athflying

I ended up being able to find a lot of information on the State Board of Health site for FL. Had standard protocols and orders even. I would need a MD to sign off on those and order the supplies for me. Thanks all!!!!

I would love to start a part time business that could eventually lead to a full time business. Where is the best place to find information on what a RN needs to order vaccines and administer immunizations legally in the State of FL. I haven't found much concrete information. I plan on focusing on corporate settings and would like to expand to corporate health risk assessments and coaching. To keep me busy, figured I can do some CPR classes in between. Anyone have success doing anything similar??? Thanks for the help.

Because the syringe is labeled as "Normal Saline" or 0.9% Saline or something along those lines and if you add medication to that syringe, it is no longer normal saline but could be confused as such. We aren't supposed to use them even if you label it properly due to the risk of a med error.

If you want to be real nit picky, should never use a pre filled flush to admin meds with. I understand the need for a larger syringe with central lines when assessing patency, but our hospital policy states we are to NEVER use anything smaller, even if patency is assessed before hand. I haven't run across a drug yet I couldn't dilute, so no real issue so far.

I work on a renal floor and see renal patients occasionally with elevated troponins. More likely to see on a patient who does CAPD as it isn't as efficient as hemodialysis and tend to carry more fluid.

I went to school full time and had 2 jobs, so yes it is possible. I don't have children and at times my grades suffered, but I made sure I was never close to failing.

Where I work, we have flowsheets. As long as the C02 is above 8 they come to the floor, any lower and they go to ICU. They get 2-3 liters of NS pretty quickly and then once there BS below 300 we switch over to fluids with D5. In the meantime, we draw chemistries often and monitor C02 and K. If K is

Agreed...if there is ever doubt, call the RR. Better to be safe than sorry. As a newer nurse I sometimes struggle with knowing if I am making the right decisions, but I do know I would rather a couple ICU nurses roll there eyes at me then have someone code that shouldn't have.

We do it....not sure why nurse are so resistant to change, but I like it because you can catch things the other shift may try to stick you with. Also, I think it's a great way of seeing your patients...introduce yourself and let them know you will be back soon.

I am a newer nurse with just one years experience, but the two most important things I have learned are get as much done as you can when you can. If you have a lull in your shift...chart, chart, chart, or get wound care done or something. Been a couple times I let myself get lazy thinking I had an easier assignment or was ahead of schedule, then next thing you know you get a really difficult admission or a patient goes bad and before you know it, you are way behind. Secondly, whenever I go into a room, I try and anticipate anything that patient may need for the next couple hours and go ahead and grab it. Saves me a lot of trips back and forth. Lastly, we do walking rounds at shift change, when I am in the room saying my hello, I take 30 seconds to check fluids, IV sites, line expiration dates, etc....with that snapshot of what is going on, you know if you should grab a bag of fluids when you pull 8/9 o'clock meds, maybe ask the charge nurse to start a new site for you....helps keep you on top of things and save some time.

During our busy time or season (I live in FL), I usually did 1-2 extra shifts per pay period. I work Thur, Fri, and Sat so would work every other Wed in addition to my regular shifts. I was called a lot in between those days for additional shifts. I helped out when I could, but didn't feel bad when I couldn't. It doesn't hurt that during our busy time, they give us time and a half plus $10.

I work on a diabetic floor and we use one site for re-hydration fluids and insulin but on separate pumps. The re-hydration fluids run directly to the site and insulin gets run on a micro drip pump running into the port closest to the patient. Insulin infuses at to low of a rate to run it in a dedicated line and you would never infuse insulin without hydration fluids anyway, so the setup works well. We always try to have a second site to infuse abx or any iv push meds.

Also as far as calling docs at night, you get to know them and you have to figure out what is important enough to call immediately and what can wait till either morning or rounds. I don't feel bad about calling as it is there chosen profession and what they went to school for. Of course you get ones that want to scream and yell or make you feel like an idiot, but you are there eyes and ears and I would rather get an earful from them then have a patient go bad and be in serious trouble for not reporting a condition or lab. If they are over the top rude or disrespectful, write them up. Our hospital has an increasingly lower tolerance for MD's being inappropriate and several have had privileges suspended or terminated.

I started on days as a new grad but now work nights. I enjoy nights MUCH more for several reasons. The reason I switched initially was for pure financial reasons, but soo glad I did. We get $5 an hour night differential, plus I committed to a years worth of weekends and that gets me an extra $15 an hour on my 2 weekend shifts. I usually do Thurs, Fri, Sat so I at least get Sundays off (well half of it anyway). We can take one weekend off a quarter. The reasons I like nights...much quieter. As others stated, less docs and family members to interrupt your flow. Most days I felt I was just bouncing from meaningless task to meaningless task. Rarely did I have time to actually do any sort of meaningful research on what was going on with my patients or what I should be doing to help speed there recovery. Instead I was grabbing cokes for visitors, pain meds for patients, and trying to keep my head above water charting wise. On most nights you get a chance to read notes, H&P's, go through orders and catch things day shift never has time to. I can read about conditions and as a new grad it has been helpful connecting the dots between ordered treatments and diagnosis. I work at a larger hospital, so while staff is much "thinner" at night, we still have at least someone in most departments. You do have less resources, but sometimes that is a plus because it forces you to become more resourceful and learn. Unless it's an emergency, most things can wait till morning anyway. Sleep....I am fortunate and can sleep most any time. In fact, I get more sleep doing nights because I could never force myself to go to bed the nights before I worked. I often would be up till 1 or so and have to wake up at 5 for work the next morning. I would be miserable all day. On nights, by the time I finish a shift, I can't wait to get to bed so I take a quick shower and in bed by 9 am. Usually sleep till at least 3, so I get a solid 6 hours. It definitely helps me to do my 3 in a row. On Thursday, my first night back...I try to sleep in as late as possible then go to work that evening. Then I am in bed like I said by 9 am the next day. When I get off Sunday morning, I am in bed by 9 am but force myself up by 1. I am tired, but after a quick shower I feel ok and then you have most the day to do what you want. Because I get myself up early, I am usually ready for bed by midnight that night and I resume a normal sleep schedule on my days off. Nights works great for me and I truly think it is a better fit for my lifestyle, but you will never know till you try it. You have to give yourself a couple months to adjust and see what works for you. You can always go back to days if you just can't get your body to cooperate.

If you figure it out let me know. I only drive 20 minutes and it's a struggle for me. I ride a motorcycle to keep me awake.