jkr2020788

It's not about being perfect. It's about ensuring that I dont take any shortcuts. Everything at the hospital is made to where if you don't take shortcuts, you will be okay. Please give me an example of a time when I do everything according to policy, and the fault is still my own? In any case I can think of, I would be covered under the hospital as Lon as I don't take those shortcuts. Example- not scanning pt bracelets, asking name/date of birth, ensuring all call bells work and are close by, frequent pt rounds, chart checks..... Sounds to me like you are advocating for immunoglobulin when you should be advocating vaccine....(prevention)....

I have ADHD an take adderall. First off, if you have a prescription, they shouldn't ask for a reason, although I'm sure in your paperwork they said to list ALL medical conditions. ADHD is a medical condition that should be listed. Second why are you afraid that they will see it in the screen? If you are prescribed a medicine, then you can take it.....as far as quantity goes, one hospital I work for does do a quantity level, but it's always really high for amphetamine levels anyway. If you are afraid that the will find another type of amphetamine, labs have ways to tell the difference between say meth and adderall. It kind of scares me that you are asking about quantity though, are you taking more than you should be ?? Not a good thing for a nurse to do... Lastly, if you are worried that they will find something else in your urine ( ur question is somewhat unclear to me) then maybe you shouldn't be putting yourself in care of patients? Everything you take that would be "illegal" should be prescribed.

I agree with the osmolality poster.

I would follow up, but only to give yourself a sense of really knowing. As long as you didn't get the fluid in any open cuts, you should be okay. The only possible place to transmit would be orally or through ocular contact( low incidence) if not through an open wound.

Generally speaking, as long as you do everything you are supposed to do including looking up drugs, following orders, ensuring the 5 rights, and documenting correctly you should be okay. If you feel like you might not do these all the time, I think you should consider it. I've never even came close to needing it, but it's pretty cheap, so why not.

I know this topic will differ greatly from hospital to hospital. I am a nurse that has been working in ER/ICU for almost 3 years and have never worked on a general nursing floor. The way my ER sends patients up is fairly straightforward. ER doc calls admitting doc, ER doc and admitting doc write orders together, room is requested, report is given, and patient is brought up. I often have problems with floor nurses complaining that nothing on the admission orders were done. First off let me say that our ER uses computer MD ordering and to have any orders that are written out completed by ER requires me to ask to busy ER doc to put in for a lisinopril because the BP is high even though it is on the admission orders and not meant for ER. I don't mind doing this kind of stuff to help out if I'm not extremely busy, but it kills me when a nurse says "can u give the lisinopril for that 160/90 BP" when I have 5 brand new sick patients every hour. I don't know if it's floor nurses thinking we are trying to dump patients on them, but I think a lot of them don't realize that I am getting new patients constantly, having to collect urines/ekgs/blood, start ivs, titrate and monitor drips, and appease pain med seekers, all while trying to separate sick ppl from ppl that need to go home. My question is if there is anything in particular that I can do as an ER nurse to make the receiving nurses more accepting without me having to get a med that I have to stop the MD for for something of relatively low importance.

One of the good things about documentation in the ER is that it is usually aimed at fast documentation. At least at my hospital it is. As far as what you should be concerned about is more about good primary assessment skills. On the floor, the intial assessment is completed by the ER and you have gotten somewhat of a report. In the ER though, YOU are the one who makes the inital report. You really dont want to be caught off-guard when someone asks you something about the patient. You dont want to sit there with your mouth open and say "I dont know..." You just dont have anything to go off of aside from what the patient tells you and your assessment skills.

I absolutely hate bed baths. It is my ONLY dislike in the ICU. At my hospital, the patient has the right to refuse a bed bath or they can do it themselves if they want to. You had better be sure you offer it though, because the next nurse will sometimes ask the patient how they tolerated the bath. If there is a brand new patient who is not stable, I will definitely hold off on the bath unless they are going to surgery the next day or something. The main point of baths is to help reduce infection, I dont really know how much that water and tiny bit of soap on that crunchy washcloth effects the amount of bacteria, but evidence-based practice and all that jazz. Somebody would be a billionaire if they could invent a quick way to clean a patient/ sheets AND effectively disinfect.......

