Stcroix

Not a normal scenario for me. I been a preceptor for many young nurses. I would have them an average of 10 weeks. Then they were on their own on a floor of experienced nurses who are mostly glad to help. That's how I was trained but other parts of the country may be different.

why is this even a question. daily of coorifice

I was a seasonal nurse. had the flu once, called off for what turned out to be hospital acquired pneumonia. was admitted to my own hospital, visited by my manager and many co-employees. when i returned 4 weeks later after acute kidney injury a c-diff, my manager said i violated my seasonal contract and could leave or work at beginners pay, thank you very much. said hospital lists retention as their biggest problem.

I replied to this topic years ago. I tried at least 10 different types of shoes. In the last two years of my career i found Hoka 5, a running shoe. Lightweight, well padded, and protect my arthritic feet. Like it has been said, no one shoe works for everyone, but I am a happy camper. oh yeah, they last a year on the floor.

i average 15 home case manager

I worked a while for Hospice.. We used sub Q to administer morphine on a continuous drip. The rate need to be very low (in volume). Sub Q injections by their very nature go into spaces that don't exist, they 'make their own space'. I have never seen a sub Q site flushed, heparin or otherwise, it would do damage to the skin. In fact, SubQ sites go 'bad' quite quickly, often the site is changed daily. We used a tiny TB type needle mounted on a plastic base that adhered to the skin by a peel off sticky base. Maybe the OP was seeing a type of true IV, and of course flushing would be done. As a hospice nurse I never used a peripheral IV. I would on rare occasion access a port or Picc if the patient came with it.

So glad it worked out. yes, they are nice folks

Many good points made here. The one I haven't heard much about is the patients. I know that at 4 weeks in if I had been cut loose on my own my patients would have gotten to short end of the stick. I don't think they were in jeopardy because I would ask if I didn't know, but because of being in the 'deep end' so early (especially on a tele floor) I would have very little time to spend with them. At four weeks I was so inefficient that common tasks took me twice as long as they should. Heck, I barely understood where things were on the unit. No, four weeks is not adequate at all. Only you, OP, can decide if you should go for it.

I agree. Like many of us, I have had more alcoholics than I care to remember. Currently, the approach in favor is to detox ALL of them using benzos and (hopefully) prevent seizures. There is also a prevailing sense of urgency among the nurses and the doctors to discharge them ASAP before the magic 3rd day where severe withdrawal tends to occur. I for one just don't get it. We know the vast majority of these folks aren't going to quit drinking, so why even try? It makes much more sense to me to keep withdrawal at bay with the poison they came in with, address their other medical problems and discharge them back to their lives without try to be virtuous and detox them. Unless of course the patient expresses the wish to attempt detoxing.

Good people, even better community of nurses. I worked in the home care end. I felt comfortable and welcome. They look for you to do 4 visits a day, occasionally a fifth on crazy times. You are well supported. Docs are great, available, down to earth and willing to support the nurses. Good luck!

Ok, I guess I have to chime in. If you want it, really want it, and you are physically fit- then go for it. I graduated at age 60 and am now in my 4th year. I spent 3 years in cardiac- med surg and am now with hospice. I might go back to the hospital. I am healthy, physically fit and work alongside and even train the 20 and 30 year olds. But like everyone says, it is a demanding but potentially rewarding occupation. I always love it when the youngsters complain about how tired they are at the end of the day, validates how I feel! Yes, it's only a number but be realistic about your physical abilities or you may find yourself well trained but not able to hack it.

This week I got a new patient, a very sick fellow. He is an alert and oriented walkie talky with serious problems.. He was just sent home from a cancer center where he got the news "we cant do anything more for you" He has been fighting bladder cancer for a year. He now has 2 nephrostomy tubes, an ileostomy,a peg tube for decompression because his bowels are completely blocked and he was vomiting. The decision was made to run TPN into a port. I have not been with hospice too long and was kind of surprised about the TPN. I guess I can understand because we do tube feeding often, but TPN seems kind of I dunno, heroic? Not making a judgement here, just surprised I guess. Daily visits to hang new bags, family wont participate. Doc says we will do it for as long as it works. Anyone have patients like this?

