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zoidberg BSN, RN

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  1. zoidberg

    Any facilities actually using an AccuVein? Any thoughts?

    that is nerve damage waiting to happen. lawsuit anyone? Even with ultrasound I have seen poorly executed ultrasound guided piv’s cause permanent nerve damage. i don’t care how good you are, it’s too risky. and the infrared stuff is garbage.
  2. zoidberg

    I don’t know what to say 😩😩😩

    Providing great care in situations like this is nursing at its best. Round frequently, advocate if more/different analgesia is needed, explain things to the patient and family so they understand what is happening, make sure they know what options are available (comfort care, hospice, surgery, chemo, etc) palliative care teams are a great resource if you have one available.
  3. zoidberg

    I’m burnt out

    That sucks. I love float pool. All the units I go to are happy to see me for the shift-they aren’t short due to my being there. I agree, it’s not an easy place to start. I had my feet wet on a really difficult unit before starting to float. Don’t work extra, try to get 12 hr shifts, and make sure you take time for yourself. I’m a sociable guy, and like that i know pretty much everyone in the hospital. You make floating what you want. many of my float friends like it as they can keep to themselves.
  4. zoidberg

    The wage gap myth

    As I guy, I get treated differently. By my fellow (female) nurses, by my manager (who gives me my raises yearly), by physicians, and so on. I avoid drama, get made charge nurse before equally/more qualified female nurses, I could go on. It is not always the advantages that are obvious. Think past just pay to why men may be promoted or hired to a management or leadership position before a female even though the male is not nearly as qualified.
  5. zoidberg

    What are the low stress nurse practitioner jobs

    It seems the derm/esthetics crowd has a sweet gig if you’re into that sort of thing
  6. zoidberg

    What's next? I hate my job

    If it helps you feel better, I think i'm a good nurse, and very often, I forget my patients names!! :roflmao:You will get the hang of it!
  7. zoidberg

    Peg Tube Feeding

    Assess your patient as well. Any abdominal distention? Bowel sounds? Complaints of nausea or fullness (or restlessness if unable to speak)? Also, something to note: make sure you follow your facility policy regarding checking residuals (and whether you should check them or not) and what your parameters for notifying medical team are. Some evidence shows checking residuals leads to fewer patients meeting caloric needs without adding any significant reduction in adverse events. Monitoring patient for tolerance would include nausea, emesis, abdominal distention, restlessness, etc. Effect of Not Monitoring Residual Gastric Volume on Risk of Ventilator-Associated Pneumonia in Adults Receiving Mechanical Ventilation and Early Enteral Feeding: A Randomized Controlled Trial. | Critical Care Medicine | JAMA | JAMA Network I have more somewhere... ask and I will try to find.
  8. zoidberg

    Force to change unit in the middle of shift

    those words are what make a float nurse swoon If only more people had this attitude. I do try to have everything tied up with a bow and some ativan for the next shift, but crap happens!
  9. zoidberg

    Return to Med-Surg, new way of charting slowing me WAY down

    I have heard Med-tech is terrible and slow, so its not you!
  10. zoidberg

    new grad high turnover

    MMJ has a lot of experience to share, so do not be dismissive. I can feel the anxiety, stress, and new nurse angst in your tone (and the long-winded rant). We all have felt like this at one point or another. Some workplaces feel like this from time to time. Some places are always like this. If it is bearable, do your best to keep a smile on your face, accept criticism with an annoyingly good attitude, and attempt to be introspective about the process of growth that is the first year as an RN. Nursing is overwhelming at first. That is ok.
  11. If a working port is present, it is best practice to use it. PIV's cause a ton of BSI's. If you have a functioning port and insert OR use an existing PIV which leads to a complication (infiltration with complication, nerve damage from infiltration near a nerve, etc), you can be held negligant. If a patient refuses use of their port, you better document that on the notes when you chart your PIV...
  12. zoidberg

    Non-Clinical RN to NP

    It would be wise to return to the bedside in an RN role in a mental health environment at least part time prior to enrolling.
  13. zoidberg

    Normal Saline as a flush for PEG

    I have used NS via PEG or J quite often. If we can maintain a normal sodium with NS via enteral flush, rather than through IV, they can leave the acute care environment (they can go to rehab...) Pushing large amounts of free water into someone all the time will often cause hyponatremia over time.
  14. zoidberg

    Why is Med-Surg so hated?

    I float so I go to the ED often to help out with people waiting for a bed and have witnessed the ED first hand. I don't care what shape they come to me(within reason), I know they are doing their best. That place is nuts. BUT, when I get a patient who was in the ICU all day with most likely a 1:2 ratio, come up with all her PIV's not working (and an AV fistula in the other arm,) and she's been soiled for a long time... that really gets me going. I always drill them on how the patient is doing and touch base with the accepting physician if the transfer sounds sketchy.
  15. zoidberg

    Medication Error

    oh albumin. I have BATTLED with those bottles. My facility recently switched to bags!! Do a patient safety report and say bags would improve care delivery.