lucyshuman

I have a question for those nurses who are currently using e-mar scanning to administer meds in PACU. How is it working for you? Our unit "goes live" with e-mar scanning next week. We will not be allowed to go back and document, all VS and meds must be documented at the exact time given. Sometimes I am up to 30 minutes (or more) behind on charting if the patient is high needs or unstable. I am wondering what other nurses are doing in regards to e-mar scanning. Thanks in advance for any information you can provide.

It's been so long since I started my first job that I can hardly relate :). But I have oriented many new nurses, and here are some tips that I hope you find helpful. First of all, you are absolutely correct in being intimidated about the sheer volume of work and the short orientation. Let your preceptor know this! Nurses appreciate that their co-workers care about doing a good job. Tell her/him exactly what you have posted here, that you have no health care experience, and that you are unsure how you will get all the work done safely. This helps your preceptor know where your mindset is. Next, don't be afraid to ask questions. When I am teaching someone I would prefer to review something umpteen times, rather than find out later that something really important was not understood. Next, ask your preceptor and other nurses who work there what kind of tips they can give you to help. Ask about specific things such as the med pass and general things such as the flow of work throughout the day. If you ask nicely someone may be willing to write down a list of things. Sometimes I will make up a "Top Ten" list for people. Learn as much as you can during your orientation, but don't get so stressed that you can't concentrate on anything. I can tell from your post that you want to do a good job. Make sure that your facility provides you with the tools (an adequate orientation period) to do just that.

Many years ago when I was in nursing school a classmate came to me in a panic. Our frazzled nursing instructor told her to "Put 10 drops of this into orange juice and go give it to your patient". The student did as she was told. Then my classmate came to me, clutching the bottle from which she had given the 10 drops of liquid. It was labeled Potassium Iodide on the front, and displayed a large skull and crossbones on the back label. The poor girl's hands were shaking and she wanted to know if I knew anything about why our nursing instructor would tell her to do this. I told her I thought I remembered something about avoiding thyroid storm with iodide, but I wasn't sure. I told her that she needed to contact our instructor right away. Our instructor carried a walkie-talkie so that she could stay in contact her students, and everyone on the floor (including the patients) could hear bits and pieces of our communication. So my classmate goes to the base unit and yells "Mrs. Walker, come quick. I think I may have just poisoned someone!" Within about 10 seconds all the call lights on the floor were going off!

Here are some things for you to think about, in addition to the good points that everyone else has brought up. I have never been a teacher, so I can't speak to that portion of the equation. But my sister is a teacher, and we speak almost daily about our jobs, including the frustrations, the high points, the concerns. I never cease to be amazed at how parallel our jobs are in many ways. For instance, much of how we do our jobs in nursing is dictated to us by administration or the government (Medicare regulations, reimbursement, and SCIP project). In nursing, one patient can use up a huge amount of resources, time and energy, often with a less than desirable outcome. I believe both of these situations could apply to your students and situations. So you may just be trading one frustration for another. Here are a few more things to think about. First is job security. Once you are tenured into a district, your job is secure. That is not necessarily true in nursing. Nursing wages have risen rapidly over the past 10 years and as a result many administrations are looking for ways to "off load" the more experienced and thus higher paid nurses. Mind you, these nurses are not being fired directly; there are more subtle forces at work. Another thing you should consider is retirement benefits. If you become a nurse, there is no pension. Most companies contribute a minimal amount (2-4% match to a 401k), but for the most part you will be funding your own retirement. Along these same lines, there is no defined early retirement for nurses like there is for teachers. You work until you drop or until you can afford to retire. I 'm not trying to be negative, I'm just trying to give you some more things to consider before you make a decision. Best wishes to you in whatever you decide to do! Lucy

Hello, I see it has been a month since you posted this, so don't know if you still need this information. I do know about the Pine Ridge Reservation. I applaud your ambition to enter this kind of work, but there are a few things you should know. First of all, if you are a big city person you will find this area of the country desolate. It has its own beauty, but it is hours from any even moderate sized city. There is some housing provided, mostly for the physicians. This housing is on a restricted/fenced part of the reservation due to security concerns. Most of the people who work at the hospital live in the small towns outlying the reservation. The need for health care is great, as you will be serving one of the most destitute areas in the country. Alcoholism and violence are a way of life. The Lakota Sioux live very difficult lives. Having worked with this tribe for much of my early nursing career, I can honestly say that it was also the most rewarding part of my career. I learned something new every day. I was appreciated for the care that I gave. I know that I may be looking back with rose colored glasses, but I really did feel like what I did made a difference in people's lives. Good luck to you.

I'm unclear what is making you so upset about this situation. Is it because you feel you did something wrong? Or is is because someone didn't want you to be their nurse? You did a human thing, got sidetracked and forgot to go back and do an initial assessment. Did you ignore this patient on purpose? No. Did you in any way harm this patient? No. Accept that from time to time you will slip up on the job, and be glad that something important didn't get missed. If, indeed, the patient was "one of your own", they should be grateful for the same thing. They should not go out of their way to make you feel awful about yourself and your profession over something so trivial. A real professional would have welcomed the opportunity as a basis for teaching, not as a way to make you feel bad about yourself. Best of luck to you, and you can be my nurse any time!