09NewGrad

I moved from one state to the next and have two active licenses currently. I NEVER plan to move back to the previous state no matter what happens, so should I just save some money and let it lapse or does that look bad if I let the license expire from my old state? Also, I am new to the requirement of CEUs to maintain licensure as I didn't have to in my previous state. Are there any good places online that you guys use to get your CEUs? I've seen various sites that advertise them but how do you know if the credits are actually acceptable or accredited? For example, if I take a quiz online and after I pass it says I got one credit, do I simply need to print that page and keep it for my records and proof in case I get audited? I assume they wouldn't want each page sent in when the time comes to renew. Thanks for your help.

Yeah.. I'm not sure what a typical flush is every shift which is why I asked. The nurse I was working with who had done frequent feedings read the order as a 30cc h20 flush every hour, so that's how we set it. Later on I second guessed myself (as usual) and was freaking out thinking that might be too much h2o during the feeding.

Yeah the pump has a water bag - it's one of those kangaroo pumps that alternates the water with the feeding. Anyhoo.. with the order given the pump was set to flush 30cc/hr water.

I took care of my first patient the other night with a peg tube. He was admitted from a longterm care facility and the order was put into his med reconciliation the same way the order was written at his facility. The doctor chose to continue the tube feeding with the order written the same way his facility had it. It was written like this: Jevity 1.2 @ 75cc/hr at all times with 30cc free h2o. How fast would you run the flush with an order written like this?

Thanks for the replies guys, but back to my actual question - What COULD happen if some of the precipitates DID go through his IV line into his circulation?

Nope, as I said above, I was just using the pump with NS infusing as a flush...

Hey guys, today I had a patient with several IV push meds all due to be given at the same time (lasix, protonix, thiamine). He had NS running at the same time and I pushed the meds through the port closest to the patient, using the NS running as a flush - BIG mistake, lesson learned, won't happen again. Protonix and lasix went through just fine, but once I started pushing thiamine, white thick precipitates formed. I immediately stopped the infusion, threw the tubing away, and used a NS flush before I finished the thiamine push. I felt HORRIBLE about this and left the hospital thinking - "What if some of the precipitate got through before I saw it and he codes tonight from a clot"? Even though I didn't see any of the precipitate make it through to him. Could this actually cause a clot, or is it more likely to have a med reaction? What COULD happen if some of the precipitates DID go through his IV line into his circulation? He had a peripheral line going into his AC, not a central line.

Hey guys I just wanted to give you an update. I did manage to get an interview with the job I am seeking next week. Does this mean they already called my references or can they still call after the interview?

Thanks for everyone who decided to post and give advice to me. I decided to put down both references and be honest (supervisor and house supervisor). I will try and let you know if I get an interview.

Hey guys I really need some advice. I'm applying for a new job right now and I'm wondering what I should put in the (Supervisor) box on the application. I left my former position due to having a poor supervisor, and actually more than half the staff on the floor have left in the last year due to this as well. She is a very vindictive person and I'm afraid if I put her down she will give a bad reference even though I left on proper terms. She's the type of person that acts like if you are no longer on her ship you are the enemy. The house supervisor was awesome and said I could gladly use him as a reference. Though he was not technically my supervisor. What should I do??

Thanks for the replies everyone. She felt fine while she was having the temperature, she was just resting quietly in bed. I actually just read up on the policy at my facility and plan to do so on other topics as well. Here's to hoping it wasn't a reaction she was having. I sometimes worry in the back of my mind that I'll receive a phone call in a week or two after I've taken care of someone asking why I did something, stating a patient has died or something of that nature.

True, and I did report the 101.2 to the physician, however this was after the transfusion. The physician also said he wasn't alarmed because temps post op are frequent.

Background... still a new nurse, 1 year experience on surgical unit and still learning every day. Situation... I was taking care of a total hip arthroplasty patient who had only been out of surgery for around 12 hours, and her hemoglobin was Could this have potentially been a transfusion reaction? At the time I kept telling myself this is autologous blood and these patients commonly develop temperatures the night of the surgery. However when i was giving report the nurse told me she had seen a patient develop a reaction to autologous blood in the past. I always love ending my shift with something in the back of my mind before I go to sleep . As I replay the night in my mind, if I could redo the situation I would stop the transfusion, call the dr. just to be safe and see if he wanted me to continue the transfusion.

When I was in school I always thought that two consecutive 12-hour shifts was the most I ever wanted to do because I always felt so worn out doing 12 hour shifts doing my preceptorship my senior year. At my current job that I started in October, they have me doing three 12-hour shifts in a row, I get one night off in between, then I do three more 12-hour shifts in a row, I get a week off, and then I repeat the process all over again. I am getting worn out, burned out, and the week off isn't worth the LONG week of work. It doesn't feel safe and I get so extremely exhausted, especially on the 6th 12 hour shift. I finally talked to my manager about it and she said she would see what she can do about my schedule, but nothing has happened yet.

Thanks guys, I feel alot better after reading your posts. However, I still am upset about this situation as I'm not one of the night nurses who just sits on their butt and doesn't ever check on their patients. I'm constantly seeing how they're doing, monitoring pain control, and seeing if there's anything i can do to help. I know some nurses who go in the patients rooms as little as possible, and this has probably never happened to them. Oh well, I'll use this as another situation to make me better.