SilleLu

400+ beds, SE michigan but not Detroit. 3 ICU units, a makeshift ICU in an unused area, 2 out of 3 med/surg units, 1 large tele unit were ALL made into Covid units and ALL had a good number of covid and/or r/o patients. BiPaps made into vents because we had no more vents. This is ridiculously real. Deaths of several in their early 20s. IT IS REAL. Hopefully your area won't see what we see.

I'm wondering if you pushed the medication slowly, which of course is correct, while other nurses had been pushing it faster, giving her the quick buzz. Might explain why she is accusing you of not giving it.

How is the abx ordered? Our are all ordered IVPB, so to me that means if I run it as primary I'm not following the order as written. I would hang it piggyback even if I had a choice, for the reason many others have noted, and so that I can back flush and use the same set up for other IVPBs ordered instead of starting over with a new primary line if not compatible. It's annoying when the nurse before me runs as primary and runs the line partially dry.

Patient in respiratory distress, lungs sounded horrible, RR in the 50s, accessory muscle use, shallow, sat ok on just nasal canula however. Lasix given but patient getting worse by the minute. Resident comes to me and asks for STAT Flonase and saline nasal spray because she thinks she might have some nasal congestion. That was her entire plan of care. Luckily the senior resident was around the corner, and transferred patient to ICU on BiPap immediately.

I too was a CNA before I was an RN... The work of RN is more mental than physical, although I still do a fair amount of the physical care as well. So what is an RN doing while sitting at the computer or on the phone, other than charting? Reviewing labs - abnormals, trends, are labs missing? call the doctor to get orders. no result even though it was drawn hours ago? Call the lab. Result doesn't make sense? Call lab for redraw. Critical value? call the doctor for orders... Reviewing meds - patient getting lasix but no potassium? call the doctor. VS abnormal and home meds weren't ordered? call the doctor, enter tons of orders so you can get blood pressure under control. Medications can't be taken at the same time? reschedule meds. Medication prescribed and verified by pharmacy despite known allergy? Call pharmacy, call the doctor. Patient has new onset symptoms...review meds for side effects, call doctor for alternate treatment. Manager wants to know why this patient hasn't been discharged, review physician notes, see they wrote about several new orders yesterday but didn't enter orders for any of them...call the doctor to clarify, enter new orders. Patient was independent at home prior to admission, has been here 7 days and no one has attempted to get them up to a chair let alone ambulate. Get orders for PT/OT evaluation. Yay, patient is discharged! Get paperwork in order. Realize a new expensive medication was ordered, call Case Manager to check insurance coverage. Medication isn't affordable, discuss with doctor to come up with alternate plan. Another discharge...oops brand new diabetic and no teaching has been done, plus patient is forgetful and has little support at home...discuss with Case Manager. Review I/Os....looks like patient is putting out much less urine than previous day, review meds, IV fluids, PO intake. Bladder scan shows retention, get cath orders if toileting not successful. Review previous days assessments as you chart your own...this patient was alert and oriented but today only knows her name and seems lethargic, review medications administered previous 24 hours to see if there is an obvious cause... Honestly I could go on and on. I remember feeling the same way that you did when I was a CNA and was amazed at how much 'behind the scenes' work that RNs are responsible for. There is little time to be bored and it can be mentally challenging. Good luck to you whether you decide to go to nursing school or to follow a different path! edited to add: ok, I see I put a lot of "call the doctor" in there, generally anything not critical is discussed when they do rounds. I also didn't put in many nursing interventions, but there are a lot of things we can do independently too.

Sweet little couple both mid 90s, both sharp as tacks. Wife recovering from hip fx. I was helping her off the bedpan and pulling up her undies and pj pants. Husband pipes up, "I would have helped her, but I'm much better at taking them off...I've had more practice!" Wife couldn't stop giggling... Edited to add: They had 9 children

Question from a past clinical rotation. IV kept occluding, couldn't walk away before it was beeping even after. As a student at the time, I was not allowed to do any IV care without the RN or instructor other than pause, reset, adjust kinks out of tubing, etc. RN and Instructor not available to fix, so I paused the IV (NS). Told RN, she was fine with that and said she'd be in shortly. Found instructor to help with new IV site. Was scolded for pausing the IV because it would clot she said. So the question is...how is a paused line with NS different from a saline lock...I mean, why wouldn't a saline lock clot but a paused IV (no air, I checked) would clot? And really it was constantly occluded and not running anyway, so did my pausing it hurt anything?