student4ever

Do you drink a lot of water? Have a below normal body temperature?? I do drug screens almost daily, and for us at least, "outside normal parameters" means it didn't show up the right temperature when we first take the urine sample. Ask for a witnessed collection, make sure you wash your hands right before the test (shows that you didn't use some chemicals to change the results), empty your pockets, etc. There may even be a way that you could request catheterization for the specimen to indeed prove it is your urine, and not some other substance, if that is the problem. I would say fight it, because there are many steps along the process that could be points at which the collector is not collecting correctly, or it's fairly easy for someone to cheat the system. And believe me, I've seen it done! Now if it is a problem of something showing up in your urine abnormally, then that would be something to talk to your doctor about. Unfortunately, a lot of the things they test for in urine are more difficult to test for in the blood, or so I've heard. Good luck to you, so sorry you're dealing with these troubles!!

When it comes to med vials, they should go into the sharps - not because of meds, but because in my facility anything that is sharp or could become sharp goes in the sharps bin. Theory: med vial made of glass - not sharp - but if it breaks then it becomes sharp. What happens when the housekeeper bumps the trash bag against the tile floor and that med vial shatters? Bag gets punctured, glass shards go on the floor, that 2 year old whose parents allow him to run around barefoot now has a lac, or the housekeeper gets stabbed by something sharp that she doesn't know if it was a needle or glass or if it ever had body fluids on it or not. IMHO glass should always go in the sharps box.

I understand your point, but as a safety measure, our hospital does not include last names on our badges for ED and PSYCH. The ED has LOTS and LOTS of potential for unsafe issues. Patients often threaten us, and many are such frequent fliers that they know an awful lot about us anyways. It's always better to err on the side of safety. In addition, we get a lot of very unstable, at times very violent psych patients on TDO holds, and they have to be medically cleared by us before they go up to psych. I personally feel much safer not having my patients know my last name. There are several nurses in my ED who have been stalked by former patients, and they requested that last names be removed from the front of the badge. The last name is now on the back of the badge so you can still find its owner if it gets lost, but it is not easily visible to patients.

You might also want to put a note in about the differences between the ER vs. the floor - most new grads have had the majority of their nursing experience on nursing floors, where the focus is very different! I see new grads spending TONS of time doing TOTAL care on one patient and "forgetting" about the others because they have difficulty delegating, and are "trying to make the patient comfortable." Not to say that we shouldn't make ER patients comfortable as possible, but we are there to treat an emergent condition, and we have many people needing our emergent care. Spending a ton of time chatting with a patient and attending to their every desire while the med orders pile up on other patients is not effective ER nursing. Also, I don't know how many times I have pried a warm blanket or drink of water out of a new grad's hand and asked why they are giving the man with an ankle deformity a drink of water when he will most likely be going to the OR very soon! Or asked if they've checked the pts temp recently to figure out if they're really freezing or if it's indicative of a spiking temp before giving them a heated blanket to further increase their temp. These are comfort measures given to just about everyone on the floor, but we are very careful with in the ER. The docs don't write NPO on the charts - but that's because standard protocol is NPO unless otherwise specified. These are things that they just don't talk about when doing ER orientation it seems, but I think they are very valid points. Also, at most facilities, ER techs are allowed to do more procedurally than they are on the floor - delegate these tasks out so you have more time to concentrate on your meds and IVs!!! Why spend hours doing tasks your tech can be doing instead of sitting at the computer playing games? New grads have other things they can be doing with that time. That said, be good to your techs, and treat them with respect, and they'll do anything they can for you. I know, I am a tech. The nurses who treat me well and respect me and my job are the ones I will bend over backward for and help them with anything, and work my little tush off for. Good luck with your handbook, it's a great idea!!!

To add to the list of wierd allergies... I'm allergic to peppers - no matter if they're hot or sweet, rocephin (but no other med in its class/category), and yellow dye number 5 - no other yellow dye, just number 5. Oh, and a common one, amoxacillin - stupid me, when I was a kid, I loved the taste of that yummy pink liquid - and I drank an entire bottle of my brother's rx.... i was puffy and covered in hives for a LONG time!!! No more cillins for me!

Where do you work, I want to come work there! At my ER pts have to wait HOURS for admission, some d/t hospitalists w/ too many admits and take too long to do assessment, some d/t floors that are full or understaffed and asign "dirty" beds so we have to wait to bring the pt. up, some d/t ER docs who can't figure out what the heck to do so they keep adding on more tests, which adds way more time to pt. stay. I'm so sick of patient satisfaction scores. Whatever happened to pts being grateful that wear there to help them when they're sick/injured? Oh yeah, I guess that went out the window when the majority of ER patients became drug seekers and stupid idiots who don't know that a hangnail isn't emergent, and who come to the ER to see all their friends, because don'tcha know, the ER is more fun than the mall these days!!

