Salls25

Aloha! I'm a new transplant on Maui, two weeks in and I feel right at home! I've been an ER nurse in the greater Boston area for 3 years, with 5 additional years in healthcare. I'm waiting (...and hoping) to hear back from MMMC to get started in ER, ICU, etc... new place = new experiences, I'm ready for it! In the meantime, enjoying the beautiful outdoors, weather, and culture here. I am totally impressed by Maui's heathcare initiatives going on. I am constantly seeing/hearing about health fairs, women and children's wellness events, the Association for Improved Healthcare on Maui... I definately need to get my volunteer hands in on this!

Thank you Leda, I did take a look at this previously, which contains information about licensure, code of conduct, and mandatory reporting, ect. I was hoping to find if there is a place recording the more specifics out there. For example, I was told during my training that it is out of scope for the nurse to administer propofol as a push med. Not sure if this is more than our facility's policy, or statewide. Regardless, where are specifics of nursing practice hiding?

I was hoping to provide a new nurse some resources that I actually can not even locate myself. Can someone help me find resources for Mass BSN scope of practice, standards, rules and regulations, Practice Act, ect. I have been all over the Mass.gov site and MNA site, what i have found seems so limited. such as the MNA's nurse practice link: http://www.massnurses.org/nurse_practice/np_act.pdf they talk about delegation more than anything else. The ANA seem like a joke, you have to be a paying member to access their resources. What I really want to know is: for an RN practicing in mass, who is the law and where is it written? Thank you!

my first week in triage: Intoxicated and unhygienic patient comes to triage in her pj's, robe, and slippers c/o breast pain. when did it start, I ask. "When we were just in bed (explicits removed) rough, they were swinging all over the place." patient and her partner stare at me stone-faced and concerned.

Thanks for the feedback. I think I will need to walk on egg shells with this MD in the future, clearly he need to study what an HCG is again, because I would never say "you are pregnant". This whole thing stinks because his focus seems to be more about turn-over than education, something that I am well versed in.

thank you very much. i am in the midst of this class, test at the end of this week and will def. take a look at the practice test. I feel very confident about this class as it is a lot of review. Regardless of your experience, a refresher is good and I suggest reading the book it is very well written. There were some good points from the instructor that I will keep with me 1) we don't rock the hips anymore, 2) listen to the heart, nurses are so notorious for that.

I am croc obsessed and would have nightmares of giving them up (i feel your pain). I tried other types, nursemates and danskos, but the bottoms of my feet hurt so bad after half the shift. I can highly recommend Borns. Very shock absorbent (like the dansko), but with plush padding. I have not tried Borns yet for nursing, but I have a couple pairs I used to walk ALL day in as a tourist and love how they feel even at the end of the day. Zappos is a great place to get shoes! http://www.zappos.com/n/br/b/342/Born.html

Working with a new-to-our-ER doc the other night who totally lost his marbles when he found out I disclosed a positive urine pregnancy test to a patient. MD wanted the beds turned over and gave me the chart to D/C patient home (musculo-skeletal), "and just send the urine if it is positive". UHCG turned out to be positive, and became part of my counseling for home care teaching and pain control. I would not have normally just told a patient such a life altering result had I not already talked to her about her recently stopping the pill, her late cycle, and that she tested negative at home. Fortunately I had the tact to assess the patient's desire to keep her young child out of the loop by using adult-friendly terms "OB/GYN", "prenatal vitamins", ect. The aid returned the d/c'd chart to the doc and showed him the urine as the patient was getting dressed to leave, clueless doc walks in a blurts "i guess you already know that you are pregnant" in front of the kid who clearly knew what that means. Poor woman. After she left we totally had it out because he was livid and said the most ridiculous things i could imagine: "Would you tell a patient that they had cancer? or an MI?" "I can understand that you would want to be a part of revealing such a fun test" and "Why is a +UHCG the only test that a nurse feels like they just have to run in to tell the patient immediately?". I'm not sure what prior issues he had with nurses, if all of his experiences with +HCGs have been great ones, or if discharging the patient as he requested qualified as rushing in. And as for the cancer comment, I told him i would absolutely never give a patient a diagnosis, but I felt it is within my scope to talk about test values, even the ones that patients already suspected they had. But it is still on my mind and I can't help but wonder if it was out of scope. There is not much to the interpretation of this result to a G2P2 that requires a doctor to explain. What are people's thoughts? How about any difference for a pt who had taken multiple positive tests at home and CC was request for one done in the ER? (like ours are any different!) I find in our ER it is commonplace for the nurse to run the urine and give the result in that case, rather than making them sit there waiting for who knows how long to see the doc knowing full well every time I walk by the room that I already have the result.

We were visitied recently also, what came of it was that we don't 'assess' everyone for self harm, but do a quick 'screen' on EVERY patient. adds a lot to triage including who do you live with, does anyone hurt you.

If you are looking to move during/after December then my suggestion would be to start applying now. My experience of coming from out-of-state 2 years ago was not an easy one. Boston hospitals are very hard to break in to, especially as both a new grad and out-of-stater. Start the application process now, you may not even hear back from HR for weeks to months. Interviews can start now and a tentative offer of a position can be made, but nothing official until you pass the NCLEX. As for relocation assistance, it won't hurt to ask, but i would certainly not expect a dime.