FLoat RN

Here is the simple solution! Tell your educator what's going on. They may set you up with another preceptor. Move quickly! Every day of your internship is precious.

You should let the endocrinologist know what's going on. Sugars in the 800's or 30's can be lethal.

I'm not sure where you got your information about 100% job security. You should check your sources. Hospitals are cutting back big time. They are not really even hiring new grads any more. Enter nursing because it's your passion, not for job security. It's probably one of the most stressful jobs available. You have peoples lives in your hands. You administer extremely dangerous drugs and procedures. The responsibility of practicing nursing is tremendous.

I'm in ARNP school right now. I have shadowed a Primary Doctor in the Past. One thing I noticed is he did move very fast and efficiently because he was only addressing one problem and he knew what the diagnosis and treatments were immediately. He would go to each room very quickly order labs or simple point of care test, then go to the next patient while the blood was being draw or test being run. Yes you have to be fast yet attentive to the patient and their needs. It's a business and the physician may not be reimbursed as much as he/she charges. If the patient bring up another problem then they need to set another appointment.

Let me correct my statement I should have have said something along the lines of a pt complaint. I wasn't referring to lab results or vital signs. For example, i had a pt that was complaining of pain. I noticed that the nurse from the prior shifts were administering two tabs of Darvocet N-100, which contains 1300 mg of tylenol! By the time I had her she had over 3200 my of tylenol in less than 24hrs (This pt had a history of hepatitis). I called the Dr. and reported this. He just said give her what pain medication she is not allergic to. This example is not that rare. I'm sorry if I offended you that was not my intention. I was replying to the entry before mine. I don't think floor nurses should diagnose pt symptoms or lab results. However, I was always under the impression that NP do. I am agreeing with the article that more authority should be given to NP. The original article states ,"For years advanced practice nurses — as well as a host of other caregivers such as chiropractors and physical therapists —have butted heads with doctors over "scope of practice" considerations. Doctors maintain that even with an advanced degree, these nurses do not have the same education that physicians get in medical school and residency programs and that patient safety could be compromised. They are also wary that their practices could see significant patient losses if the nurses were allowed to practice more independently."

First of all, is English your first language? Regardless if it is or isn't, I believe you need to read more. You need to read a lot more. While you're reading you need to look up words you don't know and use them in a sentence. A runner never wins a race by only running when he or she needs to. Another thing you need to consider is your ability to understand English grammar. I struggled with the subject of reading and writing for many years during my childhood. It wasn't until I relearned the rules of grammar did I begin to retain information. Let me leave you with some questions. What's a demonstrative? Think of an example. What's a preposition? Think of an example. What's an adverb? Think of an example. In a sentence what's the subject? What's the predicate?

They must preform interviews differently in Australia. I think in the US they assume you know the basics of the profession if you have passed your boards. However, I did have to take a medication math exam. In order to keep the job applicants had to score over 85%. It required a lot of knowledge of pharmacology. The main concern of employers in the US is experience and attitude. Don't sit in front of the individual interviewing you and dictate to them all your terms and conditions. Also ask the interviewer questions related to the position you are interested in. For example, What is the nurse to patient ratio? What are the expectations of nurses on your floor? Ask these questions if the employer ask you if you have any questions. It will make you seem interested not pushy and demanding.

The fact of the matter nurses are already more directly involved in pt healthcare than many physicians. How many times have you called a physician with results and they asked you what do you want to do about it? So you just tell him or her what you think and they just say yes to your orders. Nurses need more authority. However, I believe nursing school needs to be more difficult and more involved with pathophysiology, diagnosis, pharmacology and treatments. I plan on going to NP school fall 2011. I looked over the courses and I could tell it was just a bunch of fluff. NP school should resemble PA school. PA school is more like medical school.

I think first of all you need to figure out whether you made a medication error or not. Elderly people usually have several comorbidities. Remember to always check vital signs before giving BP med or HR meds. Figure out if the pt is symptomatic. A BP of 86/53 really is not that low. You need to determine first if the BP was taken properly with the right size cuff. Often times CNAs don't measure the BP correctly with the right size cuff. If the pt is thin they probably need a pediatric cuff. In the case of a low BP you can place the pt in trendelenbergs. Also you need to monitor the urine output. If you have less that 30cc/hr that's an indication that you do not have proper kidney perfusion. If you maintain the MAP above 60 you have good organ perfusion. Another thing you need to take into consideration is the pt's trends. Has their BP been on the low side or is this new?

In the state of Florida we do not have nurses unions; which I believe is our saving grace. The organization I work for is a not for profit hospital system. A lot of the nurses I know have part time jobs at other hospitals to make up for the fact that we no longer have any overtime available. I've always been under the impression that nursing has it's peaks and valley's just like other professions. I predict that as jobs become unavailable for gradate nurses nursing schools will go at off business. Then in ten years or so there will be a huge demand yet not enough new nurses to supply that demand. Then we'll see those huge sign on bonuses and overtime available.

I agree with you about the FNP degree. I am going to see what I can do about preforming my clinical hours in the ER. Thank you very much for your input. I'll looking into the CD you recommended.

I'm a float nurse so I'm almost always the new nurse. I believe that as a newcomer I need to try harder to get the approval of the people I work with. I'm treated fairly most of the time. Every once in a blue moon there is that one person who has a chip on their shoulder or perhaps just doesn't like me very much. That person I try to assault them with kindness. I try to make them feel comfortable. I offer to help them when I can. Eventually their walls crumble when they get to know me. This is something I've had to practice over and over again because I have a young pretty face. Never judge a book by it's cover. And never judge the people you work with because one day that person may be your boss.

Kudos to all of you for your hard work and dedication.

Ok I have one year of acute care nursing under my belt. I am planning to start my MSN next fall at a private university. They offer adult and family track for ARNP. Does anyone know how I can specialize once I'm done? I want to specialize in either ER, OR or ICU. I also intend on continuing to work as an RN for the next 2 to three years while I attend school full time.

Most importantly you should always remember to ask questions. Ask question! Ask questions! Even as an experienced nurse I will get the opinions of the nurses around me and consult reference material if I'm not sure about something. Yes it may take more time to search for the right answer however it's the safe thing to do. Safety first. And never forget your abcs and Maslow's hierarchy of needs. That's how you will know how to organize your day. Remember haste makes waste! Always double/triple check yourself!