SolaireSolstice

Do you have your CPR certification? That's BLS, basic life support. ACLS is advanced. It is required in my hospital for ICU, ER, OR, L&D, and I believe telemetry. There are a ton of certifications available for nurses and which ones you "need" are depending on what area you wish to work. I only hold BLS. I am also chemo/biotherapy certified. You wouldn't need that if you did orthopedics. I'm thinking of going for wound/ostomy certification too. Wouldn't be required, but would be beneficial. Many certifications require you to already be a nurse before starting, and many others require an RN.

The bariatric beds we have can be "broken down" to fit through the doorways. They simply expand along each side. Was this an issue with the bed not being able to fit through the doorway, in which it was an issue of lack of equipment teaching? Or did the room not accomodate the bed? Which I cannot fathom how small the room must be to not fit a bariatric bed. We had an issue once where the patient, on a bariatric bed, needed to go down in the bed for a procedure. We broke down the bed to fit through our doorway, but somehow, halfway through the doorway, the bed frame popped back wide and the bed was hoplessly stuck in the door frame, with the patient on the bed. Was a stupid hour long issue that had our superviser demanding maintenance to remove the doorframe. We ended up transferring the patient lengthways onto another bed, took the headboard off one and the footboard off the other. Took 7 of us. Once she was off it, it was easy to manipulate the bed to get it free. Reminded me of that puzzle of a truck stuck under an overpass and the little boy says to "let the air out of the tires".

Yes, you can stop a blood transfusion. As long as you get the transfusion into the pt within the 4 hr period, then it's fine. While I *have* kinked the line above the port and flushed, put in med, flushed again, I think it's safer to stop the transfusion, disconnect, flush, administer, flush, reconnect and re-start. Whether to hold the med until after its done depends on the med for me. What's it for? Do they need it NOW? What would change if it were held until the transfusion is done? A PRN pain med? I try to medicate before transfusion, but if breakthrough pain happens, then there you are. Do I make the pt wait 2 more hours? No, that would be mean. I've had a peripheral line infiltrate during a transfusion. What to do? Well, you stop the transfusion, start a new line and restart. However, it is best to follow your facilities policies.

I don't see anything that says you have to change it within ten days of the name change. I see that it will take THEM ten days upon receipt of the name change information. It would be ridiculous to require notification within ten days of a name change. I'd like to see where you got the information "on your own". But if you are that concerned, you can call them or e-mail.

We are on electronic mars. If there isn't a computer in the pts room, to bring the mar in you have to wheel in the cart. I usually park it in the doorway to the room to minimize "exposure" then wipe it down afterward. The third "check" is scanning the med, so you have to have the computer to check the med against the mar.

I had a huge argument with my sister (a teacher) about the coughing in the hands vs the elbow thing. I voted elbow. She says hands because then "they get washed". I said "only if you wash them".

I would address the fact that this patient is moving into end stage care, comfort care, while the doctor is ordering invasive and uncomfortable interventions that will prolong life. For what purpose? To what end? How about: Risk for compromised human dignity?

I forgot to deaccess a mediport once. Pt was being transferred to a SNF via transport service on a Friday, and was going for OP chemo on Monday. The SNF had no idea how to deaccess, so I called the MD who said to leave the mediport accessed and that way they wouldn't have to reaccess him on Monday. Thank God. The SNF was all the way on the other side of town and I really didn't want him to have to get transported back just to deaccess it.

Yes, either talk to her about it, or when these reference seekers call, let them know it's been 10 years since you worked with her, and actually she's your cousin, so maybe you could give a personal reference.

After this incident https://allnurses.com/nursing-humor-share/things-patients-have-52823-page150.html#post5020053 , the oncoming nurse and myself went down so I can show her where the IV line had "just come apart" (we knew he had done it on purpose) and she asked him "Why did you do that?" He answered "I guess I just wanted some excitement."

Do not "mess with", "play with", or even "touch" your IV line if they seem to "come apart by themselves" (like it did a couple of days before, amazingly right above a pressure hub, again, making your chemo infused blood spill all over the floor). Especially when your nurse just hung chemotherapy. Especially when that chemotherapy is a vesicant. Especially RIGHT AT SHIFT CHANGE.

I was taught differently; to round normally based on the first decimal point. But you should check with your instructor in order to get the question counted right in case they don't give partial credit. In practice, the difference between 17 drops/min and 18 drops /min is 1 drop and in this case

Well I'd say it's a typo and they meant to say drops/minute, but maybe there's something I've missed? You've got micro drip tubing there, and it's drip factor is 60 gtt/min. I did find a calculation for micro drops, but basically you would just move the decimal over, what, 6 places? So you'ld get some crazy number like 18,000,000 micro drips/min. Which is just ridiculous and not even applicable to nursing care. What would that number even mean? How would you apply it in practice? This is homework right? Ask your instructor if they mean drops/min or micro drops/minute.

And does it really say microdrops/min? is that some new conversion I don't know? You can't calculate a microdrop can you? I'm seriously giggling now, mcgtt? It sounds like something you could order at McDonald's. At least it's not apothocary conversion. Those REALLY made me irritated and luckily we only have like 2 MDs who still order that way.

