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Long term care; med-surg; critical care
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JBMmom has 6 years experience as a MSN and specializes in Long term care; med-surg; critical care.


JBMmom's Latest Activity

  1. JBMmom

    I Made A Mistake

    Sorry you're feeling badly, mistakes happen and this isn't a particularly bad one. Your patient will likely be fine after some lasix, and with a lactic that high, they should be getting fluids anyway, I would think. We will always treat sepsis with fluids, knowing we can correct the CHF later without much difficulty.
  2. I don't have any experience, but I think that will be a very valuable skill as a RN. I've thought about getting some Spanish training myself because I would be more comfortable if I could communicate better with some patients. However, if my area we have had spanish, french creole, portuguese, mandarin and arabic speaking patients, so I guess I'll never be able to communicate with everyone. I love the translator iPad. Good luck!
  3. JBMmom

    PASSED ANNP Exam Yesterday + some more

    Congratulations, good luck with your new career.
  4. JBMmom

    Passed boards, found a job, reflections

    Congratulations and best wishes in your new career!
  5. JBMmom

    Debating between two jobs

    In my experience, the new grad residency programs are hands down better than just an orientation to a new job. Starting with a cohort of new grads gives you an instant peer group that is going through exactly what you are going through, and the support that brings can be vital for new grads. Residency programs generally show that the hospital is committed to helping new grads transition. You usually have scheduled education days with specific seminars and skills training that you will not get in a traditional orientation to a unit. I understand you're probably looking for feedback that says #2 is your better bet, but almost everyone I know that went through a new grad program is very happy that they had that experience. Good luck.
  6. JBMmom

    The Trouble with Work-Life Balance in Nursing

    I am a second career nurse and I don't think that the challenges of work life balance are unique to nursing. In many fields of work these days there are challenges related to balancing everything. Much of it comes down to the expectations of employers and bosses that people are easily accessible at all times. And in defense of employers, many workers spend much of their time at work connected to outside distractions which is also not in balance. My family knows that when I am at work they can contact me, in an emergency, through the unit phone. I will not be checking texts and phone messages because I'm at work and I'm expected to focus on my job. For people that feel burnt out, I hope that they can find something that allows them to feel a better balance. I know that for myself, especially when my kids were younger, I tried to make sure that when I was home they knew they were the priority. Not my phone, not my computer, time with them. So what we lacked in quantity, I think we almost made up in quantity. Even with teenagers now, a good family game night is something that we all enjoy. It can be the little things that really help when the rest of life gets busier than we might like.
  7. JBMmom

    Epinephrine Error - Broken Heart Syndrome, Part 1

    What an awful situation for the patient and the nurse. I can only imagine how difficult this has been for everyone. If the CEO's first response was to actually ask how they could have such an incompetent nurse working in the emergency department, without having all the information, that's the sign of an administrator that really has no understanding of their own staffing, and no compassion for staff. Unfortunately, there would be so many scapegoats at every level that this will never get up to the people responsible for setting up such an awful system. It's all about those stupid survey scores, not providing the best medical treatment.
  8. Just my personal experience, obviously not medical advice since we don't give that here. I was wandering through Walmart recently and saw a weighted blanket for around $40. I've heard all about them and while I don't have sensory disorders (that I know of), I know that since I went to night shift over two years ago I have had trouble sleeping during the day. I have no trouble falling asleep, (anywhere, any time) but I would wake up every hour or two and sometimes be up for hours in between short naps. I have not been willing to invest $100+ dollars for the ones on the internet, but $40 seemed worth a try. Life changing! I've read some articles that say it's because the weight is making my body produce more serotonin or melatonin-like chemicals. Whatever it is, I am now getting a solid 5-6 hours some days which is awesome. I don't know whether I'll be able to use it when summer comes back around because it will for sure be a little warm, but sometimes I'm okay with my "thermometer foot" hanging out from under the covers. I have no personal gain in posting, not really meant as an advertisement, but from one night shifter trying to get through life, to any others that are struggling, I hope this might help you. I've recommended it to all my coworkers and a couple have had similar positive results, but another one didn't really care for it. People that sleep with dogs seem to like it better, maybe since we're used to be smothered by our dogs. Hope this might help someone else.
  9. JBMmom

    Hands on Training in school?

