all4ofus

I am a meg-surg nurse. Occasionally, we receive patients from IR who have had new G-J tubes inserted. Each time we have received one of these patients, the G port comes to me with a gravity bag already in place, and the J port is capped. Each time, we inevitably receive orders to start tube feeds to the J port. The problem is that there is always a hard, white, plastic piece inside the J port that does not allow either a Lopez valve (stopcock) or the tube feed connector to go far enough into the tube to grip and stay in place. This results in workarounds, normally involving tape, which is an infection prevention breech, and also not very effective and is very messy, because it doesn't really work. I called our IR department to inquire about this, and was told that there is a "tool" that they use to remove this plastic piece from the G port prior to attaching the gravity bags, but on the floors, we just have to wiggle the plastic piece out (which we haven't been able to conquer!). So my questions are: 1. What is this "tool" that removes this plastic piece? 2. Why not remove it from both ports prior to transfer? One person told me it is meant to stay in place on the j port, but couldn't tell me what purpose it serves, other than impeding adequate connection with tube feedings. 3. What brand(s) do you usually see on these? I would like to track down packaging, manufacturer, and any instructions that are with it. Thanks!

So here we are a month later... and I have to say that I am finally beginning to enjoy my job. One day I left thinking, "Where else can I get a genuine "thank you" from three people and two proposals, all in one day??" It is still very challenging, but I don't dread going to work anymore, LOL. I am improving with my time management and most of my skills; I don't have to get backup for every procedure anymore. I am definitely not always johnny on the spot with my rounds and pain reassessments but I do actually make sure I complete all my dressing changes and five rights of med administration, etc. Even the little things are hard when you're new; like all the little rules our phlebotomy department has. Or learning to encourage patients to track their questions for morning rounds instead of paging the evening on-call (who knows less than you). Thank you everyone for the encouragement!

I received my course map today with a July 2 start date. Unfortunately, I will be on vacation the first two weeks of July. I don't have to take any other prerequisiste courses thanks to my previous bachelor's degree. I am actually wondering if these are self-paced enough that I could wing it and play catch-up the last three weeks of 3645A instead of pushing my start date back.

I really hope it's not the same everywhere, otherwise there is nothing to look forward to. I know that much of it has to do with the fact that everything is still so unfamiliar, which slows me down. But I have a sneaky suspicion that our manager is more stringent than others. I will have a better idea how we compare when I start floating. On the upside, most of my coworkers are incredibly supportive and have the same complaints, so we laugh together a lot.

I am a new med/surg nurse and just wanted to say I hate it. It's been 4 months so far and I have never been more stressed out in my life. I applied for everything BUT med/surg (at first) because I had a feeling that this wouldn't be for me, but as everyone knows, jobs are slim pickings for new grads. My primary complaint is that this is an environment in which you are expected to lie incessantly. Late med administration? Lie or be written up. Couldn't make the pain reassessment in time? Lie or be written up. Stuck with a pt who is tanking for 3 hours until the transfer to ICU? Lie for the rest of them or be written up. Almost every night at the end of my shift, I spend between 2 extra hours charting my lies because there is no time for charting during the shift. Even the experienced nurses are having to stay late with me. And this floor is so busy, it's not uncommon to turn over almost your entire team of patients in one shift. It's insane.

I work on a surg floor at Parkland and we typically have 5 patients with 1 admit and 1 discharge (days - 7 nights). I hear some of the other surg floors only have 4 (I haven't floated yet so don't know for sure). During school at Baylor Dallas (med floors) the nurse I worked with always had 6 (days) with admits as soon as one was discharged. I think the trade-off is in documentation. Parkland requires lots of computer charting.

