msygrnbw

I think I was just ranting a little bit coming off a frustrating shift where I couldn't keep my head on straight running people back and forth to the bathroom. I feel better, just needed to get it out I think! I know reducing catheter associated infections is important, and I do believe in getting them out early - I just need to figure out a way to clone myself so that I can get multiple people to the bathroom at the same time =p

Glad you're feeling better...Hope you didn't get all your classmates sick in the process -_-

You will do it! While in clinical 1) Be early! If assignments are made, look up your patient early as possible! 2) Develop rapport with your nurses. I know it's important to develop with your pt as well, but imo it's as much if not MORE important to develop it with the nurses on the floor! Let them know you will help with ANYTHING and EVERYTHING you can. This will make them soooo much more likely to bring you around when they see something neat. 3) Don't be overly weird/cheery/annoying. If you are trying to chat while your nurse is pulling meds for pts, just shut up. I don't see this advice much on the forum, but there is a time for questions - use it and observe that your nurse is still human! Do not rapid fire them with questions while they are obviously busy (Yes, I actually have seen this quite a bit with students on our floor) 4) Answer call lights - but do NOT get the patient up unless you are 100% sure that you know how they get up (1 assist, 2 assist, etc) I would 5000x rather you let my pt know you will let me know they're in pain than having that call light ringing and ringing since I am busy passing meds/changing a dressing, etc. 5) Look through ORDERS. This is one thing I REALLY didn't get/overlooked while I was in school. I looked up my meds, I looked up the pt history, labs, etc. But I don't know how, I totally blanked a lot on orders. I don't think I quite understood the hospital computer system I had and I didn't realize how much information the orders have in them. They tell you parameters, blood transfusion orders, whether you should elevate an extremity, lab orders, etc. I so wish I had gotten more experience with orders both as a student and as an orienting nurse. It tells you a lot about your pts treatment that is so easy to miss as a student. 6) Don't be afraid. I was so SCARED of making mistakes, of not knowing answers, that I lacked participation. I could have seen/done so much more. I got decently easy patients. I aced classes. But I could have learned SO much more had I asked for a challenge. Good luck! You can do it!

No one said you didn't use clean gloves. We said wearing gloves in the hall creates the appearance that you may not have. If that's the case, just explain it and it won't be a big deal anymore.

Maybe I miscommunicated. I didn't mean JUST for my convenience. The pt had a long history of issues, and even night of surgery had no catheter. Difficulty ambulating, but managed, I got them up a number of times without complaint, just....I get it. The pt ASKED for a cath the next day and ask for a renal consult and was told no to both. I agree part of it is I just need to work through 'dealing with it' but I can't be the only one feeling like this. I wanna give you ten minutes to get to the bathroom but if you have to go 10 times on my shift and it takes you a long time each time, it can be frustrating.

This is somewhat of a rant, and a discussion. So if I offend, I apologize, and those that get me, I'm glad we can relate. I work on a post-surgical unit where mobility is almost always an issue. And sometimes we get overflow from another unit where mobility is an issue. Our unit is generally pretty standard about catheters. If you're having a surgery that will make physical therapy unable to see you for approximately a day, you have a foley catheter inserted. This is the standard, minus maybe one physician. And every patient that physician sends up post surgery ends up unable to void. With 300+ in their bladder. Yeah, they get an indwelling catheter too, except it's an extra step for the nurses because we have to call to get an order, etc. P.S. PACU nurses, it's annoying as crap when you send up someone and I scan them the second they get to the floor and they have like 500+ in their bladder. Anyway, I'm a new nurse, and I'm wondering about your unit's policy. With surgeries that cause prolonged immobilization do your physicians always order catheters? I realize CAUTI is a huge problem, but I have seen physicians deny catheters on a patient with a known long history of urinary problems. I don't mind helping a pt to the bathroom, but 8 times a shift with a post-op and I have 5 patients and my nursing assistant has 14+? I don't want to seem crass, but even if my patient takes just 5 minutes total to get to the bathroom and back that's 40+ minutes a shift. How does your unit handle this if you are on a unit where EVERY patient cannot get up on their own?

