SkaterGurl

1-At bedside report, flush all IV's so you know they work. If they need to be removed, you will know and can plan accordingly. 2-Plan your shift appropriately: if you are able to, write down the med schedule for each patient on a single sheet of paper. You can also schedule in tasks needed (new iv's, baths, emptying drains, hanging new iv bags, etc.) 3-For new admissions, I give each family member our unit card with my name written on it. I tell them they can call anytime, and I would be more than happy to talk with them and give them updates. I also ask who is staying overnight (I work nights) and I plan to get them a sleeper chair and linens. It makes them feel wanted and welcome and eases the way in an unfamiliar environment. 4-When spiking a piggyback bag, first roll the clamp all the way to the top and tighten it. Spike the bag, fill the chamber, and unroll the clamp. The fluid will fill the tubing with no air bubbles. 5-When hanging fluids or piggybacks, program the pump to slightly less than the volume in the bag and note how long the fluid will run. Write this down on your schedule so you know when to return to shut it down/switch bags, etc. (of course you are still popping in to check that all is running well). Tape some iv plugs onto the pump and you will be ready to cap off when the fluids are done. Your fellow nurses will love you for this if they have to go in and saline lock your patient if you are busy. 7-If you don't know something, ask. If you need help, ask. If someone needs help, pitch in. We are supposed to work as a team. 6-Be kind to everyone, even if they rub you the wrong way. They will remember your kindness.

Not to mention all the arms sold from the US to various military regimes in South America, which a study has proven to fall into the illegal weapons route. It's easy for that to happen when you have soldiers (in SA) that can make money selling such weapons on the black market. Remember, the same thing happened in the Soviet Union-several thousand weapons of various types landed on the black market after the country fell apart (we're talking bombs, high caliber machine guns, hand guns etc). I had a patient that was (is) a gang member and asked him how easy it was to get guns; he said it was easier than getting drugs, which is also easy for them to obtain. One just has to know who to ask.

I work at a 200-bed hospital. We alternate holidays but I actually like working them. It is the time when some of our patients are not visited (perhaps no family close) and some are completely alone. We do our best to let them know we care about them and help keep them from being lonely (sit with them, have pet visitation, etc).

I work in a step-down unit and we are required to have ACLS. We get pulled to the ICU and go down to the ED during trauma alerts. We typically have about 3-5 codes per month (hospital-wide). We use the online certification & renewal for ACLS and it is NOT enough! Some of my nurses have never been to a code, and when they go they are totally clueless! It got so bad during one code, afterwards our Clinical Educator had a mandatory "where do the pacer pads go and how to turn on the machine" education (seriously! the whole code was run with only the ECG lines attached and the AED in the OFF position for a severe bradycardic event). We as a whole keep requesting that the training be in-person and for the two-days (for initial) but it falls on deaf ears. I'm told that it is much cheaper to do it this way. That may be true, but cheaper isn't always better and when lives are on the line you want personnel that are highly trained!

I had a similar situation when I was doing clinical rotation at Mom & Baby. The lactation consultant had just talked with the mom about breastfeeding etc. The mom asked me a question totally unrelated to breastfeeding (it was about laundry detergent). I answered the mom with what I used when my babies were little...I was asked to leave the room by the lactation consultant, she also left the room. She dragged my clinical instructor into the hallway and reamed us both out! I relayed the information to the clinical instructor, and I told the lactation consultant she had no right to disrespect me....she began another tirade, calling me "uneducated" etc. My clinical instructor calmly told this woman she needed to "behave in a more professional manner" and we both left. I was told later that the lactation consultant tried to write me up, but instead she was written up by my clinical instructor. I had the rest of the shift to spend with the mom, so once the lactation consultant left, we discussed breastfeeding, bottlefeeding, etc. The mom never wanted to breast feed, as she had to return to work (in a chicken processing plant)...pumping would be near impossible. Now that I've been an RN for 3 years, I've only seen this type of unprofessionalism once, during a code between the RT and the doc running the code. It got ugly before it got better. We no longer tolerate that behavior where I work, no matter who is involved (family or patient to doc, rn etc, doc to rn, rn to rn, etc.)

