grinnurse

What's the dumbest HIPPA code you've heard? I admitted a pt yesterday and I had already suspected that the "elevator wasn't going all the way to the top" with this guy when I asked him if he wanted a to do a HIPPA code. I have found that most of these codes have some meaning to the pts in the past and this guy comes up with 1 2 3 4 5 6 7 8 9!!!! I had to excuse myself from the room!! Anyway, I thought we might all get a laugh from a thread such as this. Let's see em!!

Definately not weird at all to thank someone who has helped you out. I sent my preceptor flowers at the end of my orientation with a card that had a picture of painting that I had done so after the flowers died she would always know that she touched not only my career in a positive way but my heart as well.

I would have done exactly what you did and as a matter of fact have done that several times to my patients that I have known (by clinical signs and symptoms) are in the end stage of life. I have also even prayed when I went home at night for God to take the patient home. I don't know if this is illegal activity or not to me it's simply humane when the family is in the state of mind that it is!!

I was kind of like you in HS math-just skirting by and when I was thinking about going to NS and found out there was math I was devestated!! But then I took a nursing math class and they give you the formulas so that made it a little easier but I still freak out when I have to figure dosages. But the more that I use it the more comfortable I feel. It will be ok and don't let math be the thing that holds you back from Nursing as a career.

If you didn't take report and "control" of the patients then this is not patient abandonment IMO and I think it would be in the boards opinion as well. Sounds to me like she is just mad that you called her on her errors and knows that you will probably "freak" out by being told something like that. You can always look in your BON handbook to see what constitutes patient abandonment and then I would make a copy of that page and politely give it to her just to get her up to speed on what patient abandonment really is!! But of course, I am kind of a smart a** too!!

I am on self scheduling so I usually try to work3-4 days a week-depending on my financial needs at the time. Usually will work 3 in a row then 1. Although this week I scheduled my self for 5:uhoh21: . I like working the 3s as long as I have a couple of days off in a row after it.

The way that I prepare for each shift is I listen to music on my way. Thank goodness for XM radio, I drive 45 minutes one way and can always find something to listen to usually upbeat and sometimes loud, but I am ready to work when I get there. On the way home it's almost always quiet in the car!! That is how I unwind so when I walk in the door at home I have my Mom hat on again!!

Maybe ER isn't your "niche" and instead of quitting the field of nursing all together you should ask to be oriented to other departments. Maybe somewhere else would be a better fit for you and the personal goals that you have for yourself. How long has it been since you passed boards and began working? There is such a wide variety of things that you can do with your degree. I would hate to see you throw away all the blood, sweat, tears, and money that you spent on your education. I had a friend who started out in ICU right after graduation and was disillusioned with nursing and almost quit the field too. Then, she got into management/case management at a different facility in the oncology department and absolutely loves it. And don't think that just because you're new that this couldn't work for you too. She was barely off orientation when she changed. Don't give up yet. Good luck in finding the right field for you:wink2:

When a patient has a saline lock, do you clamp the site or leave it open. If you do..................why do you do it? If you don't..............................why not? I have always clamped and thought that it helped to save the site but I am hearing from other nurses that it's not necessarily the case. Also, does your hospital/facility have a policy on changing the IV site say every 72 hours regardless of whether or not it is bad and do you think that is a good policy? Thanks for the feedback.

My most unforgettable clinical instructor was Amy. We were her first "real" clinical group. It was our first "real" clinical as well. She was so patient with us and tried to calm us down before procedures giving us encouragement. She had the best sense of humor as well. One time, while standing at the med cart before my first IV push, I was supposed to be figuring the math, and I told her I had absolutely no clue how to do it!! The look of fright on her face, then I busted out laughing and she almost wet her pants she was laughing so hard. She was tough on papers though but I felt prepared for the next level!! She was great. My most unforgettable lecture instructor was Dr. Ray Huttel. Talk about striking fear in her students at the drop of a hat!! She always had the best lectures though. The room was totally silent when she was up and most of us were on the edge of our seats. She always made me want to learn more and strive to be the best and safest nurse that I could be. Even though she came across as being this really tough lady, she had a heart of gold and would always make time to help you with studying or whatever help you needed. These two instructors made nursing school so much better than what it could have been.

