Mandychelle79 ASN, RN

Mandychelle79 has 2 years experience as a ASN, RN and specializes in Psych.

Mandychelle79's Latest Activity

1. 

   Do you consider it helpful or not to be given a Pt’s attitude during a report?

   Mandychelle79 replied to DesiDani's topic in Nursing

   As I was in psych then went to med surg I usually get hey we made sure room 4 was in your assignment
2. 

   Dosage Question

   Mandychelle79 replied to dancrinme's topic in Student Assist

   Basically since it says you have 1000 mL you will pour out 90 and mix with 110 for the total of 200 like you had posted.
3. 

   What's your best 'Nurse Hack'?

   Mandychelle79 replied to KimasaurusRex's topic in Nursing

   I work nights. I hate to wake people up unexpectedly. I combine as many of my med passes as I can at one time. When I'm doing my assessment I tell them about what times I will need to bug them. At the same time letting them know if they need something before that just to call. So I may say Mr. Smith I will be back in about an hour with your bedtime pills and I will be in at 11 to empty your drain. Good news is that I then can leave you rest until 5 am when I have your antibiotic, and it's IV so if you make sure I can scan your band and access your iv site I barely have to bother you. if you need your pain meds or anything though please call out. If there pain has been not well controlled I offer to wake someone when the PRN is avaible to try to get them to the point that they don't need the breakthrough medication.
4. 

   The difficulties of trying to be proactive

   Mandychelle79 replied to JonathanClouse's topic in Psychiatric

   I'm sorry you experienced that. I used to think it was only mental health that was broken but after just 5 months of med surg I guess it's across the boards. Pts admitted because PCP can't get them in in a reasonable amount of time. It's frustrating.
5. 

   Doctors Say the Darnedest Things

   Mandychelle79 replied to allnurses's topic in Nursing

   While reading psychiatric notes from a family meeting, talking about pts mother.... who escaped institutionalization by some unseen benovolent force
6. 

   Administration of PRN narcs too close to scheduled meds??

   Mandychelle79 replied to pumpkinspice's topic in Medications

   Everywhere I have worked they are considered seperate orders. So I would give the scheduled. The way our emar is set up though others nurses may not because it would take time to research if it was the prn dose vs the standing dose. Is there any a difference in the dosage? Like say for Ativan I may give 2 mg bid scheduled and then 0.5 mg q4 hrs for anxiety.
7. 

   Unreasonable requests

   Mandychelle79 replied to emmafrancis's topic in Nursing

   We have a recommendations portion of the chart where we note family requests. I also write notes on the patient white board to help remind patient to ask.
8. 

   Dilemma - family as a possible patient on my unit

   Mandychelle79 replied to Nurseannieb's topic in Nursing

   My best friend traveled over an hour to go to the hospital I worked at because the local one ignored her symptoms. When she told me where she was being admitted, it was my floor in my block of rooms that I had been assigned the night before (we try to keep same assignments). I called into the unit, told them what was going on, and she was assigned to another nurse. No biggie.
9. 

   Drug calculation

   Mandychelle79 replied to foleyu's topic in Nursing

   What were you looking for in the first place? With the given information it's not a calculation problem
10. 

    Left psych but still get the psych patients

    Mandychelle79 posted a topic in Psychiatric

    So I went from inpatient psych to med/ surg at the beginning of the year. I know psych patients can be anywhere but I can definetly see how my approach differs from those who haven't worked psych. I recently had a patient who during introductions stated I'm going to be a pain in your... I said well I worked psych for 7 years so you can try. Apparently I was the only nurse he didn't give a hard time about things to. He definitely had a antisocial (my abosulte favorite Pd) or male borderline (I can handle make borderline better than female) flavor and mix in the hx of addiction and pig got my favorite type. I also recently had another pain patient who wasn't getting the answers. I explained/educated him and his wife about why the drs couldn't order more, why it seemed like not working, etc. While he did not get what he wanted he atleast understood why things were going how they were.
11. 

    Change of shift

    Mandychelle79 replied to Mandychelle79's topic in Relations

    I'm new to the floor (been a nurse for about 6 yrs and in healthcare for about 14). It was no big deal for me to spike a new bag and it wasn't worth the fight. Just in the future if I'm taking her assignment I will expect the same courtesy.
12. 

    Change of shift

    Mandychelle79 posted a topic in Relations

    So at the end of my shift I restocked the COW, made sure the tasks were taken off and made sure my fluids were not going to run out in the first two hours of the shift. Or so I thought. The person replacing me asked if I'd hang a new bag as it was getting really low. So I grabbed one thinking oops I missed it. Nope. There were 200 left and was running at 30/hr, so 5-6 hrs worth. Am I wrong to think the nurse replacing me was just being picky?
13. 

    Nurse yelling at patient

    Mandychelle79 replied to MSUOUgirl's topic in Relations

    I'm a loud person by nature and get louder as my emotions/adrenaline increase. When I meet new patients I tell them if I sound like I'm yelling it's ok, I'm just excited... now if I drop my voice low and it has a steel edge to it.... yeah not good. Effective, but not good. I just transferred fron psych but got to put psych nurse skills to good use when dealing with a pt in DTs. Said pt responded well with set boundaries and a little humor... like me saying I don't what everyone to see your bits and pieces when trying to convince pt to stay dressed.
14. 

    Leaving Psych

    Mandychelle79 replied to Mandychelle79's topic in Psychiatric

    i can see me eventually going back. Not the same hospital (if same manager/dr) but who knows what the future will hold.
15. 

    Leaving Psych

    Mandychelle79 posted a topic in Psychiatric

    I have spent the majority of my health care career working in psych. But because of things occurring on the unit I cannot support I am leaving psych. Amazingly I was able to find a floor position who was willing to give me a chance (I had been looking for almost a year, off and on). I will miss the population but I will not miss chaos of the unit.
16. 

    Disrespectful patient

    Mandychelle79 replied to hwknrs's topic in Relations

    Well some benzos don't show up in a uds, klonopin is notorious for that. Also depending on the time between consumption and the uds it may not show up