lillystarrn

Hello everyone. I have a question. I'm wondering if I've been doing the "scoop method" wrong this whole time. Whenever I draw up a med with a syringe, I set the cap on the counter and once I've drawn up the med, I "scoop" up the cap with the needle. The part that I'm confused as to whether or not I've been doing it wrong is that I'm wondering if I'm suppose to set the edge of the cap on the counter and then "scoop" it up with the needle. Have I been contaminating my needles this whole time???????????? I feel absolutely horrible and am worried sick that I have been. We use needless ports to actually administer the meds, so I'm not using any part of the needle on the patient. Also, whenever I'm doing IM, I change out the needles anyway since it's been dulled after inserting it into a vial. Please help!

I have a feeling that I was taken off orientation early due to staffing. I was never told why, but just asked how comfortable I felt. I work in a small hospital on the med-surg floor. I told them that I am comfortable working as a second RN (meaning I supervise the LPNs taking care of half the patient load), but not as charge nurse for a full house (which is up to 30 something). I was put as charge nurse for the two times when there was a patient load of 9 or 10. I do/did not feel comfortable as charge nurse, but I don't know what to say since this is my first nursing job. I talked to the DON that I didn't mind being charge nurse as long as I have another experienced RN with me (there's usually only 2 scheduled per shift and 3-4 other LPNs on average) who's usually charge nurse. However, this past time I was the only RN. I'm really beginning to wonder if they're trying to get rid of me and I have no idea what to do if this is the case, except to look for another place that won't look down upon the fact that I quit my first job after only 2 months of working there.

Hello everyone, I was wondering if anyone knew if facilities would hire a new RN as only part-time or prn (as in weekends only). I'm currently full-time and have worked at the hospital for almost 2 months now. I was taken a week off orientation early and have been charge nurse twice, so I don't know if that's a sign that I'm doing well or I'm just being "tossed out there." I've been trying to figure out that last part and I have a feeling it's both. I've already been put on-call twice (which is going to cut my pay-check by quite a lot since I only work 36 hours/week), because of low census. Well, I may be offered another job (not nursing but a research tech position which was my old job) and I want to take it, but be able to still do nursing. I want to stay at the hospital I'm at now, but move to part-time or prn status.

I have received replies from previous posts that my patient load is considered high. The usual ratio for where I work at is 1:5. The LPNs do the majority of the patient care as far as meds go, etc. Working as an RN, I am responsible for the patients that the LPNs care for, but I am doing the initial assessments and administering IV push meds mainly (+ admissions, etc.). I don't know what it's like at other hospitals for an RN because this is my first job since graduating nursing school in December. I've seen other hospitals have only RNs working the floor with maybe one or two LPNs. I'm guessing those are the hospitals that have the RNs doing the role of LPN also. Whenever I am working as an RN and doing LPN duties, then my patient load has not been more than 5. What is considered a typical RN workload? Also, I'm wondering what is a typical workload for a LPN?

Thank you so much. I get "advice" from people, some who are nurses and some who aren't working in health care, to not "tell on myself." As you can tell, I worry too much about what my actions could have done because I always picture the worst-case scenario with the patient. I agree with the other reply that I feel it's better for me to point out my mistake than to have the patient or another nurse to. I hope that after working for a while that my anxiety will go down and I will get better with everything.

Hello, I've got another question and don't know if it's considered a "stupid" question or not. I'll give you my background first (for those who have not read my earlier posts) and what had happened. I'm currently on my 8th week of working as a new RN, but I have only worked 2 weeks (2 shifts total) off of orientation. I worked as the second RN last night, which consisted of 4 admissions, assessing 14 patients and giving IV pushes (the LPNs did the med pass and took care of the patients). I had a new admit around 1 am and did not know they were NPO until later and I did not even think to ask. I picked up from watching other nurses that you always check before giving anything to eat or drink. I was having so much anxiety because I still had to chart on all the patients and I was administering blood to another patient (they were already on their 3rd unit) so my judgment was not where it should have been. The LPN had already brought them ice (so I was assuming that they were not NPO. That's what I get for assuming). Anyways, my shift did not end until 7:30 that morning and it did not even hit me until I woke up this evening that I had let them have ice and they were NPO. I'm freaking out because I made a mistake like that and called the nursing supervisor who had worked that shift. They kind of giggled and said that giving them ice would actually be the "best" thing (as in least harmful mistake) to have accidentally given them since they were NPO. The patient was fine and to not worry about it. I asked if this would be considered a write up or something like that and was told no, but it would be if it happened again. Here is my actual question: Am I stupid for "telling on myself" by asking about something like this? I've already made "little" mistakes that I've caught and once I calm down I realize that these are small mistakes, although still mistakes, that I shouldn't worry so much about them. Is this normal to worry like this as a new RN? I'm beginning to wonder if nursing is right for me because I stress so much about everything.

