Altra BSN, RN

Emergency & Trauma/Adult ICU

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All Content by Altra

  1. Altra

    Patient care or charting first?

    Altra replied to BSNbeauty's topic in General Nursing

    This thread title reminds me of "do you carry your lunch or walk to school". Both of these responsibilities are paramount. Asking if I prioritize one over the other ... depends on which second of...
  2. Altra

    Can we recommend a medication to a doctor to prescribe?

    Altra replied to stallion8797's topic in Patient, Colleague Relations

    You've learned a lesson about that oncall psychiatrist then -- when someone disagrees with his/her judgement his/her automatic response is to look for someone else around to take the heat, rather than...
  3. Altra

    I get out on time...

    Altra replied to nursedanny614's topic in General Nursing

  4. Altra

    Can we recommend a medication to a doctor to prescribe?

    Altra replied to stallion8797's topic in Patient, Colleague Relations

    What you did was totally in your scope, and your manager is a little nuts. BTW -- if this was a conversation between you & the patient's physician, how does your manager even know about
  5. Altra

    orientaton for experienced nurses

    Altra replied to Kidrn911's topic in Emergency

    For someone without work experience with adults, including the geriatric population that is likely to make up a large percentage of ED patients in a community hospital, 4 weeks seems a little light....
  6. Altra

    IV insertion problems

    Altra replied to nursing_problem's topic in Emergency

    When I get that vibe from patients/families I take a timeout. I actually sit down, if possible, to have a conversation. I review with them what we're doing and why. I calmly and matter of factly...
  7. Altra

    Day shift nurses: what do you eat for breakfast?

    Altra replied to Morainey's topic in Health, Stress Management

    As I've learned the hard way over the years, you have to think this out in advance, the night before. I try to eat something small (a yogurt) at home while getting ready for work, then another...
  8. Altra

    Odd ER visit

    Altra replied to inshallamiami's topic in Emergency

    Have you considered ... That your doc is notorious for telling his staff to tell people, "just go to the ER" ... in other words turfing patients so that he doesn't have to deal with them? That the ED...
  9. Altra

    New grads being rushed into "nursing maturity"

    Altra replied to PA_RN87's topic in First Year After Licensure

    Excellent posts, above. Healthcare has changed. Acuity of patients across the spectrum of acute, subacute and long-term care is generally significantly higher than it once was. Healthcare culture...
  10. Altra

    analgesia before cardioversion

    Altra replied to mrnewman's topic in NCLEX Exam, Programs

    Have assisted with many cardioversions - both with meds given and without. Have not seen the "terrible" scenario some of you are describing. If there is time to prudently medicate, fine ... with the...
  11. Altra

    Dealing with rude people when applying for positions

    Altra replied to RNdynamic's topic in Job Search, Interview, Resume

    I really don't see rudeness in this scenario. HR is a conduit to provide a pool of qualified applicants for consideration. Their job is to find applicants with a defined set of objective...
  12. Altra

    Transition from medical floor to ICU

    Altra replied to lisajtrn's topic in MICU, SICU

    The move to a new building and reorganization of your old unit has little to do with it -- the bottom line is that you went from a med-surg unit to an ICU environment. If you have never worked in...
  13. Altra

    IV Therapy

    Altra replied to Ciale's topic in Emergency

    For your migraine example, here are things I would have assessed: 1. Does the patient have a hx of migraines? If s/he has never had one before, or has been well-controlled for a long time but then...
  14. Altra

    What is the quickest specialty certification out there?

    Altra replied to jaej5's topic in General Nursing

    OP, from your later post in this thread, I get that you have an immigration issue looming over your head. That is a hard road to be on, and I'm sorry for your troubles. But please understand where...
  15. Altra

    How Many Nurses? ACA Intensifies Hospital Debate

    Altra replied to herring_RN's topic in Activism, Healthcare

    Some good info in this post; however, I would like to have seen the gender reference omitted, as it does not add anything meaningful to the discussion of whether or not legislation of nurse - patient...
  16. Altra

    Reactions to being a NP

    Altra replied to orangepink's topic in Student Nurse Practitioner

    So true! $70K-80K-ish ... is a nice living, but not a game
  17. Altra

    Reactions to being a NP

    Altra replied to orangepink's topic in Student Nurse Practitioner

    Bravo!!!
  18. Altra

    Will I get bored?

    Altra replied to Chesam7's topic in Emergency

    Not sure what the dilemma is, as you've already made the move and taken the job. My advice would be to treat the new job as a new start -- if you walk in there already with a mental checklist of how...
  19. Altra

    Older workers that are new grad nurses, please explain.

    Altra replied to wish_me_luck's topic in Job Search, Interview, Resume

    OP, you appear intelligent enough to boil your situation down to the basics: you are a new nurse with zero nursing experience, in a state-mandated monitoring program, in a tough economy. These are...
  20. Altra

    What critical vital signs would institute a rapid response

    Altra replied to uniquegifts1's topic in Patient Safety Issues

    You can discuss this with your preceptor (even if your formal orientation is over), your unit educator or another nurse mentor on your unit to get more meaningful
  21. Altra

    Pt with bs low on two different occasions overnight

    Altra replied to uniquegifts1's topic in Patient Safety Issues

    "Screw it ... give cake" to get the blood sugar reading up says to me that you're simply looking for a number and not thinking critically about the patient's underlying pathology. Was the patient...
  22. Altra

    Oldest patient

    Altra replied to MessyMomma's topic in Patient, Colleague Relations

    In my first year as a nurse I took care of a patient who was 108.
  23. Altra

    Pt. belongings in the ER

    Altra replied to psu_213's topic in Emergency

    Yes, claims of theft/loss have come up and been reported to the DOH in every ER in which I've worked. The hospitals have sucked it up and reimbursed patients for items of value, unworkable,...
  24. Altra

    How often do bad references for good workers happen?

    Altra replied to wish_me_luck's topic in Job Search, Interview, Resume

    For the managers out there who have been described as "badmouthing" an employee so that they are not considered for another job ... talk about shooting yourself in the foot. You get to keep an...
  25. Altra

    Core measures to my core.

    Altra replied to CrystalCMSRN's topic in General Nursing

    This has to be addressed from a multi-disciplinary standpoint. Order sets need to be standardized for admitting diagnoses that include core