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There are supposedly big differences between 6 and 7. My hospital will certify you after they hire you. You just have to get it within 6 months. You could always let them know you are in the process of getting your NRP and sitting for the practicum on xxx date.

Had a pt come up from the ED for admission. Refused all treatment-no IV, wouldn't give current med list, wouldn't allow an exam. I finally asked her why she was here if she wasn't going to allow us to do anything. She said "Dr. XYZ made me." My response? "Well I don't see him here now." She finally let me do her admission but man was she a handful.

There are a couple of different things going on here. First, were those positions posted anywhere? If they weren't posted internally they must've been posted on a company website in order for the new grads to apply. Keep you eye open for those positions and apply! If you qualify for the position it would have to go to an internal candidate before they hire someone from the outside (unless it was posted as new-grads only.) At least that is how it is in my hospital. Hourly employees would have preference over on-call though. During your probationary period you can usually be let go for any reason and the union can't help you. My advice would be to either look for another position or wait until there is another one posted in the unit and apply. At that point you would be out of your probationary period and the union could then fight on your behalf.

Maybe she means to give the meds first that are the most important. Sometimes it's difficult to get a lot of meds into some pts. I would give BP, lasix, any psych meds, etc and hold onto the colace, multivitamin, etc for last. I hate getting to the end and then they refuse to take anymore.

In some areas it isn't easy to find a medical ASL interpreter. In our state you have to go through one facility to book them; they supply interpreters to anyone who needs them. I used to work in an office and we had a horrible time trying to get an ASL interpreter to last minute appointments. Legally we had to supply someone but it was next to impossible to get one when we needed it.

I had a pt scheduled to be discharged, everything in place. All I had to do was go over paperwork with him. He didn't want to go. He called the police and told them we were killing him. Needless to say it was a very long day by the time he left, the police came to check things out and everything go straightened away. He was by far the most trying pt I ever took care of. He was so challenging, nobody got him for more than one shift.

I had a provider ask me about something that would've been done on night shift but wasn't documented and I didn't get it in report (nothing major and something she could've gotten in report from the dr who signed off to her). She kept asking me the same question. Finally I said to her "I'm sorry, it doesn't matter how many times or how many different ways you ask me that question, I don't know the answer to it." She stopped and then ended up apologizing to me five different times. LOL We never had a problem after that.

I haven't seen a child with chickenpox be hospitalized. In a pedi office you would be more likely to come in contact with chicken pox. Have actually seen a couple of adults hospitalized with it but they go in a negative pressure room so you would know. And I think you are correct, you are more apt to come in contact with it out in public. My daughter had chicken pox as a child and only AFTER 120+ other kids in her preschool got it. HAHA pretty easy diagnosis that time.

Hi! I know I had to have titers drawn even if I had proof of the immunizations. My insurance paid for the titers although not all do. I had to be revaccinated on some even though I had vaccinations previously. Call your insurance company and see if they cover it. Once you have it all done, hold onto the forms that show your immunity because you will need them again for jobs in the future.

Actually we have had this same discussion at work. If you clock out and then continue to document, technically they have proof you are working "off the clock" and it is a reason for termination among other things (like time card fraud). Also, you are technically accessing peoples charts, etc when you are off the clock--another violation. Be careful, you could loose not only your job but your license. What if something you document off the clock comes into a lawsuit? How could you have documented you did something when you weren't working? Lots of "ifs" if you work off the clock.

Ok, I know the point was the MD yelling but from what I read, wasn't the pt A&O? She would be the one that has the say in the catheter. The POA doesn't have a say unless the pt is unable to. I hate when people call and say "well I am the HCP and I want information" or " I am the HCP and if they don't do this, I will refuse that procedure". Ummm sorry, your mom is perfectly with it and she is the one to decide who gets what info and what procedures are done. That being said, I have gone head to head with a physician because I was advocating for my pt. In the end, the family appreciated it and the dr was put in his place. LOL I have also had a dr YELL at me and lecture me in the nurses station because a night nurse didn't document something. I very nicely said to her "I am sorry but no matter how many times or different ways you ask me the question, I don't know the answer to it. The nurse did not document it and she did not pass the info on to me in report." Needless to say, she apologized three different times that day and said she was sorry we "got off on the wrong foot." Her issue was actually with the night MD who took the admission-she didn't like the orders.

I won't answer each one individually but we use the Harriet Lane handbook for all peds dosing. It gives us specific instances where the general max dosing is exceeded. RE: solumedrol or prednisolone. When we calculate a dose and it is higher than the max dose, we question it with the MD. We even had a case where we "strongly" questioned a dose and asked for clarification. MD changed the dose. They explained their reasoning but we still did not feel comfortable with the dose so they changed it. As for narcotics in kids, it depends why they are being given. We have some MDs that will go bonkers that narcotics were given to kids first without trying tylenol or motrin. All depends on the reason. Try the Harriet Lane book, it is really a great tool for pedi.

Our floor does it a little different. Our holiday starts at 3pm Christmas Eve (thanksgiving and new years too) and goes until 11pm the day of. So even day shift has 4 hours on the eve and then 12 hours on the day. The way it works out, each shift has the same # of holiday hours. We have a sign up sheet and then the holes are filled in. People can "request" what holidays they want but in reality, someone isn't happy. LOL Either way, day shift works Christmas Eve until 7 (usually means 8) or Christmas Day.

There were people I went to school with that had a similar arrangement. When they graduated, the hospital didn't have enough jobs for them so their scholarship was forgiven. Of course, then they had not job. If they offer you a job, take it and you can always move in four years. It is very difficult to get into a hospital as a new grad now let alone asking a hospital to payback loans. I don't see that happening.

We always have 2 RNs on the floor, even if there is only one or two kids. We do have another side that takes a few adults and we usually will split the floor, one stay on Pedi and one on adults but we are two pedi RNS right there. No adults and one 1 child-still two RNs. I would never be the only nurse on a pedi floor. What if you are in the middle of an emergency and there is no one to scream for to help?