supaflyz

The next day the dietician fix the problem and reminded the doctor. Had order for water flush q4 h. Thank you for those who responded. NOADLS your smart comments are the reason for most altercations at work. I'm sure you know everything.

I have a question to ask regarding peg tube feeding. I'm usually good with peg tube and have experience quite a few patients that were on peg tube. One of the patient from another nurse two nights ago had an order for peg tube feeding without a flush order. I advised her to call the physician to clarify as I have always seen peg tube feeding with flush order. The physician told the nurse that the patient is eating and she doesn't need water flush. Patient is on peg tube feeding because of poor appetite. The nurse asked the charge nurse and the charge nurse called the physician again. The physician finally just said to give one bolus feeding can and he come take a look tomorrow. I won't be back until another two days. Don't we have to flush to prevent the peg tube from clogging?

Ok I spoke with my supervisor, charge nurse and pharmacist too. The pharmacist said it was ok to give it. My supervisor is very nice. She was concern at first, but then she sawed the order and the time period as well. The doctor was also aware that was why he ordered it scheduled. I made a note of it. It says norco 10-325 mg (2 tabs) 5x day. The thing is that it was spread over every 4 hours. 0600, 1000, 1400, 1600, but the last one was scheduled for 2200. I tried to wait to wait past 1 hour after the schedule period but it stilled pop up that message. I went ahead and told the pharmacist in the morning and she told me she was aware of it as another nurse brought it up to her the previous day. This patient also has dilaudid prn meds but he doesn't take them.....

I have a question that needs some input guys. One of the patient has an order for Norco 10-325 mg (2 tabs) to be given 5x/day. I gave the last 2 tabs for the 24 hour period. However, it pops up on the computer screen that I have exceeded the dosage. I went to check back on the computer and it was indeed the 2 pills that I have given is the last dosage equal to 5x. There were 2 tabs given around 0400, then 2 tabs around, 2 tabs around 1000, 2 tabs around 1350, 2 tabs around 1740, and the 2 tabs that I gave around 2300. That should equal 3250 mg which is the maximum dosage for the day. However, it pops up on the screen that it exceeded the maximum dosage for the day. The physician said it was ok to give it that was why he order it to be schedule in the first place. Pharmacy also said it was ok. They told me it does that because the computer somehow counts it as less than 24 hours? I'm just a little worried. I gave it anyways even though it pop up that message. It was 5x a day like the order stated, and it was scheduled.

The CNAs just give me the results when I'm in the room. The CnA on that day is usually pretty good. She does more stuff than the other ones. I notice that the night nurses are having a hard time working with the CNA. I'm new there so I just sit and listen. It seems like it is like that everywhere though even when I was doing clinicals. There are only a few good CNAs that actually does there stuff. I was just sitting there and the nurses started talking. They told each other that they ask the CNA for help turning a heavy patient to do wound care, and only one time did the CNA came in and the nurses were just getting too frustrated. One of them did told the other nurses that if she worked her butt off doing work then the CNA could work their butt off doing work as well instead of on their cell phones all the time. I really didn't know what to tell them as I'm new, and I have a hard time telling other people what to do. It was like that too as well at my first job until I really got to know the CNAs. Yeah I'm glad my preceptor did tell me and I gave the PRN med and her temp went down.

I'm pretty scared now guys. THis whole computer charting is giving me a headache. I have also heard of the huge turn around on the nurses at my facility. It seems that there is too many things that I could do wrong and could hurt the patient or mess up on charting or some minor thigns and I would be in trouble. I also failed my PDBS assessment. I could take it again but I'm already thinking if this is the right field for me. Hopefully I will graduate this December with my bachelors. I see many other young nurses that area also working. I know if they could do it then I could too. I"m just afraid of failing. I almost cried today after I found out that I failed my PDBS. Even for a guy, I feel really bad about this.

Yes use one of those sheets (brain sheet) that has the patient rooms, allergies, procedures, important lab works, if they on lovenox or not. I printed out a bunch of them to bring with me my first day. My preceptor was very impress with that. She told me I was ready for the first day. LIke tokmom said, keep your cell phone in your pocket. Only use it during breaktime. I'm a coffee person so I needed to use the restroom at least 4 times throughtout the shift lol. My preceptor knows though because she drinks coffee as well. Always offer to help. The first 2 days is basically shadowing. However, my preceptor is very nice and open to questions. Make sure you tell them the first day what are your weak points. Mine was starting IV and how to work the IV machine since my old workplace didn't have those. She also went over with me some of the computer tips since she know I will have a few classes regarding computer charting and such. We just hung it and calculate the drips. My preceptor is awesome!

Thank you Tokmom:) Yes I came from a SNF. The workload here is nothing compare to the SNF. The SNF we had to pass more medications. However, there is a routine once you get it down. Here you have new patients almost every time. I also had an AMA on my first day on orientation. I only had one AMA at the SNF in a whole year! It is the charting that is intense.

I feel so overwhelmed and nervous guys. Today was my first day. I was just shadowing but i was so overwhelmed with what I have to learn and chart. I will also have to learn new skills that I didn't get to do while working at a rehab/snf. Lucky I brought some coffee to keep me up the whole shift.

Thank you Allie!

Hello guys, I will hopefully start in med surg floor soon if my physical is clear. I have been working at a rehab/snf for a year. I'm scared, but looking forward to it. I wanted to get some advice on what medications to hold. I know about the blood pressure medications. Can you guys give me some tips on the (Important medications) and when to hold them.

I'm in the exact same boat. Have a job offer to a big time hospital here. Night shift med surg. Pays more than my job now. I'm just afraid of looking like a dummy because I'm not exposed to all the nursing skills or forgot them since nursing school or only done them once while in clincals. I have been a nurse at an SNF for almost a year by this October. I get along with my coworkers and aids there. I don't want to give up this job and fail at my other job.

Guess what guys! I went to the interview and they have offer me the job. I have a few days to decide should I go forward with it. I'm just afraid of the transition from rehab facility (skilled nursing) to a medical surgical floor. I will start out night shift. There are some skills that nurses at the hospital get to do that I'm not exposed to at the rehab facility. I know it will be overwhelming having to learn a new system. However, I'm also worry about not knowing certain skills. I got a chance to meet with the charge nurse, nursing director, and discharge nurse as well today. They were a board of 3 interviewing me, plus the nursing director, HR person, and another charge nurse.. So in total 6 people. They seem friendly and very nice. I would love to work with them, but I just don't know. Any advice guys.

Thank you guys! I just get a lot of anxiety. I will go to the interview :)

Some of my classmates whom have landed job at that hospital (at a different location) told me they will give me 3 months of orientation. I'm just so afraid of failing. I went to get a bachelor degree to land a job like this so I could actually experience what I learn in nursing school.