mitral

I'm wondering; what was your orientation like? I know for mine we did a full 40 hour week and had to go through multiple tests, including diagnosing symptoms, pharm with math questions, mock CPR and scenarios, and it just seemed like it was pretty thorough! What was your experience? How many people were in your class?

It is so hard because you have to know and do everything! From NG tubes to Copd to insulin/heparin drips to strokes to etoh withdraw to central line care to heart cath, just SO much to know. And you have to do YOUR job of nursing, but you are also responsible for everyone else's job too. I got in trouble not long ago because the dr ordered physical DVt prevention but not heparin. This was my fault because on admission, I filled out a DVt risk form that showed the pt was at risk. Prior to that I was in trouble because an X-ray had been ordered 2 days ago on a pt and it still hadn't been done. (The other nurses involved were in trouble as well). I think this is the hardest part of MS for me, doing all that I have to do, plus the drs job, plus radiology, plus dietary, etc. it makes for an extremely busy day!! *I would like to note though, everyone told me I could do my year in MS and go anywhere, but now it's at least 2 years, sometimes more. If you are stuck in MS for now, talk to the manager of the floor you like, they will often let you pick up shifts on their floor without hiring you and this will look fantastic on your resume!!

If you have trouble relaxing, it will b harder. Set yourself up for success. Announce to the secretary, charge, or another nurse you're going to attempt an iv, and will be tied up for a little while. They will often answer your other call lights for you, knowing your busy. Take in double supplies, keep in pocket. I am often slow getting j lock to vein, so I bring in a towel too, and lay under the pt arm. All blood will be absorbed, one less thing to worry about. Don't be afraid to manipulate pt. Push, pull skin, twist arm... They'd rather this than being stuck again! Look in unusual places. One of our nurses always gets hers in the thumb vein. My favorite spot is the back of the forearm, most people tend to go for the palm side of the arm, but there's a vein there in the back that you can feel all the way to the elbow in some people. That suckers huge and PTs love it when I use it because it doesn't impede movement as much as some others do. Also, Ask the pt! Often, at least 50% of the time, they will tell me exactly which veins people have the most success with and which ones to avoid. They are usually right!

Great thread!! Let's keep the tips coming! I know I've found that the skin prep I use for colostomies also works very well under tagaderm for people who have sensitivities. Once I had a pt who didn't know she'd react, and when we took off her picc dressing she had several good sized blisters. Unfortunately our hospital had no alternatives, so after I cleaned the area I had to put the same covering back on. This time I used skin prep (and PC course avoided the blisters) and when her picc was removed her skin was perfectly intact!

Is it truly a legal issue? We're permitted a 30 minute lunch and 2 15 minute breaks. However, I have never taken a break, and often (3 out of 4) my lunches are only 15 minutes. When they are the full 30, I have to answer a minimum of 2 calls, and often come back to take report or answer a dr.s questions then run back to break room to finish lunch. Once I didn't get a lunch at all, and I wrote it in the books so I'd get paid for it. That was big no-no, me and my charge both got reprimanded for that. I'd love to know I have legal support, because if so, I will happily insist on that time!!

Thank you, your answers are very helpful! I too felt it was excessive filter use and could not find any policy specifically stating that it was necessary. Probably as one poster suggested, she just misinterpreted the mandatory TPN filter use. Our facility filters anything that will be running long term, even just 0.9, that may have something to do with it too. P-lock is a term for heparin locked/line not in use, just capped.

I always like to look at samples and beef mine up from bits and pieces that I can apply. Here are some good examples: Registered Nurse Resume Example Registered nurse resume - Templates - Office.com Nurse Resume Sample http://www.job-interview-site.com/registered-nurse-resume-template-rn-resume-example.html

I tell my patients to pretend theyre drinking a thick milkshake; most of them are NPO at this point because theyre post-op and they love this lol. And it is amazing how just cheering people on can get them to use that IS! I was afraid at first that it would be too juvenile for adult patients but most really like it. No matter how high they get it I say "I bet you can get it twice as high!" Then when they are REALLY trying and doing it right I say something like "Wow! Most people can't get it that high so soon! Good job!" Cuz' humans love a little competition (Some people just flat out feel like crap and find this cheerfulness annoying. I tone it down for them!) Also pop your head in the door randomly and remind them to use it with a big smile, because they often forget. 9 out of 10 times when I come back in to check on them they brag about how well theyre doing with it.