Paula- Unfortunately-the first year is something we all have to get through:uhoh3: But like all the advice befor this post, the best thing is learn from your mistake and move on and know that there will be more to come no matter how prepared we are out of nursing school it's not anything like the real world of nursing. I've been a nurse now just a little over a year and I finally feel like I have some kind of organization and that simply gets better with time. And I feel your pain on the pumps. When I first started in May of 05 I always was wrestling with the darn pumps, been soaked in saline more times than I care to think about during those first few weeks, and wondered for about 6 months why the heck I chose this profession with all the stress, etc. Then, my gut instinct kicked in and I caught a situation with another nurses pt that helped to save his life and realized, yeah-that's why I went to nursing school and am working here-to help people!! Stick with it, it will get better. Just have to give it time and go easy on yourself, ask tons of questions of your senior nurses. Good luck and keep us informed how it continues to go for you. We're here for you gf!!

This is the time for you to make your stand. I have found in my short past as a nurse that if you don't put these remarks in their place then all you are going to do is build resentment toward these nurses and in the ER I think it is all about teamwork just as any other department. I relate these nurses to the bullies on the school ground, the longer you take their crap the longer they are going to dish it out. I am not saying be rude to them, but pull them aside when the chance arises, confront them and say something like, I think that was an unnessescary comment and since I am new and trying to learn here, how would you have handled the situation differently? Or something to that nature what ever would fit the situation at hand. It is very difficult at first to deal with these types of people. Like someone else said, find an ally in the deptartment and ask advice on how she has dealt with nurses like this in the past and other things. And if confronting these co-workers doesn't work and the rudeness continues, go up the chain of command. Sorry that you are having to deal with this, but I think all new nurses go through this to some extent. The good thing about going through this is that you know what you won't do when you are no longer the new person on the unit right??

I started on Med Surge right out of NS last year and at first it was a "stepping stone" to bigger and better position. Now, a little over a year later I wouldn't work anywhere else. You see such a variety of illnesses and treatments it's like no other place. It is definately fast paced and it seems like at times you are juggling a million different things but I have worked on OB and in ER and I would take Med Surge over them any day. Good luck and rest assured that there are many nurses who started out with their "obligatory" time on Med Surge that wouldn't work anywhere else!!

Love Med/Surge here. Took the advice of my instructors and started on a Med/Surge unit right after grad in May 05 and haven't looked back since. There have been days when it has been really stressful dealing with all the things that you have to deal with but there are days when you know what you are doing is making a difference in someone's life. And some days it does seem like all I am doing is passing meds or putting out fires but then there are the days when I have all my ducks in a row and have charts opened by 10 a.m. and am able to keep up and actually perform "real" nursing care like we learned about in NS. Love the pace and also chose Med/Surge as a "stepping stone" for my future plans of home health and hospice care. Initially I wanted to start in ED but when I was choosing it made me sick to my stomache so I went with MS. Good luck in making your decision and I would say look at your future plans and what kind of experience you will need and then go with your gut!!

Sorry to hear that you are having such a tough time. You spoke of the miscommunication about the BS of 377 can you elaborate on that? Was it a language problem? The last little paragraph said it all-you are not happy to be there and you don't feel they are happy to have you there. That speaks volumes to me and if I were you, I think that I would start looking for either a different department or a different hospital all together. It sounds to me like it isn't a "good fit" for either of you. Good luck and let us know more.

First off Congrats to the both of you on your new licenses!! RNLisa-everything that you are experiencing and feeling is normal and once you get on the floor with the preceptors stuff will start coming back but what's even better than that is it will "come full circle" and start making sense of the things that you learned in nursing school. I think it's great that you are having 2 preceptors to show you the ropes. You will have 2 different perspectives to look at and mix from to form your own style. Just know the first few weeks/months will at times be very frustrating and that you will still feel like a "student" for a while, but, there will be one day when something happens and you will know exactly what to do with out asking anyone and your confidence level will begin to increase. When those impossible days happen you can come here and find the support that you need to get you through the tough days that lie ahead. It's been a little over a year for me since I became a nurse and at times I still feel like a student. Best of luck and let us know how it's going for you!!

