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rn undisclosed name

rn undisclosed name

Telemetry, Oncology, Progressive Care
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rn undisclosed name has 4 years experience and specializes in Telemetry, Oncology, Progressive Care.

rn undisclosed name's Latest Activity

  1. rn undisclosed name

    How does chemistry apply to your RN position?

    I don't find the chemistry course per se to be helpful. They do cover the parts of chemistry you need to know in your other courses. What I remember most from chemistry is doing the calculations. They always got the best of me and I'm pretty good when it comes to math.
  2. I NEVER say I have the time now. Does that mean if they need me later I won't have the time then? I think it sounds absurd. I can't tell you how many times I round on my patient and ask if they need anything. I think just saying that gets them thinking and when you put them on the spot they can't think of anything and that is the reason they think of it after you leave. It never fails that the iv pump can be working perfectly but the minute I leave out of the room it starts beeping and on goes the call light. Since we are not psychic and everyone has different personalities that you don't get to truly know it is impossible to anticipate every single thing. When you give someone a laxative you can't predict when they're going to have a bowel movement. Everyone reacts differently and some can go a couple times an hour. Forget if you're cleaning them out for a colonoscopy. I could go on and on.
  3. rn undisclosed name

    Personal Experience after Many Years as a Nurse

    Sorry for your loss. I can not imagine. I would love to have seen the article but it appears it was removed. Remember to take all the time you need. I do think a support group would be incredibly helpful to your situation. It is so hard to know if you did the right thing. It sounds as if things progressed so quickly and you were forced to make a decision in a moments notice. But knowing that you respected your son's wishes should provide great comfort to you. Hugs to you!
  4. I've worked at a couple of facilities and was always able to give lorazepam ivp. Never given it IM. Haldol is another story. I worked at a facility where only ICU nurses could give haldol ivp d/t prolongation of QT if administered too quickly. We could give IVPB. Yeah it sucks when you make a medication error. I've made a couple in my years. I was still a new nurse on orientation and heplocked a dialysis catheter on a pt who was HIT +. I let the nephrologist know. They wondered why I called about that. Likely none of it got to them systemically. Just a few months ago I had 5 patients and they were all on some sort of drip (I was the only nurse with patients on drips that day and I got them all). I started a bumex drip and I am not as familiar with that as other medications. I programmed the pump incorrectly. I believe I was supposed to have it going at 3 ml/hr and had it going for 3 mg/hr (don't quote me on those numbers). I was used to lasix gtt's which are 1 mg = 1 mL. The nurse on the next shift didn't catch it either and the nurse on the following shift caught it 6 hours into her shift. I apologized to the nephrologist the next day and he told me not to worry about it. The particular nurse who assigned this load to me does a horrible job of making assignments. I've complained and my manager blows me off about it. My educator talked to me about the mistake. I told her it was not a good day for me on the unit and they shouldn't assign all the drips to 1 nurse when there are 7 nurses on the unit. That wasn't an acceptable excuse. Unfortunately mistakes happen. We're only human! We try our best and would never intentionally harm someone.
  5. rn undisclosed name

    We Are ALL On The Same Team

    I'm guilty of not knowing how much oxygen is on a patient. Sometimes you confuse who is on 2L and who is on 3L. Unless it's something more obvious like 15L or a nonrebreather. If I don't write it down I won't always remember it. I can have multiple people with pneumonia so I sometimes forget the exact number of liters unless I refer to my "brain". After your shift sometimes you're just a little tired. I rarely get report from the ER in my facility. I receive very little notice about an admission. I would love to get report. I am told whatever information I need is in the computer. A lot of times it is. If I have a question the contact number for the nurse who is supposively responsible for that patient never knows anything or the patient comes up at the beginning of my shift and they've already gone home and nobody can help me. I write up incident reports for it. The ER nurse does get preliminary orders but sometimes they're incorrect. They just write down what the doctor says. I had someone admitted with severe abdominal pain and there was an order for a general diet. Luckily she didn't get anything. I talk to my manager but I am told to write it up. I have gotten patients on cardizem and heparin drips and had no idea. I don't avoid getting report on a patient. If I am in the middle of something I take their number and call them back as soon as I finish. The majority of the nurses I work with at my current facility do the same. That is a great article and I have experienced most of that at the various places I've worked at. I'm lucky I don't deal with a lot of that at my current facility. I've been there 2 years and it is by far my favorite place.
  6. rn undisclosed name

