LEM1234

I didn't mean that the line would be directly in the lung. Isn't a complication of insertion of one of these lines a pneumothorax? So if the lung could be punctured upon insertion, doesn't it also follow that the lung could be affected if the line is moved around after insertion and placement is not verified? If placement isn't verified, isn't 1/2 an inch (for an infant) enough movement for it to possibly be in the vein leading to the lung rather than the superior vena cava? I've never seen this happen or anything...it just seems like it could happen. Which is why it would be a bad idea to put fluids through that line...unless i'm making ridiculous leaps of logic...but i thought i remembered hearing this stuff in school... Also, couldn't movement of a PICC cause cardiac arrythmias?

I think you did the right thing, absolutely. 1/2 an inch is a lot for a one year old's veins. The vanco could have "infiltrated" into the lung, right? That's why you wouldn't even flush it...because the PICC could be leading to the lung and you could fill the lungs with fluid...if my thinking is correct. And I'm pretty sure that if the tegaderm was sterile, then there's no increased risk for infection. I don't think this is going to come down to whether or not the board of nursing backs you up. Your patient remained safe and that's what matters!

I went to Baker College for my ADN and they have the NLN accreditation in addition to being approved by the state. They will also have a BSN program starting soon. They have no waiting list for the program. If you don't get in, you just don't get in. no list. That being said, Baker was an ok school but if I had to do it over again I would not go there. I had several issues while I went there and frankly the administration at the school disgusts me. At one point, I had to drop two classes when my Dad had a hemmorhagic stroke, was in the ICU for 2 weeks, and then died. They were going to fail me because of this. And yes, before I dropped the classes I went and even spoke to the vice-president of academics about my situation. Everyone knew what happened, and the director of nursing said "I can't give you a break, because then I'd have to give everyone a break, and I hear this stuff all the time" while I was sitting in her office, death certificate in hand. DON'T GO THERE!

I have not used the Hurst review. I used the Kaplan and passed the NCLEX in 75 questions. However, I have heard that Hurst is pretty good.

I forget what the exact # was, but the mag was normal. The patient was not on tele up to that point...when i got the order for the IV KCl I got an order for tele too...I finally had to get a sitter for the guy because he was in restraints yet kept ending up hanging off the side of the bed and I was afraid he was going to hurt himself...my manager really questioned me about requesting an order for a sitter...but what else was i supposed to do? He was going through DTs and kept ripping off his ostomy bag (and he had mitts on) and poop was EVERYWHERE.

I asked the nurse when she told me in report if she did anything about the K of 2.8 and she told me she talked to the resident on call and he told her "it was OK because he had K in his fluids" I also figured out that the lethargic lady with the low BP had not received two important medications because I guess no one ever checked her med rec form to her MAR...so for like a week she'd gone without her renagel and lasix. Actually I didn't report that...I know I should...but I don't want to be the new nurse on the floor reporting everyone. Seriously...I'd be reporting at least one incident a night. I know I should.

I work nights all the time, and some nurses are just not fun to follow

I too am a new nurse since March, just off of orientation. I feel the same way! I get a max of 7 patients on our floor...I don't know what I would do with 9! Many times the PCTS (the assistants) seem to know more than I do about all kinds of stuff. I mean, I know how to assess a patient...but where to get supplies and how to hook up things in the room are all things I didn't learn in school. I'm frequently embarrassed because I have problems remembering specific things about my patients...like who actually has SCDs hooked up to their legs, who has what IV where...It's hard. You are not alone. I think it is normal to feel anxious. Good Luck!

Thanks everyone! It seems like I spend so much time when I'm not at work thinking about the things I did while at work, making sure it was the right thing to do...

Yeah, I'm on a surgical floor. One side of our unit is reserved for elective surgeries and the other is for trauma surgeries. They were all breathing at the end of my shift, thankfully. I'm just glad I caught the lady with the low BP because she was not looking good. Can't wait to get some experience and move on!

I'm a new nurse about three days off of orientation. I come onto my shift and here's what I get: A patient with a K level of 2.8, left uncorrected all day, going through the DTs, in 3 pt restraints, hanging off the side of his bed; a pale, lethargic patient with a BP of 80/50 and a K of 5.3 after offgoing nurse gave too much catapres; a patient that has ZERO urine output for the last 12 hours with a Foley that the doctor called me 3 times in 1 hour so I could flush it (sorry busy with the lady with the low BP who won't wake up); a patient crying in bed because she's in so much pain and she needs her vicodin NOW!; and the list goes on... Oh my gosh! Is this how nursing is everywhere? It seems like everytime I go to work I'm just running sround putting out fires and not really getting anything done at all (except hours of charting)...

I am a new nurse and I understand what you mean. I work at a hospital where we have patient care technicians that assist the patients with ADLs, etc. It is a difficult spot to be in when you are supposed to delegate to someone who may be older than you and may have worked longer than you at your place of employment. Often times I find the same techs not doing the same things over and over again. Like turning patients. Or changing dirty gowns. Or assisting 1:1 feeds. Or not emptying out urinals and foley bags...I haven't really said anything because I don't know how. Then there are other techs that do their job and do it very well. If I had advice to give, I would give it! So far, I've just been using positive reinforcement for when they do a good job (because wiping butts all day SUCKS). I would love to hear from other nurses on how they handle these problems.

OK...I am a new nurse and I have a question for all you other nurses out there. I had this elderly patient post-op who was on a clear liquid diet and eating greater than 50% of his trays, with D5.45 c 20 @ 75 thru IV. He was receiving 25 units of Lantus at night and there was no sliding scale ordered. The patient said his diabetes was controlled with Lantus alone. I gave him his Lantus per order. The next morning his blood sugar was 70 (I work nights). The oncoming nurse gave me all this crap (boy did she have an attitude) about how I should have held the Lantus and called the doc. I was always taught that we give Lantus to patients even if they are on a clear liquid diet. My reasoning was this: he had dextrose through his fluids, he had a large cup of juice at bedtime, his sugars hadn't been low since his admission with Lantus being administered regularly, he was post-op and stressed...why would I hold it? Am I missing something here? I just need some input since I am a new nurse and thought I was missing something...HELP!

I was always taught that it is the first sound you hear.