All Content by workingspaz
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Looking for Advice-New Grad, 8 patients?
A job it is and take it if you must. But former new grad that was in your shoes, my experience was bad. And the director wasn't kidding when they said 8:1. It was routine. Don't get me wrong; I learned alot in the hairy five months I was at the position. Mostly how NOT to do things, how to worry an ulcer into being and how to slipshod care for patients. But also got enough experience under my belt as an ADN to apply at a better facility close to home where I could refine my practice and actually provide quality care to the people for whom I am responsible. I do not envy you your decision; best of luck.
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What a night!
3 total cares, turn 2 (1 that had RRT'd the prev night) 2 AMS, actively crawling OOB (1 that had fallen during stay) 2 DVT (1 with tach HR 150+ just hanging in bed & active SOB- can we say poss PE?) And I came from a facility that routinely assigned 8 or 9, but these guys were VERY sick. I'd had most of them the night before and barely held it together safely with 5. There are nights that 7 is safely doable; not that night, in my opinion.
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What a night!
:mad:Jeers- to the charge nurse that made my assignment. To the other charge nurse that stared at me like I had grown a second head when I stated "This is unsafe", refused to take any of my patients, and offered the only alternative to the situation as "You can give one of your patients to another nurse, but you'll have to take the first admission." Hello?!?! What part of 'unsafe' sailed past cranial nerve eight? :jester:CHEERS- to the unit sup acting as house sup that night, that acknowledged my concerns; assured me it was okay; offered SEVERAL potental solutions. For getting another nurse to relieve our floor (The RN's had 7, LVN 6). And for reinforcing that once staff start throwing around legitimate "unsafe" concerns, that admissions don't keep coming! You shut the floor down!! I am forever grateful for your excellent leadership skills!! :redbeathe
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Loans, loans and more loans
ditto canes- i'm no spring chicken and would be interested in financial planning. i've been very lucky so far to have all 3 of my degrees paid for by work. recently i've been considering msn with a dual mba, but not so excited about the potential pricetag (25k)...as many prev posters have stated to the OP pay the first degree significantly down prior to jumping back into the debt ocean. advice from someone who swam in debt r/t my husband getting ill. best of luck
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Flaming rant
Disclaimer: This is a general rant about my crappy night, and any generalizations made are just that: GENERALIZATIONS. This is my statement of fact: I respect ALL of my colleagues that strive for professional, courteous and safe practice, whatever your discipline. Who the H*#% does ER think they are????????? Seriously? Charting that "report given to a nurse via fax. Pt condition disclosed and all questions answered" @ 2130, then the pt arriving at 2133 when I've just gotten the fax and called to question orders? How frickin' safe is that???? Or legal? Add to the fact that the room wasn't clean, and us medsurge peeps are just asking for you to hold the pt for 5 or 10 mins tll the room is clean with the floors dry so we are all safe in transferring the flailing combative confused person from stretcher to bed? Could it be so hard? Or the fact that you answer the phone to my request pt is already on your floor we're not taking em back. Is it safe for me to keep this combative person just hanging in the hallway with transporter and spouse (on a walker)// staring at me running around prepping the room??? We're all in the same healthcare boat together- Let's not crap in our beds and be crappier to each other while we're at it! I know mgmt is pushing for ever loftier goals of "NO WAIT!" And more service than care oriented. Satisfaction scores? Seriously? We're a HOSPITAL, not a resort! When does it go from expedient transfer of care to DUMP JOB? Wait- I got it. I will transfer there so i don't have to be on the receiving end. Rant over. (PS- Again, ER you guys rock, but this one episode just latched onto my chest and wouldn't go away)
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To all Night Nurses:
Wow- that's the highest comlpliment I've recently received from a fellow colleague. Thanks for recognizing our unique challenges- I bet you are a great nurse to work with, having insight..... Can you bottle it up and send it to some of the management??? THANK YOU!!! ps- and a hearty thank YOU for working in the day time around doctors writing crazy orders, multidisciplanary team members yanking your pt's off the floor, breakfast, lunch and dinner and the neverending stream of family members that just hang in the room and smile as g'ma pulls out her NG tube. Kudos to my day colleagues.