    In my ADN program we were on a tiered system for our clinical. By the fourth semester I had five patients with my co-assigned nurse and I could complete tasks independently of my instructor (except med pass) as long as I had already been signed off. For example, I had been signed off on Foley insertion so if my patient needed a Foley I could find another student to do the two person safe insertion checklist without my coassigned nurse or instructor. Usually, though, the nurses were happy to be in there because we were still saving them time by doing the intervention, they were there for the safe checklist and moral/technical support. We functioned more as PCTs, taking care of vitals and patient needs like assisting with toileting, washing, etc. But we were responsible for knowing the pathophysiology of what's going on and the medications and treatment plan. By the time we finished our community college program, we were mostly prepared to hit the ground running in a new grad residency or nursing orientation. Our community college program is known for putting out nurses that can quickly transition to the floor because we have some experience with time management of multiple patient assignments. Granted, in the semester we probably only passed meds on five patients 2-3 times because there was only one instructor with eight students. In my current NP program I'm working with a hospitalist. After one day of a shadow-type experience, the routine has become that I see a patient first and then write up my full HPI, assessment and plan. My preceptor does the same and we compare at the end. The only part I don't do is enter the orders and note into the computer, but I'm pretty well versed in that particular computer system so I'm not too worried about that part. There are not many interventions being performed by the hospitalists in my hospital, so I'm not doing much skill stuff, but I'm focusing on assessment, documentation and coming up with a treatment. It's been a great experience so far.
  10. This is a great tool that could help guide so many nurses in different situations. I'm going to keep it in mind in my practice for sure, as recently I've also found myself in a few frustrating situations where I wasn't sure that the MDs were really aware of the discomfort the patient was experiencing based on the orders I received at the start of my shift. I think there's nothing more frustrating than watching a patient endure discomfort that you think could be alleviated, but your pathways seem to be blocked by the providers. Cobby545, I'm sorry you had a disheartening experience. I think we can all identify with those situations and how you're feeling. I hope you can take solace in knowing that you had the best interests of the patient at heart and you did what you could at the time for that patient. Your efforts are appreciated, for sure.
  11. Not to scare you but I would caution that while the manager may have expressed he or she is happy to have to shadow and then join the team, the nurse you are teamed up with may not share that enthusiasm. Day shift nurses get a lot of shadows- student nurses and paramedics, new nurses on orientations, and others like yourself that are invited to shadow. There just isn't a whole lot of time to spend, so please don't take it personally if you just end up watching and not really getting a lot of instruction or personal feedback. Now, you may hit a great nurse on a great day who has the time and energy to teach, so I don't want to set it up as something you won't like, but know that when they're busy, they just don't have the time to worry about the person shadowing, they need to focus on their patients. I hope it's a great day for you.
  12. JBMmom

    ACNP - best programs in your opinion?

    I totally agree that the amount of group work at Maryville is ridiculous. This semester is the first one that I have found a group where I feel like everyone is putting in a good effort and that's been fantastic. I understand we're supposed to be learning collaboration, but group work with nurses all working full time, different shifts in different time zones is awful. I'm not as concerned about the skills not being covered because my goal after school is not an acute care position where I would be placing lines, intubating, etc. For those that would be interested in such positions, they would have to find very understanding preceptors willing to show students things. But skills aren't the sticking point for me, we all learned IVs and similar skill based tasks much more easily than putting together the larger concepts of pathophysiology, pharmacology, etc. To me, the lack of instruction focused on putting together the big concepts is their biggest disservice to students. To the previous poster that asked whether you could be prepared if you attend Maryville? I guess you can. I see people post on facebook that they passed their licensing exams and have work. I know a couple people personally that loved the school and feel like it totally prepared them for their current employment positions in primary care. Good luck with your decisions.
  13. JBMmom

    The Vehicle Has Not Come Yet To Take Me!

    A beautiful recount of such a personal time. It sounds like your family had a good experience with the care your uncle experienced at the time of his passing. I hope that happy memories bring all of you peace in difficult days.
  14. JBMmom

    Night shift to day shift interview

    Didn't you have an interview to get your night shift position already? I would think a schedule transfer within the department wouldn't be an actual interview, just confirming your interest in changing shifts. In my facility if you're the most senior person applying for a shift change, they just confirm when you want to switch. Good luck.
  15. JBMmom

    Secondary PTSD spread the word PLEASE!!!

    Good luck to you in your future endeavors. I'm sorry to read that things have been so difficult.
  16. JBMmom

    Hospice Abuse

    In most states you can make an anonymous report, I think it's to the board of health. However, in most states the laws are so ridiculously backwards that ratios that are unacceptable to anyone with common sense, are still legally allowed. The system is set up to maximize profits for corporations, not provide care for the people that deserve it.