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SarahLeeRN

SarahLeeRN BSN

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SarahLeeRN's Latest Activity

  1. SarahLeeRN

    New Career in Management???? Advice?

    If you are someone who loves to have friends at work among your co-workers...and you have good solid friendships and a team with the people that you currently work with...then I would say seriously consider not taking the management job. I only say this because-in order to be an effective manager I feel that it involves a different skill set...one in which you need to enjoy the people that you work with certainly...and develop your team of people and allow them to grow and develop...but the bottom line is-when you are their manager, you cannot be their friend. I mean this in the nicest way possible. What I am basically trying to say is: when you are the manager, you cannot be the friend. You can be friendly, and caring and supportive...but if you are the 'friend' in the same way you are currently with your co-workers-you will lose the ability to be an effective manager. And if having many work friendships are important to you-you are best remaining where you are. That being said- if it works better for you pay wise and distance wise-and you are up for a new challenge....go for it! Either way, all the best on whatever you decide.
  2. SarahLeeRN

    Input on clinical instructor responsibilities

    A few tips that I have...have been doing clinicals for a couple of years now. (of RN students but I feel that some of this will translate). 1. If you are not also employed at the facility I would not do a 'nursing task' that would not fall under the student heading. Therefore, no, don't do a PICC line dressing. Allow the students to watch the nurses-but don't do this yourself. You have to remember that you are employed by the school and not the facility. 2. I have a strict "No meds are passed except with me" policy. Procedures...are ok for the student to watch the nurse do. However, anything invasive like a foley, I would rather be there. The last thing you as an instructor wants is something to be given/done to a patient incorrectly and you had no idea it was happening. I just decide at the beginning of the day what meds we are passing and then let the nurse know. 3. If the school you are working for has guidelines for what the students can be doing along the timeline of where they are in their studies, look for that. 4. Check your state board of nurses for the scope of LPNs. Keep in mind that students of course are not LPNs...at the very least they should have been checked off in the lab on a skill before doing it in a facility. 5. Stop into the facility on an off day and meet with the DON or whoever and ask for their policy book and review it. Hopefully something here can help you...all the best!
  3. SarahLeeRN

    The Future Nurse Bully- Is it You?

    Sure to be a much discussed post. Quite the story about the preceptor who said "congratulations on your first initiation." I just thought I would add, for what it's worth, there are difficult and rude people wherever you go. While it wasn't perhaps smart or even nice of the nurse to do that to a new hire- it was also rude and unprofessional of the physician. Perhaps time needs to be spent on discussions for new nurses or even those long in the profession about how it is ok to stand up for yourself -professionally and with dignity. In other words-it's not just the "bully's fault." Everyone has choices and not allowing yourself to be the victim can also be a choice. There are tools as well that can help with that such as conversation classes etc. where conflict management and difficult conversations are role played.
  4. SarahLeeRN

    What to do about burn out.

    Caregiving is exhausting hard work. Everyone who is a nurse has the potential to burn out. Everyone has given good advice. I think if you have another non-nursing job option you should do it. And just keep per-diem status for the sake of the resume. :) Why limit yourself with phlebotomy? That might not be far enough away from healthcare to help you get some motivation back. Maybe there is a coffee shop that could use a new employee!? Or anything really...there are many options out there in life. Just have to be brave enough to try something new!! :)
  5. SarahLeeRN

    Struggling with report

    When you look up your patients, look at the same thing the same way every time. For example, here is how I do it: 1. Why are they admitted and who is the admitting doc? 2.When were they admitted? 3.What are their recent orders? 4. What is their dietary status (NPO etc.) 5.What is their ambulatory status? 6.What recent labs were done? Write down ones that deviate from normal. Even if you don't know what they all mean...write down ones that are flagged as abnormal. 7.Check the meds and see what is due and write them down. Check allergies 8. See if they are on any IV medication and or need glucometer checks. 9. Look up any imaging that was done. 10. Read the last dictated provider note. At the very least if you look in the chart the same way every time, before long it will become second nature. You can give report in that way as well. "80 y/o patient admitted with pneumonia under Dr. so and so, recent orders include...diet status is...recent labs are...etc. If you know what you are starting with, you know what will have changed before you leave. And even if someone "already knows the patient" I think they should listen to you give a full report anyway. The most dangerous thing anyone can do is think that just because the patient was one way on their last shift they will remain the same on the new shift. :)
  6. SarahLeeRN

    Did I cause this rapid response?

    My two cents: You didn't cause this. If someone is admitted with sepsis-all bets are off. Essentially you are playing a game against time and an infection going through someone's system and sometimes sepsis takes a turn for the worse. I would be more interested in his other vital signs (HR/BP/respirations) around the time when you place him on oxygen. That said...what you could have possibly done is questioned the am 20 units of Lantus. Lantus is far better served being given at night in my mind. Officially they say Lantus doesn't peak. Or I should say doesn't have much of a peak effect. But I've seen it happen many times. And if he got the Lantus at lets say 8 or 9 am...around 4pm is just about right for it to catch up to him. Other question would be if he also is on any oral antidiabetic meds along with the insulin. In any case, a good learning scenario and at least it was caught and he is in the ICU. You will be a better nurse because of this. :) I would be more worried if you weren't wondering what happened!
  7. SarahLeeRN

