2011nursetobe

You're gonna kill yourself! Each summer class is equivalent work of 2 fall/spring classes. So by taking 4 classes, it will be the work equivalent of taking 8 classes! Ouch! Hope you have a lot of time on your hands, and good luck :)

Hi, I'm a new nurse and have been having trouble starting IVs. I have no problem getting a flashback of blood, but it seems like I bust the vein every time I attempt to advance the catheter. I always feel like I have to force the catheter in as it doesn't slide easily and it is so awkward for me. Can anyone give me some advice as to what I may be doing wrong as I'm advancing?

Yes got all of them in the same arm. If it still hurts in a few days I will go see my PCP although not really sure what they would be able to tell me...

My sister who is extremely skinny (78lbs) had an IM once and she said it felt like a knife stabbed her arm and she was in tears within seconds. I assumed they hit her bone, but from what I'm hearing, most people don't flinch. Thats why I'm thinking maybe when it hurts like heck, its a nerve that has been hit, not a bone. I've heard I/O's hurt so they use lidocaine for conscious individuals. But this is going into the marrow, not just hitting the outside of the bone.

Got the last of my 4 rabies vaccines last Saturday. The first 3 shots made my arm hurt the night I got them really bad but were fine the next day. This 4th shot has made my arm hurt TERRIBLY for the past week and has not gotten any better. (to the point it hurts to sleep on it and get dressed.) My question is not asking for medical advice in anyway..I'm not worried about this from a medical standpoint. My question is have you ever hit a bone/nerve while giving an IM injection and if so, how did the patient react? My arm is super skinny and I'm always afraid someone will hit bone. As a nurse, I'm also always so scared to give IMs to skinny older patients.

....and what kind of unit do you work on (ICU/Med-Surg/Tele/Ortho)? Does your unit have a ratio limit? I work in Tele and we have 4 patients during the day, 5 at night.

I feel like although part of the success of nursing school is the curriculum and amount of clinical hours, more importantly, nursing school is what YOU make it. My first semester, I was scared of everything and shyed away from any experience. My second semester I began to realize that this is my chance to learn, and my ONLY chance before I'm on my own. So I took initiative and volunteered for every opportunity I could. I am a very shy person who prefers to be in the background but I began to think about how it would be after I graduated when I had no experience with things. Yes, my diploma nursing program had TONS of clinical hours and was great at teaching us, but a lot of students ran from opportunities instead of running to them. I had done NGs, at least 7 Foleys (all or most on women), multiple IV starts (most of which were not successful), and was handling 4/5 patients by myself on my preceptorship close to graduation. I had seen 6 codes, done CPR compressions, seen bedside procedures...chest tubes put in, taken out, cardioversions, etc. This was all because I took the initiative to BE there in the room. I asked if anything was going on and jumped on every opportunity I could get to improve my skills. I feel like I made myself available to learn and it has really paid off in my first job. All my co-workers are impressed at how quick I have caught on. I am 8 weeks into a 12 week orientation and I have basically been doing complete care for all my preceptor and I's patients since week 4. Everyone is saying I can be on my own already, but I need my preceptor because I am still learning policy and procedure for our hospital. I don't ask my preceptor to "help" me with things I know I can do. I need to be able to handle things on my own. I think of myself as being on my own because I know that soon I will be. Now I am the question queen and I ask my preceptor absolutely TONS of questions. How are you supposed to know things if you never ask? You can't! I ask her questions that aren't even relevant to what I'm doing at the moment because I know that one day I I'll need to know these things and I may not have a mentor close by. So, to answer your question...really there's nothing in school they could have taught us more...if I had to absolutely pick one thing, it would have been things like troubleshooting..."What if...." situations..."What if the patient does _____ during a code", or "What if I walk into the room and see _______"

Thank you all who have responded. The general consensus is that I would call an RRT/MET but never ever a code. I was never sure if I would be frowned upon by calling a RRT. If all else fails I can always seek the advice of a more experienced nurse. I just don't want to call them if the patient is actively dying and it's their time to pass on...and nothing can be "fixed". And I definitely never want to try to fix something and end up causing pain and discomfort to the patient. Such a fine line to me....

I have a hard time differentiating between something that could be treatable...like just a low blood sugar, and something that would require intubation, etc. Now of course if they are pulseless, or agonal breathing (actively dying), i wouldn't call anyone but the gray area is what concerns me. Would it hurt to call a MET/RR and just let them know they are DNR? Or is it pointless?

Sorry if this is a stupid question, but I'm a new nurse, freshly graduated. If I walk into the room of a complete DNR pt and he/she is unresponsive, diaphoretic, breathing is labored, should I call a MET/Code? Thanks...

Thank you...great link!

Ok, so I know someone can get "colonized" with MRSA and it can be found out by swabbing their nares. Many of us nurses are probably MRSA positive if we all got swabbed. My question though, is what exactly does this mean? How would we infect others or become infected ourselves if it is in our nares? If we touched our nares, and then touched one of our wounds, would we infect ourselves with MRSA in the wound? I'm SO confused!!!

I have a cheap Prestige one that is lightweight and I can actually hear better out of it then a Littman and the more expensive Prestige's. Its very odd b/c most people hear better out of Littmans. I would suggest going to a scrub store and actually TRYING different ones. Bring along a buddy to listen to! I actually bought a different color of the one I used in nursing school (same stethoscope, different color), but I prefer my faded pink one I used during school b/c I can hear everything through it!

Daily...usually at midnight along with tube feeding sets.

Definitely the 12s. I have a 45 minute commute that turns into an hour and 15 minute commute if I work 7-3:30 b/c of rush hour. Its not bad at all...I use the drive time to get my mind off things before I get home. I can't imagine waking up 5 days a week to go to work. Working the 5 8's will burn you out in my opinion. Everyone prefers different things though. I like 12 hour shifts because I'm already there, I know my patients, why not just stay an extra 4 hours and finish up what needs to be done for the day!