I consider myself pretty lucky to work in a hospital that has effective committees. They are truly the movers and shakers and get things done. I will say to the op, the "patient satisfaction" committee has a purpose. Satisfaction scores drive reimbursement and it trickles down to employee satisfaction (i.e. bonuses) at least where I work. This is a non-profit hospital and yes we do receive bonuses if patient satisfaction is up. Our committees and members are agents of change and have made positive steps regarding patient and employee safety, customer satisfaction, reduction of infections and hospital stays, etc. If a committee is not working for you--are you working for it?

I took the N-CLEX on Jan 12th at 8. The computer shut off at 75 questions. I felt horrible (just like I did for the PN test lol). By 2pm, I did the Pearson Vue trick and got the "good" pop-up. I did it about every hour. The next morning, I kept getting the same thing, and by 10:30, my results were posted on my state's BON listing. I passed!!!!

I can tell you, being on the other side not knowing what is going on with a loved one can be extremely stressful. I was in the service overseas and only knew (from a distorted ham-radio relayed call) that my mother was in the hospital. My commanding officer immediately got in touch with the American Red Cross and they moved heaven & earth to find out exactly what was going on. Until I heard that she was ok, I was a nervous wreck and had a hard time performing my duties. It must be more difficult today, even though communication is better. The military is spread out into areas where there are no radios, cell signals, or anything. Not knowing if your loved one is ok is a horrible thing to go through! You can absolutely melt-down if you aren't informed. Thanks for posting the info about HIPAA and the Red Cross-I didn't know that either.

Most of the hospitals in my area prefer 2 years before they consider hiring for Mom & Baby/OB. They like to see well-rounded (i.e. Med-Surg) experience first. And with the aging population, most of who you will see there is, the elderly. If you don't like to work with the elderly population, start scoping out for externships with a pediatric unit while you are still in school. And also consider getting your Bachelor's degree. You will go a lot farther and have a bit more choice if you do that.

People make poor dietary choices because: it's easier, it's cheaper, it's what they've always chosen, they don't know any better, it tastes better, everybody else is eating it, etc. You can educate them, provide them with substitute choices that taste just as good as the bad food they are eating (but is this a reality?), show them how much healthier they would be by eating healthier (but you are up against the curve-at 400+ pounds and older, as most people have a fatalistic attitude "I've got to die of something, so I'll just eat what I want until then" type of attitude.

It depends on the agency and the type of visitations. For the home health agency I worked for, the nurses worked holidays, weekends, snow, sleet, etc. They stayed home if the roads were closed due to a state of emergency-that was the only reason for not going out.

I know a lot of the temp agencies are hiring (like Bayada). It's a good way to gain experience and get your foot in the door. Also, Bayhealth is hiring for pt/per diem but you have to be persistent and have great references.

Congratulations & Good Luck on the NCLEX!!!!! What an amazing journey, huh? I finish this December...taking one summer class to lighten the load, then I'll have two classes, three clinical settings, three finals, one NCLEX, one mini-vaca, then one pinning! (but who's counting?) Then I start my preceptorship!!! Woo-hoo!

I have spent the whole 2 years of school studying alone. I have participated in group projects and have gone out with my classmates as well. I don't feel that I have been shunned or that I have shunned anyone in return. People are busy and each person has their own way of studying. I prefer to study alone. I wouldn't let it get to you.

Graduates are getting hired, but they are the ones that are networking and putting in the mileage to meet-n-greet not faxing their resumes. They are pounding the pavement, meeting the managers, and attending seminars and meetings with other nurses. People who only fax and call are not the ones that get hired. You have to show your face to the managers and make a good impression. Yes, it's an old-fashioned way of doing business but it works.