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  1. JDougRN

    Excelsior Paramedic to RN?

    Does anyone know if Excelsior stopped their Paramedic to RN bridge program? I was telling a Medic friend about it but I can't find info on the site?
  2. JDougRN

    New grad RNs: Do you hate nursing already?

    Actually, I totally blame the hospital for some of it- But SOME floors seem to attract miserable people who really have no work ethic. I moved to the ED about 8 months ago- I love it. The pace is killer, but the people I work with actually WORK- They don't spend 20 minutes complaining about the 10 minutes of work they have to do. It's funny, because the ED has only 2 of these people- #1 Birtha burned-out type who should have left 30 years ago, and 2. Wilma- won't you PLEASE come help me do x-y-and Z? Reguardless of the fact that it took her LONGER to find someone and to explain what needs to be done than it would have taken for her to do it.Everybody else pulls their own weight in a big way- And SURPRISE! the hospital fills short positions. There is no repetative call ins, no "I have a note from my MD that says I'm traumatized because they stopped making my favorite flavor of ice cream, so I'll be off for the next month trying to deal with the emotional turmoil!!! (Although I'm not sure how I'd cope if they stopped making Cookies-n-cream)
  3. JDougRN

    How does Safe Harbor work??

    Most places have something similar- Ours is called an ADO- Assignment Despite Objection. It is a paper we fill out and send to management when we have one of "those" shifts. I basically says we felt we were understaffed or in some other way asked by our employer to have an assignment that we didn't feel safe taking, but that we agreed to do the best we could. It gives us a safety blanket, so if something does go wrong, we have a record saying we TRIED to argue for better staffing , but had to just "Do the best we could"
  4. JDougRN

    Nurses Tell All: What Nurses Wish You Knew

    I don't think that is what was meant-
  5. JDougRN

    Nurses Tell All: What Nurses Wish You Knew

    Ehh- mediocre article at best. Too bad, since it seems like it would have been a good platform to educate patients. Nurse Jackie??? Really? That's the most relevent thing they want to talk about? MY list would include- 1. Keep an UPDATED list of your medications, as well as your medical dxs- There is NOTHING more annoying than trying to figure out what meds a patient takes- "Some white pill for my heart" IS NOT THAT HELPFUL!!!! NO- we CAN NOT just "pull up the records from your MDs office." 2.You will NOT die from constipation or an upset stomach if you've only been having sx for an hour....and NO- if you come in to be worked up, DO NOT ask for a turkey sandwich and cop tude with me because "You haven't eaten all day..." 3. I'm a nurse. Not a waitress. I try to make everyone happy, and if I have a minute (ha!) I will actually ask your visitors if they would like a coffee- but don't EXPECT it. YOU are the patient, and you are my concern-not everyone else. 4. Leave children home, or supervise them when they are there- do you have any idea what kind of yuck falls on the floor they are crawling on? 5. No- it is NOT my responsibility to find you a ride home. You are an adult. Seriously... 6. You are in the hospital because you are sick, and I am very happy to help you care for yourself...but please don't ask me to do things you can do yourself. This includes fluffing your pillow, handing you the remote, and cleaning your tush after you poop! Your arms aren't broken, you wiped perfectly well before you came in...DO IT YOURSELF!!! 7. Standing in the doorway to the room giving me dirty looks will NOT make me move any faster- I will get there just as soon as I possibly can... 8. When you put your buzzer on, and they ask you over the intercom what you need.PLEASE tell them within the constraints of your privacy. If you need pain medication tell them- that way I can get it to you faster. If you need a towel, or need help walking to the BR- PLEASE tell them that. A CNA can do that, and often they don't answer lights because the pt says "I need my nurse..." This will help you, since you will get your needs met quicker. 9.Be civil! Don't order me around like I'm your personal slave for the day. I treat you with respect, a simple please or thank you is very appreciated. 10.If I can't get to you right away, it isn't because I'm sitting on my butt watching TV and eating bon-bons. I'm probably helping another patient, and I will be there as soon as I can.BTW- I can have several other patients as well as you, and some might be very ill-I'm only one person, and believe it or not, I HATE it when I go home feeling like I didn't get to help my patients. 11. We LOVE to hear from you after you go home. Very few things make us feel as appreciated as a short thank you note letting us know we helped.
  6. JDougRN

