flip/flop

Yes, I believe there is research that insulin is about the only drug that adheres to the tubing, requiring a second flush. It is a high alert medication, and requires its own line per our protocol anyway.

New policy on my unit is to hang all ATX using secondary tubing, back flowing the tubing, then setting the volume to 20 ml greater than the volume in the spiked med. The rationale is that this will insure the patient receive the total volume of the antibiotic, rather than leave some of the infusion sitting in the secondary tubing. It is ok to use the same secondary tubing for antibiotics that are compatible. If running incompatible ATX, a second primary solution, and piggyback would need to be set up. Though there is no official policy yet, on using secondaries, I have heard that in the ICUs in my hospital they have been using the back flow technique for years, but even take it a step further. In the ICU, they only use one (1) secondary tubing set, and infuse all meds through it, compatible or not, as long as they are compatible with the primary solution. Once the secondary med is empty they back flow the primary solution into the empty piggybacked bag, thus flushing the secondary tubing. This allows the RN to administer any medicine, compatible or not, even colored infusions such as iron, using the same secondary tubing, as long as the med is compatible with the running primary. We run all drips, heparin, insulin etcetera separately. This practice is only used for intermittent infusions. Do you agree, or see any issue with using the same secondary tubing for all medicines?

I would have requested a psych consult, if they were not already following.

That board has to be the dumbest idea ever, if someone has time to post a "star" by someones name, they well off have the time to go answer a call light. It is usually a request that can be fulfilled by anyone, if not, get the nurse. If you see a call light on and have down time, answer it. It is just good customer service.

Yes, she needs to be reminded of her job priorities, maybe pull up the application that specifically says what a CNA is responsible for. At my facility it lists CNAs are responsible and accountable for accomplishing identified clerical tasks and patient care activities as delegated, directed, and assigned by licensed nursing personnel for the achievement of patients plan of care. Everyone is responsible for saving lives, from the RN to the cleaning staff. Each person has a part in the care of the patient. It also may help explaining why you are asking her for what you are. Blood glucose monitoring is important for many reasons. If it deviates too far from the therapeutic range infections and death are possible.

It would be best to speak with an adviser or admissions councilor of the school being applied to as programs vary.

How about Case Manager. They always leave notes in the chart, "Patient sleeping, did not want to disturb. Will check back tomorrow." ......Seriously?

Clarkson prepares you for boards. Progressing through the program I had doubts about it, but upon graduation I knew why things were the way they were. The instructors are very helpful. Many of them are still in school themselves, so they are understanding. I don't have an opinion of the other schools because I do not have any relevance with them.

Have you worked as a tech? I too had second thoughts as I was finishing my pre-reqs. So I worked as a care tech while completing them. I got a grasp of what the profession is like and it helped me decide, yes, I want to be a nurse. At graduation an instructor told the class that, "nursing is not a job, it is a ministry." I believe that to be true, and love my profession. It is not one for everyone, but anyone interested can certainly find their place. There are multiple areas of practice. I work med/surge, on a very fast paced and high acuity floor. You are constantly moving and have to use critical thinking a lot. I'm new, and learning everyday, and love it. Your possibilities are wide, bedside nursing, OR, emergency, clinic, too many to name, you can even work behind a desk. You have to think about the type of person you are. If it is what you want to do, that decision is only the beginning of a long journey. I never wanted to work in med surge, but ended up precepting on a med surge floor because I had been told, I would learn a lot in preparation for boards (I did, and surprisingly I really liked med surge). Anyway, do not rush yourself, and best of luck.

Acute pain RT original post AEB headache

You need to speak with an academic adviser at the nursing college you wish to attend. They can tell you exactly which classes you need to take. If you do not know of the school you will be applying to, talk to an adviser at a college near by, most of the prerequisite classes are similar from program to program. The amount of time it takes to complete prerequisites for a BSN is roughly 2 years, I am not sure how long for a RN or LPN, so you should consider which license/degree you will be pursuing.

I paid for Kaplan. Other than that I would suggest answering as many practice questions as you can and familiarize yourself with the medicine classes.