When I was in your shoes, I asked pretty much what you are asking and the AllNurses community responded with this. I saved it and give it to you: Anticoagulants/antiplatelets: Heparin Lovenox Coumadin (warfarin) Bivalrudin Aspirin plavix (clopidogrel) Blood pressure: ACEi's- captopril, lisinopril, enalapril ARB's- losartan, valsartan Other heart meds Beta-blockers (olol)- labetolol, carvedilol, atenolol, propranolol Calcium channel blockers- verapamil, nifedepine, amlodipine, nicardipine, diltiazem Vadodilators- nitroglycerin, nitroprusside Pressors- Dopamine, dobutamine, norepinephrine Statins- atorvastatin, rosuvastatin Fibrates- finofibrate Cholesterol binders- ezetimbe, cholestyramine Lung meds Albuterol, salmeterol Ipratropium, tiotropium Advair (fluticasone/salmeterol combo) Symbicort (budesonide/formoterol combo) GI meds Anti-acids H2 blockers- ranitidine, famotidine Anti-acids PPIs- omeprazole, esomeprazole, lansoprazole Bowel preps- mag citrate, polyethylene glycol Constipation- docusate, senna, miralax, lactulose, enemas Diarrhea- loperamide antinausea- ondansetron, promethazine, prochlorperazine Kidney meds Diuretics- furosemide, hydrochlorothiazide, spironolactone, acetazolamide, Bumex Endocrine Diabetes- metformin, insulin (lantus, aspart) Thyroid- levothyroxine Steroids (glucocorticoids)- prednisone dexamethasone, hydrocortisone, methylprednisone, GU meds antispasmodics- oxybutinin, tolteridine (detrol) solifenacin (vesicare) BPH meds- doxazosin, tamsulosin, finasteride ED meds- sildenafil, tadalafil Neuro Alzheimers- donepezil (aricept) Seizures- valproate, levetiracetame, phenytoin, topirimate Benzos- lorazepam, diazepam, Agitation- benzos (lorazepam, valium), haloperidol, Pain meds Opiates- oxycodone, hydrocodone, morphine, fentanyl NSAIDs- ibuprofen, ketorolac Other- trazodone, cyclobenzaprine, lidocaine patches Headaches- fiorocet, sumatriptan, metoclopramide Gout- allopurinol, colchicine Psych meds and antibiotics are too numerous to name

Ya, report his a**. That is waaaaay off base.

I have an omron wrist manometer and it works fine as long as the patient remains still. Also I use a cheap Walgreen temporal thermometer, works fine. I do however, keep a full sized cuff and a rectal thermometer with me if I get weird readings.

our is 5 but doesn't have to be weekdays only, we do Saturdays too.

Ok OP, here is a suggestion for dealing with stubborn set in their way people. Use a 'presumptive statement'- "I really appreciate your years of experience and I know you are an open-minded person, so you might be as surprised as I was when I heard newer research that has shown...." After a statement like that the person is not going to contradict you because if they do they will be saying that they are stubborn. Has worked many times for me. As a previous poster said, you can't win by butting heads, so you need other tactics.

i had one the other day that thought it was fun pushing the blue button-

"I need to see the doctor now!" What's wrong, I ask. "I don't feel good". What's wrong I ask again. "I don't know, I just don't feel good". I check vital signs, all good. Can you be more specific? "No, I just don't feel good" - and then goes back to munching on a sandwich and texting.

I've had many experiences being struck. The worst bodily fluid incident I had was when a clogged rectal tube 'blew out' while i had the patient rolled on his side so i could investigate. As the writer above, I got coworkers to get me some OR scrubs and I hosed myself off. I am thankful it didn't hit my face, but otherwise I was baptized in liquid poo. I learned to stay out of the 'line of fire'.

Yes, I have lost a few days from back strain, and never had a history of it before becoming a nurse. Also, there have been 3 assaults on nurses on my floor alone during the last year. One nurse was injured and has been out of work for a month now. Our manager brought in a consultant to review best practices to help prevent more injuries. All assaults were conducted by etoh/ drug withdrawal patients.

Uniball, black, extra fine. And you can borrow it when you pry it from my cold dead hands. Don't ask.

Meet Harold, he's our new transporter. He doesn't use stretchers, just carries the pt under his arm.

Excuse me for not being clear. She had a PCA pump, knew how to use it, but did not want to push the button for pain relief. I instructed her that she had the cure for her pain in her hand, but she "didn't want to use it". I guess she just wanted to let me know she hurt- go figure.

The exam is very difficult. I took an in-class course over two days, followed by the exam. It was an intense course followed by an even more intense exam. Obviously, the course was tailored to us passing the exam. I wouldn't have wanted to study that info from a book before the exam, it was a lot to learn, but I am sure many do. Good luck.