I do rude things all the time without realizing it lol. Alot of times you say "oops haha, that was dumb", but you realize that you are human too. Like the other day, I forgot that I told a pt they could go ahead and get dressed after being discharged from the ER, and I forgot to get them to sign something, so I went back into the room. The lady was like "ummm excuse me?!". I walked out and said, "oops sorry". She kept trying to say something, but I just left it at what I said, and she just kind of stopped. That was that, I made a mistake and shrugged it off. Dont let patients or their family make you look weak, because then they think you are incompetent or weak. You dont have to be mean to accomplish this, but sometimes you have to know when to put your foot down. In your case, I would have said, "Oh, I'm sorry, Im just here to fix the monitor. I will be out in a second." NCLEX will want you to say to the family, "Please, tell me more how I can be better." In real life choose A. On a test, choose B.

I could never where a fanny pack..... I think I would lose a couple man points for that one haha

I think the Aspirin, gloves, guaze, tape, kerlix, and the oxygen (maybe Im not sure, still considered a "prescribed" drug, wierd huh?) are about the only things you will need. Aside from the AED, which I definitely do not see why they wont allow it. Anything else is would just be overkill I believe. I dont think you will need a stethescope, unless you expect someone to have a spontaneous pnuemo or flash pulmonary edema. If someone is having a breathing problem outside of the hospital/ EMS area, all you need to do is find out if the person is choking or if they are having an asthma attack, either way, they are going to need the abd thrust or oxygen. Id leave the needle deflation of a pneumo to the EMS team or at the ER. There is alot of liability of doing invasive things. I know you would be trying to do the right thing, but sometimes the "right" thing is the worng thing at the time. Just remember, even starting an IV on someone as a nurse without having the premission from an MD, is illegal. The IV even says Rx only on it. Stat emergency contact, CPR if ness, and supportive care, is all you can do until you are under the coverage of a hospital.

Well to me, it would really depend on how much you owed. If you did the math of how much "extra" you are getting by them paying for your stuff and it was a substanial amount, I would think about sticking it out. If it wasnt a good amount of money, I would think about looking for a bigger hospital. What determines how well you do at a hospital, in my opinion, is how much you like working there. If you dont like your work environment, sooner or later your quality of work will suffer.

Unless you were taking an amount WAY over what you should have been, you should be fine. There is a "safe" cut-off for OTC motrin that makes you not test positive on drug screens. Next time, I would take the prescribed amount that is on the bottle to avoid this, if not, you are "technically" abusing a drug (even though we all do it) *abuse (websters)- improper or excessive use or treatment*. If this is not enough relief, talk to your MD. Nonetheless you will be fine as long as you arent taking any drugs you shouldnt be. Motrin will likely show up as a false positive for THC, which can easily be confirmed through further testing by the lab or they can even use a hair strand if you appeal.

First off, I would check your hospital's policy. Alot of places say that they have the right to search anything on the campus. Now whether it was legal to not tell you that they searched your locker, I don't know. I would definitely talk with your nurse manager and tell her of your suspicsions of the other nurse. I refuse to waste with someone who doesn't draw the meds up in front of me. They can think I'm being a jerk or whatever all they want, be in the end, if they get caught, it will be on you too because you "said" you saw them waste the drug. And as caliotter3 said, get that kevlar vest and put a trauma plate in it, because I dont think Kevlar stops sharp objects....

What i think you should do is to go get a job in ICU or ER. You will not only get alot of experience, but it will help you if/when you decide to go back to school. Schools (here anyway) like to see that exp. If new grads can get hired into ICUs and ERs, so can someone with a little clinical experience. I would hold out for one of those. Usually they pay on those floors is higher anyway.