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Been a nurse for 5 years... now 2 med errors in one week. Help.
I am a wreck, and feeling pretty wretched. I'm in my last week of a job in an outpatient clinic, administering injectable meds (doing other things too, but this is what I screwed up on.) My first error, two patients of the same name, gave one a shot she didn't need (but luckily didn't hurt her.) Second error, gave an allergy patient the wrong mix- someone else's- and luckily no harm was done. I am so thankful neither error had a negative impact on the patient's health, or I would be beating my head against the wall right now. I offered my manager to cancel my remaining 2-3 shifts, but she declined and said I need to learn from the experience. I'm glad she has faith in me. My upcoming job does NOT involve administering meds, it's mostly patient education with a little phone triage. This is somewhat of a relief- but I do have a few shifts left at the old job. Is my license at risk? I have terrible visions of being sanctioned, or losing my license altogether. I looked up the WA state nursing sanction guidelines... you can be sanctioned for even one med error. I so love nursing, I have no clue what I would do. I have put a plan into place for my next shift, with the help of nurse and QA friends, to make sure I am religiously sticking to the "5 rights", am arranging to have another RN check my allergy shot setup before I give them, and I also am taking 3 CEUs in safe medication administration before my next shift. I don't know what else to do. I'm so worried and upset and feeling like an awful nurse, I've been crying for days. Does anyone have any thoughts? Please be constructive, you don't need to tell me how terrible this could have been, or how terrible I have been, I've been telling myself for days.
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*sigh* Mono.
I have mono. (Aren't I too old for mono?) I also start a new job on Monday. I've had mono for about three weeks (was misdiagnosed for the first two) and can do nice things like swallow, stay awake, and walk across the room. The first week of my new job is all sitting and training, which is good. Any tips on recovery? I'm eating well, resting, taking echinacea, etc. I'm terrified of another relapse- this is my first one, since I didn't get a diagnosis of mono and forced myself to work/ exercise/ etc. when I felt the slightest bit better.
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My 3 year old has MRSA!
This past year I worked both as a school and a jail nurse. At the jail, treated many, many MRSA abscesses. Then one morning a 7-year-old walked in complaining of a "sore" on his back. Pulled up his shirt- gigantic MRSA abscess, leaking all over the place. Poor kiddo. I knew his family, and they were certainly loving, caring parents... just perhaps not up on the signs and symptoms of abscesses. It's everywhere. Just everywhere. Babies are getting it. There's no way to prevent it except to eat well, sleep, exercise, and make sure your kids try to stay healthy too. But it's not just for jails anymore! (sigh)
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Sleeping on the job..acceptable or not?
I used to work nights. I rarely could sleep for just a little bit, and not wake up feeling worse. However, some nurses who were having a slow night would put their heads down for a bit, with their beepers on loud volume right next to their heads, so they'd know if somebody called. It rarely lasted longer than 30-45 minutes, and nobody minded. The culture was such that it was totally acceptable to wake up a nurse to help you with something, or if their beeper was going off and they didn't hear it. Working nights isn't natural for our bodies, and I say if a coworker wants to take a quick nap, and will not be adding to anybody's workload by doing so, she can go right ahead. It doesn't harm anything, and nobody's around to see it except the other nurses, and perhaps a resident or two, who is mostly likely snoring in the corner.
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Do Nurses Need Chemistry Education?
I got a biology degree before I went to nursing school... and got almost 2 years of organic and inorganic chemistry. I use it often. We are chemical creatures, and if our chemistry gets out of whack, we are toast. It's important to understand at least the basics of what's going on inside our blood, when we take meds, etc.! Like I said, while it's not vital, often my organic chemistry background makes me able to go Ohhh yeah... that's how it works.
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Advice for new clinic job
Hello all! I just accepted a position as an RN in a clinic for low-income families. I'm very excited! I've worked in a school setting, and a correctional setting, but never in an office. On the med-surg forum they have a "sticky" with tons of advice from more experienced nurses on how to succeed in that area. (i.e. don't panic, don't stand for screaming doctors, delegate effectively. etc.) Wondering if we could do something similar here? What are strategies that you've found to make everything run more smoothly for you and make your job more rewarding? Any tips are welcome... Thank you!
