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I have had renewals stuck in the process before. They are pretty good at communicating about your status if you write them, at least in my experience. If there is any problem you will most likely be able to fix it (a fee, missing paperwork, a specific ceu, etc). Just stay on top of them.

Just watch season 1, episode 1 of Chicago Med. literally every single medical decision is wrong. I feel we could discuss for days. How do I start a thread?

If you are not specialized in psych, why are you prescribing psych meds? Especially sched 2? Are you actually a cocaine dealer? Be honest!

Was this a paper or electronic note? Either way, notes should be banned. They just create this kind of confusion. Doctors should stick to orders and putting them in themselves.

Usually when an error like this happens, it is due to multiple mistakes. For example, why was the drip scheduled at the same time as the loading dose? Why wasn’t the vial for the IV bag attached to the bag? Was there bedside scanning to check the barcode vs the order? I think guest covered the checks. This really is the point of the variance report to see how multiple safety checks failed, not just human error. I will say that new pumps automatically get programmed as you scan the patient and med so at least the rate is safer.

In general, I don’t think it is good practice to dilute meds and I’m curious about your reason. Consider that you should be flushing saline before and after the med and that the med will quickly reach the heart and be heavily diluted in blood, any additional dilution seems silly. Sometimes certain meds burn going in for certain patients, so that might be a reason. For example digoxin. Finally, consider that if the goal is to slow the delivery, the actual amount of saline doesn’t have to be precise at all. Just focus on how much of the med itself is to be given, waste what is extra, then dilute if needed. Do be careful in general that you are using a compatible diluent.

My two ideas for you: 1) spend some quiet time alone really thinking about where the pressure to keep moving is coming from and what it means. 2) rather than setting only career goals, set personal development goals (making or building relationships, exploring new places, learning a new skill in life, learn about other cultures, think about living somewhere else, etc). Try to have fun and figure out more about who you are as a person. The rest will follow.

First Austin is 17.4% more expensive than Dallas to live in mainly due to home cost. From Payscale the median to upper 10% for Austin $31.33-$42.08. From job postings in Dallas, $41-$48. Apparently Houston pays the best and then Dallas. People like Austin but avoid doing nursing there because the cost is so high and the pay is so low.

I wouldn’t worry about fitting in. Just be helpful, friendly, and open to constructive criticism. You are not expected to be perfect. Remember, you only need about 12 months experience to be get in as a non new grad elsewhere (probably less). I know in at least some states those contracts are illegal. I broke mine and others have too with no consequences. They are just another way to use threats to control employees.

I think you are looking for both the most varied experiences and the most support so I would go with med/surg ICU. Less Covid patients is an added perk.

I don’t understand why your experience would vary within the same facility. The MAR should be the same and should list times, doses, etc wherever you are. Do you keep notes on times meds will be due for patients? A large number of nurses don’t complete med passes on time. Modern dispensing cabinets and EMARS should make this much easier and keep your experience the same.

I should add, nursing or health system informatics. You may, as a pharmacist, end up there anyway.

There are plenty of outs without spending 6 or so years and 6 or so figures. Here’s a few: medical device teaching, clinical research (small amount of school), medical device or pharma sales, work on an msn while working as a nursing teacher, school nursing, legal nurse advisor, nurse researcher, hospice/ palliative home nurse, dialysis nursing, nurse practitioner, work for a travel nurse company or start one. There are many ways out of patient care, but it takes research and work getting there. Pharmacy may be easier, but at what cost?

I hate that so much of nursing and even nursing school operates on threats and intimidation. Corporate jobs do not. You can be out of there on a travel nurse contract in a matter of weeks. You are ICU, the top dog. You can go anywhere, anytime. If you want to stay and fight, I might start consulting a highly recommended employment and labor attorney to prepare to build a case for what sounds like an inevitable lawsuit.

Si