Haha, I was reading this thread and had to join. :) I graduated from El Centro (Northlake) in December and have a floor job at Parkland. I have to say, that after getting through that program, that I am at least just as equally prepared as all the other new nurses, and even more so, in many cases. It's only been a few months but already feels like it was so long ago. Parkland has an awesome education department; I took ACLS and the pre-req courses there while I was in school and the knowledge they gave me really helped through my last semester at Northlake. If you can get a job as a PCA while you are in school I highly recommend it. During my job search I found that Parkland and Methodist are pretty much the only hospitals in the area still hiring ADNs and it is extremely competitive. Also, some students who worked at other hospitals (Baylor, Med City) during school did not get hired by those hospitals in the end. Parkland is very loyal to their PCAs/nursing students. They are working towards magnet status currently, but I haven't seen a change in their hiring yet (ADN/BSN); they are just requiring managers to get their BSNs. Anyway, enjoy what you can while you are there (major care plans, haha!) and try to appreciate the instructors for their uniqueness. There is one in particular I HIGHLY recommend for 4th semester. I won't post her name here because I think it's against site rules, but she is a Baylor grad, ex-Baylor nurse, used to teach at Collin county, and cardiac is her love. Get her if you can (hope she's still there).

" now i really need to know from someone who knows...can she report me to group one if i quit with notice???? i thought they could only report you if you were fired or asked to resign. help me please someone who knows for sure!!!" call group one and ask them.

They both had these obvious little holes all over their palms, I suppose because of the fact that they're shooting this junk straight into the tissue so they don't close well. Patient 1 came down hard and slept through my shift. Refused to answer any questions. Patient 2 is in denial. So I don't really know what the deal is. One of my coworkers said they have a reason they do it in their palms and there's a name for it, but she didn't remember either the reason or the name, lol.

I've had two patients admitted recently for I&Ds of the hand. Both were early 20s and shooting drugs into the palms of their hands. Both also had very pretty veins in their arms. Anyone know why they are using their palms instead of veins? This second one will be lucky if he gets to keep his finger. Gross.

I'm sick of people who supposedly love me pointing out everything I must be doing wrong. YES, I've made mistakes! NO, I'm not perfect! If I was the perfect job hunter and the perfect interviewer, I would have a job!!

I don't have any personal experience with the program, but I work at Parkland and have worked with several students who are in the fast-track BSN program at UTA. They apparently do all clinicals at Parkland, no summers off, but it seems manageable for them. I've compared care plan paperwork to our own at El Centro's ADN program, and it it very comparable, and even seems a bit easier. Plus working at Parkland for your clinicals, you would get lots of exposure to unit managers and maybe make some connections. Several of them landed jobs as techs while they were in school.

You will do FINE. This is one instructor out of how many? I am graduating in 6 days, and I had instructors tell me I need to be more "assertive," "confident," etc. just because I am not the first in line to try new things, or very outspoken, or whatever. But I've been working as a tech for a year and a half, and I get WONDERFUL feedback from my patients, because I AM that 1 on 1 type of person. I've had so many patients sing my praises because they do feel that connection. Plus my coworkers, once they get to know me, all love me too. You will be FINE!!! Plus, from what you said, it sounds like although you tend to be quiet, you don't have a problem advocating for yourself when you need to.

Congratulations! I am also in DFW and also a mom and starting to wonder just how far out I am willing to go to find a job. Did they ask you to sign a contract for a set period of time?

I am a new grad RN in the Dallas area, and it seems to me that there are plenty of jobs for EXPERIENCED RNs, but nobody really wants to give new grads a chance. Since you are experienced, I think you could find a job. There are plenty of big hospitals in Dallas: Baylor University Medical Center, Medical City Dallas, Presbyterian Hospital of Dallas, Parkland, University Hospital/Zale Lipshy, Children's, the VA hospital, Methodist Dallas, Methodist Charlton. There are probably some I'm forgetting. Fort Worth has John Peter Smith, Harris Methodist, Cook Children's, and probably more. You will find that most of them are part of health care corporations --- Baylor is part of Baylor Health System, Medical City Dallas belongs to HCA North Texas, Presby of Dallas and Harris Methodist of Fort Worth are both part of Texas Health, both Methodist hospitals are part of Methodist Health System. Parkland, JPS, the VA, and University Hospital all have the big hospital plus off-site locations, but sort of stand alone, not as huge as the others. Pretty much all of the suburban hospitals between and around Dallas and Fort Worth belong to HCA, THR, or Baylor, so check those three job websites plus Parkland, JPS, the VA, and University Hospital, and you pretty much have the whole metroplex covered. Oh yeah, there is also Texas Scottish Rite Children's in Dallas. Good luck! PS - I did mention that new grads need not apply, right?? Also, you will have far better luck if you have your BSN already.