devi

My schools have been closed since Friday, but school nurses are employed through the health department here, so we're being utilized as public health nurses while this is ongoing. We've done everything from phone triage to covid-19 swabbing to active monitoring of suspected/confirmed cases. It's new for all of us, but we make a good team.

Thanks for the response, Kitiger. I'm hoping my agency works the same way. If you have to take a verbal doctor's order, does that get faxed or mailed, too?

I'm totally new to PDN. I was offered a job for an agency and will start training next week. There are a handful of cases in my area, but they're split among multiple offices, the closest of which is over an hour away. The cases won't be too difficult for me to get to, but having to make regular trips to one of the offices would be a big burden, time and fuel-wise. This is something I'll need to ask my agency about, but I'll ask here, too. PDN nurses, how often do you find yourselves driving to your agency office to drop something off, pick something up, or go to a meeting or continuing education of some sort? I read something in one thread about a nurse mailing in orders. For you nurses who live far from your agency's closest office, are you given options for mailing/faxing paperwork?

It must be catching. The NM on my surgical floor just decided to put all the nurses on a track for weekends. We're supposed to start working every third weekend. Our input wasn't requested in the decision-making process at all...we were all simply pulled into the office on Friday morning and told that it's a new policy (for our floor only) that is effective immediately. Our schedule, which begins this Sunday and was supposedly finalized weeks ago, has been changed drastically two days before it starts...crazy. Some people are okay with it. Heck, I might be okay with it if not for my custody schedule with my kiddo. Many nurses are far from okay with it, though. It doesn't help that we've also had mandated overtime around the holidays this year due to short-staffing, mostly because we've lost around 5 full-time nurses in the last few months and a few others have gone from FT to PRN status. Unfortunately, they're going to lose at least one more. There's no way for me to work the new schedule with the weekend track. I work more than my share of weekend nights as is (more than I'd work on the track!), but I have to have some measure of control over which nights those are. I made sure I'd be able to do that before I accepted this job. I understand things change, but I would have appreciated at least a month's notice before the scheduling change to look for another job and be able to give appropriate notice. I'm going to talk to my NM about it on Tuesday morning and go ahead and give my notice then if there's no resolution. I don't want to just wait for the absences to rack up on my employee record, so the notice might be shorter than I'd usually give. I refuse to feel guilty for that when they're giving us a grand total of 48 hours notice about a major schedule change. Just felt like venting a little. And whining 'cause, UGH, I hate job hunting! I can't imagine it's going to be easy with this economy, either.

Thought this would be the thread to share this, since we've discussed availability of appropriate PPE during a pandemic. Anxiety in Mexico City Near the end, there are a few healthcare workers complaining about not being given masks at the hospital. Other healthcare workers had the masks on, so I don't know if they just ran out that day and gave them to employees in direct patient care first or what. Still, though...

Thanks for the input, everybody. I found out last night that I'm not the only nurse on the floor who's upset about this. It reassured me to hear that even nurses with 10+ years experience are worried about it. Many say they're going to voice their concerns at the staff meeting and will begin looking for new jobs if the change occurs. I'm not sure if I believe that or not. I've learned that most nurses around here aren't willing to vote with their feet and will end up eventually accepting things like this after a period of venting about it. I like almost all of the people I work with. Originally, I'd planned to do my year of med/surg and then move on, but then I'd decided to stay, after all. With this new development, that's just not going to happen. I'll be sad to leave my co-workers, though. I think I might try stick out the next couple months and then look into home health. But honestly, I'm worried about even two months of a 1:8 ratio on my floor. And to think, we're a newly-awarded magnet status hospital. I hear that the day the magnet people came by, they made sure to have the best nurses scheduled on days with a 1:4 ratio. Oh well, I'm sure the 'M' looks nice on a billboard.

Hope it's alright to put this under general discussion. I just wanted to get some other nurses' opinions on a new staffing grid that's supposedly going to be unveiled during our next unit meeting at work because I'm not sure if I'm overreacting. I'm a new grad RN, a couple months shy of the one year mark. I work nights on a Surgical/Oncology floor. Mostly post-op orthopedic surgeries, abdominal surgeries, bariatric, etc. and maybe 1/4 Oncology patients, although we're seeing more and more of them and are working on getting all our nurses chemo certified. We also get medical overflow as well as many patients on telemetry. Assignments are not based on acuity. When I was interviewing, I was told ratios were 1 nurse to 5-6 patients. The reality has been 6-7 patients per nurse and one PCT to anywhere from 10 to 30 patients. No LPNs. On the rare night with 5 patients (only when we are accidentally "overstaffed"), it seems ideal to me. 6 is usually fine. 7 feels unsafe and is impossible most nights without cutting major corners. I often don't feel safe with 7 patients, and I leave work depressed after a night with that many. Of course, this is all relative. We all know that some days, 5 patients can be busier than 7, but I just mean in general. There have been more and more nights with 7 patients and less with 6 lately. And now...word is that our staffing is being changed to a standard of 8 patients per nurse on nights. I've never taken 8 patients and can't even imagine it. IMO, it would be very unsafe for the patient and for our licenses. So, I guess what I want to know is...AM I overreacting? Is this an acceptable ratio for the types of patients on my floor and I just "had it easy" with 6 or 7? I've never worked anywhere else, so I have nothing to compare to, but I'm just so upset about this and trying to figure out if it's just me (being a new grad, less developed time management, etc?) or if this would be unacceptable to even more experienced nurses. Thanks in advance for your replies!