    The Enemy... The Nurse Manager

    Nurse management is such a tough job. I have always thought that the management alone is hard, but then to have to do scheduling and coverage on top of that? Crazy. Thanks for such a forthright and accurate post. I'm sorry you feel like you are the enemy-you're not. I'm really enjoying reading everyone's posts-a lot of great perspectives. A few tips from a stint that I had in the management world: 1. Develop alligator skin. 2. You can't change personalities-but you can limit the time they spend behind your door. There will always be a select few people that always have a problem with EVERYTHING and will have to tell you about it every single day/week. I'm not saying their concerns aren't valid...but usually you have to listen to them respectfully for a bit and then figure out how to end it so you can get on your way and your day and make them happy and not get yourself get sucked into the quicksand... 3. Maybe this is naive of me, but don't waste time worrying about gossip on the unit etc. in other words unless something is said right to your face, don't deal with it or waste the energy. 4. And if possible, always granting PTO (as much as possible, you are right about no-one gets 100% of what they want )that might help set a culture where everyone realizes that they all have to help build the sandcastle... Really, at the end of the day though, developing alligator skin was what worked/works best for me. Haters gonna hate and all that. I can't let snarky personalities impact mine or I'd drown in the negativity. Just because you posted this obviously means to me that you are a caring person who wants to do a good job. So don't let it bring you down!!
  8. SarahLeeRN

    Young ADON

    I was 20 and in charge of an entire LTC facility and staff for over a year. It was hard. I did some things right, and I did some things wrong (as far as relating to staff). But I learned tons from the experience and everyone I worked with...even the difficult staff. My 'two cents' is this- They already understand that you are the ADON. You don't need to worry about making anyone think that you are 'capable', you just need to do your job to the best of your ability and be fair and understanding to all of your staff. Humility and a willingness to learn from those who are 'under you' in position but 'older than you' in experience will get you far. Watch your back, don't get pulled into, entertain or create drama, if you have any serious meetings with staff have another person there to witness with you. And don't make any quick or drastic changes that your staff will hate. And help them when they need it. :) Hopefully something was of help! All the best!
  9. SarahLeeRN

    But Why? Fingersticks and Common Sense

    Great discussion-this has interested me before. I am interested in what others have experienced in this area. It was always my understanding that fingerstick is not as accurate as serum. I have certainly seen differences between the two numbers. Although not usually drastic, it is nice to have the most accurate number possible when planning the overall care of the patient, I would think. Especially in instances such as DKA or HHS. Thanks blondy2061h, MSN, RN for the article on the meters. Here is a link to a study that was done in a ICU between bedside fingersticks versus plasma from the Journal of Intensive Care Medicine: Accuracy of bedside capillary blood glucose measurements in critically ill patients | SpringerLink
  10. SarahLeeRN

    Christian Nurses

    What a great topic... I have always been extremely thankful as I navigate the nursing profession...with the anxieties that I can have about staffing and patient care and doing the right thing and the complexities and the complicated patient situations and the often unanswered and depressing situations...thankful that I know Someone who cares more about those I care for then I do. That I know Someone I can pray to for help and roll off my worries onto every step I take from the time I leave my car to the time I get report and start my shift. And Someone I can talk to during my shift. Leave it all with Him to work out, that has worked for me!
  11. SarahLeeRN

    Love Nursing? Or ????

    How much longer do you have until you can take the NCLEX? My advice is to stick it out-after a while I think even the starting pay rate might be worth it for you and then you can maybe find an area of nursing that you like...there are so many choices out there and they aren't all at the hospital. :)
  12. SarahLeeRN

    7 Things You Weren't Taught in Nursing School

    This is a very good article-but I have to admit, I am very curious about that insulin story. What about the dose of insulin and how it was calculated/related to the patient made the new grad nurse unsure about it when it didn't concern the Doctor, the Pharmacist and the Preceptor?? I mean it sounds like the new nurse was right on, but wow!
  13. SarahLeeRN

    Overwhelmed new RN

    That seems like a normal ratio for that kind of unit. It can be very overwhelming especially for the first few months. I suggest trying a few different methods to organize your time and see what works for you. Don't forget that it's not the only nursing job out there, and you will be all the more stronger for learning how to give that many medications to that many people! Also, leaving the bed up is a simple mistake, if the patient didn't fall, no one was hurt, learn from it and don't beat yourself up. And, you caught that you took the gluccometer home. And brought it back so all is well. I accidentally threw out a whole ring of supervisor keys once! Took hours to find them, but I survived it! Keep it up and I think you will get through this a stronger nurse! And if after enough time has passed to help your resume and you still feel unsafe there, you can look elsewhere!
  14. SarahLeeRN

    What's in your nursing portfolio

    I do not have a portfolio per say but I do have a binder with protective sheets where I keep copies of certifications, even some recommendations, some policies and procedures (I work a couple of jobs ). It helps to keep me organized more than anything. I have never had to show a portfolio for a job, a resume has sufficed. But I do think it is a terrific idea to keep track personally of your accomplishments etc. so you have easy reference.
  15. SarahLeeRN

    Why Do Nurses Quit?

    Great article! I think that many of the reasons nurses quit were brought up in the article...something that has stood out to me lately is the thought that part of reality shock/burnout/wanting to quit is simply having to be around sick people all of the time! As much as we want to help...that has got to play a part in it. Every job has its stresses, I get it, but we do have to realize that many times we are seeing people on the worst day(s) of their life/year. I find that pretty draining.
  16. SarahLeeRN

    I really do feel depressed about the situation

    I just wanted to mention something about your statement "Being a nurse is the only thing I wanted to do and that makes me happy." I hope that you can find some other things that also make you happy-nursing is wonderful, yes, but will not fulfill you or be the only thing that will make you happy. I am sorry that you were recently sick-don't forget to care for yourself before you care for others. :) Don't beat yourself up about not having a job at the moment-if you want another one/keep looking, one will turn up. I wish you all the best, and will pray for you!
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