RN2B07

My facility has started team nursing & I dont care for it. I am on a busy sugical/ortho floor. We have had meetings about team nursing and 10pts at one time is to be our max. Lately we have been going up to 12. I told the CNM it is way too much for 1RN and 1LPN, she says well you have at least 2 d/c's. The point is I am ultimately responsible and must pass their meds and so an assessment. Not all the RN's are doing this seems only a few. And I dont know why. But I emailed the DON and her response was they will have 10 pts max and 11 pts if necessary. Which probably mean I will be in the same situation. What are my options? Can I refuse the pt. load of 12??

Prior to nsg, I never worked more than 8 hr shifts. I was a little nervous at first, but they arent as bad as I had imagined. I love them and couldnt imagine going back to 8 hrs. Ironically 8 hr shifts seemed to drag more than 12. But I am not gonna lie, I work on a very bust M/S ortho floor and am pretty beat when I come home. But 4 days off makes up for it.

On a post-surgical floor this is very important. I find many pts to be very sleepy and groogy after surgery. How can I effectively encourage this?

Let me clarify...original order was for po. Last post was correct because pt had recurring C-Diff infections. Thats why she was on po. The po vial is a powder mixed with sterile water...when mixed is clear. The MAR states for oral use only! I dont know for sure but she was the one giving it 250mg qid...and said in report pt was receiving IM vanco. I never heard of it...but she had been giving it.

Hi I have been working with a LPN doing team nursing...I am worried because she told the charge RN that one of our pts gets vanco IM. She gives all injections and p.o. meds. Now the following day we had the same pt. group and a SN asked to give the vanco. The LPN said oh...you get to give an IM injection. The SN looked at the MAR and said, no its po. The LPN just stared blankly for a second and said oh right. But I think she had been giving it IM. What would happen? I am scared. Only worked with this LPN 4-5 times and I dont trust her. Please help!

What color are your crocs? :monkeydance:

2 days on the web

First of all, you CAN do this. I have been working M/S for 6 months and it really does get better. I had a horrible preceptor and sounds like you do too. What really helped me was to make up a sheet that has all info about my pts. and tasks needing to be done. If I need a stool sample, I write it and make a box next to it. Then I check it when its done. Prioritze your day. Things will always come up. Honestly, I left in tears many times. But the best thing for me was coming off orientation. I was scared as hell. But felt free and able to prioritize my own way. You need to hang in there! Give it at least till you are off orientation. Just tell yourself, you are still learning. I tell myself that everyday when I feel overwhelmed. Good Luck

Anyone trying team nursing? I am currently on a very busy med-surg ortho unit and my manager wants to try team nursing for more effective patient care. This consists of a RN/LPN team caring for about 10-12 pts. (usual load for RN is 6 pts.) Not sure if assessments are split or together, but the LPN would handle all p.o. meds while RN gives IV pushes. I am curious to hear any feedback!

Can you explain what the Betty Boop I-140 is??

I'm with you on this one! I know I have BSN tacked on behind my name but it doesnt bother me that it isnt printed on my badge. Some pts. will ask and I can tell them. As long as RN is there, thats all I care about. Life is too short to be caught up in the petty stuff!

Hi Jason...I am a new grad, working 6 months now. I am not gonna lie, its hard work getting thru school. Now I am working its stressful, but extremely rewarding. I love what I do, and wouldnt change it. I work 3 12 hr shifts and then have 4 days off per week. Plenty of time to do whatever intersts you. Its not for everyone. but good luck in whatever you decide to do. :welcome:

Many hospitals will hire you as a graduate nurse as long as you pln on working there after passing the NCLEX. You will make less than a RN but it is better than miminum wage. But that depends on the state. Look into that to get your foot in the door & gain experience. You will most likely buddy up with a preceptor and there are certain things that obviously you will not be able to do without a license..such as administer meds. Dont freak out about the boards, you will do fine. Go in with confidence...GOOD LUCK!

Just questioning whether a rough estimate of 6-10 units per bag sounded right. Not questioning the order. The next nurse came on and she said she would find out and start the transfusion. Then I was off, so I am not sure.

