Any nurses work in acute inpatient geri-psych? What is your typical day like? Typical diagnoses on the unit? Are you charge nurse or worker bee? Is this specialty competative?
(I know there is a psych board, but there it's kinda slow so I thought I'd ask here!)
Well in the ER I often start the IV, draw/order labs, start a fluid bolus, order an Xray, and sometimes give meds before the MD even got to see the patient. I was still within scope since these labs/meds/xray is all on a standing order protocol. But I will often suggest what med I want and the MD will write the order for me. ER nurses often have close relationships with the docs which allows this kind of thing. I find they trust our clinical judgement more often than not.
Sorry, but that is ridiculous. Skin assessments are about the last thing I am worried about in the ED. Who has the time to do a skin assessment when the patient next door is seizing and needs intubated? Or that level 1 trauma that just rolled through the door. Or the psych patient who is running through the hallway naked?
The ED nurses are being lazy by not completing the skin assessments. And really, the ED is not the place for it to happen.
I hate those retracting butterfly needles. I don't use them, so I have no advice on those. Just be very aware of where the needle is. Do not become careless handling them. Also, watch out for patients you made need someone else to hold. I don't do venipuncture or IV starts by myself on children or confused patients. Get someone to hold the arm so you don't get stuck. The AC is the obvious place for a blood draw, but you can use other spots. I like to use above the AC in the elderly who have used up veins. Hands work too, but I don't like to use them unless there is no other option. Tie the tourniquet tight. I like to have my needle almost flat against the arm when drawing from the AC. Bevel up. Remove the tubes from the vaccutainer before you take the needle out. ALWAYS wear gloves...ALWAYS! Know which labs go in which colored tube. You can google these. Know the order of colors in which to draw.
I have 3+ years RN experience. I took a case management job in the private sector and it is not going to work out long term for me. I'd like to go back to the acute care setting. I thought I'd stay 6 months and them make an exit. Is that reasonable?
What is the proper length of time to stay at a job you don't like? 6 months? 1 year? Do you think a future nurse manager would look poorly on an RN that was out of the nursing field (but a health-related field) for a year?