Honestly, I think you're just being a bit touchy. In our hospital there is a rule not to wear gloves in the hall. She probably just mistook your new gloves for old ones since you were out in the hall. Your logic about being dirty doesn't make sense - the idea is you go in a room, wash/clean your hands, pull on gloves, and move from there. And YES - as a CNA/NURSE/WHATEVER you are kinda dirty going room to room, but making sure to use new gloves, washing, etc helps decrease germs as we can. I think you're being silly being angry - the nurse was trying to protect the patient, so just explain yourself as you did here to your supervisor and it should be a non-issue. In the future, bring gloves ink, wash your hands, put them on, then help whatever resident's room you are in, deglove, wash, repeat!

I am addicted to the cooking ones, but the only thing they are adding to is my pants line! I have been cooking a bit more though in the past few years, and they help inspire me to try new things, so I guess that's at least good? But yeah, cooking shows are a bunch of fun to watch with my boyfriend because it gives us fun things to chat about/consider trying. Big brother though....Yeah, that's probably my guilty tv show.

The only thing that comes to mind is that some people aren't the brightest bulbs in the pack. Personally, I would be horrified to realize people could see my underwear. With that said, I think white uniforms/scrubs are just mean because I won't even wear white pants on my off days because I would stain them within five minutes! I hate navy too, but I love my navy scrubs =p

Fever, strep throat, stay home! For the sake of yourself and your classmates. I hate when people come in when they're really sick and then everyone else ends up getting what they had. Once your fever is under control and you've had at least a day or more of antibiotics, you can get to class. Until then stay in bed and try to recover! No one will look down on you for being sick, heck, we work in a profession where we take care of sick people all day - If a person teaching you about SICK patients can't deal with you handling being ill in an appropriate way, then they really need to reevaluate what they expect from people. You are a nursing student, not a robot.

I couldn't decide what I wanted to do. I started in psychology, dropped out of university and worked at a dry cleaner for a year, went back to community college and tried computer science and criminal justice. I finally decided on social work, but them part way through decided it wasn't for me. I got into a 2yr at community college 2 yr at university program for nursing. A semester and a half into the nursing program my grandfather got sick with lung cancer and passed away. I was close to him and helped take care of him and felt like nursing wasn't for me after that. I spent a while working as a pharmacy technician and then applied at the local university and got in. Family and friends encouraged me to go back into nursing since they thought I would be a great nurse and come from a huge family of nurses. I did and here I am! It has taught me a lot. I do wish that I had chosen something different, but I know that I really care about my patients and I do have them at heart when I'm working. It's not just a paycheck to me, and every elderly person I help I think of my grandfather =)

- Ask if you can help. Ask anyone, ask everyone! If you are always helping out they will be more likely to bring you in on something interesting. That being said, also do not spend all your time helping people to the bathroom. Help out some, but keep an eye out for the nursing side of it - it can be easy to get caught up in tasks and miss out on a chance to help with something interesting. - Ask your nurse if you can go with a patient to a test/procedure, if you can stay in the room while they place lines, if they know of any other interesting patients on the floor that you could peek in on with their nurse. One of our nurses is great at this - whenever she has something we don't see a lot she tries to pull me in so that I can see it. - Never say no to an opportunity - Answer call lights and let the appropriate people know what they need - Do not stand in front of the med cabinet while your instructor asks you about the meds. Once you pull them out step to the side and let the staff nurses get their meds while you go through yours. - Be friendly, but please don't chat my ear off while I'm passing meds/doing a treatment/etc - Ask about things you don't understand - Make sure you know about how to move my post-op patient before you get them up/turn them/etc. And most of all, thank your nurses. I cannot express how much a little gratitude can go a long way. *disclaimer*I haven't had a student with me yet, but I have been around them while my coworkers have them and these are what I've observed/heard on my unit.