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Corrections Vs. Psych Institution for the Criminally Insane
Heck, I worked in a residential locked psych facility for teens- not criminally insane, just mental health diagnoses- and got assaulted all the time. I work in a jail for a few shifts a month, and I'd say it's safer than your basic ER. Always CO's around when inmates are out of their cells, plus they know if they mess with medical staff, they're getting sent to the hole and most likely getting their sentence extended. I've been verbally abused, and sexually harrassed to a point, but nobody's ever touched me violently. If an inmate has any history of attacking staff, or is an ultra-security, they are shackled. I guess they could conceivably bite you, but even working the psych unit, I've never had anybody try anything like that. I would never, ever work in a facility for the criminally insane. I would be too worried about being attacked. It takes a very special and very brave person to do it, and if that person is you, I commend you for it. And if you decide it's not for you, I commend you for making the right decision for your career, too. :)
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Oddest things found in a patient!
I was working in a teenage psych home... a girl told me her ear hurt. As I approached it with the otoscope, this blue glow began emanating from her ear canal... all I could think was, "aliens?" No, she'd stuck a shard of blue glass in her ear that was reflecting the light. The doc told me to remove it if it came out easily- it did. There were two pieces of clear glass behind it. She had to have surgery. I wish I could say she was the only one there who did this..
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Chicken or the Egg?
Our school seems to have a policy somewhat in between. If there are live bugs in the hair- the kids stays home. If there were nits, and the kid still has two or three, but the parents are conscientiously combing them out, we'll let them come back if they're old enough. Kindergartners and preschoolers touch heads constantly- sixth graders not so much, and they can understand it if we say "Don't hug anyone, don't touch heads with anyone, don't share clothes." We've found that the anti-lice shampoo, plus lots and lots and lots of combing, works well. All the lice cases I've diagnosed have been quite far-gone, with live bugs running around all over the place. If it goes from that to a couple of nits, as long as the parents are continuing treatment and the child is old enough to follow directions, they can come back. Yes, we technically have a "no-nit" policy, but our supervisor is changing it for next year, and has told us to perform exclusions on a case-by-case basis.
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HELP! Class assignment needs to be completed
I work in a jail. 1. 4 hours of classroom, 4 shifts of orientation (I'm agency.) 2. What self-defense course? 3. I won't know until I am, and I doubt I ever will be. 4. Nope- had some unconscious people/ chest pain/ emergent situations, but never had anyone stop breathing. We're correctional nurses too! :)
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Missed a fractured arm?
I just talked to a girl with her arm in a sling. I saw her on Wednesday after she fell off the monkey bars. She was calm, didn't seem to be in much pain. Said her arm hurt- it wasn't swollen and she could move it. Gave her ice and sent her back to class, telling her if it got worse to come back. Turns out the next day she was diagnosed with an arm fracture! I feel very oblivious. Just left a long rambling message with the mom apologizing. I feel like there's something I should have noticed... but what? What did I miss?
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How would you have handled this?
Jeez. Even if the candy *had* come out I would have had his parents pick him up, because I'd imagine he was scared and traumatized! If it hadn't... definitely wouldn't put him on the bus.
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Staff nurse hoping to get manager's perspective...
Quick Update- Did a lot of job shadowing, and my experience in L&D was amazing. I loved the hospital, the nurses, and the experience from beginning to end- actually quite a hard labor, but it ended with a beautiful baby boy. I was able to speak with some RNs and higher-ups about what makes a good L&D nurse, and I think it's a good fit. Only one hospital (the one I shadowed at) will take me without recent acute care experience, and it's going to be an uphill battle getting the job. All the others want me to have a year of med-surg, which I understand, but which terrifies me nonetheless (I've heard so many bad stories). We will see what happens. Thanks for your advice, everyone! I'm keeping my fingers crossed.
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What do you wear at work...?
Street clothes, no jeans. No nametag. It's a small school, so the kids know who I am.
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Anybody work at, or heard anything about, these hospitals?
Stevens Hospital, Edmonds Northwest Hospital, Seattle Skagit Valley Hospital, Mt Vernon Valley General Hospital, Monroe Providence Hospital, Everett (a more well-known one) Evergreen Hospital, Kirkland Thanks guys!