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ortho neuro detox nurse, new tele nurse

Content by locolorenzo22

  1. locolorenzo22

    Lost very important paperwork. Am I in trouble?

    i did this as well, realized it as I went to chart blood at end of shift. Called the blood bank, they sent up a duplicate, and I filled out the info best that I could. However, the nurse that signed it that night had left already. I notated that the blood was witness by this RN, and this form was a duplicate. knowing that if it ever came up, there could be a problem. But Honesty is a big part of the profession. Admit it asap, and do what matters to make it right. You know you'll never lose it again!
  2. locolorenzo22

    Balancing safety and time management for a new nurse

    Oh, I remember those days. I worked a unit just like yours, we got everything except hearts we joked. It takes time. Question: 8 and 9 oclock meds? why can you not give them together or at 0830 or save yourself time that way? In terms of assessment and vitals, I am going to say you have GOT to do that ASAP. say you leave it for later and then something changes. how do you know what the baseline is? But do assessment with med pass and vitals, get em all done together. Medication wise, you have to study the most common meds for your common patients and get those down. I found a small 1000 common medication book at barnes and noble and it was a lot quicker than the computer. With no aide at night, I would NOT leave your patient in the bathroom, if you do and they fall, you'll quickly be found at fault if you were in doing another assessment as you weren't really "watching" for that light. when you push through assessments, make sure to let your patients know that you'll be happy to talk with them later....when you have time. but make sure you go back and talk with them soon. with those @#$@#$ phones, if it's trival, you just have to take a hard stance if management comes down on it and say, "I am getting my medications. the Joint commission and numerous studies have shown distracted nurses make medication errors. Do we want a culture that allows that here?" and just grow a tough skin. If the patient's call about that stuff, let them know you will be there as soon as you can, but they will have to wait. When everything has to be done "right away" and when my co-workers are often busy pushing through this beginning of shift rush as well, what can I do? It takes time to set up a routine and get it down. I didn't feel like a good nurse for at least a year. give it time. Also, those "walkie-talkies"? they are in the hospital and they want help because it's there. That's what we get paid for. we see it all in this world. A personal question, but were you a CNA before becoming a nurse? Aides have a lot of skills that we don't always see. perhaps asking them for some points for vitals or clustering care, etc may help. do you have a preceptor or a mentor that could help? good luck, post back and let us know how things are working out.
  3. locolorenzo22

    We have to COUNT drugs like lisinopril and Claritin

    OP, yeah, our accudose comes up with counts, but I only worry about the serious(red bordered) ones. If they seriously think I have time to count 28 protonix while trying to get meds and work done....they should come up and count it themselves.
  4. locolorenzo22

    Sleeping on the job.

    i have VERY little compassion if I had a confused or agitated patient who, by virtue of having a aide sitter, could be corrected in behavior or agitation and keep themselves safe, and make less work for the staff as well. If they fall asleep, and the patient ripped out a important IV line(think central line), or a foley, or got up and fell and broke something.....BOOM, you're gone! I have personally sent sitters home(after two checks 5 mins apart, and verified by another staff member) for sleeping. You're not doing anybody any good by being asleep! go home, I'd rather know that I need to be in there. just my .02 cents.
  5. locolorenzo22

    Being overly sensitive/overly emotional when dealing with patients

    depends on the situation. You have to show enough emotion to care, but not enough that they think they have to comfort YOU. Hospice cases are tough personally, I find myself doing what I can, being strong in front of families, and running to the bathroom to let it out after being in there for a while. You can't open yourself to everyone, but you'll find the line, it develops with time. good luck!
  6. locolorenzo22

    "Medic" to replace the term "nurse"

    Well, I don't really care about my title....I'm a NURSE! plain and simple. As I always tell my patients, "oh it's great to have a male nurse...we care for you, we help you a lot, and we never get PMS." (don't flame me, it's true!) seriously, I don't get too hung up about it. It doesn't matter, and unless men were the majority, nobody else will either.
  7. locolorenzo22

    I'm becoming discouraged about becoming a nurse :/ How will I get a job?

    two years from now the market will be very different. Last year my hospital hired 2 new grads...this year they're in the market for around 11(last I heard)...not counting the other open positions. You will find work, no matter what you have to do to do it. good luck, use the student forums here at an.com, helped me soooo much when I was in school.
  8. locolorenzo22

    Reprimanded for giving glucagon?!!!

    wouldn't be suprised with the cost issue. Working in the hospital we have a new policy to treat when blood sugar is under 70, and a 20 something reading would have got some Dextrose IV, with some oral glucose if tolerated, and a rapid response code. Good for you for following your judgement, but next time make sure your diabetics have emergent prn meds ordered for this situation, or find your facility policy Before someone has a issue.
  9. locolorenzo22

    What do you say when calling out sick?

    our policy is two hours, although the day shift often calls at 4am a hour before change, which makes it tougher to get someone in. Nites there usually isn't a problem with the timing of call-offs. We can get pull nurses from all over the hospital, if the other floors have a available one, sometimes we don't and you have to suck it up and deal with it.
  10. locolorenzo22

    Stop! I don't want someone like you touching me!