    Nervous Nurse can't pass CPNE :)

    I'm not sure I'd recommend Xanax before the CPNE- Sometimes the adrenaline and sharpness you get from nerves can be a good thing- Just know your stuff backwards and forwards. Something else that helps- when you are going through that monster 3 ring binder to prep for it- imagine/picture in your mind exactly what you will do from the moment you walk into a patient's room. The difficult part is remembering to stay aware of EVERYTHING you do and say, as well as chart. The best way to deal with it is to drill untill you have all of the requirements down cold-Then act (even if you don't feel it) confidant in your ability to do it. In my experience, the examiners were very nice, and while they were professional, they weren't out to "get you", and really tried to give you the benefit of the doubt. If you mess up one section, regroup, relax, and don't let it get to you. When I did the practice lab (meds & treatments) I was so nervous I mixed insulins backwards- A stupid thing that I've done correctly thousands of times, but I let my nerves overtake my concentration. I had to go back the next day and retake that one part, but that was the only thing I messed up. It is torture- by the third day you feel like a train wreck- when I finished my last patient care scenario and she came back from marking my nursing notes and told me I passed, I LITERALLY burst into tears at the nursing station- and trust me, that isn't something I'm prone to do. It's horrible, but it is passable. Another suggestion is to make yourself as comfortable with the testing site as possible. I actually took it at the hospital I had been working in- it reduces your anxiety if you know where you are going, where everything is, how to work the beds/IV pumps, ect. The student boards through Excelsior are also very good- everyone is in the same boat, and people post scenario that you can use to study from. Let us know how it works out.
  7. Hi guys! Hope all is well in your studies as my future co-workers. All I can say is...It gets better, I promise! The reason I'd like to talk to you is that starting tonight, I'm precepting another nursing student. I volunteered to do this, because I LOVE working with students, and I remember being in your shoes, wanting to know,learn,see everything. I've acted as a preceptor for students before, and I really like it. I have a new student coming in tonight for the next 2 weeks, and I'd like to know, in your opinion, as an ED nurse, how can I give her the best experience possible? I try to make sure if there is anything interesting (code, chest tube, ect) I let them watch, or even get involved within the level of their abilities- but is there anything nursing school is really missing these days, in your opinion? Thanks for the input, and remember- there ARE some of us, even like me, who remember being a student 20 yrs later. You all rock!
  8. JDougRN

    Physician, nurse indicted on drug charges

    Sorry- I'd like a bit more information before I condem the MD and PA. I work with a population that sees a LOT of drug seeking behavior- In the ED, it seems like every third patient is there demanding narcs- some of the stories they come up with are just amazing. The sad thing is, it does cause the prescribers to be very leery about giving pain meds- causing people in actual pain to suffer. There is the chronic drug abuser who has had his "fantanyl patches stolen" I don't know how many times- his answer? "But I made a police report!" This patient is in usually 2-4 times a month looking to get Lortab and Fentanyl- TRUST me when I say wild horses couldn't drag me into his appartement- amazing how he keeps getting broken into. Or the girl who called the ambulance and reports being thrown from a horse at an event- even has a fresh bruise- You'd believe her, right? Untill EMS calls back, and says- BTW- I just checked her "facts" There was no horse show where she claimed she was....Pull up her old records- This is the 7th time she has been "thrown" from a horse. In talking to her, she tell you she has 10 horses.....but then asks for a medicaid cab to be called to get home...Things that make you go HUMMM......Or the husband and wife team who had been there...together the day before. Both had gotten scripts for narcs,...and they are baaack the very next day. Both had "lost" their scripts- after they had filled them, of course. When the ED Doc refused to re-script, the guy got abusive, and starting making noise about killing himself- so guess who bought himself a 12 hour psych hold, while wifey got to cool her jets in the waiting room. NOT happy campers, and as soon as he was sprung, the were found smoking crack in a doorway of the hospital. REALLY? People like this should be put on a nation wide NO NARC list. If the patient averages twice a month ED visits looking for pain meds, they should be told that unless there is a bone sticking out, don't bother to return looking for meds- you will just be directed to a pain clinic. That way people in genuine pain would be able to get help.
  9. JDougRN

    How many fetal demises in a month?

