become like family even when you don't always loooove the people you work with. Also, it really depends on you as a person. Can you function on less sleep and stay up all night or are you a day person? Day shift has to deal with a lot of discharges, doctors, social workers, visitors...it's just more hustle and bustle. I will never say that night shift isn't as busy because at least where I work we are just as busy at night. The one thing that makes a big difference also is how confident you are in your skill. We have less resources at night and you should be able to make quick critical thinking decisions for the health of your patient. You have to call doctors and wake them up in the middle of the night...we deal with a lot. BUT...I love night shift and could never imagine day shift work...and yes of course the $$ is a lot better.

Of course we all have doctors who will complain about being called for anything, even a 3 am Tylenol order. HOWEVER, that's unprofessional and inappropriate. Doctors know that part of their job description is being woken up in the middle of the night to meet their patients' needs and that whole being "on call" thing isn't a joke. As charge nurse you need to defend your nurses and let them know that they have a support system.

It seems to be seasonal. Our floor right now is teeming with spider bites and snake bites. Of course, living in Georgia, I assume this is going to be the norm but I can tell you that we rarely see this in the fall and winter months.

I would DEFINITELY send that letter...she should be reprimanded for that behavior.

I just graduated in May and I started applying for nursing jobs in March prior to graduation. I had a job lined up before I even passed NCLEX. I was actually hired for a day shift position but requested to switch to nights (I'm a night owl ). My nurse manager actually just hired 3 new grads for day shift so it's not impossible. HOWEVER, most facilities do prefer to start new grads on nights and it's really for your own benefit. You can always switch to days when you feel comfortable if you can't start out on days immediately. If you want to be a nurse do it! All of the other details will fall into place!

In some states LPNs can give IV meds but as far as I know they are not to give IV PUSH medications especially something like Dilaudid.

The only 3 people in my class that didn't pass the first try didn't study enough for the test...I'm just sayin...

So I graduate in May and I was curious when is the time to start applying for jobs? I don't want to wait too long, but I'm not sure if it's too early. Can anyone help me figure this out?? Thanks!

In reality I would take the blood sugar immediately, note in the chart that it wasn't done until after the patient started to eat, then administer insulin based on their order/sliding scale. However, we as students know that there is a RIGHT answer ( what you would do in "real life" as a nurse) and a CORRECT answer...the correct answer being that of your book and or instructor. I would ask them for verification on this issue. Also, it's going to depend on the facility's policy.

I'm not sure you can get an accurate reading from the chamber. You need to empy the urine into a graduator or some other container to be able to accurately measure.

I work in Augusta GA...close to SC...I make $11.72 an hour during the day and $13.72 if I work nights...so worth it