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Neuro, Telemetry
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mrsboots87 has 6 years experience and specializes in Neuro, Telemetry.

mrsboots87's Latest Activity

  1. mrsboots87

    I was slapped by a patient

    I’m glad you reported this. The police can subpoena his information. The hospital can give his name and address when this happens s if you wish to file charges. While your biggest issue is that he was a man harming you as a women, there is an even bigger issue. A patient wanted to harm you. Outside of the hospital, it would be a large man hitting a woman. In a hospital it is more then that. It is a felony to assault a health care worker. Even if this was was a little old lady. If an alert and oriented little old lady slapped me because she wanted to harm me, I would report it just the same as if a big man did. The only difference is that I would probably be a little more fearful of a large man then a little old lady. But in either case, assault is assault.
  2. mrsboots87

    12 patients for a new grad to much?

    I think people here are forgetting what a SNF is. These are very low acuity patients. The busiest and hardest part of the day is the med passes since the patients usually have quite a few. Most of the dressing changes are basic dressings that take 10-15 minutes tops to do, and TF doesn’t take that long to administer once a nurse is proficient. The charting takes a bit to get used to but it’s a task heavy but otherwise low acuity job. (And yes I have worked at a SNF with what would be considered good ratios like this as a new grad and did just fine. No one died.) Nurses in SNFs don’t provide much ADL and toileting and such like in a hospital. The CNAs do those cares. Therapy services provide more activity and care. Tbise who haven’t worked a SNF should stop complaining about the comments of those who have. 12 IS a light load for a SNF. It just feels overwhelming for a new grad just as any other new grad job feels overwhelming. Because it’s new.
  3. mrsboots87

    12 patients for a new grad to much?

    You’re in a SNF. This is actually a very light load for a SNF and you are lucky. For you to have less patients means some other nurse has to take some of your work and add it to theirs. New grad or otherwise, the facility will not be able to change the patient load. Youre going to feel overwhelmed for at keast the first few months to a year. Just power through and you’ll be ok.
  4. mrsboots87

    Case Study: HIPAA violation or not?

    Picture taking of anything in a patient care area (patient or otherwise) was expressly forbidden when I was in nursing school. Would have been terminated from the program for it. Taking pictures of a patient for documentation requires a signed consent from the patient. I would imagine it is the same for a student to do so for learning purposes. Read the nursing school handbook. I can almost guarantee that there is a policy about this that that student just violated.
  5. mrsboots87

    Medication error

    Cardene is very vasoactive and requires very close monitoring and very frequent vitals checks. But this is a multi person error and not just you. The physician should be transcribing their own orders as this is a prime example of what can happen when they don’t. I know sometimes they can be away from a computer and you need a need fast. But as a regular practice, they should enter themselves. This is in part on that MD as well. Next, do you know what cardene is typically used for? That is your next step in realizing this was the wrong med during transcription. Cardene would not be used for RVR, but for HTN. Next, the nurse who spiked and hung that med should have asked what it is being used for. This med error is also on that nurse as she spiked and hung the med for you. It is her duty to understand what she is giving that med for. She should have questioned hanging it if you mentioned it was for RVR. Next, you should not be left in s floor with no support. Whether you are brand new or experienced, a charge or swat should be available for you to get help from and this is why. Why was a rapid not called when the when the patient was still deteriorating while on amio? That part is neither here nor there now. Basically own your osrt part of this error. Learn from it. Everyone makes errors, we just try our best to not make them and hope when we do, it’s not a fatal one. Unless that drip had been running for over 5 mins, it’s unlikely it would have caused the code. Do your best to be more prudent in your transcription and med knowledge next time and keep your head up knowing you are not alone in this. Also remember, you are not the only one at fault. Multiple people failed here. I only hope your facility does a complete review of this case so all involved get education in preventing this in the future. Penalizing you alone does not fix the bigger problem.
  6. Does your Pyxis not warn you if an incorrect waste? Ours does, but it's the newer model and I don't remember if our old one did or not. When we type in the east amount, if it doesn't match the expected waste amount, a warning pops up and gives you a chance to retype the waste amount. Which is nice in case a fat finger or something happens.
  7. mrsboots87

    How many phone calls do you get as a bedside nurse?

    I need the therapy calls. What if I have something I need to do with the patient and walk in to find therapy with them? What if there is a reason therapy shouldn't see the patient right now? I personally take these same calls from the various services and use them to plan my day and keep track where my patients are and what they are doing. When a doctor asks me how therapy went, or where the patient is, or if a certain exam has been done, I need to know the answer. I may not always be right by my computer and most services don't chart immediately after each patient. These are all quick calls and then move along with my day. If I had to stop and look to see if there is a therapy note or see where the heck my patient went when I go to give my meds, the day would be more unorganized probably less efficient.
  8. mrsboots87

    documenting a chart check?