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What is your definition of an RN?
i disagree for BSN as minimum standard for education requirement; i've observed both new adn and bsn educated interns and the bsn looks a little lost when it comes to hands on down and dirty nursing (bath, poop patrol, iv's, catheters, adl's) versus the adn nurse this was the meat and potatoes of their clinical experiences. in my area the bsn nurses "shadow" their working nurses to "watch and learn". the adn's shadow to "learn and do". i think continuing from adn to bsn is strongly advised, but from what i've seen it shouldn't be the standard. even as far as professionalism, i've seen many an adn that had classier manners and professionalism compared to some bsn's.... perhaps the kicker for me today, was giving vaccines in a retail setting. my name tag read clearly : Name, RN. the lady i'm giving a shot to says she used to work for the CDC regulating the production of vaccines against MMR, smallpox etc. She looks at me and asks, so what do you have to do to be able to give shots? Are you a CNA? Seriously??? talk about burned biscuits... 2 yrs science prereqs and 2 yrs nursing plus a board exam via the state....... No, I just picked my license up out of a crackerjack box and slept at a Holiday Inn Express :madface:
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Medical Assistants the new RNs???
sometimes it's not about the license but about the brains. i've worked with some RN's that made me cringe and wonder- what were they thinking????? and then i've been care for MA's that couldn't help me for squat.... so- live & let live and try to share the knowledge to better our colleagues, for we're all in this healthcareboat together, right?
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How do I get along well with my clinical instructor?
as per previous posters and a former student that was NAILED by a nurse that even the staff knew and called her "the Nazi", head down, do the assignments, seek a mentor instructor in the form of those you may have already had and just hang in there. funny enough my nazi-***** instructor happened into a retail facility where i am giving vaccines and just totally ignored me. WOOHOO! just have confidence in yourself and when you need help seek out supportive instructors as you can. good luck- it's only for about 4 months
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Should I have implemented Suicide Precautions?
good for you- it's a hard thing to assess for suicidal ideation and abuse; awkward. keep up the good work! chalk this one up to learning, and see previous post LaughingRN mentioned about plan. i wasn't there, i don't know your situation but before initiating precautions here's an idea of what I ask: Are you here because you tried to hurt yourself? Have you though about it? (if yes) Have you thought about a plan, or how would you take action on your thoughts? Let the md or anyone else say whatever they like; it's YOUR license if rounding 2 hours later you find them hurt or worse, DEAD and could have prevented it. It's one of the National Patient Safety Goals, outreach to suicidal patients. listen to your gut.
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Need advice please! Just passed the NCLEX-RN but a little unsure of my next gameplan
based on my experience with this job market APPLY NOW! if things progress to the point you are offered a position or the discussion comes up about any extenuating circumstances to your employment, then is the time to bring up sis' wedding. last year i went from may-september before landing a job... just my advice, do what you will. Welcome to nursing!
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Near Miss at Prescribing Stage - What Would You do?
are we sure this isn't troll fodder?
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To Stop or Not
Great question! I'm currently in pursuit of my online BSN and my online instructor ( who is a lawyer and a nurse) did a great job of explaining Good Samaritan. Her example was a medsurge nurse on her way in to work notices a car accident and pulls over to render aid. She notices pt having breathing problems and opens pt airway with chin thrust and remains until EMS arrive, then hands over care. Ultimately the pt suffers a bad outcome and sues everyone. The nurse is not held liable because she acted as a prudent nurse within her scope and performed CPR, stayed w/ pt then turned care over. The second scenario is same RN, who watched some medical show and sees the accident thinking "This is my chance to shine", notices the troubled breathing, proceeds to yank out a pen and wings an in the field trach placement. Pt dies of crushed larynx, family sues; family wins because it is outside her scope of practice and not what a prudent nurse would have done. I hope the scenario helps place some perspective on GS and the protections we're afforded.