    I've had it happen before, but I just view it as their right, and "hey, I'd rather take care of someone who wants my excellent care."
  11. locolorenzo22

    How to get a nurse to give a quick change of shift report

    I try hard not to give report that is long, but I personally rewrite every report I give before the days come in. For me, this is how I don't miss anything. However, I try hard not to go off on a tangent too far unrelated to what I'm talking about. Perhaps this nurse is just trying to give a full picture? however, if she's just going on and on about things that don't matter....then perhaps someone needs to speak up during the report and say "ok, how about this?" or "Anything major going on?"
  12. locolorenzo22

    Do you have time to give baths?

    wow, 5-10 mins? that's gotta be a record. Heck, sometimes it takes that long for the water to warm up and for me to get some washcloths and towels together. I can usually get one done in 20 mins or so, considering that I "came up" from being a CNA on nights, and often had to do the total care patients on nights. I like to use a little lotion after bathing, and shave the guys(especially if they're on bleeding precautions) and wash hair well. The biggest concern I have is everyone who keeps going back and forth between my/your job. It really is the NURSE'S job to ensure the ADLs are done. I am a firm believer in the fact that the patient care comes first. Now, I may not be able to do it for the first 5-6 hours of the shift, but if I know my tech isn't going to get around to it, or if it is a extremely heavy care patient who is alert enough to make decisions I will ask if they want to be washed up during the day or night....it is their right, in my opinion. I also FIRMLY believe RNs should be oriented to the duties of a CNA for at least the first two weeks of their jobs....and made to work as a CNA while learning background RN info, or doing self-studies, etc on the floor. It really would help some people understand where the hard-working CNAs come from. Don't hold the license/certification thing too highly. I know a lot of CNAs who can't reason it out, because they were never taught. just my .02
  13. locolorenzo22

    advice patient over the phone

    see, I err on the side of caution. Often, discharged patients or patients with problems call up to the floor, and start telling me things like "my mom's heart rate is 120, she has a history of cardiac problems, she feels etc etc etc." and I have to protect myself. I always tell them "I'm sorry, due to the state nurse practice act, I cannot advise you on how to handle this. If you have concerns, I would either contact your medical doctor or come into the Emergency room." You don't want your name coming into it if somebody dies.
  14. locolorenzo22

    Best Chicago Area Hospitals

    obviously I'm leery of posting my own hospital here due to the internet and all, but feel free to PM me for details about my current job/hospital.
  15. locolorenzo22

    Patient Abandonment

    it is very apt to mention this, in this time of staffing cutbacks/funding issues/and hospitals trying to make us do more with less. I am certainly always staff first, hospital needs second. The other day a CNA walked off the unit (14 pts, one tech, 3 RNs) after feeling like she wasn't getting any help. may be true, but if you walk off after 8 hrs of a 12 hr shift, you're certainly abandoning...or does it work different for CNAs since they work under RNs, and RNs are capable of taking over said care?
  16. locolorenzo22

    Is this universal or just my program?

    it's not fair, but that's the way it is. If you don't label, circle, etc. you may make a error even if the number is right. If you got somthing other than ml/hr for a IV pump, maybe you'd misprogram it. It sucks but that's the way school works. I hear ya, I had to try the 3rd time during the first doseage test...I was so afraid I was gonna fail! you do have to look out for number one during school though, so good job on getting through!
  17. locolorenzo22

    Do you bag your bodies naked?

    i think we can all agree we each have our own views on death and dignity, and perhaps the most telling thing is this. We CARE for our patients in our way regardless of where they fall on the scale of life and death. We do what we feel we MUST or what families request. I became a nurse to dignify a person's right to die as comfortably as possible. I'm personally proud to see all the posts this simple question has gotten. Keep on keeping on great nurses, proud to be one of you.
  18. locolorenzo22

    Do you bag your bodies naked?

    no way....leave them covered. If the facility is really going to nickel and dime this way, it won't be long until some funeral home director comments to some obit guy at the local paper and BOOM, big story. It's a dignity issue. I would be really po'd at the person who didn't cover my loved one.
  19. locolorenzo22

    nclex style questions

    two tips: figure out what the question wants you to do. assess or intervene? if there are two opposite answers, often(NOT ALWAYS), the answer will not be one of those.
  20. locolorenzo22

    Dosage Calculation

    total MLs
  21. locolorenzo22

    CNA's that run the unit...advice please!

    if they are on another shift, all you can do is support yours, and inform your CNAs that you will take responsibility if there is a issue with something during report with one of your residents. However, make SURE your CNAs are doing their job....changing patients, doing their tasks, etc. I ran into this before, and let them know that I'm in charge of the residents, not them. If they want to play rough, I'm ready to rumble with them. I started as a CNA, and I know the job.
  22. locolorenzo22

    Please help. Need help with Nurse career project!

    with my expierence, I would be happy to answer questions for you here in PM only. looking forward to hearing from you.
  23. What a common misperception. Here's the deal: I worked nights on a orthopedic/neuro/detox/medical floor. Often, baths were left for our techs, meaning they were tied up for 30-45 minutes at a time with one patient, while perhaps we were getting a admit, or having to answer lights, or trying to do more with less staff. people can't sleep in the hospital, so they think up reasons they need more. and families often want more at night or EXPECT to stay in the room, even though there is a roommate and there is no room. The thing is: I'm a NURSE, same as you! whatever happens, is the patients get care. sorry if your days are busy or hectic, but suck it up and deal. I get more money cause I do with less and change my life to work nights. Perhaps if you budgeted better, money wouldn't be such a concern?(sorry but it burns me up.)
  24. locolorenzo22

    Pin Number & HIPAA

    we do the same last 4 digits of their acct or record number, but we usually ask the nurse who has the patient to talk to family/etc. Has caused headaches, but I often have to just be firm and polite. If I have the chance, I'll run down, ask the patient "hey, mr x, sue y is on the phone, is it ok if I talk to her about your care?" and then go back(but that is a VERY rare day)
  25. locolorenzo22

    Question about shift differentials

    my hospital just makes it a simple $5 incentive for nights, no diff during week or weekend.