I was a PCT before RN and so were 3 of the other nurses in my clinical group. All of us were hired for the hospitals we worked for as PCTs. All hired by the floor we worked on. Tips/Tricks It's still a bit early for me to say, because I'm still feeling omgoverwhelmed every shift. I guess just if you do work as a PCT first, don't let them skip things in orientation because they assume you know them. They didn't start me off like they do most people, by day 2 of orientation I was managing a full patient load and I never got that time to really slow down. I am bad at speaking up and I so wish I had said that I wasn't ready for it, because I am having to make the time now to really search through orders and whatnot. but first step first - look for a pct/cna job because yes it will help you a bunch!

Yes! It's a great way to get some hospital experience, get your foot in the door, and get to see some stuff. The students with PCT jobs in our group were way quicker/progressed faster in clinicals than the rest of us the first few semesters. Plus, every student I know who had a PCT job were offered positions at their hospitals after graduation (myself included), some even on the same unit they worked on before.

Since when is it the nurses acting like they are 'better'? You wanna complain - it's not BSNs that make these goals, it's the facilities. So start saying this to the people actual talking about it - we can jabberjaw all day about what we think and it won't make a difference when they come down to hiring. I have a BSN and it took me about 7 years cause I couldn't decide what field I wanted to go into (And I regret I settled on nursing!), don't think that makes me any better/worse than anyone else in the field - just means I put in the time to get what I did. That being said, I am not mourning the fact that I spent a ton of money to afford that degree and those extra classes and that puts me ahead of someone with an ADN. Can you say that you would really be peeved if you got an extra 2 years of classes and studying plus tuition costs and it got you a position ahead of someone else? Basically IMO either 1) Suck it up and be happy you have a job/keep applying til you find the right fit or 2) Go back and get your BSN because getting a job is at least half if not more about how you market yourself I apologize if this sounds crass, but as a person who spent the time and money to get a BSN I'm tired of reading posts about people who hate that the 'bar' has become BSN. If you don't want it - don't get it. But for those of us who did it was expensive and time consuming and we aren't somehow trying to be 'better' than you.

You can do it! I honestly felt like the NCLEX was not even really representative of how I am as a nurse. It focuses in on your weaknesses though - so take the time to see what you're missing questions on. I did a bunch of questions to prep and a number of people have found prep programs helpful - have you considered trying one or maybe online question banks?

As a new nurse on orientation the one thing I have really ever enjoyed is getting to connect with my patients. With a 5+ patient load, I realize that this cannot always happen, but I am wondering how you all are tactful about it? When your patient starts rambling I tend to fall into the "Ok" pattern (discussed in an earlier recent thread as being not so effective/therapeutic). I try to back out of the room gently. I try to let them know I am listening, but the truth is, no matter how interested I am in what they have to say, I'm still trying to stay above water as a new grad just with meds and dressing changes and orders. So how do you experienced nurses seem to always make it out of the room so quick? (Or is this just an illusion that I seem to see when you've finished all the meds/assessments on your patients about 5 times faster than me?) What tips do you have for backing out of a room gracefully? How do you politely tell someone that you just are trying to get their admission information so you can at least get pain medication orders to start the night off instead of their whole life story? As a new nurse and someone who is VERY awkward to begin with I find myself falling into the ramble/I don't wanna be rude telling you that we need to move on zone.

"Thanks for seeing me on such short notice, I think Dr. Smith managed to walk away with my last therapist"

"I don't know doc, I know my heart is in the right place, but I feel like you've heard this all before"

"You're a good listener but you never say anything!"

"You look a bit familiar...Are you sure we haven't met before?"

