RNwithpassion

I am orginally from Orange County and have been up in Oregon for about six years. I graduated last July with my ADN and am currently in school for my BSN. The job market for new nurses here is horrible, I am lucky enough to have a job at a SNF. My husband and I want to move back to California to be with family can you give me some tips as to how you got your job? ICU is acutally the area I am most passionate about...however I would be very happy with just about any RN position in a hospital just to get working in acute care setting. Anyways, any tips from your experience that you could pass on would be greatly appreciated. Congrats on your job and relocation! :

I am orginally from Orange County and have been up in Oregon for about six years. I graduated last July with my ADN and am currently in school for my BSN. The job market for new nurses here is horrible, I am lucky enough to have a job at a SNF. My husband and I want to move back to California to be with family can you give me some tips as to how you got your job? ICU is acutally the area I am most passionate about...however I would be very happy with just about any RN position in a hospital just to get working in acute care setting. Anyways, any tips from your experience that you could pass on would be greatly appreciated. Congrats on your job and relocation! :-)

THANK YOU ALL!! Your feedback is so appreciated and it gives me much food for thought for future situations as well. As a new RN I notice that we new RN's tend to jump the gun on many things for fear of not doing due diligence. The feedback you have all provided allows me to build my knowledge base to crticical think through these situations first. And now I know what "Occam's razor" means. ;-)

Hello Again - I am a new RN and have been working at a SNF for about one month now. I have two questions: 1) I work the NOC (night shift) and I have a patient on our med-rehab unit with a foley drainage bag filled with 300mL of red colored urine, and it was obviously r/t to blood and not a medication causing discoloration. After emptying the bag...she filled it with about 200mL clear, yellow urine. The AM shift charted she had cranberry colored urine and the EVE shift charted clear yellow urine. So, on my NOC shift she had red urine again. Does anyone know what would cause a person to pee urine with blood and then normal clear, yellow urine? Is she passing blood clots? The foley was inserted 3 days ago. Also, as far as my responsibilities go - A UA had been ordered and collected the previous shift. I received the results and faxed them to the Dr. with a note stating she had 300mL red colored urine my shift. And I charted my findings and that I faxed the Dr. the UA results and informed him of my findings. Should I be doing anything else? 2) I received an order to D/C a peripheral IV in a patient and then immediatley start a new peripheral IV. It stated the IV was placed 3-days ago. Are peripheral IV's usually replaced every 3 days? Thanks in advance for your feedback. Being a new RN and in a SNF with limited training and nurses who rather not take a few minutes to try and answer my questions..or just don't know the answer to my questions - this communication site is so very helpful! :-)

Thank you ALL for your feedback - your knowledge is invaluable. Also, it is so encouraging to have you all out there willing to guide me along as I make the transition from school to work. It's actually quite touching. I'm sure I will have more questions along the way and will post them as they come. ;-)

Blackheartednurse - It is true that you are not seeing any MD collaboration in my work...I never received a chance to do that during my training and am still uncertain as to when I should contact the MD. However, the posts from you and others are helping the picture become more clear. Currently, they have me working nights and not much has happened where I feel I need to call the MD. I worked a morning shift today just doing med pass on the skilled hall and it made me realize just how little I know. I am going to request more day shifts so I can get more familiar with the workings of each unit. So that if they want to keep me on nights, should something go wrong I will know what to do.

Hello - I am a new RN and with the job market as it is I accepted a position with a SNF. I received about 12 days of training. Unfortunatley the person who trained me was a new nurse herself and has only been working as an RN for two months. Currenlty I am working nights and they have started me on the LTC unit while I get acclimated. The facility I work for has a pretty high acuity level on their skilled unit so I am hoping to learn alot over there when the time comes. However, I still have questions so here goes. 1) I learned in school that O2 should be 95% or better. However, when I ask other nurses in the facility how to check patient parameters they don't seem to understand what I am asking for. I have done some research and found that medicare reimburses when O2 is 88% or less....so should I not worry unless the 02 is less than 88% and/ or my assessment findings show other signs of hypoxia? 2) A resident has a stage II ulcer on her sacrum, currently Open to air, and the nurse reporting off told me her skin is really moist. I suggested an absorbent dressing be put on to collect the excess moisture and the other nurse agreed. So, I applied one during my shift. When I came in for my next night shift the reporting nurse said don't put a dressing on...I said I did it to collect the moisture and she said don't do that but couldn't give me her rationale behind that. Am I not understanding something here? 3) I have a resident whose pain is not being well controlled. I was told that they had to stop some of her meds because she was hallucinating. However, she continues to hallucinate and is aware that what she is seeing is not real. She stated why I can't I get more medication for my pain I am hallucinate wither way. Any suggestions on how I can best advocate for this patient? 4) On the SNF unit the LPN had a patient who pulled is PEG tube out. The LPN called the Dr. and he told her to insert a urinary cath before it closed. I helped her with the procedure. I was surprised this was in our scope...more stuff I never learned in school. ;-) the LPN said as long as the Dr. gives the order you can do it. This seem scarily broad to me...is this true? Thank you!!