    I've been a nurse for almost 20 years. One of the biggest things you can come to accept as nurses****Wisdom incoming here!*** We often can't change an outcome. BUT, as nurses, we have the position, as well as the power and training to be able to make what is often the worst time in a patients life, and make it a bit easier to bear. Dealing with IUFDs or babies who are too pre-term to live is tough, but some of the times I've felt most like a nurse, was taking care of Moms who had lost a baby. You treat them with dignity and careing, can show empathy/sympathy, and make it easier. Does it make us sad? YES. Do we sometimes cry right along with our patient? YES- But hearing your nurse tell you, "I'm so sorry for what you've gone through. I'm here to take care of you through this difficult time, and if you need someone to talk to, I'm here." This can make all of the difference in the world.
  10. JDougRN

    Companion Animals

    Email me- I am in the process of setting up one of these programs at my hospital- JDoug71809@yahoo.com
  11. Cardioversion is usually a small "shock"- usually 30 joules. It is used to try to convert people who are in an uncontrolled atrial fib into a NSR. Defibrillation is done during a code situation when a patient is in PULSELESS V-tach/v-fib, and can require a much higher shock. Pt.s can be in V-tach with a pule- then shocking the pt is not indicated.
  12. JDougRN

    BSN vs. RN Salary

    Most hospitals I've seen usually pay a small difference- I've never seen more than $.50 an hour difference. It is sad, since they push for BSN nurses, but don't really want to pay for the work we do to get it. You do have better opportunities for more jobs- In my hospital, you have to have a BSN in order to apply for anything other than staff nurse- Clinicians and NMs have to have it, and most NMs have to be pursuing theis MSN.
  13. JDougRN

    MD's scribble, and Nurse's bad grammar - room for error?

    Actually, once you have been working for a while, it gets a lot easier. For starters, once you get some experience, you get a better idea of what the Doc will order- If you are working with the same Docs, you get to "know" their writing as well. We do occasionally have to have "huddles"- a group of nurses and secretaries going word for word trying to figure out one- so when in doubt, you can alwasy ask the charge RN. And if you have no clue, you just have to bite the bullet and call them for clarification. I've been doing this for years, and rarely do they give you tude about it- If they get snarky, all you have to do is remind them that they are responsible for writing LEGIBLE orders. If I have a Doc that I know I often have trouble reading their orders, I usually try to grab the chart after they write orders, but before they leave the floor- that way if there are issues, I don't have to call them-I have a bit more trouble reading the progress note than I do orders- some of THOSE are impossible, and it can be frustrating. Good luck!
  14. JDougRN

    add future employer on facebook?

    WOW! In all of the years I've been reading posts on this site, I've NEVER seen 100% agreement on an issue. I have to add that I agree with everyone else- ALWAYS keep your FB seperate from your work. Just keep calling them every so often to "check up" on the status of your application. I honestly believe that is how I got my first nursing job- I kept pestering the HR woman untill she gave me the job- I'm sure it was in part so I'd stop pestering her...BUT- I was the only one who had a full time job offer at graduation, so it must have worked. Good luck!
  15. JDougRN

    Door to ct time for strokes

    Our Ed is in the hospital that is the "Stroke Hospital"- We have a really great MD who runs it- We have stroke guidelines- anyone suspected, we as nurses can call a stroke alert- Immediatly EKG, LAB, MD shows up to do what they need to do, and usually we hit CT scan within 10 minutes, unless the pt. isn't clinically stable enough to go- I believe stroke alerts are called a bit too often, but we have a specific set of guidelines to folllow- I've been in our ED for just a few months, but have given TPA to a 60 yo pt. who presented with total right sided loss, and was moving/feeling the right by the time I got her transfered to the ICU. It was amazing- we even have a seperate "sheet" on our computer charting- If a stroke alert is called, we have to document ime of arrival, time called, time RN was in, time MD was in, time to CT scan, ect. It's pretty impressive. Go DR. Brehaut, lol!