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s0ad's Latest Activity

  1. s0ad

    Patients lying on ciwa?

    Just wondering how everyone handles the ciwa scale. On my floor it's typically ordered q2 if the Pt has a history of drinking. However with the last couple of patients I believe the patients lied (or at least exaggerated) symptoms to get meds. I think this then led to them becoming actually worse off... Hallucinating, violent etc. Soon after when Ativan was eventually cut back or stopped they became better off. I typically go through the questions, but just as with pain, if they tell me they have severe nausea headaches pins and needles etc I enter what they state... Which leads to a dose of medication. I've also seen nurses who, if the Pt "looks OK" to them enter 0. I don't want to falsify documentation but it almost seems like sometimes they would be better off without the Ativan. So what do you do if you think the patient is lying?
  2. s0ad

    Continuous Bladder irrigation

    Thats crazy. I've never had a urologist come in and tell me my bag was going in too fast. I usually open it up enough where its fast but I can still see it dripping, rather than pouring out, in the chamber. I think an average bag for me will last about 70 - 90 minutes. Not good for the pt. if they start clotting. Anyway you can discuss with a urologist and maybe get the policy changed?
  3. Haven't had this happen to me personally, but know lots of other nurses who it did happen to, usually by a difficult patient/family. Don't know why they liked me, but I really wish they would have "fired" me, ha. I just think some people don't have a clue... I'd be thankful I didn't have someone like that.
  4. s0ad

    Would you call a code/MET on a pt. who is a complete DNR?

    This largely depends - DNR doesn't mean do not treat. I may have a pt who is a DNR who is perfectly alert and oriented, mostly independent and in with cellulitis. If I walk into the room and they are unresponsive I'm calling a MET call - maybe they had an MI or stroke and need treatment ASAP. If I have a pt. that is deteriorating over the course of week, and eventually has poor sats, bad vitals/labs but has expressed to me they want everything done short of compressions/being intubated, I'm calling a MET call. If I have a pt that has been poor, family knows they are poor, pt has no plans to ever recover etc. then I would treat whatever symptoms they have, oxygen, lasix, etc. I always try to evaluate which patients want comfort care/hospice, vs treatment but not compressions, etc. I think so many people are hesitant to sign a DNR because they think we will no longer treat them. And unfortunately I've been in many arguments with MD's because they think the patients DNR means they are comfort care, when the pt. has clearly expressed that they want treatment. I may not agree with it, nor the MD, given the patient's condition, but its not really our decision to make.
  5. s0ad

    Compassion, easily lost?

    I always have thought I was very compassionate, and still think I am, but maybe not to the extent prior to nursing. I think its because I've seen young patients die horrible deaths, yet stay in high spirits until the end, and have watched their families in misery throughout the whole ordeal and at the end thank the nurses so much, etc.. Then across the hall is a demanding pt with cellulitis, with a demanding unhappy family who are sue-happy, and have complained to management about x, y, and z, and so management says we have to give extra attention to this patient, etc. And I would never rant near a patient's room (I have seen others and find it completely inappropriate), but I must admit I will to another nurse, usually behind a closed door like the utility room or something. I feel situations like this suck my compassion, but I am still nice to all. I don't believe being mean or vindictive gets you anywhere. I think once I get out of this area of nursing it will help, its too depressing for me and that takes a big toll!
  6. s0ad

    oncology (cna interview)

    Can't answer about pay. As to the oncology part the most difficult thing for newcomers I think would be the extremely sick patients you may have - many very young (I have had numerous patients die in their 30s, 40s, 50s). And the death. CNAs at my hospital are the ones often cleaning the patient up and wrapping the body after death. I find wrapping the body after death very morbid myself, our wraps look like trash bags. Many of your patients will be very dependent - colostomies, urostomies, difficulty walking (either to weakness or bone mets.), and many times pts can become confused with brain mets. Lots of nausea, vomiting, and diarrhea with chemotherapy. Good luck to you.
  7. s0ad

    RN Salary Survey 2013: Post here!

    1. New York 2. One 3. Hospital - oncology/med-surg 4. $24.80 (Days) 5. Nights gets about $4 more, evenings $3ish, weekends is cents.... don't even notice 6. Nope I live in upstate NY which I don't find to be too expensive. I rent a very small 2br house for $650/month. Gas is about 3.75 right now.
  8. s0ad

    Being a patient where you work

    Due to insurance reasons and being in a smaller area this is quite common for people at my place of work. We've had doctors, nurses, ancillary staff we know on our floor. Thankfully I've never experienced that. I agree I'd be quite mortified. However, many of the nurses and doctors I know that have been through it are able to make jokes. I feel like some doctors even forget, if you see 25 butts a day, you'll probably forget about most of them. I must admit this is why I chose not to have a colonoscopy. A doctor I see often enough would have done it.... and hecks to the no (though I really don't think it was needed anyway). Also, I have some people I wouldn't let touch me with a 10 foot pole, though those people are every where and it may be of benefit to know who they are. I certainly feel for your situation - best of luck to you.
  9. s0ad