    The Patient Who Receives No Visits

    It is amazing any parent can leave a sick child in the hospital. I am lucky I have only had each of my kids stay in the hospital overnight one time. My son was a bit older and could have been left but he was only there to have a 24 hour EEG and not sick. They provided him with a video game system and he was in heaven. I was in nursing school and had clinicals the next day (I've never missed a clinical under any circumstances cause I was too afraid of the repurcussion) so my husband stayed the night. My daughter was admitted with asthma at 15 months and I never left her side even when she was sleeping. I just can't imagine. I don't usually pass judgment on my patients because I learned there could be multiple reasons why there are no visitors. It does bug me though when family does not know what is going on and all of a sudden they visit because they are hospitalized and want to monopolize all of your time and are very demanding. I do tend to notice the patient's who are not very nice don't usually have visitors and it just kind of makes me go hmmmm.
  7. rn undisclosed name

    Do you tattle on your co-workers when you find something missed?

    I am fortunate the unit I work on is nothing like that. If I find something I tell the nurse about it. Or if it's during report I tell them. It's usually a new grad. If they're not receptive and the issue is significant enough I will talk to my manager or do an incident report. But I do attempt to talk to the person first and have it taken from there. There used to be a nurse on my unit who would write up "everything". My manager knew that and took her write-ups with a grain of salt. I was once written up for putting restraints on a pt and neglecting to tell that nurse and there was no order. Except I didn't put restraints on the pt and it was the caregiver at the bedside who did it and it wasn't the first time on that admission. Had I known that I wouldn't have had the restraints at the bedside. I did however tell the nurse how the patient started acting beligerent near the end of my shift but was ok and didn't have to do anything further. Luckily this nurse is no longer there. Everyone hated giving report to her. I will admit I don't do incident reports as often as I should. I'm just not going to stay any later throughout my shift to do them. I'm usually ready to go home. I do less than one incident report per month.
  8. rn undisclosed name

    Power port question

    I recently had a pt with a power port that was accessed with a non power port huber needle in the ER and the pt went for a ct with contrast. I suspected that the port was used for the contrast and I confirmed with CT they did actually use the port. Somehow CT didn't question that it wasn't accessed with a power port huber needle. I did some research and found that the needle can burst and damage the port. Everything appears to be ok except for a sluggish blood return but this appears to be the norm for the pt. I let the hem-onc doc know and their response was "so what?" I was flabbergasted by her response and would think she would have been upset. Am I missing something? I did speak with my educator and the oncology educator. I also completed an incident report so hopefully this doesn't happen in the future.
  9. rn undisclosed name

    How is the floor/hospital census lately?

    I work in a medium to large size community hospital and we are literally busting at the seams. Putting patients in areas where we don't typically house patients. Opening up units that were previously closed. There are no beds in the ICU. My hospital is offering incentives for staff to work extra shifts and are actually offering double what they normally offer. It is insane. I have been doing nursing for almost 7 years and have never seen anything like this. I have also worked at 5 different hospitals and was actually at my current hospital last holiday season and it was not like this. Earlier this year we were closing units because there was not enough patients and we were being told not to come in due to a lack of patients. Sometimes this happened 2-3 times a pay period. We did a restructuring of staff as well because we thought that things were changing and there would be less inpatients. I'm just wondering how things are throughout the US and why this is happening. I thought maybe because it is near the end of the year and people have deductibles they want to use but the admitting dx of my patients does not support that. Only one pt had surgery that you could say was elective. BTW I work on a cardiac unit (tele/step down).
  10. rn undisclosed name

