Jamuhh

Where I'm from we're required to write a progress note, or shift summary basically, so a lot of the time, what's in the note is redundant because there is nothing to say other than there were no issues with the patient. It's annoying, but it is what it is. Most of my notes are the same because of this, they are essentially a template.

Thanks! I guess I understand better when to use it. It's just how I was taught but I'm learning not everything I was taught is correct

Looked for some info here but didn't find much, but if you can point me to another thread please do. A funny meme on FB about the phrase "will continue to monitor" started some heated conversations in the comments section. I'm concerned now that I need to change my progress notes. I was taught by my preceptor to put this ridiculous phrase at the end of every note but some say it opens you up to more questions in court. Some say, "it's the end of your shift, you're not monitoring any more!" but technically I usually write my notes between 3 and 5pm for 7a-7p. The thing is, it's just filler. Obviously I'm going to monitor my patient, so I shouldn't put this in my note, right? I'm concerned too that there might be other things I write consistently that should be removed. Any legal nurses want to shed some light? Example: Pt transitioned to open crib, temps stable. Witnessed three bradycardic events while pt at rest, self corrected. Pt taking full PO feeds x2 so far. Notified Dr. XYZ of gastric residual >50% x1, verbal orders received and carried out. Residual stable at this time. Peri care as ordered, buttock excoriation resolving. Parents at bedside and active in care for one round. All questions answered and updated on plan. Will continue to monitor.

UF has both acute and primary tracks which is why I'm struggling. I'm a floor nurse now but I really like the hospital setting and the variety. On the other hand, I don't know if I'd be good in acute situations. I've thought about it a little more and probably gonna go with primary cause I'd rather be comfortable than in over my head.

Don't worry about reading anything - you will learn as you go. It is much easier to learn when you have seen something than for you to read it from a book. Fav example: we covered oxygen delivery systems in school, but I was totally clueless on them until I actually touched and handled them in real life. The best piece of advice I can give is, although the child is your patient, be mindful of the parents in the room. They are watching and they pick up on things that you wouldn't think about. They can tell when you're nervous or not comfortable, so if you're not comfy, fake it! I say that not to scare you - just to prepare you so you aren't blindsided when someone fires you for being "too stressed" (true story!). Good luck :)

I think they are looking for related experience. My friend got hired out of nursing school to work in Allergy but she had worked in an allergy clinic all through and before nursing school. Doesn't hurt to apply. The worst they can do is say no.

We never have drips. That could always change, though...

I DID do some searching in the forums before deciding to ask this but didn't find an answer. IF I chose an acute care track (in peds, but does it matter? :)), could I later decide to work in primary care without any extra schooling? I understand going from primary to acute and needing extra in some cases, but has anyone had this particular experience or know if it's possible? I can't figure out what I want. I like being in the hospital but I'm not sure if I'm cut out for the high-stress of ER or ICU. If there is a thread that you know of and want to point me in that direction please feel free. TIA.

Amazing catch, klone! May borrow this one as an example :)

Great save, CountryMomma! It wasn't the "right dose" :)

Wow, that one is huge. We almost never have to worry about that in peds, but definitely would be a problem in adult world. Does your hospital have a reporting system?

Good catch, and thanks for contributing! Interestingly, I read this a few weeks ago about shellfish/iodine. I think that needs to be studied more. Iodine Allergy

I am starting a project at work to help improve reporting of near miss events. I am trying to gather real-life examples of near misses. If you look through the interwebz, near miss is defined as an event that didn't reach the patient but could have had terrible consequences. I would also like to hear about events that reached the patient but didn't cause harm (you might call this risky behavior instead.) I know it's hard to put yourself on the line and admit when you've had a near miss, so I'll give some examples of my own. -- *ibuprofen was prescribed and approved by pharmacy for a patient under 6 months (none was ever given to the patient) *I wasted the wrong amount of a drug (didn't waste enough) but caught the mistake before administering *I gave a med via PICC line w/o first flushing the previously running med; the two drugs were compatible but I was unaware of this and could have caused harm if they were not. (More of a risky or reckless behavior). *We have pt cubbies for meds; both current and d/c'd patient prescribed the same nasal saline. The current pt dose had not arrived and d/c'd patient's dose was still in cubbie. I grabbed saline without looking at label and once in the room scanned the barcode to see that it did not belong to that patient. (Sure, it's just saline... but could have been something else.) *I've taken CHG wipes to patient who is allergic as well as non-verbal but realized the mistake just before starting the wipe down *The wrong weight was charted on a patient at admission. The physician prescribed a medication based on this incorrect weight, but the pharmacist reacted with There's no way a 14 year old kid weighs 5kg. Fix this weight!” (Imagine if the weight was more likely to be correct but was off significantly!) -- Thanks y'all! Let's get a dialogue going!

I guess I meant until you feel confident. The decimal thing should not be an issue for YOU if you are the one checking. If the physician writes an order and misplaces a decimal and you check the math (correctly) you'll catch the mistake and question it. Spend time practicing dose checks. With nursing comes responsibility!

Check your doses and then ask someones else to check too.