Nursey103

My infusion center is not associated/attached to any clinics (only associated with my hospital). We strictly do infusions/injections/labs/port flushes. We have an assignment. We each take 1 patient per hour that has already been assigned by the charge nurse so the acuity is fair. I might have an abx patient at 0700, PRBC at 0800, Carbo/Taxol at 0900, hydration at 1000, etc. We also have a lot of patients that come in strictly for labs so we usually have a lab/resource person too. When we dual sign, the other RN is checking patient identifiers, independent med calculation, blood return. We have 4 infusion centers associated with my hospital so some centers check the labs but we really don't where I'm at.

1. I stop the chemo and hang a new bag/line of saline. My co-workers all jump in when there's an HSR so if I'm stopping the pump, another nurse is already priming the NS, another grabbing the vitals machine, another grabbing the HSR meds. 2. I have never done this and I don't understand why someone would. Just program the pump to run at the prescribed rate and when the bag is empty, start the flush.

You can work in a med/surg oncology unit to learn how to start IV's, maintain PICC's, access/maintain ports. You'll get chemotherapy experience if that's the kind of infusion center you want to work in. You'd also be giving lots of blood products too.

I think 8 weeks is plenty to hone in on IV insertion skills. If they're that desperate then at the end of the training period, if you don't feel ready, I would simply ask for more training days. If you're part of the IV team, it sounds like that's strictly what your job would be but I would definitely clarify what exactly your role would be.

Just browsing through posts & came across yours. I'm also looking to transition away from bedside & thought about GI lab or something similar. Did you end up making the transition??

I've been an RN for a little over 9 years now. I started out as a new grad at my current hospital and I've been on 3 different floors. I've done basic med/surg, step-down unit with trachs/vents, and now I'm on a surgical step-down unit with a focus on post-op GI & cardiothoracic surgical patients. I remember I used to love going to work and in the last year or so I've had rollercoaster weeks where some weeks I hate my job and others I love my job. It's only been in the last few months where there are way more lows than highs. I work in a wealthy part of the county and I don't know if the patient population (being treated like a waitress vs a nurse, etc) is more pronounced and causing me to feel burned out but regardless, I feel like I need a change. I've tried taking little vacations but that burned out feeling returns quickly. I sometimes want to go back to working at a desk Monday thru Friday, 8 hour days but I also love having a week off between 12 hour shift so then I don't think that type of nursing would work for me. I read that the closer you are to the patient, the higher chance of burn-out. I've looked at jobs online but I have no idea what I would be interested in doing. I just know I feel tired. I am so tired of sacrificing my body and coming home physically and mentally exhausted without ever even receiving a simple thank you in one single shift. I know I want to get away from bedside nursing - that's 100% of what I do know! I also have a per diem job doing hospice (on call 2 nights a week & good money for a side job). If I did take a Monday thru Friday job with a pay cut (I'd be losing night shift differential), then I'd also have to quit my per diem job and that's just not feasible for me. Does anybody have any experience transitioning away from bedside and if so, how did you know where you wanted to go? Thanks!!!

I get like that too...some weeks I can be happy & get lots accomplished & then there are weeks I'm in bed every night I'm off & just feeling miserable. I just ride out the lazy/tired/yucky days. If it continues, can you switch to dayshift?

I've always worked nights so I can't say personally but quite a few co-workers have made the switch to days & say they never regretted it....they felt like they had a life again...hope that helps...good luck!!

I also believe in universal precautions....those that wear gloves for everything because wearing gloves is still cleaner than your clean hands.....do you also wear gloves when eating?! I mean...imagine those filthy hands touching your food....

I've seen a doc do vasectomies in the office every week never washing his hands before/after...in fact I never saw him wash his hands period....disgusting!!!!! I didn't work for him but he used our office space some days...thank God he finally retired!!!

Smallest # I've seen was 9cc

I wouldn't be entering orders for pain meds without the doc giving me specific orders...that's practicing medicine & out of our scope of practice....I value my license too much...

