smcelroy5

Hi All. I have exclusively worked in the hospital setting my entire career (12 years). I am transitioning to a county mental health clinic so I can get experience prior to beginning my mental health NP. There is a BIG difference in what is considered appropriate and I am mostly being advised/supervised by non-medical professionals. I have been told to use the MD Progress Note as an order (meds, labs, tox screens), which presents some concerns/questions. I would never use a MD note as an order in the hospital, but I am being told that "we have never had anyone have a problem with this before." I have also been told that I do not need to have verbal orders signed by a provider??? The rationale is mostly that this is not a hospital, but as far as I am concerned I am a RN no matter where I go and scope of practice is the same. Verbal orders are definitely a thing of the past in the hospital, but I am trying to explain this to people who aren't nurses. Am I being overly fastidious? I have been known to be a black and white thinker, so I'd love some input!

Hi, I am a new OR RN (4 months) and appreciate the dedication it takes to be in this specialty. I definitely want to stay where I am with the understanding that it takes quite a bit of time to be comfortable in the OR. I am also a recent graduate and worked in ambulatory surgery after nursing school. My questions is this...I feel like I am missing the Med/Surg experience that familiarizes a new nurse with procedures, time management and general knowledge. Is there the potential to move into a more general area after several years in the OR? I love learning all that the OR has to offer, but I don't want to limit myself in the future by not having the floor RN experience. Is it difficult to go from the OR to another unit?

Thank you so much! One more question: Venipunture vs. IV start - do i advance the catheter after flash or just stop once I get return? Then, leave the tourniquet on until I have my specimen, remove tourniquet, remove specimens tubing and then remove the catheter, correct? I appreciate the help! :)

Hi, I am new to home health and have my first client tomorrow. I am going out for a surgical wound eval, initial assessment and PT/INR draw. I am pretty rusty on venipuncture (I have been in ambulatory clinics since RN school) and could use some tips!! I know I am to use the blue tubing and have been told that it is tricky to get them to fill to the top. Any tips/tricks for blood draws, specifically PT/INR?? PLEASE!