I did not size up, and they were snug for a few weeks, but after spending 12 hrs. in them, 4-5 days a week, they stretched out quickly! Now they fit so well I hate the idea of buying another pair to break in! I wore mine around town doing errands for a week though before I ever wore them to work, just so my feet got used to them and they were a little broken in before I had to spend 12 hours working in them!!!

I can hardly believe this!!! If I were that poor pt. I would have sued too - and if I was her nurse, I would have totally testified on her behalf. What stupidity!!! Sometimes I think all people have been born with rocks in their heads!!! Lord allmighty!!!

I am wierd I guess, but I wear mine with the earpieces angled towards the back... can't hear a darned thing with them angled forwards. I have strangely shaped ears though - can't wear those earbud headphone thingies... they never stay put. I just find that the earpieces fit much better into my ears when angled "backwards" than when they are "forwards." Try both ways. BTW, I have an adscope too, and I LOVE it... I can hear really well with it.

Also check for dizziness with position changes. If a person is truly orthostatic, they will usually feel dizzy and/or about to pass out with position change, especially when standing. Some do not of course, but as a general rule, dizziness with position change accompanies a postural patient.

Yes yes yes!!! Would love to just slap on the electrodes, throw on a BP cuff not attached to any wires, and a sticky little bandaid thing around the finger (which would actually stay on as opposed to most pulse oxes) and it would automatically transmit signals to the monitor screen/box thingy. If they can have wireless internet and cell phone headsets, I'm sure they could do it for the medical profession. Of course then in a perfect world we would have to have healthcare facilities actually willing to pay for such equipment.

Good advice so far from everyone! I am an ED tech, and I LOVE it! I'm always getting requests from nurses, sometimes 5 or 6 at a time. If I'm busy with something I will let them know and then let them know I will get to their request as soon as possible. I will also let them know what other tasks I have to do, and they can take it up with the other nurses if their request is more urgent than others. For example, there are many things that techs do that nurses are not trained to do, like urine drug screens. So, when nurse A has a pt. needing an EKG and nurse B has a pt. needing a foley, and nurse C has a pt. needing a urine drug screen for worker's comp and is about to burst their bladder, I will go to nurse A and B and tell them I will be glad to do their EKG and foleys, but nurse C needs a urine drug screen, and the pt. is hopping up and down in the hallway needing to pee for me! Usually they will say it's okay, I can do the EKG and foley myself... however, if they are too busy to get to it, and I've finished with the other task, I will come back to make sure it's been done, and if they haven't gotten to it, I will go ahead and do it. Basically, just get to know your nurses and let them know that you want to work hard for them, and they will respect you for that. When I'm caught up and have nothing popping out at me to do right then, I make sure I look at the charts, see what still needs to be done, and see if I can't take a couple minutes to coax the old guy to pee, though he's said for the last three hours he cant. It's all a game of balancing and prioritizing, but if you show you'll work hard and don't mind doing whatever needs to be done, you will be appreciated! Good luck to you!

I don't care what anyone says, I avoid the Q and S words like the plague, and never mention FFs, and HATE full moons. Maybe it is all in my head, but I tell ya, last night the ER doc had cleaned out the ED, you could have heard a pin drop, and he said "well, since it's all quiet down here, I'll be in the office napping on the couch." No sooner had the words come out of his mouth (they were still hanging in the air, like a cartoon bubble) than we hear CODE BLUE paged overhead. So we run upstairs, run the code. Come back downstairs, 5 more pts to be seen. Quick orders a couple things on each one (usual middle of the night bull$#!@) and by this time, we had been back from the code for about 15 min. and what do we hear, but another CODE BLUE paged overhead. Come back downstairs after running that one, and here rolls an MVA, a CP and 5 minutes after that, a code comes rolling in our doors this time. So, basically, theres enough proof for me - and the last time we were chatting about our list of most honorable frequent fliers, all 5 of the ones we had mentioned came in at the same time - seems they even shared a cab to the ER since they live in the same housing projects. Go figure. I'm definetly superstitious. New grads laugh at me when I tell them what our no-no words are, but a month or two in, and they're cautioning everyone else!!!

ever wonder just where people manufacture all those illegal drugs? a lot gets made out here in the boonies - plenty of room for meth labs and such, and less attention as fewer people around... not to mention narcotic seekers who hurt their backs catchin chickens and got hooked on their pain meds... more wierdos who know NOTHING about healthcare than you've ever seen in your life, more "dumber than a box of bricks" patients - with their 20 children in tow, along with 50 relatives - the family trees look more like topiaries - not to mention when a family feuds, there is LOTS of gunshots and knife wounds to go around... the boonies ain't so quiet!!! And there are primadonna docs everywhere - it's like the plague!

