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mmc51264 ADN, BSN, MSN, RN

orthopedic; Informatics, diabetes
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mmc51264 has 8 years experience as a ADN, BSN, MSN, RN and specializes in orthopedic; Informatics, diabetes.

mmc51264's Latest Activity

  1. My first nursing degree was an ADN, less than 10 years ago, and I had over 650 hours of clinical. When I was hired, I was hired on an orthopedic unit with extended orientation (6 months!) and I felt so very prepared. What I see now in new grads is so very scary. With the Covid issues, it is going to get worse. We are getting ready to start about 5 new nurses on our unit. The last couple of new nurses and probably the last 2 years, are not prepared at all for what floor nursing is. They don't seem to want to learn, to work, to care. It is heartbreaking. Many are getting into NP programs with less than one year of experience. To me, that is frightening. I used to be a school teacher. Same problem: teach to the big stakes tests. Don't care if the kids actually learn something. I got in trouble once as a teacher because I "had too high standards" I expected 5th graders to know their multiplication tables. I have the same problem as a nurse. I am "passionate" about my job.
  2. That pt needs to have some sort of plan put into place. Something to the effect that you will be available for routine care in certain intervals. I work in a hospital setting and it is a little different, but there needs to be boundaries set. You should NOT have to take that abuse. The person who told you that should have to take over for a shift or two.
  3. mmc51264

    HIPAA Breach?

    No. I agree about teamwork. You are not accessing a pt for any other reason than to relay a lab value while you are in the program, saving your teammate time. Especially if she was perhaps on the phone with a provider.
  4. mmc51264

    Too strong of a personality?

    I get in trouble because I am "too passionate" about my job. I hold people to the standards I have for myself. I realize I have issues with being blunt. I have issues with social cues, not great at getting to know people and I genuinely try not be rude or a b****. I am misread. Even my boss was intimidated by me (I am older and have my MSN but choose bedside). I work really hard at being more social. I just find it difficult when people don't do their job and it may or may not affect someone else's health/life. I tend to care more about pt experience and safety than I do about someone's feelings. I don't express myself well, and I am sure that this post will not be interpreted the way I intend. It's a struggle.
  5. mmc51264

    I can't get a job!!

    where are you? I know they are hiring at every hospital here in Eastern NC.
  6. mmc51264

    new job, can I be denied job for benzo PRN

    @ScarletPixiedon't mean to hijack thread, but how you do that signature? Scarlet Begonias is my fav Grateful Dead song. LOVE it!
  7. For my ADN, I burned the damn thing (It was HUGE! and all compassing) After that, I rented everything. It was very cost effective.
  8. mmc51264

    Med-Surg IV Meds

    Antibiotics. All day every day.
  9. mmc51264

    Duke vs UNC vs UNC Rex

    I've spoken to you before. 1-Duke Neuro. We are so short now hospital-wide, you can get all the overtime you want. I am pretty sure they don't negotiate salary. I am also pretty sure you might, however, be able to negotiate a shift preference. Rex. Nice hospital. Not a teaching hospital. I am an ortho nurse at Duke, so ortho is my thing. High turnover of patients and time-management is a must. It is kind of difficult to get a job at Rex so that is great for you! They have expanded their square footage over the last 5 years by 3 times (I did my clinical for nursing school there). All the level 1 traumas go to UNC, they don't stay at Rex. I am not sure about Rex and UNC-CH having same benefits. CH is a state facility attached to the university so the benefits might be difficult. I had a friend who was going to work there and Duke PRN, but after a month, she hated it.
  10. mmc51264

    New Ortho Nurse Tips

    Don't be a "pain med judger" I work with some nurses who don't believe pt's pain. It's real. I have chronic pain and multiple ortho injuries/sx. Part of the reason I am an ortho nurse. Understanding PT/OT things is helpful, especially reinforcing what PT/OT has taught them. Good body mechanics to save your own body is important!! I love ortho!! I find it great because many people are not really "sick" they have an injury. Very few pass away, and their stays are no very long.
  11. mmc51264

    Orthopaedic Certification

    I just got an email from them that are doing live proctoring so you can take it from home. I have to recertify this month and I am tempted to test again as I am terribly unorganized and not sure I have all my certificates for CE hours.
  12. mmc51264

    Precepting in ortho

    Spend some time with OT/PT and learn about precautions for each joint replacement (anterior and posterior hip precautions, dos and don'ts of knees). It is imperative that you learn good body mechanics so you don't hurt yourself helping ortho pts. If you are going to be dealing with spines, logrolling, c-spine precautions (including how to move them). Pain management is key too! My best advice is Tylenol is underrated and you need to wake them up to give scheduled doses đŸ˜‰
  13. mmc51264

    Orthopedic nursing

    I have been an ortho nurse for 8 years. I love it!! I am at a large teaching hospital so we get all kinds of ortho stuff. We have a separate spine unit so there is very little spine (which can be tricky). We have amazing joint doctors, ortho oncologists. With Covid and new best practices, we are having less straigh total joints, so we too, get the overflow gen surg pts. Lots of variety and lots of things to learn about the comorbid conditions that a lot of our joint pts have. I wouldn't work on any other unit!!
  14. I would think that if a person is deemed unfit to make the decision to leave AMA, they should be on a medical hold and require a 1:1 attendant. It sounds like a financial thing. If we have someone on a medical hold, we have an attendant. If they are not, they can leave AMA-it is STRONGLY discouraged and all help is given to avoid.
  15. mmc51264

    How to handle patient’s threats

    As an orthopedic nurse, that is a very common problem. I just have to tell them that I have orders and that the PO goes before the IV. I will write on the white board what times they can have what. If they want to leave AMA, that is their choice. I explain that I will not risk my license for anyone. We are lucky because, as a teaching hospital, there is always a provider available. Pushing it up it not passing the buck. We are not able to change orders. I try to educate people that AMA means that if they have insurance, the stay does not get paid for. Every shift I have at least one pt that is a manipulator. You will get better at being firm about dealing with them.
  16. I drive 45 miles to my job. No way I would be able to do that 5 days a week. I love my job and I love working 3 days a week. To help us out, don't give us more pts to care for. It is really not efficient to have to have report given 3 times a day rather than twice. 30-45 minutes to give report? not a good idea. With 12 hour shifts, you can't be asked to do doubles (once in a while I have stayed an extra 4, but very rarely) When I worked 8 hour shifts, I was constantly asked to stay an extra shift. I come from a different background-nursing is a second career. I worked in the horse business where days were 16 hours long and harder work. To me, a 12 goes by fast enough.

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