lrobinson5

In epic when you chart on your care plan it generates a generic note that you can modify. I put most of my narrative charting in that note since it backs up what you're doing for the patient to meet their goals. I use progress note to put anything else important in it (change in status, critical labs, things that people need to know regarding discharge etc.) They can't tell you not to do a note, but they are right to make sure all employees are aware that patients can read all of the notes. Be mindful of the language you use, state facts, all that good stuff.

There is an associate infection control certification that can be taken by anyone, and it at least shows potential employers that you have a working knowledge and interest in the field. That being said, it does expire, and cannot be renewed because it is meant only as a jumping off point to become fully certified with a CIC. It does seem a bit tricky to enter the field, but hopefully that gives you a little more to research and see if you're interested. Good luck! https://www.cbic.org/CBIC/Get-Certified/Get-Started/a-IPC.htm

You are right! I am thinking under my current hospital's rules, but another hospital I worked for had the hour rule.

Both nurses are incorrect. At least where I work you can't give two pain medications at the same time unless one is scheduled and the other is as needed. The other thing is that you technically can't give the Norco unless the patient is reporting moderate pain (usually 4-6) according to this doctor's order. So the proper action is to give the Dilaudid (assuming it hasn't been given in the last 2 hours) and reassess pain in 30 minutes. Then you could administer the Norco if the patient is reporting pain 4-6.

As a former cashier, people hand over pretty gross money. Sweaty boob money (and money from other inventful places) is common, and can scar your psyche. Even if you could wash your hands immediately after handling it, wouldnt you wish you had gloves on to do it? I'm sure they wear them all the time so they can avoid offending someone by putting gloves on in front of them to handle their money. I think gloves AND sanitizer are a great idea.

Are you applying to ANY hospital nursing position? Many students seem to lean towards specialties, and I often wonder if the reason it is so hard to get hired is because people are only applying to ICU, ER, L&D, (insert anything other than med/surg í ½í¸‚). Good luck, -Leslie

Total failure of the safety net that was supposed to be your preceptor. There is no way in hell I wouldn't step in and teach what to do in the event of a hypoglycemic patient. We have a very standard protocol when a patient's blood sugar falls below 70, and I wouldn't expect even a seasoned nurse to know exactly what is expected. There are specific ways and places you have to chart and you also HAVE to call the on call MD to discuss upcoming insulin doses as well as a review of the IV fluids. I would imagine that most people would hold the long acting insulin just because hypoglycemia presents a much more immediate threat than the possibility of hyperglycemia later. In my opinion, that is something the doctor should decide. If it were me I would hold the medication until the doctor gave me the go ahead to administer. If you are in trouble for this I can't imagine that the other nurse is going to walk away either, not that it makes your situation better, but they are making you feel solely responsible even though they have to realize they messed up too. I am sorry that this happened, it wasn't a good experience for anyone involved, and I hope that they do try and make this a learning opportunity for nurses and PCAs on the floor. The only other thing I can say is many people have different presentations for low/high blood sugar. Some people only start to feel off when they are dangerously low, while others are completely out of it the moment they drop below 70. It isn't good enough to just ask how they're feeling, you really need to check their blood sugar to make sure they're out of the woods after an episode like this. Good luck to you.

I went to Cal State Fullerton and had a good experience there. The grading system has the downfalls of any school that gives +/- . It's possible to get lower than a 3.0 overall if you get too many B- or lower grades. I still think it is a good program though, I earned the grades given to me, and wouldn't want an 'easier' program just for a higher GPA. Good luck!

So for people using break buddies is there not a charge nurse on the floor to relieve nurses for breaks? Or is it not common for them to do break relief?

Strong unions and persistence is key for staffing ratios. You think the hospital lobby didn't fight tooth and nail against mandated increased staffing? We usually have 2 CNAs for a unit that can go up to 30 patients (telemetry) but when you have a 1:3/1:4 ratio it really makes a huge difference. Yes we do more total care, but we also have more time to think, prepare meds, educate, and of course chart. Occasionally not having a secretary is sort of a bummer, but I honestly don't know how nurses handle having 7+ patients!

Just so long as it doesn't belong to the facility there is no problem there. I would say if you are uncomfortable with 'giving medical advice' or 'prescribing medications', just make the bottle available to them so they can read and dose themselves.

What area of California are you in? Also, have you taken any college courses, or are you fresh out of high school?

I live in Southern California and hopefully can help with some of your questions. Right off the bat when you said what your end goal was I thought of CSULA and their ABSN program. They guarantee an interview for the NP program and heavily favor their own students (that are in good standing). I know this because my husband is about to graduate from there. If you need any tips on prerequisites just shoot me a message, my husband was able to complete his prerequisites quickly.

The hospitals just don't want to hire more RNs, plain and simple. We're managing over here in California. No mandatory OT, mandated breaks, and state mandated ratios. There have been times where the clinical nurse manager comes on the floor to take patients when we were very short, but it is much better since the last hiring wave. I think this is a huge problem for LTC (I remember reading a lot of people's complaints about this happening) but this article looks like it is focused on only hospitals.