    Narcotics administration

    I have a hard time with the drug seekers like a lot of other nurses. Some things that help me out: If it is ordered and the patient is requesting it they get it IF it is due. I always go over the pain scale with patients. If they tell me their pain is a 10/10 I correlate that with mild, moderate, severely, extremely severe. I had a patient who kept telling me her pain was a 4 and it turns out she was actually experiencing mild pain. Well that would be a 2 or 3 so it required reeducation on the pain scale. If a patient has norco and iv pain meds ordered and they are refusing the po I tell the doc. A lot of times that will have the doctor getting rid of the dilaudid/morphine. If you are taking vicodin/norco at home and you are not in the hospital for an exacerbation of a pain crisis I really don't understand why you are requiring dilaudid just because you are in the hospital. If your pain is at the level it is when it is at home and you are at your goal we are all good. People who have chronic pain do cry when their pain is so out of control. People who say that doesn't happen...well everyone is different. Many (not all) patients with chronic pain need limits so they are not monopolizing all of your time. I let them know when there next meds are due. I find it extremely frustrating when they go on the call light 1 hour or more before they know their next pain med is due. I don't understand why they do it and there is nothing I can do about the timing of the pain medication. It is ordered by the doctor and If they are getting their dilaudid every 3 hours well I don't need you to start calling me 1 hour, 45 minutes, 30 minutes, 15 minutes before you can have your dose. I will give it to you 3 hours after you had your last dose because that is then it is ordered. Many of these patients have an extensive psych history and are on multiple psych meds. Sorry but these are things that make me go hmmm. These people need to find other methods of pain control besides iv narcotics. They really need to open their minds to other methods of pain relief. I believe we as nurses should second guess a pain regimen with a doctor. As nurses we receive much more education than they do. Ordering morphine/dilaudid q6h is ridiculous when it has a short half life. I recently went to a conference and learned doctors are lucky if they get 1 hour of pain education in school.
  11. rn undisclosed name

    How is the job market for nursing where you live?

    I've been a nurse for 6 years and things were so different when I graduated. I got offers everywhere I interviewed. It was really crazy. I've been in my current position for a little over a year. I didn't have a super hard time finding this job but it wasn't super easy either. I probably applied for 10 different positions and interviewed for 3 of them. 1 position I wasn't picked. Another position I was told in the interview an offer would be forthcoming. It took me over 1 month to get that offer. In the meantime I received an offer for my current position. Even though I had to take a cut in hours. I went from a 0.9 to 0.5 becuase they didn't have any full time positions. It was worth it because my previous place of employment was a very toxic environment. I am an RN and have my ADN and am currently working on my BSN. I live in Illinois. New grads are having a very hard time getting positions in this area. Many hospitals won't hire if you don't have BSN. They are in the process of doing restructuring in my deparment so some nurses are losing their current positions. There are less patients in the hospitals so it's really rough for hospital nurses.
  12. rn undisclosed name

    Time Frame for Med Administration

    Anywhere I have worked at I've been able to give meds within an hour either way. So 9:00 meds can be given as early as 8:00 or as late as 10:00 and still considered on time. Of course it depends on the medication, especially if it is time sensitive such as certain antibiotics (like vancomycin).
  13. rn undisclosed name

    Working for the Rich Population?

    I don't notice a difference in how I'm treated. They can be just as grateful for the care you provide as someone who is poor. I do find the affluent/non poor are much more receptive to education and take a greater interest in what you are doing and why you are doing it. They are generally compliant with their care. I notice there are not as many frequent fliers compared to when I worked in a poor community. ETA: There have been many times I have taken care of a millionaire and had no idea. I found out after the fact and was actually surprised. My hospital is somewhat of a mixed area but definitely more upper class.
  14. rn undisclosed name

    Job market

    I don't think it's very good. New grads are having hard times getting jobs. I am an experienced nurse who is experiencing huge fluctuations in my hospital. We are currently on a hiring freeze. I am very worried I may not have a job in the very near future. I am getting cancelled once a week and my unit was recently closed but has reopened. You are not too far from Alexian Brothers and they have many openings so maybe things are better at that hospital. It is too far for me. If your license is inactive you may have a hard time getting a job becaucse you don't have recent experience.
  15. rn undisclosed name

    Local Community Hospital

    All community hospitals are different. I have worked at a few different community hospitals. My current hospital is a level I trauma hospital and Level III NICU (I believe that is the highest; we are whatever the highest is). We also do CABGs and are magnet so it really just depends. We have also received a lot of awards which isn't typical of a community hospital but they do exist. You just have to look at what they offer. I will say it is by far the best community hospital I have worked at. 12 weeks is a good orientation. Probably the longest you are going to get unless you specialize in ICU/ER as a new grad. Good luck!
  16. rn undisclosed name

    PICC Ports that won't Flush

    The dwell time can actually be extended up to 2 hours and then it can be repeated once. Once you get a blood return you want to make sure you withdraw enough to make sure the TPA does not go into their circulation. I also recently read you can do sodium bicarb for some clots (medication related), however, I have not yet done that.

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