NurseJenn

I love precepting, but I understand there are some people who don't. My supervisor has started a new way to precept. She asked everybody whether they like it or not. Those who do not, do not precept. She also picked several people, those she thought would be good preceptors, and designated them as the preceptors. That way, the new hires would be placed with one person, and not thrown around the unit going from person to person. So far it has worked out well, and there is consistancy. Unfortunatley, there is no difference in pay, yet!!

On my unit I work with peg tubes/J-tubes almost on a daily basis. You pretty much treat them both the same. It is very important to flush to prevent them from stopping up. Coke works well to unstop a tube because of the carbonation and acidity eat away at what is stopping up the tube. I always check residuals every time I place meds in or at least twice a shift. Most people who have tubes are not active and are famous for getting obstructions and illeus, in fact it is quite common. By checking the residual, you make sure everything is working properly. I like to give extra water/juice to my patients because I think of it like offering water/juice to my nonpeg tube pts. Some older people get dehydrated easily, and extra fluids help. Also, some of my patients who are mentally there, but still need a peg state they can taste what goes in there tube, and they like the juice. We have been known to put Jell-O and melted popsicles in their tube. As far as dissolving the meds before placing them in the tube, I have done that before but I used room temp. water.

At the hospital I work for, we clear pumps at shift change and when we put in a new syringe. Also, when when clear the pump it must be witnessed by two nurses. It is followed by all the nurses.

As above, I, too, always give my bolus IVP, but I have seen a nurse give the bolus SQ. I didn't get around to ask why SQ!

Just a reminder, if nursing is what you really want to do, there are many areas of nursing in the world. You might want to check into them, and see if you find something your interested in. Not everything involves blood and guts!!