I think if you word it in a way that shows your concern for her she MIGHT take it better. I think the type of person that pretends to be a nurse is probably one that will get really annoyed by someone calling them out on it, regardless of how nice you come across. Good luck

Do you think your current job will be flexible enough to attend an RN program? The one benefit I can think of with the hospital schedule is that it might work better for school, unless you are able to not work while going back for your RN. While it would be somewhat helpful for nursing school, the med/surg experience is not necessary. A lot of people have no prior medical experience and they do just fine.

No, she is shifting blame on to you to try and cover up HER medication error. She has working eyes and a brain, she was just in a rush and/or not paying attention, which is not your fault. You would be surprised how many people blindly follow what the MAR time says, which is a VERY bad habit. Enoxaparin often will double dose someone because they receive a loading dose in the ED and a different daily recurring dose to follow up the day after. Sometimes it doesn't show up the day after, but instead shows up for that day. Antibiotics are sometimes given late, or they change the dose but the start time is way too early on the MAR and is a med error waiting to happen. Like it would be nice in the future to re-time it as a courtesy, but by no means was this your fault!

You have to be extremely careful to disclose everything on your record, or like people said above it will look like you are lying on your application. I know someone that was permanently blacklisted from a major hospital chain for not disclosing something on their record (nonviolent, not drug related). Even people that make honest mistakes are thrown under the bus, it is what it is. I agree that you should call and try to head it off before they get contacted because the background check found something that wasn't disclosed on your application. Also, while there is much to be said about the wrongs of the for-profit prison industrial complex, mentioning it when talking about your previous record does not give off the impression of someone owning up to their past mistakes. It must be frustrating to constantly have to explain yourself, but employers and schools do not want the suggestion that it wasn't a big deal (trumped up charges etc.) because to them it is ALWAYS a big deal. Especially considering it is drug related and you are going into anesthesia. Good luck to you.

I really think I want to go to WGU. As for why I'm not mentioning the many other programs in SoCal, West Coast has more start dates and the price isn't too high (convenience and timing play a large part in this, not really the online aspect). I didn't include this information before, but I am also trying to go to school with my husband at the same time who is just graduating with his BSN. This limits him on what programs are on the table. Honestly, the more I talk about it the more I'm leaning towards WGU. We'll save money on the MSN and give him time and experience as an RN, which I think will benefit him more than entering any program at this point with no experience. For a post master's after WGU I would consider a lot of other programs (APU, CBU, and LLU are all in my immediate area just off the to eat of my head).

Every travel nurse says contracts in California are the best. I also think you should try it out before moving. It will give you a good idea about the actual cost of living as well as the work environment. You can also show them what a great nurse you are and get hired at a hospital you like. Good luck!

Maybe it's because you don't do it as often as shots? I used to shake like a leaf when starting IVs but I only seemed to notice it was really bad after I got blood return. Maybe because I was worried that I might still mess it up, or maybe I was concentrating so hard on keeping it together and doing it right that the second I saw the flash I relaxed and then the shaking surfaced, who knows? I hope it gets better, but I agree with above, go to your doctor for a medical opinion.

It really is amazing that only one state has been able to pass mandated ratios. I can't even imagine what nurses in other states go through. Almost every traveler that comes through the hospital (in California) is flabbergasted that we can't go out of ratios for lunch or 15 minute breaks, to the point that you will be paid extra for a missed meal or break if the charge nurse has patients and can't relieve you. I really hope it passes! If they want the nurses to decide safe staffing levels, ask the nurses to decide what it should be and then mandate it by law!

Becoming a nurse was the best thing I could have done for my family financially. There are definitely difficult days, and always more than enough work to keep you overtime. Bedside nursing is a physically and emotionally draining job. I like the organization I work for. They expect a lot out of their employees, but they also offer very good compensation. I realize that I am super fortunate to work in California and I don't plan on leaving. I am looking into the MSN/FNP to transition into a new role when I can't do the more physically demanding bedside stuff. Being a nurse educator is also on the radar because it is something I enjoy. Not everyone wants to go on to graduate/post-graduate studies, and I can agree that you have to find a niche because bedside nursing can prove to be too demanding for a lot of people. I have a friend that became a case manager for a large insurance company. They work(ed?) while traveling across the country in an RV. There are so many different jobs out there, I hope you find something that gives you a better work/life balance.

After being away from Allnurses for a while, went to my activity and found my last topic was this thread. So an extremely late update: I got the job I was interviewing for! You're all awesome, thanks so much

I still am wondering if the MSN degree has a bad reputation. Most people have strong negative feelings about the BSN program that I think carries over to the MSN. I mean, it has regional and CCNE accreditation, it can't be that bad. On the other hand, I guess it doesn't matter what accreditation the school has if the people out there hiring think it isn't a good program.