    HELP!!!question about prn med

    I reread it, and would have given it. Though I wouldn't necessarily give the PRN 20 minutes after the routine, I try not to completely snow anybody. But yes, I consider PRNs and routines separate orders. Maybe ask for an MD clarification so the pt receives more consistent pain management. If her pain is always a 7, maybe she needs some adjunct therapy.
  10. I had a small debate once with the older nurses on the floor. I was newly out of school and taught that many IM injections don't, in fact, need to be aspirated. They looked up the policy in the nursing guide we use, and low and behold, it did not say that you have to for all. I mostly give IM injections for vaccines, so I'm not sure about ALL medications. A quick google search revealed this: " The results were not surprising; there was no research evidence to support the use of aspiration in giving I.M. or subcutaneous injections. The researchers recommended the following for consideration: Aspiration is not indicated for subcutaneous injections of immunizations, heparin, and insulin Aspiration is not indicated for I.M. injections of vaccines and immunizations Aspiration may be indicated for I.M. injections of medications such as penicillin Until a standard can be established, injection techniques must be individualized to the patient to prevent incorrect needle placement (Crawford & Johnson, 2012). " (Source)
  11. s0ad

    leaving a contract at a hospital early- not traveling RN

    The information they provided is all relative. If 500 people applied and only 7 were hired thats not a ton of openings. My flood alone hired like 10 new nurses in one summer, and we're relatively small. Also orientation for a new nurse is expensive. While doing hospital orientation, floor orientation you're getting paid a salary, but don't count as staff - you're just learning. Thats a very large cost. I wouldn't take it so lightly. I'm not sure if they could send it to a collection agency if you chose not to pay, but you def. need to do some research. I signed a contract for a 10k sign on bonus for a 3 year commitment. I don't plan on staying all 3 years and plan on paying back what I owe. I signed the papers. I committed. Maybe you can transfer some place else within the organization.
  12. s0ad

    Magnet curse!

    I was not at my hospital prior to magnet but honestly don't care for the status. For one, I think we miss out on many potentially good employees because they will not hire those with two year degrees. A lot more paper work is added. It seems to me as if the nurses who have been there for a while don't care for the changes. To be honest I think magnet is kinda a load of crap and doesn't mean a ton...
  13. s0ad

    Is night shift healthier for some people?

    Thanks everyone for their input; its very helpful. :) I think with less stress and better eating it may work out well for me. I feel tired a lot right now, so I can't see that getting worse, only maybe better. And maybe I will be able to see my boyfriend more, by the time I get home from work now, take a shower, cook dinner, walk my dog, its already 8 or 9 pm so we hardly see each other (we don't live together). If on night shift I'll be up an hour before he even gets back from work. Also, because of the pay increase I'll be able to work 4 days instead of 5, which would be nice..
  14. s0ad

    Is night shift healthier for some people?

    The anchor sleep thing is very helpful - thank you!
  15. s0ad

    Is night shift healthier for some people?

    I was hoping to just give it a whirl first for a very short time to see if it would be a good fit. I just remembered that in school (Jr. high and HS) every time in the summer, I would go to sleep later, later, and later, and eventually I would be awake at night and sleeping during the day. I wish I knew how I felt otherwise to know if it worked for me. It just frightens me about the associated health risks. I always hear people saying how much better they feel on days vs nights but never vice versa, which concerns me. Eventually I'd like to get away from bedside nursing and do maybe public health or more teaching based stuff, which would be day shift things but I think even 9 - 5 or 8 - 4 would be a ton better than 7 - 3 and thought maybe nightshift would be better for me for the time being.
  16. So I work days, which as a new RN can be difficult to get. I've worked a bit over a year. We're a busy floor. I am typically out late, between 4:30 - 5pm (supposed to be 7 - 330 shift). I usually am unable to get a lunch, so either don't eat, or eat worse than I'd like to when I get home. I usually get VERY hungry before bed, but try to avoid eating right before bed. I usually scarf down some breakfast. I never used to eat breakfast because it made me sick (nausea) but I would just be so hungry from not eating all day, so I made myself. Any who I've read through many topics here that state how unhealthy night shift can be on the body. I'm very health conscious. I feel like days isn't that healthy because of my eating habits. But will nights really increase my risk of hypertension/cancer/diabetes/weight gain/ etc?? I'm only asking because I feel like I may be more nocturnal. For one I can eventually fall asleep whenever. But even on my days off when I wake at about 9am I want to take a nap by noon. I have a VERY hard time going to sleep before 2 am or so. I start to become really energized late in the evening like 8pm or so. I have an *extremely* hard time waking up in the morning. Even if I had 8 to 9 hours of sleep. I have to drag myself out of bed and am often sleepy until noon. Also the most stressful things for me on days - dealing with doctors, families, and lack of teamwork - is minimal on nights. I did a night shift once before and it was fine for me. But it was only one shift. Thoughts/experience?

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