Hay, RN

I have also wondered about this. What I do (not saying it's correct): If the patient is on it every four hours (as needed) I don't generally get a whole set of vitals, I just put the pulse ox on them and leave it there for about 15 minutes to make sure they don't quit breathing. As for diluting the medications that is a big no no no no no no. At least to the patients ( go figure ). However, on our emar morphine is now coming up with a note to dilute it and push it slowly over 5 minutes. But there's not a note to dilute the dilaudid. That'd be sort of alterting the medication.

When I worked night shift I hung quite a few lipids. Lipids usually comes in a smaller bag and I did not use 'vented tubing.' You do have to use a filter, though. Maybe the book has a typo and meant 'filtered' and not 'vented' ?

I choose 3. Pay off extra each month. That way there's credit history and also savings on interest and in the bank. (:

Oh... about the big bold 7am - nursing is 24/7 just in case you hadn't realized. I do not agree about the "real nurse is here now" attitude though. Sorry. A nurse is a nurse.

Yes, it is legal for them to search their property anytime they wish.

My Facebook is private. Not public. Only my friends can see ANYTHING on my profile. (: So I don't care what I put on there.

Really... if I understand you were required to sign off orders that you didn't take? Easy solution. Just make sure that they were ordered/carried through then you can sign it off. If you see that it hadn't been carried through/done then there's a problem and you need to let the charge nurse know and NOT sign it 'til it's completed.

Everyday I take my lunch break. I usually go around 12 or 12:30. I have never missed a lunch and never will. (: -knocks on wood-

The purpose of the TLC round is to have a member of staff to go into every patient room on our floor/unit and ask them if they need help to the bathroom, if they need pain medication, if they need their belongings, etc. Our facility started it to help boost are HCAP scores. And it's just to talk with the patient - communicate with them - let them know someone will be in their room everyhour to help them if they need it. (In addition to all the nursing things their nurse does). Our scores are going up, too. We don't get report on the patients/we don't know that sort of thing. it isn't required really. (:

I start at 6:55am. Hide my vital machine in the bathroom and put my name on a med-cart. Round up them night nurses and get report. (After all - why WANT a day nurse who drags in 10 after 7 and come get report 20 after? You want to go home and I want to go home when you come on - have some courtesy). Go get vitals and do system assessments/make sure everyone is alive. I usually do the easist/low acuity first. I save the sickest for last becuase they take the most time. Update the boards while I'm in there - my name, date, phone number etc (I actually erase the whole board and re-write it because half the nurses here don't have ligible handwriting). Sit down at 0800 and put in all my assessments. Answer any call lights/needs/pain meds. I go to breakfast at 0830. I start med pass at 0900. Breakfast for the PTs is served around 0800 so if I have any feeders, I'll feed them before I go to breakfast. Med pass lalalala, more thorough assessments, med pass lalalala. I like to start baths on totals at 1000. Anyone else I cover their IV and put them in the shower. I change their linens while in shower or during bed bath. At 1130 I get my 1200 vitals and do meds lalalala med pass. I go to lunch around 1200-1230. Come back half an hour later and round on my patients. I do 1400 meds at 1300. Med pass lalalala. In the mean time all the lalalas are talking with the patients, assisting the patients with whatever they need, talking to families, etc. 1500 I do 1600 meds and obtain vitals. Med pass. Lalalala I sit down and play on the computer ... in the meantime. Waiting for things to pop up to do - my patients to need me. An admission here or there ... gotta plan them in. Hope for a walky talky ;-) All in the mean time while in the rooms make sure they don't need help to the bathroom, clean them if they are soiled (I cannot leave a patient in pee or poop, no way)! Start some nursing notes on what I did - bathed them and whatnot. Do 1800 meds at 1700. Chat with the patients ... discharges. You know. And I just wait on the night nurses to come on in and take over! (: I rarely leave anything to do for the nightnurses other than what they are required to do on their shift. Of course, all my days don't go this well but it's the PLAN I like to stick to. I've been a nurse a little over two years on a Med-Surg unit so it'll take some time to work into a schedule/habit. Oh, I forgot to mention our hospital does hourly rounding on EVERY patient on our floor. Meaning all the nurses have to sign up for a slot (one hour) and then do rounds that hour. I usually go around 1600 - this seems to be the calmest time. Good luck!! Edit: We usually have 4-5 patients. No PCT on our floor. Usually four though. If we're full one nurse has to have 5 patients. Usually the LPN.

Oh, I forgot to add that I throw my dirty scrubs in my hamper with all my other clothes. My BF has his own seperate laundry basket for whenever he does his laundry (never...). Lol So, the dirty scrubs sit for about a month UNLESS they get soiled while at work then I'd change at work - put the dirty scrubs in a bag and maybe wash them my next day off.

I had a normal day except DCF came to investigate the caregiver of one of my patients and the son was freaking out in the hallway because a police officer came with the lady and was demanding I go into the room and report back to him what they were asking her etc. etc. I'm like no way, man! So I ended up hanging out in the bathroom for half an hour or so until they left the patient room and went to speak with him.

If it's your first time then you may not get into too much trouble. Just call your job and ask to speak with your supervisor on your floor and them tell you were doing your laundry and found a PCA Morphine and you need to bring it back. Tell them it's been two days because you just took off your pants and threw them in the dirty clothes and didn't check the pockets. Then you should come in and waste it with a manager. A staff nurse should not have to waste with you. It should be someone in a manageorial position. Good luck. This happened to me but was a vial of half used hydromorphone. Found it two days later. Just had to waste it with my supervisor and go down to medical records and sign that we wasted it on the paper chart.

Oh, what a typo I made!!!

Yeah, I've said it a few times and the charge nurse would be "Sssshhhh!!!!"