Candyn

Have you been looking for hospital job? Since you like nursing, maybe continue to look for job while working as your current job for cash?

I work as a teaching hospital and it is not true that nurses will lose skills. Think about it, dr skills are different than nurses' skills.I personally like started as teaching hospital because I have residents available in the hospital all the times...even at night...instead of having to worry about calling dr when they sleep. It is easier to have them come to see your pts too

Yup protect yourself and your patient

I am sorry to hear that

Missnurse, To my understanding from your post, you got into CRNA program? Congrat to you both:)

I am 2-3 months off orientation and my advice is enjoy your time on orientation. There is someone who check your charting for you, check your patients and always there for questions...how awesome is that????

Unfortunately my unit does not have protocol for rhythm change. I agree, I need to use my charge nurse more. Rather be safe then sorry. Sometimes I get too focused about pt crashing that I forgot about resources...which is no good!!!

Thank a lot for your responses.What rhythm is K/mg imbalance associated with? I have not have a doc ask me to draw a K/Mg stat or maybe not too urgent that they just wait til morning lab?

We rarely have cardiZem drips. If we do mostly is for stable hypertension crisis. For afib with uncontrollable hr, they will go to ICU.What to do if pt unable to report whether they are light headed or dizziness? I took this patient BP every 30 minutes. patient BP was mid 90 but no change when pt hr was 60+.

His Hr went up to 130 for few seconds and down, beside that hr mostly below 100. He was in and out of afib. How do you assess patient whether pt is symptomatic (dizzy and light headache) if pt is confused?

I work night shift and sometimes I have patient with a change in cardiac rhythm such as afib or Brady down to 40. For afib, I called doctor and stat EKG was ordered. Nothing else was done since pt BP was 120+ and asymptomatic. For Brady, pt BP was 96+ but that has been pt BP since she was admitted and also asymptomatic. People kept asking me about it when alarm went off. My question is what else can I do for patient with change in cardiac rhythm? I know for afib, If diagnosed, pt will be on aspirin but that will not happen at night and immediately and if patient is stable. Same for brady.What stressed me out was I had to take care of pts and monitor tech started to stress me out by keep talking to other nurses and then I had to explain it to them the situation or none-nurse staffs and what I got from them is "I am not doctor." I am new grad, it already stressful enough to take care of patients with these situation as I am scared they will go unstable, yet dealing with others and their questioning make me second guess myself and become doubting myself.

I love grumpy old men yet when you get to know them. They are hilarious too.I have borderline personality patient. Did not get to chart anything and ended up staying 2 hours after. Really do not mind but then what irritates me is when I think back what I did for the whole shift that I stayed very busy...nothing beside brushing hair, bathing and scratching.Another type of patient I hate is the ones who cry out loud why this happened to me, yet they are positive for every kind of drugs and alcohol you can think of. Patients need to know we test for drugs and alcohol.

I personally do not see anything wrong with nurses saying bad but relevant stuffs about patients. I meant I can listen to it and choose to trust it or not when I come in and interact with patients, however at least I know what I will walk into. I rather over prepared than under prepared. Trust me, if you have a patient who is manipulative and bad mouth about everything and other nurses you would want to know and chart/cover your a** everytime you are in that room.

I can help too if you wAnt (I am a new nurse btw)

Did you mention 4 total care patients and a code? Well then it is normal to feel overwhelmed. I am new grad on my 2nd week on my own, and really I will cry if they give me 4 total care patients or none of the experienced nurses on the floor ever get 4 total care patients. That is way too much. Also, if you get a code, a code requires team work especially with new grad. It is normal to not know what to do in those situations for now:) I only experienced Rapid response once, NOT CODE, and I went from sitting around and look at moon and stars to run my A off for the 2nd half of the shift. With what you listed, I think you already do amazing. Some shifts no matter what you do, it means to be bad. It is not you who are incompetent. It is the shift that means to be suck!!!

Hi BrandonLPN,We are all cool. No need for anyone here to feel defensive or regret:) and team work is awesome. No one can do this job alone.

Well the rest of CNA on my floor are awesome. My days are so much better except with one. If I know he is working on the floor, I know I am better off doing stuffs myself than getting the not-happy-yet-I-have-to-do-it face. So yes, not all CNA are lazy. Some of them are deserved to have more respect from me than I should be from others:)

Hehehe did my post sound angry and defensive? I apologized.

Hi BrandonLPN, I think you did not read my post correctly. First of all, you think it is right to say "It is not my patient"???? I do not think it is right to say that. Patient is patient no mater if he/she is my patient or not. If another nurse ties up in a room and a patient desat and I am sitting right there, yes I will go and check on that patient. About pain medication, I will not say it is not my patient, I will go check with that nurse, if she is too busy to get it, then I will ask whether the patient can get it yet and the dose. One of the reasons that I prefer not to have to get pain medication for other nurses before I ask is first of all, not all times they chart the medication after they give the pain medication, second of all they may have a specific pain management plan with the patients who are on 3 different pain medications and third of all I do not mess with narcotics especially I am not familiar with what the patient is on. Also, we have 3 aids on the floor that night and he only had 5 patients to take care of. Like I said, he spent half the shift to talk and fb. I do not see anything wrong with helping out others if I am not busy, stand around to talk and fb even if it is not my patient. That is called team work. If I am busy then it is another story or this is where prioritization comes in place. Lastly, did you read correctly my complain about it is not my patient story? I normally do not ask the "it is not my patient" CNA for help. I will ask my aid if time permits. However, I was on the phone with doctor, my aid was not there, that aid was standing right in front of my patient room talking, and IMPORTANTLY, my patient was going bad. YOU THINK IT IS OK TO SAY IT IS NOT MY PATIENT WHEN THE PATIENT IS GOING BAD? like bad to the point of coding? REALLY?

I am having trouble with CNA myself. I like to do most of things by myself because I find it is quicker to just do it myself. However, when I ask CNA to help, it means I run my A off. No eat or restroom and I had to stay back 2 extra hours that day. The response that I got from rarely asking was it is not my patient (I can not find my CNA, on the phone with doctor, and my patient was going bad). I hate the "NOT MY PATIENT" sentence. Also, you are too bossy (yet the CNA spent half of the shift talking, fb, and only have 5 patients). The only time I need help is those times or need some muscles to turn patient because I am small. GRR!!! If I am big and I can do it myself, I rather do it myself.

Hi there, I am not even anywhere near to the application process, but may I ask what website with PDF form did you just mention?

What are the ways to stand out I meant? Thnx:)

What are the ways to stand down Cagax4?

I usually check BP again before giving BP medication since it is not too uncomfortable for patient even thought it is better without getting pump again. But for blood sugar, really? Most patient ACHS, Q6, or Q4, if CNA check it and I have to re-check it, you know how many times patient will get poke? I look at patient satisfaction score, and one of the areas that we get low in hospital is frequent blood taken for lab and poking patient. So yes, if I can re-check my blood sugar without having to poke my patient again (which is impossible) I will take my time and do it. And no matter how many units of insulin I give, if I give wrong one, patient will go into hypoglycemia.

Did you take 4 patients right away or gradually increase the amount of patients? What my preceptor and I did was I took 1 patient first then until I am comfortable with doing everything for that patient, I would take 2...then increase to 4 patients. And yes there will be days I feel like what you are doing, there are days I feel like I can easily make a mistake. That is where it is important to stop what you do, take a big deep breath, look at the big picture and prioritize.