flashyrn2be

I absolutely love all the responses this post has drawn out. When I am not so tired - I will go back and re-read everything. I just had my first solo shift with 7 pts. 2 were new admits for chest pain, 2 with renal failure, one NSR who decided to to go A-fib with a little tach thrown in (two hours into my shift, same pt also on heparin drip), one post heart cath, and one who fell down in the ER. Awwwww.......welcome to tele. I know this may not sound like much to some but for me.......it was hectic. Some how I still smiled - nobody even knew I was a new RN (except for all my great supportive co-workers - God bless them everyone). Thanks again everyone for your responses. I loved the cat fight too.

Pt was on a heparin drip. Scheduled for a thoracentisis (?spelling) the following day. Lungs sounded clear but diminished at bases. However, Pt at one time, during a 12 hour shift, coughed up a considerable amount of sputum - thick, chunky, green/yellow. I looked up info on the net and found that approx. 26% of pts with subclavian DVT's end up with PE. Thanks for your responses. Just trying to educate myself.

Has anyone cared for a patient with this? My pt had no activity restrictions......I was worried about a PE. What are some key things to assess with this patient? What can I do to help prevent a PE? Thanks in advance.

Congratulations!

Congratulations! What an awesome feeling! Go celebrate

At my hospital, DNR's wear a green band on their wrist. "Green means go - let them go." We also put green tape on the door and indicate which bed is DNR. I think this is a great policy.

It would be a good idea to start "shopping" around now. Get information from the places that you are interested in working. See what they have to offer new grads. I graduated in Dec 04. I started putting out applications in October 04. I did my interviews in November. When I graduated I knew where I was going to work. Hope this helps.

Congratulations!!!!!!

I really appreciate you all taking the time. The infomation you all gave is very helpful to me. I have a 12 week orientation and would not mind extending that time.....I feel better when someone is looking over my shoulder :) I do ask questions constantly. I'm sure my preceptor is sometimes looking for the "off" button. We just had an awful day yesterday - awful!!!! Out of 7 pts, 3 were "high acuity" One of them ended up coding and passed. This was my first code, I had never seen one before either. .And I have to say that my training did not automatically kick in. Why didn't I see it coming? What could I have done to prevent it? My preceptor said there was nothing else we could have done. That we had provided good nursing care. But I can't stop the thoughts rolling through my head, was there more I could have done? This is more of just a vent. I don't expect anybody to have any answers for me. I just need to share. I have to admit that I probably learned more yesterday than I have learned in my previous four weeks of orientation. It was just a lot of hard lessons learned. Again, I thank those who responded to my post. Truly overwhelmed and humbled, Flashy

Hello - I have been an RN for about 2.5 weeks. I am currently in an orientation program for a tele/PCU floor. I have some questions. I do not want to appear uneducated at work. But alot of things I just do not feel were covered in school or in text books. I have asked some questions, but get unclear responses. How do you tell if a patient is going bad? I know I have gut feelings.....but when do I call the doctor? I don't want to call the doctor just because.....what are my key warning signs? I want to be able to provide the doctor with logical, objective observations that they may not have picked up on during their rounds. Do my instincts count? When is a blood pressure too high? When is a blood pressure too low? Is there a panic level? What if there is a huge difference in the ortho B/P's? Do I call or just chart? Is there any interventions I can do without a doctors order? I know you call a code if someone is not breathing or no heartbeat. That much I did get out of school and BLS. But how do I know it is coming...... I had an instructor tell me she did not experience codes because of her excellent assessment skills. I was like *WOW*. She is super nurse. So too shall I strive........ Can anybody help me and my future patients? Many thanks in advance.

hmmmm......... This is just my experience as a new grad. I had no power except to choose which facility I would work at. There are alot of little things that seem to get glossed over in the interview process. Things are promised but not delivered. The hospital I decided to work at requires a two year agreement, but you can move anywhere in the facility after one year. As far as hours, nothing was guaranteed except night shift or day shift. No specific days were discussed. Maybe in a perfect world we would get to negotiate such things........

i also took my boards today. i know how hard it is to stay positive, but please try. you do not know you failed until you get the results. that is what i am telling myself at least. if i give into the despair i feel right now, i will not be able to function. from what i read from other posts it is very normal to feel like you failed. i hope this is true and that we both passed. keep us posted!!!!! sending many positive vibes your way!

took the NCLEX today. Had about 3 Mental Health questions.

My last little refresher course in confidentiality seemed to allude that it was ok to discuss a patients condition with the patient - even if they shared a room with another. This was one of the only if few exceptions to the whole privacy thing. Sounds bizarre, but I re read everything to be sure. I have been in pts. rooms doing assessments, teaching, etc and have the pt in the next bed put in their two cents worth. Oh, tell her about last nite or what about when such and such happened. I find it very unnerving having patients overhear other patients situations or problems. I am all for private rooms, in the ER and everywhere.

Don't get depressed. Just give them a call. Chances are the hospitals are getting flooded with applications from new grads. If you call just to make sure they have your app. - all of the sudden your app is on the top of the pile.