As good as this system seems to be, I have to wonder about its practicality in places like the ER where we often have patients who need meds RIGHT NOW who haven't even been registered into the system yet, or whom we don't have a CLUE who they are. Anyone have any experience with this kind of a system in the ER? Currently our accuchecks can be scanned with the patient armband and the barcode on our badges for our personal user ID - however the thing rarely actually scans anything, so we usually end up typing things in. I cna't imagine how inconvenient this system COULD be if it is moved to medications as well. Any thoughts?

Basically, I think that in CYA management wise, I would print off any office memos, e-mails etc. that are exchanged and keep them in case the issue would ever come up in court. Keeping a journal with notes as to what was discussed in meetings could come in handy someday, but not necessarily the most important thing in my mind - like you said, documentation is definetly the best way to CYA, and that should be understood. Beyond that, I'm not sure what kind of situations you're asking about, so I don't know exactly how I would choose to cover my a$$ so to speak.

To combat the people saying (and rightly so) that class is always important, you must always go, unless you're deathly ill.. There is a lot to say for your own personal health, mental as well as physical, in succeeding in nursing school. I am a good student and I am very conscienscious about my classwork - but every once in a great while, I have to take a personal day. I work full time and try to have a life on the side, besides school and work. Sounds like the OP has her plate full with a toddler at home. Sometimes it is needed to take a day off of class. I think I would have gone with "my child was sick" and left it at that. AT least the instructor let her make up the assignment. But hopefully she got the mini-break she needed with skipping class, and can come back fresh and ready to go again. Good luck to you OP with your classes and the toddler at home!

Always! I am a very competetive person by nature, and so in school, it's no different. I find that when I know there are others competing for the top score in the class, I try just that much harder. When I'm in a class of students who consistently underachieve and are happy with a C (not to degrade those who are happy with a C - I understand when you've studied your butt off to get that C because of difficult material, it's a GREAT grade! - I'm simply speaking to those who could do better, but would rather party on the weekends than spend time studying, and therefore don't make great grades) I only do what I know will get me a 90-94 range to keep my 4.0, and don't work any harder than that. Last semester in A&P I studied my butt off because the guy sitting next to me was always boasting about his grades and how he was going to be an MD, and no nurse wanabee could touch his grades, etc. etc. I had the highest class average, and finished with a 110% in the class - 5 points from a perfect score on every test. This semester, I am not in the same class with him, and I'll say my grades have slipped a bit (maybe partly due to working 60+ hours a week as well), but of course I maintain my A average. All it takes is a cocky comment from someone (for some reason, especially a guy) and I bust into overdrive - my competetive nature is both a blessing and a curse! Sometimes I don't WANT to be in overdrive, because if I have too much going on, one of these days it's gonna kill me - but it has given me the edge to succeed in just about everything I have tried to do. Or maybe I just quit when I see that I might not be able to do it the best... anyways, all this is to say, YES, I am always inspired by competition! Congrats on your math grade!!! It's a tough subject!

Just a thought - maybe get a second opinion before taking the drugs? My aunt had a hysterectomy last year d/t years of unbearable pain and frustration as no one took her symptoms seriously. What they found was endometriosis so bad that one of her ovaries was actually fused to the uterus with endometrial yuck. The gyne said she had never seen such a bad case of endo before. My aunt is 45, and says that she opted for the hysterectomy without even knowing she had endo, simply because the pain and frustration were just too much, and since she wasn't planning on children anyways, she might as well just get it out and done with. She is SOOOOO unbelievably happy with her decision... she's lost weight, she looks so unbelievably good, and best of all, no more pain! She did have to have another surgery to remove her other ovary as she ended up with a melon sized cyst and ovarian torsion (OUCH) but that was just an unexpected bump in the road. She says her new philosophy about the uterus is "if you're not going to use it and it's causing you problems, take it OUT!!!" Her gyne is awesome - she really listens to patients and their concerns, and really believes you when you say "I don't know what it is, but I just KNOW there is a problem!" In some cases I think drugs are a best first line treatment, but in the case of endo, especially when you are done having children or decide you don't want to have them, it seems that everyone I have talked to recommends a hysterectomy. The fact is, if you have endo, even if you go through the real menopause, you may still have uterine problems, and are at a greater risk of having continued problems... I have talked to many women who have had hysterectomies because of problems like endometriosis, and they are simply extatic with their results. Just something to think about before you try a drug like Lupron. Sounds like your gyne is pretty closed to other options, so it might be helpful to talk to another gyne and see if they concur, based on your personal medical history. Hey, it never hurts to add another brain to the situation! Good luck to you, I hope you soon get some relief - you are correct that endo is a terrible disease... I wish you all the best whatever you decide! Just remember to do what is best for YOU, not for your gyne or anyone else.

