ERteleRN

Our computerized system is wonderful as well. Being able to sit in front of the screen and seeing the whole story behind the patient, i.e. labs, medications, orders, procedures, x-rays, medical transcriptions from this admission and for some patients...the numerous other admissions and complaints at those times. The only question I would pose is how do others feel about 'charting by exception'?? All of our floor units utilize this, but in the ER, we still write every single bit of info on our RADD sheets (boy, talk about hand cramps!).

On our 30 bed unit, we usually had 3 teams. 3 RN's, 3 LPN's, and 3 aides. We would take 10 patients each. However, on 7P-7A, it was not uncommon to have 2 RN's, 2 LPN's, and 2 aides and end up with 15 patients on each team. I think that we all work well as a team on our unit. When I'm caught up, or see one of my peers drowning, I do what I can to assist. I pass meds, answer call lights, give baths, etc. When the other team is caught up in a code situation or something like that, then my team helps take care of their patients as well. One thing that we don't say on our floor is "That's not my patient," and be unwilling to help. The 30 patients are all of our patients theoretically, and we are all there to help them.

It's definitely doable. A lot of people take their prereqs at the same time as the nursing. What I was saying, was to try to get everything out of the way so that you could focus on nursing only. Heck, I was taking ALL of my prereqs my freshman year of nursing (through Baptist and correspondence courses), had two small children around 2 yrs old, and going through marital separation @ the same time. So, it is DEFINITELY doable. I just try to encourage others not to have so many extra studies (and extra stress), if at all possible. And since you only need 3 more courses, I think you will do great. You just have to set your mind to it, and pray that God will guide you...and with that, everything is possible. And with you already being in the nursing profession, you know that it can be one of the most rewarding careers out there.

skay, On our unit, we occasionally have a bridge nurse that does our admissions and discharges during the day shift. Also, before the shift starts, we assign the position of RN (assessments, charting, etc) and med nurse (whether it is an LPN or RN). We have a very busy, 30 bed, acute, cardiac/med-surg unit and this seems to work well and organized most of the time (just wish we had a bridge nurse for 7P-7A shift as well).

I don't see how you can have 'team nursing' in the ER. We start out with about 3 nurses at 7A, then we have a couple of 9A/11A/1P (12 hour shifts). At 7p we have 4-5 nurses that come in to relieve the 7A nurses for the rest of the night. We all take orders as the doctor writes them (it doesn't matter who triaged or assessed the patient first). Sometimes the nurse that initially took care of the patient never lays eye on that patient again. We try to keep things moving. And that way, no one really has "more" patients than anyone else. We are "all" taking care of that patient. (Although every place you go you will have one or two that like to 'socialize' instead of work)

The hospital I work in utilizes team nursing. We are supposed to run our floor with 3 RN's, 3 LPN's, and 3 aides. Each team has 10 patients (Many x's we have 2, 2, and 2 with 15 patients on each team). The RN's are responsible for assessing patients, charting, and certain IV medications. The LPN's are responsible for medications, and charting meds given. The aides are responsible for vitals, baths, etc. Ultimately the RN is responsible for EVERYTHING that is done, and is why you hope that you have a good LPN and aide on your team. On the floors, we chart on computers and do not have problems with more than one nurse trying to chart at the same time. When we look at our charts to verify orders, I usually start at one end, and the LPN starts at another. The LPN is looking for medications, and the RN checks it all. That's how we do things, and it seems to work out fairly well.

LPNtoRN, I was not an LPN before RN. My studies were through the traditional RN course, but we joined up with the fast-track LPN's in our senior year. I'm not sure how the school coordinates this now, but the LPN's in our class did very well at that time. It was fast paced, and they had to learn how to do those tedious care plans (depending on which instructor was grading them ). I would suggest having all of your pre-reqs out of the way so that you can concentrate solely on the nursing. Baptist does start their clinicals early into the course. The school focuses a majority of the study on clinical experience, which is some of the reason I chose Baptist. We shared some of our clinicals with BSN students from local colleges, and they were impressed with the degree and depth of training that we received in our clinical experiences compared to other programs that were not hospital-based. Baptist does have a great program, and will give you an excellent start in your new profession. I wish you the best of luck!

I graduated from BHSON in 2000. The school has really expanded since that time. It's a great school...gives you great hands-on experience. My husband is going through the traditional program right now, and it sounds like there have been a few changes in their teaching methods since I was enrolled (especially since my class started out with about 150 students and lost about half....my husband has about 315 students starting traditional). I'm glad that I was able to have my training through Baptist. If there is anything else you would like to know, feel free to ask. And welcome to Arkansas!! :)

No, you would not put SCD's on a pt that already has a DVT. SCD's are to prevent clots. Once there is a clot, our pt's are placed on bedrest until the heparin has started working or until a IVC (greenfield filter) has been placed.

But how do you enforce that upon the patients?? After all, these patients are adults... I've got more important issues to deal with than to police after noncompliant people. (Actually had one MD order staff to lock a patient's bathroom door because the pt was on a fluid restriction and the MD thought the pt was getting water out of faucet??--Not in my scope of practice).

Does this happen other places or is your experience better? Our managers don't seem to have a clue what is going on in the ER. I truely doubt whether any of them could find things in an emergency! I have to say that our night shift nursing supervisors are some of the best where I work. They frequently make rounds on all of the floors and ED to see how things are going (and what beds are truely open and available, instead of taking one of the floor nurses word via telephone). When we are swamped in the ED, they jump in to help us get caught up. One of the sups used to work full-time in the ED, and continues to work once a week as a staff ED nurse. Our unit manager also used to be a staff nurse in the ED (and a very good one at that). I have a lot of respect for most of my managers. We all work together to get the job done and to take care of all our patients. Everyone has their own roles in this industry, and we can't 'unionize' against one another playing the over-worked floor nurse against the 'suit sitting high and mighty up in the penthouse'. I know I wouldn't want to shoulder their responsibilities of staffing issues, conflicts between employees or family members (just to mention a couple of minute responsibilities they perform).

There are many disadvantages of the nightshift positions. Most, if not all, 'required' meetings or seminars are scheduled for day shift workers. Night shift feels isolated from the rest of the group by not being able to attend most of these (very difficulty after 4 12's to stay awake long enough to attend a noon meeting). Sometimes the supervisors accomodate by not scheduling you the night before, but expect you to change shifts and attend an all day affair beginning at 0800.

I've worked the graveyard shift for 3 yrs. Usually work 4 consecutive 12 hour shifts. When I complete my work, I come home and sleep the day away and then wake up the next day to my day shift of getting kids to school and caring for my 2 yr old. It gets very tiring switching back and forth from days to nights and nights to days......but whatcha going to do when you need the money?? I enjoy my work most of the time, love the cohesiveness of the staff around me. We all know that it's hard being awake and perky at 3AM, so we try to hold each other up and care for our patients to the best of our sleep-deprived ability. One can always hope that every patient in the hospital has a PRN sleeper ordered, and that it's not a full moon outside!!!!!!!!!!!!:)