It really does get easier & faster with practice. A lot of the same meds you will be giving over and over and so you will actually begin to memorize the packaging, thus making it easier to pick out and you learn the fastest way to open. You will know who you have to bring applesauce into and who only will take theirs if they have milk so you get that stuff ready ahead of time and spend less time bargaining. One thing I had to learn was any other task, even chatting and socializing with the pt usually has to wait; you often just need to power through that med pass then you can back and meet less urgent needs later. LTC facilities are always looking for nurses and also know what a huge chore the med pass is(!!!) so I wouldn't worry about job security at all if I were you!

Hello, we were having a bit of a debate with the nurses this week and I wanted to see some other opinions. For a patient with a central line, one of the ports was p-locked. The patient was to get IV push steroid. So she gave it through the port with a 10ml 0.9 flush before and after, and diluted the steroid with 0.9 as well. After this, a more experienced RN reprimanded her because she said you can't ever give anything through a port without using a filter. Now this nurse did have IV antibiotics hanging which were running through a filter but was not using one for her push meds. So the big debate is, should she have used a filter for IV push? I am pretty confident in my belief on this but I would appreciate your thoughts :)

I am finally starting to get my bearings a bit as a med surg nurse. I'm fresh out of school and had no idea what to expect, so I am really shocked over how the doctors speak to nurses! The first few times I saw a dr throw a hissy fit, I didn't think much of it- everyone has a bad day sometimes. But now that i've been here for awhile I see that this behavior is consistent, especially for the surgeons. They literally scream at nurses in front of everyone (patients, other staff, etc) for the littlest things, and use large amounts of profanity as well!! For example, we had a pt with a new colostomy that was post op day 2. When the surgeon went in to see her and learned that she had an opaque bag on rather than clear, he started going off on the charge nurse about it. He then proceed to have that nurse paged up to the nurses station so he could chew her out in front of all her peers for having that opaque bag. The nurse tried to explain (politely and apologetically) that the ostomy leaked and that was the only bag available at the time, and she had already ordered clear bags, was just waiting for them to get sent up. He responded with 'this is ***ing nursing 101, I am fed up with dealing with the incompetencies of this nursing staff! This is ridiculous! What kind of moron does this? Then stormed off to yell at the general nursing manager, who later that day sent out a mass email to all of the nurses with a reprimand and reminder to never, ever do this. That nurse also got yelled at by her charge (who was angry she got yelled at) and was reminded that 'we must always keep the drs happy' What im wondering, is this the norm??? I dont have any other experience so I really dont know. Do you all have hot headed dr.s that ALL nursing staff has to tip toe around and put up with all this verbal abuse?? Must you also drop everything youre doing when a dr comes to serve him/answer ?s/get out of his way? I dont know, maybe it is normal but it seems absolutely insane to me. Thnks for any input.

I'm a new grad and still a little shaky on my feet. I've only been set loose from orientation for a few weeks. I have a tech/nurse assistant/pca that is making my job sooo much harder. When she does actually work she does a great job, but it's hit or miss. She's late getting the vitals in, so I have to either track her down or take vitals myself before passing meds. Same with glucose readings. She doesn't always enter. I and Os correctly, last night she forgot to enter them at all. Doesn't always do what I ask (sorry, I'm too busy with this other room). I feel bad yelling about certain things because I know I forget to do a lot too.. But doing 2 people's jobs is really putting me behind. I've also never had to deal with this type of situation before (the other techs are great) so I really don't know how to approach this. She is well liked for personality by management so, you know how that goes. What would you guys do?

I love the info on this thread!! Some of these time management tips are very practical and exactly what I've been looking for. Ty all for sharing

Beautiful advice, thank you!!

i love this question and the answers so far! I do as others have said for the mornings, makes the rest of the day a lot easier. Now I just need to figure out how to speed up my admissions, they take me sooo long and kind of throw my little brain chart system... I tend forget to check the new ones but I will get there! Also I try to do documenting as it comes along- its fresher in the memory and easier in little slices, too.