jemray

I had a pt on my last shift who was supposed to receive 100mg of lovenox. I couldn't remember where we keep the vials of lovenox, so I asked a nurse. As she was helping me, I asked her, hypothetically, if we could just give the premixed lovenox. In our facility, we get 30mg/0.3cc and 40mg/0.4cc. So giving 2 30mg and 1 40 mg would equal a total of 100mgs in 1cc, which is what I ended up drawing up anyway. This nurse said that if I gave the premixed lovenox, I would be making a serious medication error. I understand that I shouldn't poke a pt 3 times to give one dose of enoxaparin, but how is this a medication error?

So I'm graduating from nursing. And whenever anybody asks me if I am excited to start working as a nurse, I smile and answer "yes". But for the most part, I am lying through my teeth. I sometimes feel a rush of excitement, but I mostly don't feel anything. I don't even feel like going to the pinning ceremony. I don't think I mind nursing, and I love working with people, but I don't know why I am not as excited as everyone else seems to be. Also, sometimes, I feel stupid. I feel like I don't know anything; like I don't know simple things that I should. I study, I'm studying for the RN exam, and I'm fairly confident that I will pass, but I don't know. I don't know if this is just a lack of confidence or what. Did anyone else feel this way before graduation? What did you do? Does it get better?

I am currently nearing the end of the 1st week of my 1st clinical placement in year four, and I am so frustrated with my preceptor. I feel like a lot of the time I am left on my own to figure out what it is that I am supposed to be doing. I am her 1st student, and it really feels like I have to plan out everything. I feel like a fish out of water, especially since I have been out of clinical for a month and have never worked on this floor before. I feel so jealous of this other student on my floor who has an older nurse who is with him all the time, and seems to be giving him more direction. I'm just nervous because by the end of this placement I am supposed to be doing 75-100% of my preceptor's workload, and I don't really see how that will be possible if things continue like this. I am planing to talk to her about it, and I realize that I should be asking more questions, but also keep getting overwhelmed with all the things that I don't know yet.... Maybe I'm just stressing out too much??? Anyways, I was just wondering if anyone could share experiences with new preceptors and how they handled it?

I'm having trouble with the nursing diagnosis part of a care plan. It's for a patient who has a tracheostomy and a PEG tube, and as such they have a potential for aspiration. I'm just having some trouble... This is what I have so far: Potential for aspiration related to PEG tube and tracheostomy use, manifested by...(insert S&S here)... I have two questions: (1) Is it ok to say potential for aspiration related to use of PEG tube and trach, or do I have to be more specific than that? Should I only use either PEG or trach in this diagnosis and not both? (2) The only signs and symptoms that I have so far is that the client has difficulty breathing when she is lying completely flat, but does that relate to potential for aspiration? I know that when a PEG tube is running that a client can't be lower than 35 degrees, so (2) would only apply when the PEG is not running because otherwise she wouldn't be flat... I'm not sure what signs and symptoms I should be using.... I would appreciate and help, suggestions, etc... Thanks.