Nursing is definitely something you MUST want within....you will get a wake up call if you are just doing it for the money. If you really want to be a nurse, then yes...it is very possible to make that amount. But you have to want it from within yourself. Good luck!

I had to do a platelet transfusion yesterday...pt. had lab value of 23,000. So I called the blood bank at 2300, they informed me it would be ready around 0600 or 0700, they would call me when ready. Well I thought that was an extremely long time. The order read Transfuse 10 units of platelets X 2. BB called at 0710 to say it was ready..of course, right before shift change. Also MD came in at the same time, furious that an order from last pm was only being started now. I explained about BB, still furious. I ran downstairs to pick up the platelets, of course, a great time for a fire drill! :angryfire The bag didnt state how many units were in the bag. When I questioned lab, they said it was a guesstimate of anywhere between 6-10 units...any there was one more bag. I was so confused on how many I needed if they had a rough estimate. Any advice or info much needed!

]One of the first things I do when I start shift is the check lab values. Do you call MD with any low H&H, or do you only call with critical values?

Potter & Perry text is very helpful for the lecture part. I like RN Notes also...a small notepad size reference to use during clinicals. Handy to keep in your pocket as a reference.

Hi there, I completely understand how you are feeling. You are not alone. I honestly could have posted this myself. I am a new grad...only working 5 months on a busy med/surg ortho floor. I thought I needed time to adjust. Well, not to scare you...but things didnt get any better for me. After reading your post I realized I need to do something for myself. I cry a few times a week and dont know why. I feel so isolated from my family and friends. I just called my DON and asked for days. She was more than happy to welcome me aboard. I start next week. I urge you to do what will make you happy. If you think you will be happier on days, then go for it. YOU HAVE NOTHING TO LOSE! And I should say thanks for the reality check. Let us know what you decide. Good luck

Yes..sometimes 2-3 times a day. They have called me at 7am...before my shift even ends. I usually let the machine answer it. They called me every day while on vacation. Every message was them. I feel like I am being stalked!! I feel that I am still new and dont feel 100% comfortable yet, and when I do I will do extras. I dont want to totally stress out at this point. Good post:lol2:

Ok...first I always draw up the NS first because you will contaminate the vial if you draw up the med first. Certain meds like morphine and dilaudid come in long, skinny vials, and injecting air is a no-no. Then draw up the 2ml or whatever of the medication.

I work with a seasoned nurse who recently told me that from a legal standpoint the less you chart the better. God forbid, if you are called to court the more charting you do can actually get you into trouble. I dont see how. I mean I chart what is necessary...I dont write novels on my pts. Maybe cause I am still new? The seasoned nurse writes an opening and closing note. I do the same with any important events that occur thru shift. If nothing is going on..I will chart pt in bed sleeping..etc. Another seasoned nurse overheard this conversation and started laughing. She said, "You new grads put too much emphasis on charting. Its not as big a deal as you guys think." So tell me...what so you think. By the way, at my facility we chart be exception.

Our night ratio is 6:1...there are many nights where 5 of my pts are up all night. Other nights it calms down and pts sleep. I do dsg changes...soemtimes it didnt get done on days or it may have some bloody drainage and need it. It definitely gets busy from 5-7a, CNA's are busy doing VS..pts wake up in pain. Then time to start 6am meds and routine dsg. changes.

Hi..I have been on a med/surg ortho floor for 6 months now..many nurses recommended to start here to get you basic foundation and organizational skills down. Well, I have learned so much in a short time. I look back to when I started and see improvements and I am a lot faster at almost everything now. I know I wont stay in med/surg forever but thats just me. I want to work in the NICU. I just felt I needed to start in med/surg...and glad I did. Because really what was six months of invaluable learning?? I would highly recommend starting here...at least six months! Good luck in whatever you decide.

Question about my license...I recently moved from NJ to AZ. NJ is not a compact state yet. I have a AZ license now. Is my NJ still active, if so, do I have to renew it? Any info is appreciated, getting in contact with the BON to speak to a human is near impossible. Thanks!