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Pyxis - The Ultimate Fomite
When I have problems trying to scan my finger, I clean it with an alcohol swab and 100% of the time get an immediate read after doing so.... Maybe when you get an error try this trick and pass it on? Let me know if it works? Also, we are very lucky to have a gel dispenser right in front of the door to the medroom. I usually have a tendency to gel in and out of there, so I know my hands are relatively clean.
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Work for a mass immunization company?
yeah. they are legit (the "M" co.) a great way to get practice as a newbie, and decent pay. signed back up for a second season and are looking forward to it!!
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Texas Tech RN-BSN, Fall 2011 class
hey guys, looks like the acceptance emails are in. for anyone that got an aleternate letter/offer or no offer yet- have hope. I declined my position as I had also applied @ UTA and received acceptance and are in week 3 of courses there.... I will miss the opportunity to meet fellow posters that spent time waiting, waiting, waiting... In the meantime, keep posting how things are going! BSN here we come!
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Am I an idiot for choosing the BSN route rather than the ADN...?
since money and time are not a pressing factor, you've done your homework and have your head on right. go for the BSN. many hospitals aren't hiring new ADN grads without experience. to each their own. i did ADN first, and are now goind back to get my BSN.... so far my job will reinburse but that's now and who can say what will happen in the future? best of luck and enjoy school!
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I need your opinions please....
looks really good; but will it all be left justified? i'd make some more columns (maybe three across?) oh, and i'd have at least one line space like this _ Accept _ Reject so as no confusion about what exactly they are checking. it does look pretty good :)
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Hourly rounding logs
lots of great points on all previous posters!( pro and con) saved my behind last night, though.
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I just have to say this....
send the complainers to acute care hopsitals where pt ratio is 1 RN:to anywhere from 6,7 or 8 pts; with varying degrees of stability, many fresh post ops... oh, and no tech help after 8pm. And you must admit/discharge by yourself and file all of the HANDWRITEN paperwork some jerks just don't get it. or they have a neurological chemical imbalance? anywhich way that you look at it, stay away. their sickness may eventually osmotically affect you. (ps i hope this is not a troll feeder.. it almost sounds too good to be real)
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Rn license renewal incomplete
maybe she's REALLY nervous? lol the only time i've had to submit in TX fingerprints was for initial licensing (sp?) when in doubt, CALL the board..... even if they take longer to answer than the DMV. good luck :)
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How to tell your mom it may be time to stop chemo?
don't wait to move in. financially if you can, with as little time as is left, make the most of your time and memories NOW. (from a daughter that wishes she had done so- now i regret the memories i have a hard time recalling) i am so sorry for the pressure landed in your lap. please, get your support group around you, and enlist their help. alot of previous posters had great advice. you will be in my thoughts, please keep us posted?
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Magnet status? Hospitals choosing BSN new grads. Important!!!! over ADN??
I'm familiar with the programs you mentioned, and are in the DFW area. TCU/BSN does not instantly mean no problem in the job market arena... if you consider the amount of new grads being introduced into the area (approx 100 people per class, with sometimes 2-3 classes graduating per year, from schools like TCU, UTA, TWU, UNT, Weatherford College, TCC, El Centro....) you're competing with alot of people for a position.... then take into account, there are experienced people applying for the same jobs as new grads. YIPES! Been there, done that! My two cents? Go for the ADN @ El Centro. (I'd prefer less debt over a "name brand degree" any day) Work hard, be diligent in your clinical practicum, get letters of reference from your instructors as you go. Learn the names of hiring managers during your practicums, be not afraid to chat with them, etc.... Make yourself stand out from the crowd- You WILL be remembered, and possibly hired on as tech early on, or an internal grow your own (RN) candidate. Many magnet hospitals do have hiring preference to BSN nurses, but ADN's can be hired too. Best of luck, please let us know how you decide. ps-My ADN is helping me save so I can get my BSN thru UTA :)
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Helping patients with migraines
0 premarin or change hormones.... looks like every one else hit the treatments spot on... good luck
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contacting nurse/unit managers?
gather together all your stuff ( resumes, copy of license where applicable) and just DO IT! (show up) the worst that could happen, you get turned away till another day. the best? you could get hired on the spot! ps- if in daytime i'd suggest showing up from 930-11 or 2-430. best of luck