Took NCLEX on Saturday, June 7th. I wasn't feeling too great about it. I took it out of town (in Asheville, NC) and spent the night before with my best friend who lives there. Well, there were 4 kids at her house that night...4 very hyper, unsleepy kids in a tiny, two bedroom house. I ended up with only 5 hours sleep. I started at 10:00 am, and I felt like I knew absolutely nothing...like it was all guesswork. By question 50, I already needed a break, so I decided to take one even though it wasn't the scheduled one. The front desk guy took one look at me and just said, "There's a coffee shop on the first floor" :chuckle The coffee and the mental break did wonders. I felt ever so much better for the last 25 questions before it shut off on me. However, I still left feeling as if I'd failed...although part of me realized that the hardness of the questions could be a good sign. So, anyway...found out today that I passed Congrats to all the others who've passed recently, and good luck to those about to take your test! My advice? If you need a break, take it...whether or not it's scheduled.

Me too, me too!! Well, I graduated Tuesday night. Pinning ceremony was the night before. I had this horrible nightmare the night before graduation that one of my instructors came up to me right before graduation - already in my cap and gown and all - and said, "oops...there's been some mistake. We can't let YOU graduate." I still don't think it's quite sunk in all the way yet. It took such a long time for me. If you look at my join date here on allnurses, it was well over 4 years ago! And even though I haven't been posting much since then (d/t nursing school kicking my butt), I've come to read others' posts fairly regularly, so it feels right to celebrate with y'all :) Anyway, congrats to all of us graduates! Good luck with the NCLEX. Mine is scheduled for June 7th, so anybody who wants to send some prayers or good luck vibes that morning...please do! I'm still hoping I can get it moved up sooner, though.

Very little experience here since I'm still a student, but thought I'd give it a go. One of the ways the kidneys help control acid-base balance is by forming and reabsorption of bicarb. In kidney failure, they don't do too great a job of that (among other things), leading to the metabolic acidosis and the subsequent hyperkalemia (potassium being pushed out of the cells to neutralize intracellular acidity due to the extra H+ ions). So, I figure the bicarb was administered to replace the bicarb the kidneys are not forming and not reabsorbing. Maybe another poster with more experience can confirm or correct me here. I'm curious, too. I'm also guessing that once the bicarb helps the extracellular pH balance, the extra H+ will leave the cells and the potassium should start reentering, lowering the serum potassium further.

Like a previous poster said, CPCC is all about the points. I was never put on a waiting list.

I started the ADN program at CPCC in fall '06. I finished Fundamentals and Psych and then withdrew near the end of last spring semester during Adult Nursing. I've been accepted to start back this coming spring semester with the graduating class of '08. Sucks that it means an extra year 'til graduating, but hey...I'm just excited about going back! The silver lining is that the new class takes Psych with Adult Nursing in the spring instead of with fundies in the fall. Sooo...I'll actually sorta be one course ahead of my class. One less clinical day per week, yippee! The not so silver lining is: they've introduced a new pharmacology component for fall that was absent from my class last year. So I'm sort of afraid I'll be behind in some respects...especially after 9 months out of school! Anyway, I'll be seeing y'all in January :wink2: Good luck finishing out this semester.

online, definitely. Good luck!

Unfortunately, this isn't true in all states. In NC, sexual preference isn't added to the list of protections against discrimination unless a company adds it by free choice to their employment practices. I was fired 5 years ago from a job (not in healthcare) for being a lesbian. But the experience did at least teach me to research a potential employer's policies and history of such things before accepting employment. Now if we could just get more domestic partner benefits down here in the good ol' South.

To be honest, I really don't know. I don't study any more than my classmates do - in fact, I'm pretty sure I study less. I'm never the best clinical student, either, but our clinicals don't affect our final grade - just whether we pass or fail. And I'd much rather be the best in clinicals than the best at taking tests. The only thing I can think of that I do that some people might not is writing everything, and I know that's already been mentioned. I don't mean writing it once or twice, but again and again and again. I'll write out procedures, drug names, definitions...anything I need to remember. I don't make flash cards or anything like that - just copy it over and over on scrap paper and then throw it away. If I do this right before going to sleep the night before a test, even if my mind is wandering and I don't really think it's doing me any good - when I wake up in the morning, the information is just sort of crystallized in my mind and seems perfectly clear.