orrndavid

This is not a near miss. This is a med error big time because of the Eliquis and insulin. An incident report needs to be written and passed on. The error needs to be verbally reprted to whoever you report to.

Of course the charges are going to give you pushback. They don't want the admissions. Is it really up to the charge nurses to "assess the admissions"? Of course not. They want the easiest admissions with the least amount of work. If it's your job to assign admissions, they have to deal with it.

Take the tele position. May I just add that hired positions for new grads are stressful at best. Very stressful. I am not concerned with nurses who don't know. We can teach you, if you are willing. I am more concerned with nurses who don't know they don't know and continually buck the system because they think they do know it all. They are the ones who will fail, get sued, fail some more.

Sorry, what are DUINSs?

What is the pay scale for an ANM? If you leave the union, you should be entitled to something additional, IMO. I would offer this...if the ANM doesn't work out, are you allowed to return to your "union position"? Some institutions are a bit "dicey" about that because once you are in mgmt, they don't want you going back chirping to the union because you were "in the know" for a period of time. Others may disagree, but that has been my experience. Who invited you to apply? Have there been ANMs who have taken the position and then left or been dismissed shortly after? Remember the higher in the hierarchy you go, the tighter and thinner the wire you have to walk. Will the staff resent you for "crossing the fence"? Some may resent you. You don't mention if your unit is cohesive. Looking forward to hearing from you. In essence, give it some serious thought, especially if there's no compensating $$.

Nurses do NOT need a BSN to pass their boards. When I was in school, ADNs outsurpassed BSNs on their pass rate. All the time. Because they had more clinical time and the ability to critically think. BSN programs teach you not too much more about nursing, but are more interested in your overall education. When you get to the floor, a job, an assignment it doesn't mean ****. I was with a BSN who didn't know how to start an IV, who didn't know how to insert a foley, who didn't know how to start an antibiotic piggyback. When asked about gtts per minute, she didn't have a clue. Would you want someone like that taking care of you?

The only nurses who took call in my career of 30 years (currently) have been on the recepient side of the donation process. Individuals who are involved in the retrieval of organs are either on duty or the transplant team waits for an available room. If the patient progresses into a condition such as Diabetes insipidus, the call team is activated and the donor is brought to the OR as soon as possible. If there is a need for another room to open in addition to the rooms that are running, I would pull the scrub from the donation team, have the supervisor call down the list for another circulator to come in, or else, put someone into the room who can run for what they need while I ovesee it. While this is stretching it a bit, the donor is not going to suffer adverse effects post-surgery as will the patient who is not clinically brain dead or who has impending cardiac death.

Draw the labs and then give the Lasix without waiting for the result. You will have the information you need and chances are, since Lasix strips potassium, that your order for an IV will have K+ in it. If it doesn't, you should ask for one that does. If the K+ is too high and you have overshot (which happens sometimes), you can always give K-exelate. But if the patient is in acute CHF, they need diuresis without waiting.

Nursing school, as I am sure, was not a most pleasurable experience for many of us. I worked full-time in the operating room as a scrub tech in a level I trauma cenbter, took call and carried as many as 18 credits in a semester. When school was over and after I passed my boards, I gathered my uniforms, name badge and medication cards, made a little pile in the back yard and doused it with gasoline and threw a match into it. Watching it burn was one of the greatest therapies I ever went through.

There are many, many things that are much more defaming to a nurse than what you are describing.