I doubt the nurses in Media are talking or taking breaks....well, I guess they probably are taking breaks...but I doubt there's too much talking! LOL

Bump...? Also considering Brandman...anyone have any feedback?? Thanks

One thing I find hard on my relationship is working nights. I don't sleep w/ my fiance hardly at all anymore...unless I manage to switch to a day schedule on my days off but sometimes that's hard. We have opposite schedules...it's tough

I don't think there's a magic number but one of our urologists likes us to send the JP fluid for creatinine if there's more than 100cc out in 8 hrs. If you feel the output is really excessive, you can ask your CN & possibly call the doc if you're really unsure. I've never had to call the doc in the middle of the night b/c of excessive output though...

Having to work 2 shifts in order to get paid for ONE holiday....argh!!!

Hmmmm....I don't now how he would feel about snug fitting underwear...but I can ask him LOL! I'll also look into gel bandages. I can't use Kerlix b/c it's right on his coccyx......unless I make underwear out of Kerlix....

So, I have a patient with daily drsg changes & we've been using paper tape. His skin is so irritated I don't know what to do! The wound is on his coccyx & he is ambulatory so it needs to stick properly to him. I've tried using tegaderm but it doesn't stay on as great as the paper tape. Are there any tricks out there that I can use so his skin doesn't become so painful & irritated?!? Thanks!!

I work nights & know what you mean. Only a few of our docs come in early before shift change but if they don't (we don't have residents either) I write them a note along with pass on my findings/recommendations to the dayshift nurse. Now, they don't always read the note or care but at least I know I'm passing it along. There's not much else I can do but leave notes or tell the dayshift nurse my findings/recs. If it's something of real importance that I feel the MD should address (& hasn't because dayshift couldn't do it or the docs didn't respond to my notes)...I'll call at the beginning of my shift when it isn't too late to call. I usually work 3 shifts in a row so I already know what's going on with my patients. If you come in the next night & find something still unresolved, try calling at the beginning of the shift. It's not too late to call the docs or ask your charge if there's another way to communicate with the docs besides calling them in the middle of the night or just passing along your findings to dayshift.

Soooo......there is talk about possibly unionizing our hospital. I've heard people don't like unions but I really don't know why. Can anyone give me some pros/cons of unions?? Thanks!!!

On my floor, the nurses give report to the PCA's. We tell them diet, VS freq, void/foleys, drains, etc. If something changes throughout the shift, I'll update them either verbally or if I'm busy, I'll page them. I follow up throughout the shift. It seems to work well for all of us.

I didn't not give the cocktail because it's "not enhancing his well-being"!!!! They're both sedating agents, he was not on oxinet, & I didn't feel safe giving the combo together. Period. I practice that way on all my patients. He was not an exception. We get a lot of patients on our floor with chronic pain & I get that. I will medicate them appropriately, monitor them appropriately. Like I said, he had only been there about a day & a half...not multiple days, weeks, etc. I could have called the doc but I never got the chance. I was fired an hour into having him. Even if I would have told him I was going to call the doc about getting that specific order, he would have wanted to talk to the CN anyway, I just know it. It was about getting what he wanted right then. Sorry for all the posts....been working last 2 nights & unable to respond!! Thanks for all the replies & allowing me to vent!!

I wasn't trying to judge or cure his addiciton. My mother was an addict & I know from personal experience you can't help someone that doesn't want help. I wasn't witholding his pain medication. I was practicing safely & wanting to give his medications 30 min apart. He wasn't on oxinet & I had 4 other patients so I couldn't make sure he tolerated that dose safely (he refused oxinet btw). It was also right at beginning of shift when (especially working on a m/s floor) you don't know everything about your patient right then & there. I didn't have time to look back at previous medsheets to see what he was getting & at what times....& even then, I probably would have continued to do the same or at least bargained with him to get him to be on oxinet so we can at least monitor him that way. I just never got the chance.

He knew my rationale because I explained it exactly to him but he may not have heard me over his anger & yelling.