So many people have posted that "they'd be worried if you didn't think that way." Sorry, but I'm NOT in the least worried about whether or not I'll be able to put it all together. I KNOW I will be - not because I'm so smart or not succeptible to making errors - but I know enough to ask when I'm not sure about something, and I know where to find resources to help me - drug books to look things up, websites, more experienced nurses who are willing to help a newbie get things together. I know that I've worked long and hard to get into the nursing program to begin with, and I must have what it takes to put up with school 5 days a week, working 60 hours a week as a tech in a BUSY Emergency Department, and obviously, a good work ethic. If you can make it through nursing school and the NCLEX, you can make it in the real world of nursing. You just have to have faith and work hard at it. That's my philosophy for everything. So now will I be a potentially dangerous nurse because I believe I will do well once I graduate and am not nervous about "failing to put it all together?" I hope none of you think that... I just get tired of hearing experienced nurses saying "I would be scared for you if you weren't _____" fill in nervous, scared, afraid, overwhelmed, etc. etc. Is it so wrong to be confident in your ability to do good work and to learn something new when you aren't sure about something? Gosh, no wonder so many new nurses have such low self - esteem when they get out of nursing school if experienced nurses make it seem like you SHOULD be afraid. Am I just being cocky or stupid here? I'm not saying it's not okay to be a little nervous or scared - but why make it seem like everyone SHOULD be terrified?

I'd like to see the money put into these fancy research projects focused on "duh" concepts funneled into nursing salary - it is after all the nursing staff (this includes nurses, aids, orderlies, etc.) who does the most to prevent these falls due to impaired mental capacity and memory loss. How many times a day do the researchers have to remind Mrs. Jones that she broke her hip, and thus should NOT get up out of bed when she has to pee? I'll tell ya, the ratio is 10,000 to 0, with me having told Mrs. Jones this vital information 10,000 times, and the researcher having told her 0 times. Now you tell me who should be getting the research money???

Unfortunately, the only pairs of nude colored underpants I can find are those that are designed for under fancy dresses, and are sooooo expensive! Anyone know where I can get some plain ole nude colored undies in a BIG pack? I start clinicals (in all white) in August.

Our ER docs are really good about cleaning up their sharps. They always dispose of their dirty sharps (only twice have I found that they missed one) but occasionally leave a sharp they didn't use (they may not have even seen it, but it's always covered, and clean, so I don't bother about it much). The specialists who come in though, surgeons, plastics, etc.... that's another story. I think they're used to having an assistant who takes care of all that and is present at all times during the procedure so they know exactly where the used sharps are placed... and I guess they forget they don't have that luxury when in the ER... it gets annoying, but at least I know to be on the cautious side when I'm cleaning up after a consulting doc has done a procedure using needles. And believe me, when an ER doc leaves a dirty sharp on a tray and I find it while cleaning up, I let him know about it. It is a safety risk for whoever is cleaning the tray up, because they don't know what might be hidden under a pile of tools on a tray. One time I found a sharp on a tray of a very grouchy doc who seems to think nurses are very dumb... I put a drop of betadine on my finger and went straight to the doc and said "I hope you know you left a dirty sharp on your tray" you should have seen his face - thought he was going to faint he looked so upset. I wiped off the betadine and said "that could have been your responsibility if I had been stuck." He has NEVER left another sharp on a tray. LOL

The "down time" is a welcome relief, when you actually get a chance to talk with your co-workers, clean up the department, do some restocking, etc. It may seem a little "boring" at first, but there is always something to do! And when you get used to running running running all day long, the occasional down time is a very welcome relief! Good luck to you!

Many schools have several options. Mine has 3: 1. LPN to RN - LPN license, and a few pre-requisites, then apply to nursing program. 2. Traditional - Do all pre-requisites plus NET test, apply to nursing program. 3. Accelerated - for highschool seniors only. May take all classes - "pre-requisite" as well as nursing in the prescribed order. Call the school you're considering and ask for a nursing information packet. Attend any nursing information sessions and ask any questions you may have. Make sure you understand the appropriate application/admission process and timeline, and follow it! Good luck to you!