Use that calculation I gave you up there; it's: (Amount of solution X drop factor)/time in minutes = drops per minute

ok i got 49 kg x 6 mcg/kg/min = 294 mcg/min 294 mcg/min = 0.294 mg/min 0.294 mg/min = 17.6 mg/hr 17.6 mg/hr = 17.6 ml/hr then: (17.6 ml x 60 gtt/min)/60 min = 17.6 gtt/min and i'd round it up to 18 gtt/min.

Where did the 0.6 mg come from? Ack!! Now I'm gonna start over from the beginning. ROFL now we're all confused. You're fixing it to I'll just keep going.

I'm still trying to figure out where the 4.2 came from. You got the 294 mcg/min, how did you get 4.2 mg/hr? 294 mcg/min = 0.294 mg/min right? Then 0.294 mcg x 60 = 17.6 mg/hr No matter which way I do it, I can't get 4.2 anywhere. Oh well, I always hated these types of math problems. They take so much time to break it down. It's funny how now in the field, I can convert on the fly and not even think twice about it, though I usually have someone check my math if it gets too complicated. Heparin and insulin drips make my brain hurt.

Convert the mcg/min into mg /min. Then convert the mg/min to mg/hr. Since it's 250 mg/250ml, your mg/hr will = ml /hr. You've already calculated the mcg/kg/min and I got the same. I got a completely different mg/hr than you though. 49 kg X 6 = amount of mcg/min pt should receive. That amount converted to mg x 60 = mg/hr 250mg/250ml x the amount of mg/1 hr = # of ml/hr (and I didn't get 4.2) For the drip factor (amount of solution X drop factor)/time in minutes = drops per minute So you take your calculation from above which will give you ml/hr, that's the (amount of solution x 60gtt/hr)/60 minutes = drops per minute. Someone check my math. That one was hard but mostly because of the number of steps. You need to take it step by step, converting as you go to the final calculations, and it will be easiler if you calculate ml/hr then the gtt/min.

I stuck myself with a clean butterfly once, then almost exposed my patient. The cap wouldn't come off and when I pulled it off with force, it must have stuck me, and I didn't even feel it (those butterflies are what 28 gauge? later it felt like I had gotten a splinter). It wasn't until I was leaning over the patient's arm about to stick her that I saw blood in the thumb of my glove. I just stood up and said "I think I should get a different needle. I just don't trust this one." Now that would've been an interesting incident report.

Just piggy back one foley bag into another. Take off the "foley" part of the second bag and put the spout from the first into the rubber tubing from the second. Then unclamp the first bag and it will drain into the second. When you hang them below the bed, make sure the upper one is hung a little above the lower.

No I didn't prepare for the HESI. No more than I did for any class test. I just considered it another test for each class, not something extra. You can easily get overwhelmed if you act as if it's a seperate course of study, because it's not, it's just a different form of test for the same classes you will be taking. I didn't do any studying before school started. I did buy my books and printed off stuff once it became avilable online for the classes. I saved that e-mail for a while, but it was on my old computer, so I don't have it anymore. But I remember first opening the e-mail and thinking at first it was that I hadn't filled something out right or they needed more information. I guess I expected it to have something more... substantial to it. The subject line didn't say "You are accepted" or anything memorable. But I do remember clearly the list of stuff it had that I needed to complete in a scant 2 weeks before the date that I had to go to the school to present proof I had done those things and be registered. Maybe I had overlooked the e-mail at first or hadn't checked in a while, but it felt like I wasn't given much time. I had to get my immunization records together which for me included a couple of shots and titers, a TB test, a physical, get CPR certified, make the appointment for and get drug tested, and do the background check. I already had proof of health insurance, so I didn't need to deal with that, but others had to enroll in the school insurance program. Because I was working at the time, I had to take a couple of days off to get it all done, and even then I worried the drug test or background check wouldn't get completed in time. Just a recommendation if you get accepted. For your clinicals you will have to present proof of having been "oriented" to the hospital stuff on safety, HIPAA, etc. You'll watch a few of videos and receive a little card that is good for a year. For your first one, you'll do it on orientation day. Make a packet with copies of that card, proof of immunizations and TB test, your health insurance, and your CPR card. You will have to present it to your clinical instructors at the beginning of each clinical. Some clinical instructors will just look at them and hand them back once they've checked off that you have them, others will keep them on file, so just make copies for each class and put them in an envelope, and keep the originals someplace safe. You'll also have to sign an indemnification agreement before each clinical, so print it off, sign it, and put it with your packet before each clinical starts. It will save you shuffling through paperwork on that first clinical day, and your instructor will appreciate it. Send me a PM if you have any other questions. I don't mind at all helping. I enjoyed my time in nursing school much more than I did any other college classes I took in the many other fields I studied, and I have a few other tips that will save you much time and grief from instructors when you get there.

Well, what does the performance report state you need to work on? What areas did you fall below the standard on?

Well, that's how I applied, and all I got was an e-mail.

And on the notifications for acceptance, I simply got an e-mail, nothing came by mail. Did you guys apply online?