whitecat5000

I find that the only times I want to find out how someone is doing after I have to upgrade them, or now that I work in the ER, after I admit them; is when I feel guilty. I truly might have given it my all, but sometimes I get those nagging questions of "what if." What if I noticed something faster, or called a doctor sooner, etc. So I try to keep reminding myself that I'm doing the best I can and that's all I can do. It also helps to tell myself that I will learn from the experience and that it won't happen again.

I'll say an amount. I owed $25,000 after four years at a university. I have a 20 year repayment plan. I would say as a side note to make sure and pay them because the do not go away, even with a bankruptcy.

Yeah, she was admitted because there was pain with urination and she kept passing quarter sized clots with much difficulty. Thanks for all the feedback everyone!

So back story. . . I had a 32 yr old female patient that was a direct admit around 2300 for hematuria. We call the doctor and get orders for a CT abd/pelvis w + w/o contrast, insert three-way and irrigate PRN, and CBC. So CT calls and says they need a pregnancy test and a CMP to check renal function. I am about to call the doctor when the nurse I'm working with says, "Oh don't call that doctor for things like that at midnight. Just put it in, he would order it anyways." Of course I don't, but she puts it in anyways (which I don't care to be honest because it has her name all over it, and the patient needed it anyways). The patient gets the CT done and the doctor comes in at 0530. The doctor said, "Thank you for just ordering those and not calling me. I hate to be woken up for stupid things." So ignoring everything else wrong with this scenario (and there's a lot), how do you all manage to figure out these idiosyncrasies? For instance, I have a doctor that if you do call him after 2200 for Cepacol he yells, and another one that will yell if you don't call him. I can't figure it out. But since prescribing is outside my scope, I just call always, get yelled at (or don't), get my orders and go about my business.

I'm not saying that the nurse caused sepsis. I'm saying the nurse didn't see the alert and transfer the patient to the appropriate level of care as she should of, and as it should have happened.

I don't know about that. I followed an experienced nurse with 32 years on-the-job who was not very proficient with computers and didn't see the Sepsis Alert notification form because she says she's "old school" and doesn't use the computer much. The patient ended up being transfered to ICU with a bp of 64/22 at shift change. Not saying that all experienced nurses are like that though. I think that we need to look at the individual for how well they are doing their job and not how much experience they have or how old they are. Experience and/or age don't necessarily correlate with competence.

I have a low tolerance for incompetence. That's why I like working night shift. Less people means less incompetence. "Oh. Did I just draw blood from a fistula?" "She's not responding; I think she's just tired" ::head desk::

You have a hard time checking if your patients are A/O X4 at 0200. "No sir it's not Tuesd... Oh wait, no, you're right." You can see in the dark better than most.

Thanks for the responses! I have my ECG, ACLS, BLS, and PALS. I can't take my med/surg cert or gerontology cert until August 2013. I've just become part of the SuperUser team, Skin/Wound team, and Shared Leadership team, and I'm taking steps to become a preceptor. I'm also going back to school to probably get a Bachelors of Science in Psychology. I volunteer to float a lot to other units. That way I can learn new things, and try and remember old things. I work nights, and I don't want to transfer to days. Even though I might see more and learn new things, I work best without constant supervision. I'm the type of person where if you give me direction and orders, I'll make sure it's all done, and done well. I guess I was worried that something was wrong with me because I've never had a job where I felt this bored. And I guess I feel a little disappointed, because I was hoping that I would never be bored in nursing. That there would be new thigns to learn and new things to do always. Ah well, I shouldn't complain so much. I have a job and I'm content. I guess that's better than most people.

So like the topic says, I feel like I'm in a rut. I've been a nurse for a year and a half and I've been a med/surg nurse that whole time. I feel bored. We don't get a variety of patients, and they ones we do get seem so predictable. Even when they go into afib in the night, or go septic, or c/o chest pain. I know what to do and get my patient's their tests and transferred safely. Oh, a cellulitis patient? Well lets give Vanco, dressing changes, and measure the area every shift. Oh, a back pain? How about some morphine q 4 hours and colace BID until the doctors diagnose you with something. COPD exacerbation? Have some Levaquin, Solumedrol, oxygen, and breathing treatments. UTI? Measure vital signs to check for sepsis q 4 hours and here's some Levaquin. Is this normal? I started as a new grad in a hospital that was like county. I did everything, learned a lot. Now I work at a big chain hospital and I do nothing! Dressing changes? Call the would care nurse. Breathing treatment? Call respiratory. Central line dressing? Call respiratory. Need a new IV? Call SWAT. Anyone have any ideas? I really love to learn, and I feel so stuck. Should I try a new specialty? Just look at things with a new attitude? I don't mean to sound snobby or condescending, I just can't figure out why I'm bored. I haven't even been at this for two years. I shouldn't be bored!!!

I'm the sepsis/declining patient queen! I can figure it out before the computer (though I wish the docs would believe me more.) I transfer a patient on average at least once a month (I work Med/Surg.)

I use Mint.com to help manage finances. I love it because I can list when my bills have to be paid, how much, and I can set a budget. It pulls charges from bank accounts and credit cards and automatically sorts them into proper accounts. I think the first step to money management, personally, is figuring our where all the money is going. I'm a single new grad with no kids, with new grad pay, with a house, car, and loans and I manage to save about 10-20% of my monthly income a week for emergencies without working overtime. Good luck!

Degree type: Bachelors Graduation month/year: 05/2011 Sex: Female Age range: 19-24 Job Setting: Hospital Geographical Location: Arizona Race/Ethnicity:Caucasian How long have you been looking for your first job before being hired? 3 months Did you do any volunteer work before your job? No Did you possess any additional certifications (i.e. ACLS) before you landed your first job? ACLS, PALS Did a family/friend/clinical instructor or other connection help you land your job? No Did you work in the health care setting at all before your job? If so, what field? Yes, Pharmacy technician Did you apply online, in person (at the facility), or other? Explain. Online Did you participate in any follow-up inquiries after resume submittal of your application or interview? If so, explain. Email, phone call? No How far away do you live from your job site? Include minutes/hours. My first job - 3.5 hours and 2 counties away; My second job 45 min away Did you hold a p/t or f/t job while enrolled in your nursing program. If yes, list whether it was p/t or f/t position: p/t Pharmacy Technician If you held a job during your nursing program that was not related to the health care field, please report the general field in which you worked (restaurant, retail, educational, business, etc.) Feel free to expand: Finance Manager at a Sales and Marketing office Did you receive any scholastic honors while in nursing school (Dean's List, Cum Laude, etc.?) Dean's List, Magna Cum Laude, Sigma Theta Tau, Nominee for Outstanding Graduate of May 2011

We have a facility policy regarding Heparin that explains when to check aPtt, when to bolus, etc. Did you check to see if your hospital has one? It could be different per hospital.

It's the same with the Accu-chek machine. You get a sugar of 482 and then recheck it and get 246. Both numbers will populate in the computer. But if you look it's obvious. "What?! 482?!. . . oh a recheck five seconds later with a 246." Just because you chart both sets of vitals doesn't mean you have to call the doctor on the crappy set. If the aide had charted both sets, it might have alerted me that this is someone that I need to keep my eye on more, or recheck their vitals myself. I guess my main pet peeve was that they set the patient all the way up to high Fowlers, then retook the blood pressure, and set the head of the bed back down. Wow, way to elevate those vital signs there.