emcadams

In this situation I would tell the primary that the patients pain is still reported as 10/10 despite giving med as ordered and specifically ask for pain management. In my experience, they will put them on something oral q4 or q6 hours, and take all that other crap off the MAR. Also, if patients are eating and drinking normally, and have not just undergone a significant surgery, there is no need for IV pain medication. Doctors need to stop prescribing IV pain meds when oral can be given. Same with IV vs oral antibiotic. If they need continued IV antibiotic, they should have infectious disease on board.

I have not posted on here in a while, but I am posting now to tell you that if the only reason behind taking the MedSurg is "for the experience", this is misleading advice. I took a PCU residency out of school, and I see all sorts of nurses go through the residency. There were nurses that had been working at SNFS, hospice, and homecare. You will learn craploadz as a wound care RN. One thing I don't know as a PCU RN is wound care. Why? We have a wound care nurse for that! Ultimately, you need to do what your heart is telling you or you will feel regret. No one is telling you to be a wound care RN or camp nurse forever, but both of these will have highly transferable skills if you ever wanted a MedSurg job. While hospitals make these residencies sound exclusive, the fact is there is high turnover in bedside nursing, and hospitals have multiple tracks to train warm bodies, only one of which is the "new grad RN with less than one year experience". Write a list of pros and cons, and don't forget to write "this is what I want right now, even if not forever".

I have to agree with bluebonnet...spend a summer as a nursing assistant. I got my CNA cert before going to nursing school, and worked in a nursing home. I thought that working as a CNA at a hospital would be different (thought it would be not as much work), but hospital was MORE work for even worse staffing ratios...so I thought things would change when I was an RN. Still doing "dirty" work, along with everything else my job entails. I truly enjoy caring for others, and the skills I am learning. I can see myself being fine doing this for several years, but then I would like to teach! I had a Bachelors in English, and went for my ADN thinking that was the cheaper route. Nope. Spent about $2200 for five semesters at the community college (best nursing program in the area) for my ADN. Now I am going through paying 1500 a semester for five semesters to get my BSN part-time online through a public state university. Totally wish I had just done the BSN right off the bat at the "lesser respected" local public university, as the hospital I work for seems to employ from that school a lot too although I was told different when applying to the community college. My hospital really wants everyone to get their BSN, although it is not mandatory...but you are eligible for a clinical ladder if you have a BSN. So. All this work for two bachelors degrees. If I could teach and do nursing PRN, I'd be set!

Use this as a learning experience. All patients are fall risks. Every single one. My unit is not Ortho, but we have a policy to bed alarm all patients, unless verbally refused, and then we chart "refused" every time we chart safety rounds. I had a patient that was very restless and confused, thought his denture paste was in a drawer in the "other room" and thought I was a fool for not getting it for him (there was no denture paste in his room, and we didn't carry it on the floor). I wanted him to scoot up in the bed, so I put the walker in front of him, and asked him to stand and move to his left and sit down again on the bed. Well, the patient stood up, and proceeded to walk with the walker right out the door of his room. And fell. There was nothing I could do to stop it. And this gentleman had been ambulating with walker and PT all day. Things like this happen. Know your floors protocols and policies, and follow them. Even when other co-workers don't.

What sort of disease processes/diagnoses would D5 1/2NS+KCl be used with? Anyone have experience using it with their patients?

RN licensure is different from LVN. Why not take the NCLEX but have your school send the information to the state of California instead? That way, you are just applying for a CA license, not transferring it.

I'm assuming your talking about the VA jobs? 90k would be at the top of the range...46k at the bottom. I would assume you would be starting at 46k, and there is a step-wise grade level (GS) associated both with number of years of employment, plus performance. I would also assume the nurse earning 90k at that employer had 25+ years of experience.

Use it as a learning opportunity...Dilauded + Neuro = bedside commode/bedpan. On my floor, I can't stay with everyone in the bathroom. It is unrealistic. But if they need that much watching/help...bedside commode. Bed alarm. Also, almost every fall I've encountered (and no, your not fired if you followed all protocol and even then it's a learning opportunity) were people you would not expect to fall. So teaching is VERY important..."don't get up by yourself"...and chart chart chart.

Make sure you have 2-3 pairs of shoes for work. Don't wear the same pair of shoes two days in a row. Call a podiatrist office and see if there are shoe stores in your area they would recommend. Advil may work better than Tylenol because it addresses inflammation. Foot soaking, self massage, stretching, and exercising on off days are all things you need to do. I still have pain, but after getting good shoes, stretching, and biking (the only form of cardio I can do since my feet hurt!), it is definitely a lot better than it was. And yes, it does get better after a few weeks. Stretch during your shift (calves, hamstring, piriformis, abdominal side muscles). Take Advil on your lunch break so you are not in so much pain after work.

I can't believe, reading all these answers, that the Gov't seems to think the average student loan debt is $24k (or thereabouts). Do they not count all the private loans students take out because their dream school (or for-profit private school) is not covered by federal loans???

I have to admit, this is a big concern of mine as well. I am still in nursing school, but I have already seen how much time nurses truly have to spend with their patients. I love caring for people, but sometimes I can see that it is an impossible task. How can I tell a patient I have xyz other patients to see, and leave the room? I have seen some nurses do this, and it is sad. But I know where they are coming from. It is too bad we have an insurance focused care system, instead of a patient focused one.

Hey sduncan, just wanted to follow up and see how your med-surg experience is going?? After several months I definitely feel more comfortable with my responsibilities. Some days everything sails along smoothly...other days I have no time to catch my breath. The things I've learned are to CHART every little thing you do (hopefully when you did it!). I just go right to the computer and do it. Help your nurses as much as possible. Try not to say "no". If you can't be there ASAP, ask if you can do x and y before you come to assist. That way they know you want to help, but your stuck in a room too. You are one person.

I started work as a CNA at a LTC just before the first day of class of my RN program. I am going into my second year of RN school, and now work at the hospital I hope to work at as a nurse. Being a CNA is no easy task, but at my job I take EKG's, remove Foley's and IV's, perform ADLs, and most importantly, tell the RN when a patients status has changed. To me, this experience is invaluable. Not to mention getting used to the stress the RN has EVERY DAY!!! Less than a handful of people in my class do patient care as their job. Maybe it should be a prereq to RN/LPN school?

Personally, I have found that you just need to apply and see what happens. There is a lot of job availability in Lee County (not sure about the others). That said, there are also many people applying to those jobs. The interview is all about making sure you are the right personality for that company. They already know your credentials. LTC pay more than some of the hospitals in South Florida. While you are working, make sure you write down and put into a portfolio things that they will ask in an interview...a time when you mediated a stressful situation, provided great care, showed good teamwork, etc.

Sounds like you're trying to justify your own choices to allnurses readers!!! I say stop worrying about what others think, and go do what you need to do. I worked as a CNA in a LTC, now I work in a hospital. I am in RN school. RNs (and LPNs) have SO much responsibility when it comes to patient care. I don't blame you one bit for wanting to go LPN. You can be done in 12 months, then work on the rest of the college classes for an RN bridge program. In my neck of the woods, there are definitely jobs for LPNs. Most are in LTC...but having worked in both environments, LTC definitely has some good things going for it. I personally do not think the care hospital patients receive is any better than in LTC. Both systems have there ups and downs.