ninjago

Nurse A is core employee of hospital who works evening shift and stayed over in same department to work double. Nurse B is per diem and been scheduled to work in same department as Nurse B. Who gets to float to another department Nurse A or Nurse B?

PACs are P then P-QRS, correct? It's like two P waves per QRS? The PR intervals remain the same. This was just another either p or u wave right after the T wave. Definitely not Wenckebach if that is what you're thinking. There was no lengthening PR interval. I think you are correct, it could be U wave. Thanks so much!

Thanks for the reply. Here's the EKG strip from what I can remember. If you can kinda picture it in your mind ;-) P-QRS-T-->p? or u? wave----->P-QRS-T-->p? or u? wave ---->P-QRS-T --->P-QRS-T This was only found in V2, V3 and V4 and not in other leads. Some said it was a U wave, others said it was a PACs. Another said it was a second degree AVB Type II. If it was a Second degree AVB Type II, wouldn't this show it all the leads? If it was a PAC, the P wave would have been closer to the next P wave? This was found about 2-3 small boxes from the preceding T wave? If it was a U wave, wouldn't the interval from P to P waves remains same? The next P wave was a bit more distant from the preceding P wave in this case. I hope I explain it clearly. I apologize if I make you all the more confused. Anyways, I will try to see what the doctor said when I go back to work and update you then. Thanks.

Please help fellow nurses. How do you tell if it is a u wave or a PAC or a second degree AVB Type II?

Hi All, Last night at work, one of my patient's nephew took a picture of me providing patient care to his aunt. I told him you cannot take picture of me without asking my permission. He denied taking picture but I know he did because of the flash and the clicking sound of the camera. However, I gave him the benefit of the doubt and thought nothing of it. Now, I am not so sure if I should feel secure as my ID badge was in full view. Am I wrong to feel violated or am I just being paranoid?

delabeaux wrote: "...Thus, if you come on over, be prepared, and if it is your life's passion, none of the above will matter." So true and that applies to all professions, not only nursing. I knew one nurse that quit her job to go back as a salesperson, money is less but her passion was in the retail sales. She did not like seeing and being with sick people all the time and she did not like the responsibilities put on her. Another example, my niece graduated nursing with honors but went into automotive business with her dad instead and she is very happy with her decision. On the other side, my friend was in computer software business for a very long time. She went to nursing after retiring from her software engineering job. She is now the manager of a non-profit clinic serving low income and uninsured population. Nursing was not her first choice as a second career but she thought she'll try it because everyone seems into it. She learned to love it and the rewards of helping people made it all worthwhile for her. This I can say, Nursing has many branches you can go to. If you are bored with one, you can try another. There is research or teaching, if one does not like bedside. For me, I'm into clinical (ER and cardiac) and loved it. Good luck! whatever you decide.

Since you don't like taking care of patients, maybe you can go for the academic side in nursing like teaching or in research (though you might still have to deal with patients but it is not like the 8 or 12hr kind of direct patient care... if you know what I mean. I think Floor nursing is very tough and it is not for everyone. Good luck!

I was just thinking about what OP said, one doctor orders a med and another doctor d/c it only to have the other doctor order it again. so here's the scenario: nurse: Mr X, here is the new medicine doctor A order for you. (gives med to pt to take) patient: ok.....(leaning to his table to get some water). Putting the pill in his tongue and about to take a gulp of water when.... nurse realized in the computer the order has been changed to d/c. nurse: ooops, sorry MrX but doctor B does not want you to take the pill. Spit it out, please. Patient: are you sure? nurse: yes, there is a new order here to discontinue it. so please spit it out. patient: okay(spits out the pill) nurse: Thank you. Let me just review in my computer if I have given you all the meds you're supposed to take this morning. (reviewing....reviewing....) seems okay.......hey wait a minute! New order to give the pill. Mr X, seems like there is another new order to give the pill you just spat earlier. Patient: well, nurse make up your mind! do I take the pill or not?

Nursing responsibilities are different from doctors. And you may have clinical exp as an MD in your home country, but you will have to adjust to the U.S. way, culture, the tech equipment and all. Aside from switching duties to nursing from a doctor. Like for example, doctor put in order for the drips (you know this dose,etc since you're an MD) but do you know the drug calculation on ml/hr to put in the pump? do you know how to use the IV pump? what to mix NS or D5W? I am suggesting that LPN/LVN will get you familiarize on all these. Remember Excelsior has no clinical training in their program. The CPNE is the only and actual practical exams bec they assume you already know the clinical aspect. I don't know your life situation. A lot of things you will have to consider if you can do both at the same time. who is going to take care of your kid while you're at school? your financial situation, are you willing or able to pay for two tuitions? time wise? study time? clinicals for LPN, etc. You will have to weigh things carefully. You don't want to overload yourself and eventually neglect your health. My suggestion is to take one thing at a time. But of course, it's your life you have the final say.

Call or go to Excelsior Website. Your transcript needs to be evaluated by credential evaluators ( they will let you know which one they use) then from that, they can tell you the needed subjects/pre-reqs that you still have to take before the actual nursing program. Some of your subjects from MD might get credited. If you don't mind me asking, when did you graduate from your MD? RE: cost. I went the LPN route then bridge to RN via Excelsior, not only because of financial reasons, but also to gain the clinical experience. You're going to need it when you take the CPNE (their clinical test) later. Assuming you have no clinical experience here in U.S. (read excelsior nursing program details). I know lots of FMG who took Excelsior and they're working as RNs now. (ICU, ER, Dialysis, medsurg) As previous poster said, you need discipline. Excelsior is a self-paced independent study. I liked it bec I could work at the same time and spend time with family. Note that California does not accept Excelsior grads anymore. Good luck!

I vote for agency. I am an ED RN and agency. Loving it!!!! I control my own work days and shifts pretty much. I just pick whatever shifts and days I am willing to work. No asking boss for vacation. Unlimited vacation time if I wanted to. Don't have to deal with politics so much as am not permanent in their hospital. Pay is good enough for me. So am thumbs up for agency.

I didn't know we can get the TNCC book ahead of time. I got the book on the first day of TNCC class, listened attentively to what the instructor is teaching, read the book and above all, always remember the ABCs. You can make it. I did and I had less than a year of ER that time. Good luck! edit: About being nervous in being "watch" by instructor. I get the same thing, I just try to keep a tunnel vision on what I have to do. Pretend they are not there and also, I try to convince myself that this is "real" situation. Now, that kept my brain going.

No, only fake nurses do it...just kidding! We use IV pumps so it's been awhile since I counted drips. I hook pts in monitor for vitals so unless I'm giving cardiac meds like digoxin, I get apical heart rate and use my wristwatch. Giving IV meds, on the other hand, I use my watch to make sure I don't push certain IV meds too fast, but mixing them with NSS usually alleviates the over 1 min rule. I use my watch to get the time I give meds, start time for IV infusion, etc, etc. for charting purposes. Particularly if I cannot chart the procedure right away. I note the time so I can remember it. But you do need a good wristwatch with second hand, if you ask me.

Noah: "I would think that sugarcoating something is not objective information. I was not trying to offend my supervisor. I was trying to show how much this patient did not want to get up because when I had written inappropriate language, the man is back on my schedule again the next day. Most importantly if I use terms such as inappropriate, abusive, cursing, to describe what he said, this can be SUBJECTIVE. What one person finds extremely offensive another might not... By writing down what he said I leave it up to the reader to decide if the man is using inappropriate language." Agree 100%. I always chart whatever pt says, profanity and all in quotes.

CONGRATULATIONS to all who have passed the CEN and thank you for all the tips. I'm planning to take it soon.