CharlieTaco

You should not move until you have gotten a job which probably won't happen without at least 1 year of acute care experience. The plasma stuff won't count. The job market in San Diego is really bad, new grad positions get 2000 apps for 10 spots. Your current experience which is only in med surg won't get you a job. If you move there now you might not get a job at all and have to move back home where you might also have trouble getting employed because you dont have much experience. And you bf might get deployed. Do not move to San Diego without a job offer.

Everyones advice is completetly correct, the nurse was not supposed to give meds that way and she was probably not the best person to mentor you with the kind of attitude shown. With that said, you are done on that unit. If she is well liked, you just dug your own grave. Everyone will now hate you and treat you horrible. They will bad mouth you to everyone and when given the chance, will get you fired. Why? You snitched her out. I don't care how great of a nurse you are, if you work in LTC or on a busy unit you cut corners. They know that if they do it around you, you will tell on them so they can't trust you. And your new so they already didn't trust you. If she is doing something dangerous that is one thing, crushing meds together for pt probably doesn't qualify for that. I'm not saying this is right, but it is the way it is. You might have done the right thing by the book, but your going to pay for it.

It would make no sense for them to hire an LVN if they had to have a RN standing next to them the whole time. But at the end of the day, if you decide to push this issue, you will probably be fired by the end of the week. Do you really think a surgeon cares at all what you think? They will just get rid of you for someone who keeps there mouth shut.

From your questions, it seems that you don't have any idea about the anatomy of the heart, the electrical conduction system of the heart and the various heart rhythms. If you don't understands these, you won't be able to understand what the question is asking you.

Couple of things, This is not a stage 2, stage 2's don't have slough meaning that this is either a stage 3 or stage 4. You can't really tell because the slough is covering, you dont know if its just skin or if there is bone under there. Wet to dry dressing: if you are doing them right it could work, you need to wet the gauze, put on the wound, let it dry then rip it off that way, if it works it will take slough with it, i have often seen people re wet the dressing before removal which defeats the purpose. Aqualcel AG is not needed. This dressing would be for a high drainage wound, it would absorb the drainage which is not a problem here. Wetting the aqual is not correct, again this is to absorb drainage so wetting it defeats the purpose. The AG part of the dressing would be antimicrobial, if there is a "high bio burdern" meaning there is too much bacteria in the wound. Not infected, just too much bacteria which would make the wound look dusty and pale. Not needed here. Start with Santyl which debrids the wound taking out the slough and cover with an foam silicone dressing, we use meplix. That will absorb the scant drainage without drying it out. Use Santyl as directed, if no reduction in slough within a week or 2, it will need a surgical debridement. Remember she stills needs to be turned every 2 hours and stay off that pressure point for it to heal and not get worse. Hope this helps.

I like to keep thank you notes short and to the point for example: Thank you for pooping in the bed or please come back soon we miss you. Things like that.

Your explanation was not really correct. If the pt had a high INR, she did not need sub Q heparin. It was probably started by protocol. Possibly by mistake. If she has a history of PE, she would need IV heparin to bridge if she ended up subtheraputic. Sub Q heparin is a low dose med used to prevent blood clots from forming in the legs of pt's that don't move around and thus don't move the blood from their legs putting them at risk for a clot. It is not used to bridge a person that he subtheraputic. And she's not subtheraputic anyway. Someone with a high INR doesn't need sub Q heparin. I hope that was clear because i'm getting confused reading this myself lol.

Many times RNs will ask a LPN why don't you get your RN. This will cause the LPN to think that this person is looking down on LPNs. In my experience this is not the case. The reason I would ask this question is because to me it doesn't make any logical sense that someone would choose to do almost the same job as an RN but get paid half the amount with less ability to advance, less job opportunities and sadly less respect. Sometimes LPNs can't go back to school for a miraid of reasons but most often it is a lack of ambition, fear of going back to school or just plain laziness. Then they feel a certain way when the 21 year old who can't even start a IV makes more money than them. Education is what RN's have, and thats why they are paid more and have more responsibilty. Anyone can be taught to insert an IV or put in a foley, not everyone has the discipline to finish their education. Have pride in what you do but strive to be better, don't convince yourself that being an LPN is something to be proud of that you don't go the next step. If you do, you will probably be bitter, I know I would be.

Zoysn is supposed to be run over a four hour period. This is a new policy since most people used to run it as a rapid infusion 15-30mins. If your running it over 4 hours twice a day, what ever fluid is on the primary line would now be paused for a total of at least 8 hours a day.

lol, forgetting to change a dressing is probably the smallest mistake you could possibly make. If its supposed to be changed every 12 hours and you didn't do it, it was still changed that day. The Dr was blaming it on you because he didn't want to make it seem like he was the one causing the pt pain. It would have hurt either way. The pt isnt going to die because you didn't change the bandage so just keep trying to get better. With more experience you will get your task done faster and be able to complete them all and take your breaks. If you don't, you'll burn out.

You ADN nurses have probably been working for a very long time and have not tried to get a new job lately so you are very defensive about your level of education because in your experience a very long time ago, it did not hinder your opportunities. This is no longer the case. My hospital won't even hire you to med surg with a ADN. The chances of you getting a top position as a new grad with a ADN with the market flooded with BSNs are very slim right now. It is correct that ADN and BSN have the same licenses but the way these degrees are being looked at by employers are changing rapidly with everyone trying to get magnet status. You are setting yourself up for a harder time getting a job and then advancing with "only" a ADN. Just because you know a ADN with 5 years experience getting a good job opportunity doesn't mean you as a new grad will. Times are changing.

Being a CNA gives you no advantage in getting a job as a RN because of the difference of the roles. The advantage you get is that you will be considered an internal candidate and will get to know the managers who will be in charge of hiring you. This will give you a huge advantage over other applicants. So if you want to work in a hospital as a RN, you should be a CNA in that same hospital because your CNA experience will only give you an advantage in the same hospital. Good luck.

Lots of coffee because if you are still working, you won't be sleeping much.

Your state isn't broke because of welfare. It's broke because they invested their money with businesses that tried to get rich off crappy prepacked housing loans and when the whole system collapsed, so did your states money. The part that doesn't make any sense though is that you don't want people on public assistance to access health care yet you only work with that population? Wouldn't that cause you to have no job? You worked on half your usual pay cause they knew you would do it and instead of being mad at them, your mad at your own clients. That's the trick to this whole thing, screw everyone over and then get them to blame themselves instead of the people who are really at fault. But if you think we are in a recession because of people on public assistance, and your educated, we are really screwed. Your probably a republican too.

I really don't understand why any nurse would care if someone was paying for there health care. How is it any of your business? Your job is to take care of them, not judge them. And if you have that attitude, you probably aren't giving them the best care possible. This is what businesses do, turn the poor and middle class against each other. You think if the hospital receives more money this year your getting any for all your worrying about their finances? They probably fire you because then they could save even more money for a important conference on a tropical island. Those poor people who come into the ER, their lives suck. They live in crappy housing ridden with crime and hopelessness. They are usually miserable and don't know how to get out because their parents and grandparents grew up in the same situation. If the only good thing in their life is a smart phone, so what. You didn't do anything special besides fall out of the right uterus in the right county in the right neighborhood and now have oppurtunities that others don't.