SpecialK38

C-section: IV Toradol first 24 hrs then 500 mg Naproxen q 12 or 600 mg Motrin q 6; 5-10 mg oxy q 4 PRN or Norcos q 4 PRN Vag: 500 mg Naproxen q 12 or 600mg Motrin q 6; Norcos q 4 PRN. Oxys if severe tear

you can dance "gangham style" in the nurses station and not get in trouble for it......

You get up at 3pm after working the night and say "good-morning" to all your neighbors as you walk your dog.....

Hi Sandy- I'm curious why you go from couplet care to nursery and back? Our nursery is open 24 hrs and we try to staff a RN and a PCT if we can- if not, just a RN so assessments can get done. Although the nursery RN does much of the care, the couplet RN is still responsible for making sure it gets done- they are also taking babies to moms to nurse so they have contact with both babies and moms at night. Our standard is the bedside report and we also do it like others mentioned- social issues alone with RN and POC/etc in room with pt. I also ask pt if they want to be woke up for bedside report- if not, I document it. Our shifts are 12's and we are scheduled from 0700-1930 with the understanding that report is from 1900-1930. Our ratios are an average of 3 couplets with a max of 4. To streamline my report I have my report sheets printed out and then I fill in all the info I feel like is pertinent before the next shift comes on so it goes faster. Another way we streamline report is that the Charge RN tries to give same assignments if you had pts the day before (unless there are issues). It's much easier to give report on mom's and babies together!

I agree- we use peppermint oil on a 2x2 in our hats and it sometimes helps. Unfortunately women's bladders can get distended during pregnancy and have less sensation. That along with some residual epidural can leave them without the urge to go. Also sometimes there is so much perineal swelling (even with some c-sections) that it makes it hard to go. If you have to I and O cath after trying many interventions I wouldn't sweat it. Sometimes it just takes time to regain sensation and urgency.

Just curious if this is in fact a HIPA violation- The Hospital System was identified, but not unit, etc.- the poster's ID and pts ID (including any demographic information) was not disclosed. This is from a previous Allnurses post on HIPA:HIPAA regulated Patient identifiers include:* Account Numbers * Name(s) of relative(s) * Biometric identifiers * Names * Certificate/License numbers * Medical Record Number * Dates * Photographs and comparable images * Device identifiers * Postal Address * Email addresses * Social Security Number * Fax numbers * Telephone numbers * Health Plan Numbers * Vehicle identifiers including license plate numbers * IP address numbers * Web URL's * Any other unique identifying number, characteristic, or code Maybe not the smartest idea to post that much info, but technically not a violation, I think. Any thoughts?

Yes- the trach irritates the trachea causing more mucus to be produced- the humidification is necessary because the air doesn't go through the nasal turbinates for humidification. I've heard of patients who weren't humidifed well enough getting mucus plugs in their trach and coding!!!! The trick with suctioning is to do it enough to help clear the airway but not too much to irritate and cause more secretions to be formed.

I always wanted to meet a nurse who had that guys walk in to her ER........"Yes, I've had an erection longer than 4 hours. Can you help me?"

Hi Brooke- I am SO SORRY this happened to you! I just graduated in Dec 2010 and was hired to a IN LTAC. My orientation was 12 weeks with classes for even the experienced nurses- EKG, etc. We also had a very good preceptor program. Unfortunately, it sounds like next time you need to be a advocate for your education on the job. I am also worried that other nurses were concerned about your performance and did not come to you first with their concerns. Obviously we can't learn if we aren't being told what we were doing wrong. My opinion: Yes, you were cheated!!! The best thing you can do is learn from this experience and move on. You are NOT stupid! You got into nursing school, passed and passed the boards. Try not to dwell on what you could have done different, but instead learn from it. For you next interviews ask specifically about orientation for new grads, preceptorship and support. Obviously you got good feedback from many nurses- you are going to do GREAT!! You just need to be nurtured. Good luck!!!

