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Double-Helix BSN, RN

PICU, Sedation/Radiology, PACU
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Double-Helix has 10 years experience as a BSN, RN and specializes in PICU, Sedation/Radiology, PACU.

Double-Helix's Latest Activity

  1. Double-Helix

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    Perhaps the timing. If the patient requested an anxiolytic immediately before the scan was going to start, the medication ordered would need to have a short onset. PET scans involve injection of a radioisotope about 1 hour prior to the scan and imaging should not be delayed too far beyond that one hour mark or imaging becomes suboptimal. It would take an additional 30 minutes or so for an oral medication to become effective.
  2. Double-Helix

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    The article says that the nurse couldn't find "Versed" (brand name) in the Pyxis. So she tried to search for it using "VE" (again, implies she was looking for the brand name. My assumption is that the nurse didn't realize that the medication would be profiled under the generic name, "midazolam."
  3. Double-Helix

    Did you leave bedside nursing?

    I still work in a hospital, but took a role in patient safety and quality improvement. Though I still do clinical care occasionally, I'm primarily away from the bedside, and yes, there are times that I miss it and feel like I may be losing my clinical skills. My job is still rewarding and challenging, but in different ways than bedside nursing. Did you perhaps mean to direct your question to those who have left patient care altogether, not left inpatient/hospital nursing?
  4. Double-Helix

    Quality Improvement Specialist (Nurse)

    I don't see how it could be a conflict of interest for you to reassign patients from one provider to another since you don't receive any benefits related to which provider the patients see. And if the providers are equally qualified there likely isn't any ethical reason not to reassign them either. However you might advise the facility that this is likely to decrease patient satisfaction and ultimately be counterproductive to their goals. You could recommend a different method of reallocating patients- such as asking for volunteers or assigning new patients only to the providers with the fewest patients.
  5. Double-Helix

    G-Tube residual checks

    I agree with the above posters- pause the feeding, check residual, return the aspirated contents, and restart the feed (if the residual is within normal limits). Assuming that you have a consistent rate of gastric emptying, your residual should be consistent also. If gastric emptying is too slow, the residual will be high, so you can get the information you need without interrupting the feeding. Castiela gave a great summary of methods used to check tube position. The best answer is to follow the policy at your facility. It will vary from place to place. Our facility uses pH of gastric contents to confirm tube position. A x-ray is warranted if the pH is inconclusive or you have other reasons to suspect tube displacement.
  6. Double-Helix

    Foley Catheter Pull-Back

    You're correct. Our policies instruct us to gently pull back on the catheter after inflating the balloon until slight resistance is met.
  7. Double-Helix

    Schedule changes

    It is not normal in my experience. The dates and times of my classes and clinical rotations were set the previous semester so that students could register for the classes that worked best for their schedules. But this was a 4 year university program, and there were other non-nursing courses that were required as well.
  8. Double-Helix

    Advice on what to do next

    I haven't heard about the ATI virtual program, but I haven't taken an ATI in over 6 years. And yes, you are not actually an LPN until you have become licensed, and thus not eligible for a bridge program.
  9. #1, thank you for being clear, specific, and including your work and thought process when you posted this question. #2, unless the question specifically asks you to reconstitute or dilute the medication, I don't assume that I need to add additional volume. If both these questions were presented to me exactly as you worded them, I wouldn't add additional volume to either. If you have a question this ambiguous on your actual exam, just ask the instructor to clarify. As long as you have a good understanding of the process (and it seems that you do), I don't think you'll be faulted either way.
  10. Double-Helix

    can i still be a nurse if i pass out from shots?

    You're not alone. I routinely feel faint or pass out when I get blood drawn, get immunizations, sometimes even with my annual TB test, and there's no chance I could ever donate blood. And I'm not the only one of my colleagues who have the same problem. I've been a nurse for 6 years, given hundreds of injections and placed hundreds of IVs. There's no reason you can't be a nurse because you don't like needles.
  11. Double-Helix

    Advice on what to do next

    What kind of school did you attend? Community college or a for-profit nursing program? It sounds like you may have attended a for-profit program that lets almost all the students pass each semester so that they can continue to collect your money. Then, they set a high final passing requirement (like the HESI), which keeps their NCLEX pass rates higher. Failing the exit HESI and the NCLEX-PN twice suggests that you either have difficulty answering NCLEX-style questions, or you lack understanding of the content. Which do you think is the problem? I would recommend you take an NCLEX review course to refresh yourself on the content and practice as many NCLEX-style questions as you can. The quickest way to get your RN would be to obtain your LPN license and then enroll in an LPN-to-RN bridge. Returning to another nursing program is also an option, though I highly suggest you choose an accredited program.
  12. Double-Helix

    Making the most of an unrelated placement?

    I agree wholeheartedly with both posters. You stated you're in your second year of what is likely a 4 year program. This is the time where you learn the basics of assessment, pathophysiology, critical thinking, and basic interventions. The advanced skills and knowledge required for ED/Trauma nursing will come later.
  13. Double-Helix

    I didn't meet the requirements.

    This will depend on your school. My advice would be to take some prerequisite classes and do very well. Nursing programs are very competitive. Have you identified the reasons why you were not successful in high school and taken steps to correct that?
  14. Double-Helix

    Dating during Nursing school

    Live your life. Nursing school is school. Do what you need to do, and dedicate the time to need to be successful. But nursing school is not so difficult that you need to have no social life. People have babies raise families while in medical school, residencies and fellowships, or other strenuous programs or time consuming jobs. You can go on dates in nursing school.
  15. First, let's be clear that those three things in your title (lose a job, lose a license, and get reported) are very different things. The most difficult is losing your license. Rose_Queen provided supporting links, but in general you have to do something pretty egregious to have your license revoked. Drug-related incidents and crimes unrelated to work are the most common reasons. Losing your job is another matter. Most states operate under at-will” employment laws. That basically means that you or your employer may end your employment at any time, for any reason excluding those protected under civil rights legislation. Personality conflicts with the boss or senior staff can and do get nurses fired, even if they are clinically excellent. Privacy violations, unprofessional conduct, or publicly representing yourself in a way that reflects badly on your employer are fair game as well. Nurses let go because a mistake was made or a patient lodges a complaint and the employer wants to appear as though someone is being held responsible? Yep, it happens- not everywhere and not all the time, but it's out there. You can be fired for many, many things that will not cost you your license. Finally, being reported. This is by far the easiest thing that could happen to a nurse. Anyone can report you to your supervisor or the BON for any reason- legitimate or not. It's the BON's job to determine whether the claims are substantiated. A co-worker set to sabotage you, an irate family member, a well-meaning colleague- all of them can name you in a complaint. It doesn't mean that every claim will be investigated or result in any disciplinary action, though. The best thing you can do is carry your own personal malpractice/liability insurance. Look for a policy that will pay your lost wages in a wrongful termination suit, or legal fees/provide representation in the event you have to defend yourself in a lawsuit or investigation. In terms of your own practice- be thoughtful and diligent. Follow your state's Nurse Practice Act and your facility's policies and procedures. Document thoroughly. And mind what you say and who you say it around.
  16. Double-Helix

    Joint Commission is like critical in laws

    Per JC standards, covered drinks are acceptable in patient care areas. Open drinks are not. So a water bottle with a sealed lid would be fine.