AnthoScott

So I was in clinicals in the ER the other day and I had a pt who was dx with appendicitis and needed some pain relief. The Dr ordered 40 mcg Fentanyl IVP. So I went and drew it up and double checked it with my nurse. The Dr was standing there and he said "actually go ahead and just give him the full 50." So I went back and drew up the rest of the dose. Since we don't scan meds in the ER, I threw the vial away after I was done. We went in and I pushed the Fent. We then went up on the floor to start an IV for one of the nurses up there. As we were walking my preceptor asked me what I did with the vial after I was done. I said I threw it away because it was empty. She stopped. I stopped. She then asked, "So how much Fentanyl did you just give our patient?" I remembered the dose on the vial was 50 mcg/ml and it was a 2 ml vial. My heart stopped beating for a second. And as I doubled over in shock I uttered "100 mics." So we went back down and I assessed my pt and he was doing very well and said his px was much better. My nurse then took me aside and said "I know you didn't push 2 ml's in his IV. I watched you push it." I didn't believe her and I was still freaking out about it so she went digging through the trash and pulled out the vial which had 1 ml still in it. I was so relieved and that's when the tears came. I had never cried in nursing school up to this point. And I cried hard. I know Fent is a pretty forgiving med, but that's not the point here. What I did wrong/What I learned: 1. I drew up the other 0.2 ml of that vial without my preceptor. Should not have happened. 2. I can't remember double checking the second time. Also bad. I will always always always double check from now on. 3. I didn't read the label on the vial before drawing up the med the second time. I don't care how many times I've drawn up a med, from now on, I will always read the label and make sure my calculation is right before I even leave the med room. 4. I did not waste properly. I should have wasted the medication down the sink with another nurse and my preceptor before I ever threw that vial away. Never again. this had such a profound impact on me that I know that I will never make this mistake again. Why? Because I will follow the rights of medication administration. Forever. And I will ALWAYS keep this in the back of my mind: once you push a med into that IV, it's gone. You can't get it back. So you better be damn sure you're putting the right medication in the right dose to the right patient at the right time. thanks for reading. :)

Sounds like a grand idea! Maybe I shall!

It sounds like you have the right idea. Most managers want to see some direct patient care experience under your belt before they will hire you to an acute care setting. That being said, however, my former manager (Med/Tele) always hired brand new CNAs to our unit because she felt that new CNAs developed bad habits and attitudes working in skilled nursing facilities. In other words, she wanted them to be trained her way. I only worked in a SNF for 3 or 4 months before being hired to my former floor.

Do you think it would be better for me to just get my MSN and become a NP that way? Instead of DNP? Are there any advantages/disadvantages to having one over the other?

Hello everyone, I'm just curious as to what the different pathways are to obtaining a DNP... I'm graduating nursing school in a year and then I'm going to WGU for my BSN... Would it be more beneficial to just do their RN to MSN program? Or is there such a thing as BSN to DNP? Also, what kind of experience should I gain prior to applying? Right now I work in the Emergency Department as a CCT and I'm planning on staying there for a while as a nurse... Thanks!

I don't know what happened to me this semester. Over the summer I took 17 credits in 8 weeks and I pulled all A's and B's. This semester I'm taking Anatomy and Math 1010. I'm not doing very well, but I won't find out my grade until mid-December. I'm pretty sure I'm going to fail these courses, and I'm feeling super depressed about it. I just didn't put in the hard work, and I fear that this is going to wreck my chances of getting into nursing school Can anyone show me the light at the end of the tunnel??

Yeah same for me, I took a phlebotomy class but it was useless because the hospital system I work for has lab techs that do all the draws. It took about 5 months for me to get hired at the hospital as well.

It really depends on where you live and the rules set forth by the state, hospital, and/or specific unit you are applying to work on. In my case, PCTs are required to be licensed as a CNA, OR be in their second semester of a nursing program (But in order to be in a nursing program, you have to have a CNA, so this is kind of moot). After I got my CNA, I went to work in a skilled nursing facility in order to pass the time while I applied to local hospitals in the area. After about six months, I finally landed a job in a Med/Telemetry unit (a job I had applied for once before). On my unit, we are responsible for taking blood sugars, managing feeding tubes (changing the bag and tubing, I/Os, etc.), removing IVs and foley catheters, and PICC dressing changes, all of which required on-the-job training and yearly skill pass-off. It is a fun and rewarding job and I wish you the best of luck!