saphie

Where I use to work, our floor was not certified for IVP so we would use a 50 ml IV bag with NS, inject the heparin into that and then run it over 15 mins, basically a push but not technically ! However if the floor you work is allowed to do IVP I would do it that way. As for the SQ what's the point, it's not really a bolus because the absorption would be quite abit slower than IV, weird.

Thank you to all of those who replied and your kind words! Things went further down hill but now seem to be going up. I have a new preceptor with loads of experience and a personality that is much more like mine. I'm still not sure this is the place for me. Most of all I miss the commardie I had with my fellow staff members who became my friends but am determined to stick it out for at least a year. I figure by that time I'll know for sure if this if for me or not. Again, thank you for replying.

Hello all! I haven't posted in a coon's age and here I am crawling back! I have been very busy. I have moved, separated from hubby and started a new job in NICU. My problem is is I am going nuts. The NICU offers a good orientation and all but I'm growing sick and tired of having someone either a- do it for me or b- telling me to do it their way even when they don't have a clear reason why that way is better. I spend 6 months on medicne and that is constantly being put down. When I ask how is it different then in adults- the answer is 'it is different'. My preceptor just walks in and does my care because she's bored and the next time is grilling me on physiology and patho when I have three babies that all need attention!! The educators say my nursing skills are excellent (which I am proud of, she said I act like I've been nursing for a few years and don't seem like a new grad, that's big compliment in my books) but I have an attitude problem. Which I do because I am a RN - abet a new one but I'm still an RN. I am not a student. If you tell me to do it that way instead of my way, I want to know why. Is it safer? Prevents contamination? To say that's the way I do it, is not acceptable to me. I give them my reasons for the way I do things but I still have to do it the preceptor's or educator's way. I don't want to make enemies. But I'm tired of this, I'm starting to dread going to work. I like this area. I don't mind being watched, I dodn't mind suggestions on how to improve but twll me the reason behind it!!! HELP!! Should I confront my preceptor? Should I live with it? How do I tell her to give me some breathing room? I don't know if this clear but any suggestions would be greatly appreciated!! Thank you again! Tara

Hello all! It's been a long time since I've posted. This topic hits close to home for me. I graduated this spring and worked for 6 months on a heavy medical floor. I am currently being oriented in the NICU. I would recommend starting in general medicine. There were a lot of days that I hated it but I tell you, I have learnt so much and have gained confidence that is really helping me. I have been complimented on my skill in this new job and that is because I spend 6 months bumbling around but had great nurses that didn't mind my 400 hundred question for the shift, that showed me ways to streamline and still give nursing care that is excellent. For me, I still haven't really found my niche so to speak. I like the NICU and will do it for a couple of years but I also would like to do ER and adult ICU. Take your time. But highly recommend that general med, you will be thankful later. Tara

Hollykate... I thought it was in terms of initating heparin therapy... plus I think it would be difficult to bolus from the gtt... at our hospital our heparin is 20,000u in 500 D5W... to me it would be easier and also less chance of med error to give it IVP or in a minibag. Also we do have a heparin protocol, where the doctor decides on the bolus and the inital rate. Then depending on the PTT is how we adjust the rate.

It depends where you work... if you are in critical care area, then IV push, if you're in med-surg like myself, where we are not covered to do any sort of IV push, we put it in a minibag and run it in fast, ie. 50 ml bag we'll bolus in 15 mins. So really it depends where you work.. And out of curiousity... I haven't heard where they bolus heparin after a gtt has been initated, what is wrong with the pt?

Okay, this has been a topic that I have been following. Siderails are not considered a restraint where I work. It is a nursing decision to put up siderails or leave them down. One lady on the floor I work will get out of bed if the siderails are down and fall - I think on purpose but my thoughts. But makes no motion otherwise. We do have a have quite a few elderly confused patients on the medical floor I work, so siderails up and a bed alarm works well. The bed alarm goes off and the siderails prevents the pt from getting too far. On the surgical unit I work, it's a bit different, most of the patients have two side rails up not very many have all four, it's just standard practice regardless of age, diagnosis or medication.