nursejami

My #1: Tiene dolor? (Do you have pain?)

If you have an order from the MD, why would it be illegal...? You're just transcribing the order, just as if he had told you the order over the phone. Now, whether it's against facility policy is another question entirely...

Re: the metoprolol, why was his blood pressure in such a good range? Was it because his BP meds were keeping him there? :) How does he trend? Also, you always want to look at the history. WHY is he taking the metoprolol? For BP management, HR management, CHF management? That BP doesn't really worry me at all. But these are definitely the questions that kept me up at night after work when I was a new grad. Keep your head up! It gets better! :)

I floated to ICU after 6 months. I was scared, but felt comfortable as they gave me patients that had orders to be transferred to my floor anyway (just no available beds). After one month, there's no way I would've felt okay doing that.

Bottom line: IT WILL GET BETTER! Speed comes with time and experience. In a month, you'll feel better. In 6 months, you'll feel great! :) You're not alone. I felt the exact same way when I first started as a CNA, and again as an RN. You'll get through this, just breathe!! :)

Two weeks of "classroom" orientation, random scattered residency classes while orienting on the floor, 4 weeks of floor precepting. I was a tech and LPN on my floor previously also, thank God, because 4 weeks of orientation is ridiculous. Also, I have awesome co-workers, which helps. :)

I don't think I can say anything that hasn't been said. I love being a nurse and couldn't see myself doing anything else. Even on the worst days, I know I've made some sort of difference in someone's day and their health outcome.

Yep. If they're lower, I'll give a bedtime snack. People often drop in the middle of the night...

I think you pretty much cover it! I also work nights, and my typical shift goes something like... Look up orders/vitals/hx Get report Assess patients Obtain vitals from tech Give meds (scheduled and prn) Sign off tele strips Look up more info on patient (H&P, imaging results, MD progress notes, Social Services notes, etc) More vitals Put out fires as they occur (resp distress? Crazy vitals? Bad IV? Jumper?) Get admissions as they come Give morning med Get blood sugars Give am insulin Report critical/borderline am labs to MD as needed Give report Obviously, throughout your shift you're doing rounds, caring for your patients (bathroom, water, repositioning, etc), and giving needs as needed. Things like dressing changes rarely happen on nights, unless they're out of necessity. With everything else we're subjecting these patients to they're having a hard enough time sleeping without a random 3am dressing change. Being on nights, you will have to learn to prioritize about when something needs to be done NOW and when doing it NOW would not be beneficial to the patient. Skills you'll probably do include IV starts, catheter insertion (Foley and straight), drain and catheter removal (in the morning), suctioning, tube feeding, etc.

I've heard them called vital carts before...VC?

Working as an RN is not a pipe dream! :) However, you are smart to be realistic! *There ARE shortages. .. just not everywhere. You may need to b relocate after school to get a job. * You probably won't get your dream job right out of school. Peds and other specialties usually like you to have nursing experience first. * This is so important: GET A JOB IN HEALTH CARE! Getting your foot in the door in this economy is so important! Start volunteering in hospitals, get a job in the hospital kitchen, whatever! Get your CNA as soon as possible and start working. Nursing home, hospital, home health... Get in there! It's not impossible, but you may have to work hard for it! If it's your dream, make it happen.

Stick it out for the year! You'll feel more confident in yourself as a nurse, which will look great for you when you transfer to the new department. It'll also look better on your resume! Trust me, you'll get it down! It just takes time! One day you'll wake up and think, "...When did THIS happen?!?" I've been working as a nurse (off orientation) for 6 months so far and I got caught by a realization halfway through my night last night, "I'm really DOING this right now!"

Better safe than sorry, every time!! :)

I think you hit the nail on the head that the patient is probably being charged for the medication. THAT is the biggest issue here, to me.

I was just going to comment "if work doesn't, school will!" I see I'm not alone in that! In addition to the professionalism issue, having extra holes in your face probably won't be very good for your health. If you're planning on working in a germ-factory setting (AKA: hospital) you will be constantly exposed to various pathogens, not the least of which being MRSA or VRE.