RNMarykay

JulesA and Libby1987 I think I was just nervous about the line of keeping comfortable/hastening their death and as a newbie RN I have not seen a lot of active dying. When I was a tech I mostly stayed out of the rooms of the actively dying while the nurse did direct care, whereas now I am the one in the room with the pt and their family. I'm trying to speak in hypothetical language rather than specifics of a situation. I just wanted to make sure I had done the right thing.

I am a new nurse and wanted to get feedback. If a patient is a DNR/Comfort measures and actively dying (say from a GI bleed, or disease process that can't be stopped for whatever reason) and becomes restless and agitated and there is prn ativan available, is it unethical to give a small dose even if it may cause resp depression/hasten their demise? Or is it good palliative care to help them relax and keep comfortable? I'm trying to see where the lines are, they seem so blurred at that point. Thanks.

Do something relaxing tonite; get some sleep, drink water and have a good breakfast that won't give you a carb coma. Answer one question at a time and do NOT keep looking at the number you are on. I've heard the average is 120 questions so I didn't even think about getting wired up until I hit that mark. When it cut off before then I was pleasantly surprised. Read slowly and ask yourself what they are asking. Don't overthink or second guess. Use ABC, Maslows hierarchy and Kaplan decision tree when answering. You'll do fine!

In every situation check the hospital Policy/Clinical Standards. Beyond that, KNOW your state Nurse Practice Act to know if it is within your scope. I recently heard of several ER nurses and a manager who were fired bc they were inserting external jugular lines. Their rationale was that if paramedics can do it within the field, they could within the hospital. It was against hospital policy AND state practice act. It's YOUR license on the line.

I am a new RN and am wondering which organizations are generally beneficial to join? I'm also interested in journals that are helpful. I would like to grow as a nurse and also be aware of trends, best practice, etc. With limited funds I want to make good choices on where to focus first. Also interested to hear how many of you carry your personal malpractice insurance? Thanks! mk

Hello, I'm a recent grad and will begin my first RN position soon. I would like opinions on which position to take in light of my experience and goals. I've been working on an adult med/surg floor as a tech for five years so I have some experience behind me, but our hospital is a satellite of the main hospital (about 150 beds). My unit does basic med/surg and a lot of the more complex things (insulin drips, chest tubes) get sent to our PCU or ICU. I can stay at my hospital for a year as a new grad on days and learn time management and basic nursing or I can go to our main hospital, a trauma 2 center, as a float nurse on nights. They offer a relatively good orientation (12-14 weeks) and according to them, plenty of support, but it is on nights, which will be a strain. Ultimately my goal is to end up in the ER or ICU and the experience as a float would be invaluable for skills and meeting people. But I wonder if it is just TOO much, TOO soon? I go back and forth in my mind on the pro and con. Part of me wants to stay where I work -- I know the other nurses, the doctors, the facililty and have good, supportive relationships all the way around. The other part of me wants to jump into the big stuff. What would YOU do as a new nurse?

I agree with loriangel 14. A good friend of mine went into nursing because he had a son who was severely disabled. He always said he wanted to work pediatrics, but when he did his clinicals he was bored out of his mind. He actually LIKES med/surg tele pts because of the variety of diseases and situations that come up in a day. My brother is a great nurse, but works at a slow pace. He learned quickly that he'd better figure out an area to nurse in that would be suited to his personality and ended up in dialysis. He doesn't mind the acuity of the patients, and he likes that he only has two at a time and never has to do any of the admission/discharge paperwork that med/surg nurses do. Me? I'm hoping to go into trauma nursing. Severe blood/guts/codes don't bother me, but dealing with the same patient for more than six hours at a time can make me crazy. It's all about figuring out where your personality fits within the scope of nursing. I think it just takes time.

This is not the practice my hospital system uses. We have several PST's (CNA on steroids) now that have all finished school, passed their boards and are interviewing within our system for RN positions. They remain on the floor as techs, or monitor techs etc until they have secured a position. G

Hello, My husband has a career opportunity in the Nashville area. We have been in Florida where I began working as a CNA, then nurse tech/Patient Support Tech, and then got training as a telemetry tech. I've been taking prerequisites for a nursing program associated with our hospital system to get my RN/ADN. Within a year I will be in our nursing program which will take 18 months straight through. My question is if anyone knows of a hospital system with a similar program in the Nashville area? I would really hate to give up a good opportunity in front of me here to get locked out of my plans to become an RN in TN. If anyone knows of the different hospitals and what educational opportunities there are I would greatly appreciate it. Thank you! G