snowfreeze

I worked at a facility that did simular, often the admitting doc for the nursing home was the one who wrote the discharge instructions from the hospital. We would call doc to let them know patient arrived and repeat discharge/admit orders along with usually asking a few questions about labs, diet etc that might have been missed. Admissions to nursing homes are much more work for the nurse than those to a hospital in my opinion.

Do you like finding out first hand what stupid human trick was attempted (work ER) or do you like fixing the problem after the labs and tests have confirmed the trick was successful(work ICU)?

In general as a nurse in the USA I am respected by patients, families and doctors.

Yes you may be fired for sleeping on the job. Making personal calls during work hours is not usually acceptable, you are working not socializing. What type of license do you have? Not giving medications because you were too tired isn't acceptable, if you are that tired tell your charge person or supervisor and sign yourself out of work. How many hours were you expected to work and did you know that you were going to be working that many hours 24 hours prior to that work time? Sounds like you need to get a different job, no orientation for what you are working is not fair to you.

Make sure you filled out the application correctly and had references with phone numbers. A nice resume also helps a lot. 1 to 2 weeks after submitting application and resume, call to see if it was received. If you don't hear from them in another week call again and inquire. If no return calls from human resources in another 3 or 4 days, call the unit or department you are interested in and ask to talk to the manager. Ask the manager if there is a position available and if they are in need of a qualified person. Possibly ask for an interview at this time depending on the response. If and when you show up for a tour of the unit/department make sure you have a resume with you. In all phone conversations, have a written outline and facts sheet in front of you so you stay on course and sound very professional. Any interview or tour, have a resume with you and all your contact reference names and phone numbers with you.

SBP less than 90 does not mean poor perfusion, look at the Mean Arterial Pressure. Assess your patient. If this was an automatic pressure, check a manual one. Ask your patient if they are light headed, do they have a headache, do they feel dizzy or are they nauseated. Check what their previous pressures were in the last 12 or 24 hours. Are they a fresh post op, are they bleeding, is this a cardiac patient, what does their EKG show? Do they look in distress? What did they look like during a prior assessment? What medications where they given in the past 2 hours? Lots of critical thinking to be done in a minute or two prior to calling a rapid response team in. I am assuming you checked all critical possiblities of a slightly low SBP and nothing to warrant a RRT. Document your assessment and leave knowing you did what you are supposed to do.

Travel RN, on 3rd contract with this awesome facility in Maryland. Type of Hospital: Community Type of Unit: med/surg/cardiac telemetry Number of beds: 24 Number of patients each RN has: 1:3 or 1:4 only 3 patients if you have a ventilator patient. Do you have a nurse's aides and/or at what census level do you downstaff an aide: daylight 3 or 4 nurse aids, nights 2. I think we downstaff at around 14 patients. Do you have a unit secretary and/or at what census level do you downstaff the sec'y: unit secretary on daylight and evening, share one secretary with the rest of the facility for nights.

The average person who is basically healthy will have 3 to 7 days/year when they are sick. Most of those are stress related not actual infectious related. If your work environment also adds to the sickness level with extra stress and exposure to infectious diseases then maybe you should either have a less stressful work environment with less tasks or be given a lot more sick days.

There are two routes, take the small hospital and semi specialize in everything for a rewarding career at the low level or work really hard for a while (teaching facility environments can be stressful) and work in some specialty units and get some awesome experience then as you slow down toward retirement, work in a small town facility and have enough experience to be comfortable with just about anything that arrives. Also be aware that there is a new direction for improving work environments. Doctors won't be allowed to belittle you and co-workers wont be allowed to do that either. What do you expect to achieve as a nurse? Do you want to teach new nurses, or be the most awesome nurse manager of all time. You sound like you would like some experence in many aspects. I wanted to be a flight nurse so I got a job in one of the toughest facilities with a low nurse patient ratio just so I could get my time in for a position in the future because that facility had just been purchased by a facility that had an awesome critical care flight team. My plan worked, I loved it and learned a lot. I am now a travel nurse. Good luck with what ever you choose. Do some research about your local facilities.

Good luck, I did some time in LTC and understand your frustration. You never see someone get better, it can be depressing. You do have time management skills that could be sold on E-Bay, lol. I am sure any unit hiring you will be blessed with your wound care and behavior management skills.

Debriefing helps a lot, talk to someone about this. The chat after a traumatic event is a defusing, a few days after is a debriefing. These are helpful to most people, going over the details with someone else who was there and seeing their view helps you to release the event. Having follow up information also helps a lot. In acute situations you are there in the middle of it then suddenly you are not even involved, that doesn't work well with our reasoning. You need some more information so that you can have a closing of this event.

As far as passing boards, I suggest test questions by yourself or with a group which ever you have access to. As far as being an orientee nurse, listen to your preceptor. Your orientation is very generic so ask questions and make suggestions as to what you feel you need to achieve and what your weaknesses are. Your weaknesses are the things that scare the crap out of you even thinking about them. Discuss these scary issues with your preceptor. Your preceptor wants to help you and have you as a future competent co-worker. The rest of the staff on the unit would like to socialize with you but you are so overwhelmed right now so they are just helping when needed,,,,,they do appreciate you and what you are going through.

htrn has good advice, talk to the manager. Suggest giving the complainers the job of finding a solution. Staff that complains about a problem needs the opportunity to be on a committee to fix the issue that is bothering them and others. Allowing the staff on a problem unit the power to fix the problems usually corrects many of the issues.

I was pregnant during my first year of nursing school and had to take time off due to a c-section mid August. I returned the following year and completed nursing school and passed boards the first time. My daughter will turn 18 this coming week!!! It can be done, I worked a 24 hour shift every Saturday as a paramedic to pay for day care for that daughter while I finished nursing school.

Injecting through anything could cause an abcess, a small piece of fiber could be embedded in the flesh and this could cause a nasty infection.