I'm not sure what other schools do, but we never had any kind of inspection like you describe. I have a number of tattoos (at least 3 visible at times to patients - on the back of my neck, behind my left ear and on my wrist, but easily covered by a watch) that I worried about at first. No one has ever commented negatively about them. Occasionally patients will ask about one of them, but it is never negative and mostly they just wanna know what inspired me to get them or to connect with me about them - chat about their own tattoos or people they know's tattoos. I also have my tongue pierced and have never removed it for work or clinical. The placement of it makes it hard to see unless I stick my tongue out, so while our policy in school and work says not to wear them, no one has ever noticed/commented. Aside from that I did the first 2 or 3 semesters with the white shoes and no one really wore them and my others were more comfortable so I changed that and no one ever cared. At work now our dress code says no bright shoes, but a lot of employees wear bright shoes. I like blue ones that kinda match my scrubs. Again, no one has minded. I think as long as you're within reason/well kept hygienic/within reason most people don't notice/care if you're off the dress code a little. I think for a school to be that uptight is probably a knee jerk reaction to something a student did (i.e. writing a super strict policy because someone made a blantant disregard for reasonable dress code).

Think about all of the ways medication errors can happen - Each medication right is there because it's a place an error could happen. Even when scanning medications errors still happen. Things off the top of my head that I see very day that are risks. - Family members/other staff talking to nurses/asking questions/portable phone ringing while they are administering/pulling meds out of the machine - Appropriate lab value examination before administering meds - i.e. K+ level before administering k-dur - Programming a pump - having a double check with another nurse, or asking for help if you aren't certain - Medication drawers accidentally being stocked wrong by pharmacy - Being in a hurry and not taking the time to explain each med to the patient - sometimes they will say "Oh! I stopped taking that a long time ago!" All of these (and many others that I haven't listed) contribute to medication errors despite emars and scanning. How can these errors be reduced? I'll give you one example - Stopping interruptions during medication administration (signs on portable computers, red flashing light that signals med pass/pull in progress). What other things can you think of? I can think of some for each and I think that'd give you more than plenty to write on.

My PCT hospital position was beyond valuable both in experience and in getting me my first RN job. It was around the same pay I was already making, so it wasn't a step down like it would be for you. But, it did get me my job and I'm now making over double what I was as a PCT, so in the short term I probably would have taken it even if it was a pay cut. I can tell you that of my friends who graduated, all those who already worked in the hospital as any type of aide or PCT are already employed six months or less after graduation and only a couple of those who didn't are employed right now. I think if you can afford it, you should definitely at least take a part time job in the hospital - in any job (reception, pct, sitter, etc) because it makes you an internal applicant and gives you incredible opportunities to network. Is it maybe possible to work 1-2 days a week at the hospital and 1-2 days at your other job (depending on how many hours you have time/energy to do)? That way you're still getting that experience but also opening up great opportunities for yourself when you graduate.

I agree that the statement you provided about colace is not appropriate for anyone other than possibly a young peds patient, but I do not disagree with explaining medication intended effects and/or side effects with my patients despite their profession. I kind of feel the opposite of what you say. I think it would be a disservice to my patient to assume that they don't want me to explain or reinforce teaching about medications they are taking. Just assuming that I shouldn't provide education because of their background seems like I'm overlooking an important part of my job. Now, in that situation I may preface it with "I like to make sure all of my patients understand the uses and side effects of their medications, but I know you probably know as much or more about many medications than I do as a pharmacist, so if it's too repetitive or you'd like me just to give you the names, let me know." Or something polite like that. That way I feel like I'm still fulfilling my duty to provide teaching, while acknowledging that they have that level of knowledge. Even if I know the patient has been taking the medication before I like to include "This is your xyz for your blood pressure" or a short statement so we are both on the same page about what the medication is and the reason they are prescribed it. I think if I was the patient I would appreciate that too because it means that my care provider is actively thinking about each medication, what it is for, and why I'm getting it, while giving me the time to process through each medication in my mind too.