BahoRN

If you're actively in a nursing program, you can apply for patient care technician or nursing aide positions as a 'student nurse'. No experience or certificates needed.

Congrats & good luck!!

Like any other area of nursing, there are the good nurses and the bad nurses. Hopefully, you find yourself within a great group who support and can lean on each other. Don't beat yourself up about not going into Med/Surg. Most graduates these days scoop-up whatever position comes their way and they go forward never touching a Med/Surg unit. If Med/Surg doesn't work out for you - don't be afraid to try something else: wound & ostomy care, infection control, quality assurance, school nursing, PICC team, recovery or a step-down unit ... the list is endless. Doing Med/Surg doesn't make you any better, or any worse than any other type of nurse -we're all valuable and contribute to patient care and safety in huge ways, and we each have our own talents and knowledge base. If you want the busiest unit, where you see and do everything (while breaking your back) -try telemetry, it's insane :-)

What position are you applying for?

You've forgotten to list your objectives. As a graduate nurse, it is doubtful you are established in patient education. I would advise omitting this wording. Provide the name of the electronic documentation systems you have worked with. Provide your RN license number. Provide the expiration dates of BLS/ACLS certificates. Under work experience, provide brief details of your duties/responsibilities, who you reported to and who reported to you. Under education, provide College Name, Degree Earned, Year Degree was granted. Listing GPA's (if good) doesn't hurt.

Don't know about the northeast, however from what i've experienced salaries are competitive, CEU's and classes were provided constantly, computer charting system is horrible, at one facility they spent money on sometimes the weirdest, non-pratical technologies. The organization is huge so transferring between facilities is simplified, many employee benefits are offered. HCA nurses work hard, but then again, don't all. Overall, many nurses look down on HCA due to the for-profit nature of the organization. They tend to acquire older hospitals so you probably won't be working in a shiny new building with modern conveniences. At no time did I feel as though I was lacking for supplies/materials/support. My advice, as a new grad -if your offered a job -accept it :) Ps -they tend to have good orientation periods for new grads (7 weeks on average with an extension if needed).

As with many other things, it depends a lot on the school you're attending, and the city you live in. But, that aside, I had no experience in health care when deciding to become a nurse. For this reason, I took the 2 year ASN course, graduated, found work, and continued with my ASN for @ 5 years. I feel the clinical experiences and skills learned were fantastic compared to BSN-only prepared RNs. I also saw that me and my ASN counterparts emotionally acclimated sooner to the hospital environment and complexity of acute care. Once I received my BSN degree through a RN-to-BSN course, the entire focus was not on patient care, but rather community nursing, public health nursing, nursing research and nursing leadership. Overall, I am very satisfied with the decision to get the ASN first and to have naturally evolved into the BSN degree. Smaller, regional, non-teaching hospitals will continue to hire ASNs for some time to come. They don't have the budgets for a fully prepared BSN staff. Be confident in your studies, actively learn and participate in the course and clinical segments, and be prepared to wait for that dream nursing job just a little while longer :)

There will be a lot of dealing with other disciplines. I would recommend being open to asking for help and info (loose any ego you may have) & be open to forming healthy relationships with RT, your CNAs, your unit secretary, PT, Dietary, and the PA's/ARNP's/and physicians. They all have valuable knowledge and experience. Know your popular medications (analgesics, psych, antibiotics, insulins, cardiac), bring your drug book to work to quickly assist you on the others. Have a good Med/Sug text or Lipincott's nursing procedures text handy for quick reference. Very important is being able to organize your time and patient care routine/responsibilities. Seek out what other nurses on the unit use to organize their days. All in all, don't worry about it. Ask for a good orientation and everything else will come naturally. If your agency is accredited -knowing the core measures will go a long way.

NOADLS, aren't you the same nurse who stated in a previous post that you would never change a patient's brief? It would be very wise to keep your identity hidden, forever.