The best thing that you can do in situations like this is to learn from them, try not to beat yourself up too bad (like we all have the tendency to do), and move on. Look at things like "what did I do wrong, did I have all the information that I needed, what other information could have been important, and how could I have done things differently? You can ask the more senior nurses how they would have handled things or what they would have wanted to know b/f hand etc. Your senior nursing staff is such a great resource utilize them when you need to!! I wouldn't have survived my first year with out using them as a resource. That first mistake is tough b/c it does bring to light the fact that we have these pts lives in our hands and that's a huge responsibility. Nursing school doesn't teach you everything that you need to know unfortunately the biggest majority of that knowledge base comes from experience, mistakes and all. Don't get bogged down on yourself and the incident, learn from the experience and move on. Good luck and best wishes

The hospital that I work at, per JACHO, has a sheet that is to be filled out, Kind of like a "portable" kardex that is supposed to pass from shift to shift with any changes but unfotunately, it is not used as intended. What helps me out the most, is to take my initial report in black ink, and then throughout the day, I add to it in a different color of ink-usually orange of any changes, new procedures, labs, tests, changes, etc. We always get a sheet with the patient's name, age, dx, doc, diet, etc and then add the other stuff such as meds, IVPBs, IVs etc. In report, just try to give the facts. It takes time to get the hang of it, but as they say, "practice makes perfect"!

If it were me, I would be looking for a new place of employment and fast!! There is no way, I don't care how good of a student anyone was, with 4 weeks of orientation and no support can take care of that many patients as a GN can be safe!! I started last year and I was freaking out at 6 weeks but my situation was different, I at least had other "senior" nurses that were there for backup, questions, help, etc. I say get out of there fast if you can and if that is not an option, talk to the supervisor and if you don't get any results keep moving up that chain of command. Good luck and keep us posted!!

Hi Andre- Good to hear from you. Leaving that first job, especially b/c you have been with the hospital for 7 years has got to be a gut wrenching decision full of feeling obligated to the hospital (for keeping you while going through nursing school) to the fact that you are comfortable with the people that you work with and all that jazz. I was in a similar position not too long ago. Had been with the hospital 5 yrs, worked with great nurses, but the hospital politics was just too much to handle. I tried to leave back last November and go to another hospital but my heart wasn't in it or I guess I wasn't miserable enough, and also didn't have the confidence that I needed to feel like I could succeed. Fast forward another 5 months and I got to the point where I HATED going into work, was physically becoming sick, and the new DON was working the nurses to death and everyone was miserable and began leaving. Even nurses that had been with the hospital for 20 years were leaving in droves. I have been gone now for nearly 2 months and haven't looked back!! The old hospital has called a couple of times for me to go and work PRN and I can't I still get that sick feeling when I think about working there even for an occasional shift. The only thing I miss about that place is the nurses that I worked with. I say follow your gut and your heart. They will both tell you when it is time to leave. Good luck with your decision.

Ditto

The first thing I need to say is that it can work to your advantage to have more than one preceptor b/c it can give you different perspectives on things such as time organization and styles of doing things as long as you are not with a different preceptor everyday. As far as #1 goes I agree that it is not a safe thing to do to carry to pts meds to the room unless clearly marked like maybe in one of those little plastic bags b/c you are checking name bands and all before giving. If you have med drawers on a cart, it is a good idea to pull meds and leave them in the drawer and then come back to get them for each pt. This can save time b/c the med carts can get congested. #2 keep up the good work and don't fall into other nurses bad habits especially with the newborns!! That is wrong the way the others are doing it. That would be like not counting for a minute on an apical pulse for an adult. I have been at this for a year and I still count for a full minute and when I go for orientation next week for OB and nursery you bet I will be counting for the full minute. #3 I think you will understand this more once you get on your own. The better thing for the preceptor to have done would have been to help you first and then do the other for the oncoming nurse. For the past three days I have worked on a unit with no teamwork what so ever and it sure makes a difference in how the day goes from not only the day shift that I worked but also from the night shift and I will take teamwork any day over what I just experienced. Keep on doing what you learned in NS and don't let others sway the way you do things and good luck your first year.

Sounds like you've got a good system down and the only advice that I have to offer is when the patients are requesting things if it is something that the aid can get them or help them with don't be afraid to utilize them. Or if it is non emergent things that will just require you, set up a time to go back. If you explain to most patients that you are in the middle of a med pass they are understanding on waiting as long as you keep your word. Other than this just know that things will get better with time. But somedays all nurses are running around like chickens with their heads cutoff!! Keep up the good work!

Me too!! Love my ultrascope and get more comments on it that I would have ever imagined. I have a yellow smiley face one. Wouldn't trade it for the world. As far as the cuff, I spent about 35$ on it from Scrubs and Beyond and have not had any problems with it at all,

A nurse that I worked with at my previous hospital made 80k during 2005. She was contract PRN making $30.00/hr + shif/dif of $2.25 3-7 and $3.25 on weekends and this was what she earned being being cancelled too!!! Of course she worked her butt off-usually 5-6 days Qweek and 12 hours shifts. This is at a small town in Texas about 40 miles E of Dallas.