Hey there! I am just a newly graduated RN, and may not have the MOST seasoned advice, but it seems like I struggle with the same thing you do-being painfully honest!!! :) I feel guilty if I don't tell all the truth in every gory detail, but it's not always helpful to you or those you are interviewing with. I am in NO WAY advocating dishonesty, however there are other ways to be honest without hanging yourself. With the pregnancy issue, it may be better to state you had a "unexpected or urgent health issue" that required you to have to quit before a two week notice was given. Granted pregnancy isn't an emergency, however emotionally you obviously needed to get home. A recruiter might peg you as emotionally unstable if you state you NEEDED you family so badly you couldn't wait for another 2 weeks out of a 40 week pregnancy!! :) Secondly, GET THOSE CONTACT NUMBERS!!! By not providing everything required on your application you are communicating that you are content to do incomplete work on the job. And finally about a mistake you made.....that is a hard one. It is risky to share a story about a safety issue that ended in injury. You might do better with one where you catch something BEFORE it becomes an issue, or how you got better with time management. Hope this helps and good luck on your second interview and school!

Hi RN071 It's true that there is a comfort level to PP- also lower acuity level which I'm looking for after my intense stint at LTAC. Found out that they are looking for mostly evenings and some nights, but have interview this am at 1000 and will find out more. From what I have heard about Medical, its a lot of "lifestyle choice repeats"- ie cirrhosis, COPD, CHF, etc. Not sure about post-surgical oncology. I'm having a hard time b/c I went into nursing I initially wanted to go into L & D. During clinicals got turned on to critical care, but then struggled with it in the "real world" as a new RN. From what I read, it sounds like ANY new RN is going to feel like a fish out of water for at least 6 months if not for their first year. Will let you know how interview goes!!

I agree with SweetseRN- I graduated in Dec 2010 with tech experience. I found a job opening I was really excited about-applied online and then went to the hospital. I introduced myself as a new grad and applicant (It was a smaller specialty hospital) and asked if I could get a tour. After the tour I wrote a thank-you to the person who was with me and managed to snag the job.

Hello all-Well, obviously you are NOT me, so I will tell you more about me....40 year old F with previous BS, graduated with ASN (RN) in December 2010. Three children 14, 12 and 9. Husband's job provides enough income- nursing for pleasure and added income. Worked 3 months in a LTAC facility out of school- patient to nurse ratio 4:1- many patient's vented, fistulas, drains, G/PEG tubes, crazy diabetics, CKF, CHF, incontinent, decubs, dementia, pneumonia, sepsis, incontinent, c-diff, coding, crashing, etc. I am moving on and have 3 job interviews. If I got offers for all, which would YOU choose:A.) Post Partum/Mother Baby- PRN Variable (my old unit I worked in as a PCT before nursing school- I like everyone there)B.) Medical Unit- PT DaysC.) Post Surgical Oncology- FT DaysThanks for your thoughts!!!

We could pass NCLEX first go around at 75 questions, but could we take a patient load of 6-7? I did not feel confident that's for sure. I was told by a nurse once that you're not a real nurse until you hit the 5yr mark. I took great offense at that for the longest time as I thought NCLEX and a job made me a real nurse and then after that first year, that would make it official. But the amount of time needed to get that experience...it can be about 5yrs. Some can get "there" sooner, some might be later. They don't tell you in school you need much more experience in order to feel more confident and settled. They let you think videotaping yourself doing skills is enough. NOTHING replaces hands-on experience, real life experience. Amen sister- I am 40 years old with a BS in Science Education and wanted to go into nursing for 12 years. Finally graduated in December of 2010 with only 1 B- passed the NCLEX with 75 questions and landed a job in Critical Care 3 months later. I crashed and burned. In my clinical experience we had 1-2 patients of this caliber, but I wasn't prepared for 3-4. I know this sounds like a small ratio, but our patient's were on vents, PEG tubes, wounds, critically ill with multiple co-morbidities, huge amount of meds, paper charting, admits, discharges, procedures (we had to go with patients), non-ambulatory (constant turning), brittle diabetics, kidney failure, etc. We had a code in our 75 bed hospital at least weekly with patient's dying at least every other week. I started making errors and getting overwhelmed. Finally at 3 months they told me it wasn't right for me, but felt like I would do really well in a less-acute environment. They are trying to help me find another position within the system. For me this is like entering college again and trying to figure out what major is right for me. I never saw myself working in a Dr.'s office, but knowing how much I enjoy teaching (difficult to do with pts AO x1) and spending time with pts, plus stress level it may end up being right for me.