dankimal

Heya! i can empathize with you. Accept that for the short term, your eyes are not going to pick up on subtleties an nuances. Therefore, I would do your assessment as near you can, report what you think you seeing, and then ask your preceptor what they’re thinking and seeing. when you’re first starting out, it will be difficult to hone in on the cluster of signs that are really important. the fear of ‘missing something’ may cause you to OVER-assess inconsequential details. Keep it simple, keep it safe. best of luck!!

Hey all, I’m investigating care giver response in the acute phase of high stress situations, specifically, the observed “freeze” response. Imagine, if you will, a nurse walks into the room of a just bedded patient in a busy ER and finds the patient apneic and blue. The chief complaint was benign, and triage gave no indication that the patient had a critical illness. The immediate emotional response of shock and surprise gives way quickly to action... the nurse yells for help, activates the code and begins assessing... but in her head, although she’s seasoned and trained, it’s a frozen jumble. Do you know this nurse? ARE you this nurse? I want to hear all about it. thanks!

Hey All! The nurses union that represents my hospital has called for a strike. Without getting into the gory and messy details, I was just wondering what people’s experiences with strikes have been? Thanks in advance!

I believe that a fluid restriction of that nature would require a physicians order.

Hello all: In my practice I have encountered several instances of objectively addicted pts being prescribed massive amounts of narcotic medications. May I make it clear that these are not pts with low pain tolerances, these are confessed addicts with telltale signs and symptoms of narcotic addiction. They will manipulate, exaggerate symptoms, fabricate symptoms, and will go to great lengths to have more meds. My question/comment is this: After all physical causes of pain are ruled out, isn't it simply enabling to allow this population to remain admitted with increasing amounts of pain meds to satisfy ever increasing self reports of pain? Perhaps our mantra of "pain is whatever the pt says it is" should be modified to "pain is whatever the pt says it is until objective signs prove pt reports of pain to be unreasonable."?

Are you perchance a Humboldt State Grad? HSU represent!

While I don't feel like a licensed drug pusher, I do sometimes feel that all I do is run around throwing rx at people.

I must admit, I love the computer throwing emoticon.

Hello All: I've been flexed off the past few shifts, so I've had a great deal of time to browse the discussion forums on this sight. The discourse has often been heated and I've noticed that so much of the space is taken by posters who are angry, frustrated, disillusioned... "burnt out." So my aim and question is this: What problems do you see in the health care delivery systems you practice in? What can be changed? How can we change the environment and culture so that quality health care is accessible to all? How can we as nurses ensure that our working hours are uplifting to our patients as well as to our co-workers and ourselves? May we have civil, thoughtful discussion that avoids over-simplification. Happy posting. Daniel

In my neck of the woods we get a ton and a half of cocci pneumonia.

Not sure if anyone has seen this, but I read in AJN a few years back (I believe in 2008) that a OH hospital was piloting a system that allowed for RN working nights to sleep in the on call room prn using a similar "buddy system" already mentioned.

I have though about ICU, and I have seriously considered it. But part of me (perhaps the "grass is greener syndrome") is looking outside of acute care altogether and leaning more towards primary care. My nursing program kinda shortchanged me a bit in that arena, but we were in a rural area with little clinical space, so I am looking at shadowing opportunities at local clinics and seeing if that's a better fit. Regarding home care, it sounds like a dream come true, but before I am eligible for most positions I would need a few more years in the hospital. So we'll see. My year review is coming up and my DON is fantastic. I feel completely comfortable bringing this up with her.

Thanks, everyone. I know it will get better, and relative to my first few months (see my previous posts) I am doing much better on the floor. And I have no regrets regarding the invaluable experience med/surg had given me, and to missladyrn, I have often wondered how anyone could handle more than five! My hat's off to you! Cheers to you all!

Hello All: I am a relatively new nurse (practicing 8 months). At the time I started my first job, I entered with the excitement and enthusiasm that accompanies most new endeavors. Although nervous and extremely stressed, I persevered through my first few months with few incidents. But I find myself consistently plagued by a sense of dread. This feeling that I am missing something. During my shift, the tasks seem overwhelming. Tasks.... Even with CA fantastic 5 pt ratio, the needs of my patients can be too much for me to hold. I wish I could pull up a chair, converse with my clients... be in an environment that isn't wound up so tight at the hilt... anyone get my drift? Perhaps Med/Surg just isn't my niche. I have considered searching out opportunities outside the hospital. Perhaps home health, primary care, or even pursuing an advanced practice degree. I know this post is a bit dis-jointed. And maybe it's just the rain outside talking. But I'm desperately afraid that someday, all the little things that I've missed because I've felt so under the gun are going to come crashing down. I don't want to be that nurse. Anyway, any thoughts are appreciated. It's good therapy for us all. Cheers.

I'm a new nurse, 6 months on the job so far and have made two, count 'em two med errors. Both were relatively minor, and I will spare all the grusome details, but what I have learned is this: 1.) Always check your orders 2.) Always check IV rates What has saved me in both instances is the fact that I did not try to cover anything up. Once the error is discovered, instantly report it to all necessary parties. It really is the difference between mercy and wrath. People will forgive an honest mistake that is honestly rectified... people will not forgive one who tries to cover up an error, and nor should they. We are human. We will make mistakes. But we own up to it and prevent as best we can any harm from befalling those in our care who have given us their trust. Luckily for me, my institution has installed mobile computers on wheels with attached scanners which prevent a lot of errors from happening provided that one always scans, which I do, religiously. In addition, I am always checking orders, checking the unit dosage, the route, time, patient and rx. Keep it up!