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canoehead BSN, RN

ER
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canoehead has 30 years experience as a BSN, RN and specializes in ER.

canoehead's Latest Activity

  1. canoehead

    Unsafe Nurse Residency

    When I got trained for L&D in a small unit I had six years experience in pediatrics, and they said six month of preceptorship would be given. They gave me a L&D textbook, and I gradually went through the chapters in my own time, while applying concepts to real patients on the unit. After a month I was doing NSTs and outpatients myself and reporting my findings to my preceptor. After two months, easy deliveries with the preceptor in the room, three and four months, gradually increasing complications and independence, but verbally going over my plan with a partner. Then for the first year, there was ALWAYS a second person at each delivery with more experience who would help (thank goodness.) After about a year, I was able to be the primary nurse, with the second person having less experience. So the learning went on for a GOOD year. During my preceptorship, I learned that ACOG has really great guidelines and standards already set out for labor. Even if the hospital is bassakwards, if you know and follow those standards, you will be fine. That said, you need to find at least one person that is smart and reliable that you can pepper with questions. See if they can be available to text or call if you need someone you trust. Without that, I'd step away from the whole job.
  2. canoehead

    Nurses with nasty attitudes

    I doubt that woman was legit. Did she have hospital ID? I would call security if she didn't identify herself and the parents didn't know her.
  3. We would print out new labels in the unit and relabel before sending them to the lab.
  4. canoehead

    New job and asking for time off

    I've been in a similar situation, and I told them when they made the offer that I had previous plans for a particular two week stretch. It wasn't a problem, My new coworkers were unhappy that I got "vacation" so fast, but oh well.
  5. canoehead

    New Nurse Venting

    I think that your concerns are well founded, and you left every job for good reason. You could have gone to HR and gotten some coworkers fired, but I can respect your decision to just leave. In your current job, I think its a shame that you feel bullied. The nastiness of your coworkers, including the MD, is foolish. They will lose a good nurse if they continue. Personally, I would have a 1-1 with the MD, and express how you feel. You are new to the job, you are going to make mistakes, that's a fact. You are working to improve, and name calling is just going to slow down the process. Tell him you may leave because of the lack of support, and his response will tell you whether you need to go job hunting again. I've been in a bullying job, and it can make you believe you are stupid and useless. There are supportive workplaces out there, though they are hard to find. Don't quit. Say something nice about a coworker, and see if you can shift some of that negative crap. Maybe they just need a leader.
  6. canoehead

    Freaking out over a patient fall!!

    Even with the gait belt, he would have gone down if I was doing it. Even with a second person, depending on his weight.
  7. canoehead

    Medical Clearance for Psychiatric Unit

    I argue that if we would discharge them home with that BP, they are safe to send to psychiatry.
  8. canoehead

    Aggressive Resident and Alcohol

    I think there should be a care plan in how to respond to aggressive behavior. If withholding ETOH is part of the plan, fine. But if there is a care plan in place, it should be followed rather than coming up with new consequences.
  9. canoehead

    Should I or shouldn’t I have given Ativan?

    I suppose it "should" be administered once symptoms begin, but if you might ward off symptoms altogether, that's an even better result. Technically its a medical call, not nursing, but no harm done, and the patient benefitted. Now that you know Ativan helped, the physician knows, and you can collaborate on getting this guy a good sleep every night.
  10. If you are doing an IM injection, just encourage relaxation. The more they anticipate it, the more they will jerk. IV sticks, rest your pinkie on their hand, or just below whatever site you are using. That will allow you to follow the patient as they jerk without losing the site. wait for them to relax again, and slide the needle into the vein.
  11. I would not have made the second call. I would have asked for parameters, if I remembered to. You did a good job. If the oncoming RN has concerns that you don't share, he is welcome to make his own phone call.
  12. canoehead

    RN's skipping vital signs

    If the patients are refusing or generally not cooperative, "sweet talking them" into vitals may play into manipulative behavior. Respecting a patient's right to refuse can be therapeutic in an environment where they don't have a lot of control. If the patient is refusing vitals, but not prn meds, you could insist on vital signs within 24h before giving the drug. Win/win right?
  13. canoehead

    "Addiction" Nursing is an outdated term.

    Every twenty years we change the words used, but it's all the same, with the same stigma once people become familiar with the nomenclature.
  14. canoehead

    Ridiculous class schedule, please help

    It would have been an average load when I was in university. If you don't want to do them all at once, find out what is available during the summer and take it then.
  15. canoehead

    How to do one-person turn for quadriplegic / trach/vent Pt?

    I would recommend asking your management for a physio inservice on the best ways to move patients. Physio did that for my nursing school class, and it has saved me so much pain. I'm thirty years in to nursing without a back injury, and not in shape by any measurement, but I'm told I'm a good lifter. The main point is to use your body weight as a counter balance to the turn or lift. So you've got a sheet under them, you don't use your arms to pull, you hold with your arms, and lean back to pull with your body weight. Moving someone up in the bed, you lift up vertically, then move your whole body towards the head of the bed, not trying to move your arms alone. Very hard to explain verbally...like I said, physio will know, and if you don't get an inservice, it would be worth paying for a session privately, IMO.
  16. I bet if you contacted a ravel company they would know all the shortcuts better than we would, and could smooth the way (or tell you its not easy).
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