LOL!! ha ha. Thanks for the laugh - that was cute

Those are, pardon my french, but very crappy and vague goals. Goals need to be measurable and time specific. "Pain will be managed for duration of care" What is the current pain level, how will you know it needs to be managed, how long is the duration of care? A better goal is 'Patient will maintain a pain level of two, on a scale of zero to ten (where zero is no pain and ten is the worst they've ever experienced), for the duration of the shift'. OR 'Patient will not verbally express the need for additional pain medication prior to the next scheduled dose at 1230H' "Skin will remain intact for the duration of care" What about excoriation, is a pressure ulcer already visible, but not open? Again what is the time period you are qualifying -duration of care is too vague, as is the statement skin will remain intact. A better goal is something like 'The stage I pressure ulcer located on the coccyx will not evidence any progression to that of a stage II by the time of the next wound care consult scheduled for May 7th 2014 on day shift.'

One other thing you can do is go over to the medical center and look at the pumps and poles. Speak to the nurses working with them and see what they tell you.

As I stated in my previous post, this is not a clinical area of concern that I've ever come across. I know of no research on it either. You may have to run google searches. Another possibility is to log on to your school's library and run searches through the medical and nursing databases (CINAHL, EBSCO, OVID, and MEDLINE are some examples). Hope this helps you, good luck!

Speak to you DON about your concerns and she what he/she advises. There should be a written protocol regarding this type of situation. See if you can get your hands on a copy and have it at home. Should anything happen in the future (which I hope it doesn't), you can take that facility protocol to the board or to any investigators and state that you followed protocol, and went above and beyond by calling each RN and physician. In all documentation you should state who you called, when you called, reply, no reply, message left...still waiting for a return call etc.

I've never worked in LTC so i'm not aware of acceptable repotting practices in these types of facilities. Working in acute care, so many changes take place during the shift, your nursing 'brain', which is your paper on each patient, is very important. It helps with tracking changes, shift report, end of shift charting, and follow up for the next day when you have that patient again.

You can speak with someone in academic advising at the schools you are thinking of attending. See what is said from the 'horses' mouth. Also, you could take statistics again and achieve a better outcome (if that's something your willing to do).

I've sent you my email in a private message to you. You can email me and I will send it over if you like.

Yes, for an IV what you're doing is perfect. If it is a central line, draw out 10cc's, then flush. If the drug bag empties, and you have saline flowing until you get the new bag up, you can always flush then too, just to be sure it's in the vein.

Here is a form I used when I was a new nurse. It really helped to organize the info and provide sense to my reports. Hope it helps you! Patient Data Forms.doc

I always give my report as to what I think is pertinent, and then I finish by asking the oncoming nurse "Is there anything I missed or do you have any questions for me?" This avoids any ego issues on their part.

I've you're overhauling or adding content to your current policy, you really should be reading the latest evidence-based research regarding this topic. That is where you will find the best and most effective interventions organizations can use. Best form is to have policies related to the research, not upon what others say they may or may not be doing.

I think it would depend on what's being said. If it was loud enough, I would step in to let them know to take it to another area. Additionally, if the offensive nurse was being a bully, demeaning, or belittling, I know I would definitely step in between them and diffuse the situation. However, attacking one nurse who is attacking another is not the way to handle these situations. Sometimes tact is all that is needed. In these types of cases, a word with the director about what you had witnessed is more than acceptable. Just to note, I would do the same if it was a physician on the attack.

I don't think it is conducive to anyone's cause, be they a physician or an advanced practice nurse, to bash either side. Every profession has the good, the bad, the ugly, and the excellent. Hopefully, evidence-based research will prevail, and not personal commentary.

In the hospital, intravenous delivery systems usually become detached from the patient by way of A) them purposefully pulling it out B) the patient or healthcare worker accidentally yanking on it and dislodging it, or turning/moving the patient and having the same outcome. C) getting caught in the line, for example a family member tripping over the tubing In order to know how prominent this occurrence is, you would need to check the evidence-based literature. In my experience, I've never seen it dislodged at the pump, or have ever seen the tubing break. I have only seen the catheter pulled out, which means it is still connected to the tubing. The best way to fix the catheter to the patient would be a brace of some kind, however this is the problem because the big, big worry is pressure ulcers. Therefore a brace can not be a substance that will compromise the skin and tissue beneath. The only way I know of ensuring the catheter does not get pulled out is to wrap the site with gauze and/or netting. Hope this helps!

Once you slide that sterile hand under the teg, it is no longer sterile. When you go on to reach for the wand and/or gauze, you have contaminated your field, and the new dressing preparation and supplies. The above comment by sslamster is correct.