    I work at both a hospital with an EMR and another one that is still paper. The paper hospital def needs a chart check. Any orders you follow are on you. If someone didn't transcribe the order correctly, you just made a med error or lab error or missed a treatment or what not. That's on you. By signing that's you've checked the chart, shows that you are accepting the chart and have corrected any errors if found. It also means you reviewed results of labs and radiology and such and are taking responsibility over calling docs, or greeting lytes or whatever. If you don't sign the chart, you are still liable for all this, but if an error does occur, it will look even worse for you.
  9. mrsboots87

    Nursing compact licensure

    This isn't fully correct. The WI license doesn't go inactive. The OP would just have both a WI and GA license. But only the GA license would be a compact license. The WI license would end up being a 1 state only license until it expires.
  10. mrsboots87

    2 full-time jobs?

    You could come to Arizona and even the out of state cost for a community college nursing program is like $20K v $10k. Your rationale for continuing to dig yourself into financial ruin for the rest of your life is ridiculous. If you're already paying out of state tuition anyway and refuse to believe you could save money by moving home (yes you can because your figures are not correct) then at least pay out of state tuition in a cheaper state.
  11. mrsboots87

    2 full-time jobs?

    It most definitely would NOT cost you more money to go to a community college and eat the time you spent at another costly school. Majority of community colleges could get you a degree for under $10K from start to finish. Very few will be more then that. Basically you are planning to give away $110K to an absurdly expensive school in order to not have to redo 1-2 years of school. That's just plain dumb. Start over at a cheaper school. Adding $10K to your current $90K of loans means you be paying off $100K in the end. Half the payments each month. You won't make $100K in one year and demoed I gotta in where you work, might not even make that back in 2 years. May as well suck it up and take the extra year to start over before you put yourself in impossible debt. $2K a month may in fact be more than your new grad monthly pay. And that's with a more than 10 year loan after you factor interest in. You will basically make nothing for 15ish years. Don't continue your poor financial planning just to finish faster because you feel stuck. You will feel even worse at the end when all that education was for nothing while you live with your parents eating top ramen everyday because it's all you can Oxford.
  12. mrsboots87

    Did I cause this rapid response?

    I'm more concerned about the respiratory status change not being reported. You should have verified the food was eaten, but honestly, stressed and sick diabetics typically run high sugars whether they have eaten or not. When realizing he didn't eat anything you should have checked his sugars more frequently and maybe gotten him to drink something if possible. But anyway, back to the c/o SOB, that right there was his first sign of deterioration. His second sign was the fact that his SBP dropped from the 150s to 110. Third, he was lethargic before you gave the insulin as he didn't wake for lunch. You didn't cause the rapid to be called. You just missed early signs of deterioration that should have been reported to the provider. You are only 3 weeks in. Where was your preceptor during these changes? You are not expected to recognize all this so early in your career, but you are expected to learn from it. Next time you will be more diligent in recognizing and reporting changes in status. Don't beat yourself up. We all have to learn. The fallout is im your preceptor not recognizing these changes either to guide you into better actions.
  13. mrsboots87

    Inclement weather conditions...mandatory to work?

    Also consider, the nurses who decide not to show up may prevent another nurse from being able to leave ahead of the storm and protect their own families. They then have to rely on and hope that their friends and family have gotten their children and pets to safety in time. Or if by not showing a day early to beat the storm, some nurses are going to be stuck working overtime and in less than ideal circumstances. This could lead to patient harm and resentment once the storm passes. Next time, plan in advance when possible.
  14. mrsboots87

    Inclement weather conditions...mandatory to work?

    While the employer should be held accountable for a plan to keep their employees fed and clean and rested during a storm they are required to work through, it is on the employee to ensure that they plan ahead for child care and travel to work before the worst of the storm hits. Asking this during the storm is just poor planning on your part. I have small children as well, but I live in AZ. the worst we get is severe dust storms and mostly short length torrential downpour. At most we might be late to work if caught in a storm and have to pull off the road or detour around flooded areas. But, if I lived in an area that had the potential for natural disasters such as hurricanes, I would make sure to plan well in advance. Such as as soon as the storm warning is broadcasted. Plans for who children and pets will stay with and how I would get to work and how long I should be stuck there, should all be figured out early. Yes your employer should have sent something saying that they would have beds and food or to plan to come the night before the storm or whatever, but nothing prevented you from emailing or calling them a week ago to ask what their plan is and when they will be expecting you. It really does go both ways. Obviously at this point it's a touch late and you should very much protect you and your children by doing what is safest at this point. But it won't relieve you of the possible backlash from your employer for not planning this days to a week ago.
  15. mrsboots87

    Infusion times....in a pickle...

    Also, depending on what the Vanco and zosyn are diluted in (NSor D5) they can be compatible. You may have been able to run them together if you had a strong IV. Next time check your comparability source.
  16. mrsboots87

    Infusion times....in a pickle...

    Running the initial bolus dose of zosyn is done over 30 minutes. Maintanence zosyn is 4 hours. Both for the reason above, as well as increased incidence of c.diff development when consistently running zosyn over 30 minutes. Once here and there because of a time crunch is likely to not harm a patient. But doing this too many time potentially could.