I agree checking the IV site prior to drawing it up is a good idea and bringing the iv meds to the bedside. I'm going to try to do that from now on. I use to do that in the ER where I did my preceptorship since patients were in and out so frequently that it did help me to make sure I wasn't giving it to the wrong patient. I always do bring the MAR with me to the room, though, to make sure. I'm not sure why none of the nurses pull the meds up at the bedside, it's always done in the med room, so that's why I've been doing it that way. I am drawing up only one or two meds for one patient and then administering it to them (unless the IV site is bad...). If it's two meds, then it's usually a med for pain and one for nausea. I feel like I'm still slow as far as giving meds because I am still trying to get in my "groove" and I'm bringing the MAR with me to the pyxis machine and to the patient bedside while I'm watching the other nurses seem to go by "memory." I know they've been doing this for a while and the patient ratio is low so maybe they're just use to everything. There have also been times where it's been less than an hour of me either giving an antibiotic or another iv med to a patient's iv and then it "goes bad" all of a sudden. Sometimes I feel like I have bad luck with IVs or that it was my fault the IV went bad, like I might have pulled on it somehow and caused it to go out of the vein. The place I'm at also has a lot of older patients, so their veins seem so fragile!

I think you're right. I work night shift and the pharmacist isn't there when I'm working, so I'm guessing the nurse supervisor is the one to ask? The only meds that I've drawn up and weren't able to give at the time because of a bad IV is pain medication, solumedrol, and nausea medications like zofran and reglan (I believe).

Hello, I'm wondering how long does a medication stay good for in a syringe after it's drawn up? There have been many times when I have drawn up a med for an IV push and went to flush the IV line on a patient that's hep-locked, then find that the IV is bad. There have been times where I've tried to re-start the IV myself, but end up needing help from another more experienced nurse (I'm on my last week of orientation) to start it. Sometimes an hour or so will go by because we are so busy and nobody is able to come in to help me. I know that once meds are drawn up, that only you are suppose to be the one to give it if you drew it up and to give it immediately. But from what I've learned in the hospital so far is that things come up that you can't help and can be delayed sometimes. I've tried to find this type of information on the internet, but can't find anything on it. (The meds that I've drawn up and given after time has passed are meds stored at room temp)

Thank you everyone for the advice and encouragement. It means a lot. :) As for me having a preceptor, I do not, although there is the one charge nurse that I go to the most and is the one that has given me the most encouragement. I don't know how typical hospital orientations go, since this is my first job. But for me, my typical shift is that I show up and am asked what I feel comfortable with doing (either working as an RN supervising LPNs on one side of the hall, which consists of doing patient assessments and pushing IV meds for the LPNs--the other is taking care of patients on my own. The ratio is only 1:5, so it's not so bad, it's just passing the medications on time that gets to me since I'm still trying to find my "system" to work by). I only have two more weeks (which is 6, 12 hour shifts each) left of orientation. Orientation at the hospital that I work at is typically 6-8 weeks and after the two weeks, I will have reached my 6 week mark. I'm hoping I will be ready by then. I forgot to add that I am "on my own" during my shift, but I am asked often by the charge nurse on how I'm doing and if I do need help.

Thank you. I remember always being taught to draw just one line and had been doing it all this time (except for that one when I panicked). Are these types of mistakes common or will they see this as me being a bad nurse?

Hello everyone, I just graduated a BSN program and started my nursing career. I currently work on the med-surg floor with about 3 or 4 other LPNs and 2 other RNs. I feel overwhelmed and like I know absolutely nothing! I've already made 2 mistakes so far. One was a med error: I was to give xanax along with two other pain medications. I was told to hold one of the pain meds for an hour, take the blood pressure and then administer it if was normal since the patient was hypotensive from the meds during the previous shift. Well, I was taking care of another patient, which was total care patient..and forgot to give it. Too much time had lapsed and an incident report was done. This was my first night taking care of two patients (I know, not that much, but I was nervous this being my first time). My second mistake was a documentation error regarding an assessment that was suppose to be done by the previous shift so I felt it was my responsibility to do it at the beginning of my shift. Well, at this point I'm taking care of 5 patients and still feeling overwhelmed/nervous. I asked the charge nurse about doing the assessment and charting it in the am and they said it was fine to do that. I'm documenting that I will perform the specific assessment in the am (I work 12 hour shifts), ask a nurse if it's right to do that and was told no that if state got a hold of it that it would look bad so I crossed a line through it and wrote error. As I"m doing this, the nurse tries to give me advice to draw a thick line though it...I panic, draw thick lines though it (it's still legible although now it looks like I tried to cover something up...which I guess in a way I did). I showed the charge nurse this and was told to just not do it again. I'm worried about how this is making me look since this is my first job. All the nurses tell me I'm slow and I've made errors already. The charge nurse has told me that she thinks I'll be fine, just to work on giving medications on time since that's what really slows me down since I'm trying to be cautious. Any advice or words of wisdom would be greatly appreciated.