elemenRN

For the love of Florence, please tell me you don't work in neuro. STAT head CT's for everybody!

I think it's visually too busy. The borders/breaks in the page and coloring are distracting. Make it simple and concise! I don't think the skills section is necessary. You're interviewing for a nursing position and you've listed skills that are expected of nurses, not necessarily dynamic. Any volunteer work? What skills did you gain from your internship that will make you a better nurse? Good luck to you in your job search!

I'm kind of confused. Is this the standard NGT or the keofeed tube? Either way, I only ever use the "gastric" lumen that you described. We usually even connect a stop-cock to that for easier access. I use that lumen to suction back and check residuals, connect to continuous suction and to give the continuous feedings as well. Continuous feedings and continuous suction would never be ordered at the same time. If the "air" lumen (which I don't think I've ever seen?) is clogged with medications then the patient did not receive them. That's the only real problem I can see in this scenario. Checking residuals more than what is ordered is kind of unnecessary as the clog won't permit the feedings to pass and high residuals aren't technically possible. If that was the case any way, your pump would certainly alarm you of the clog! And just as a side note, carbonated beverages are seemingly great for GI tubes. I did hear from one company representative, however, that carbonated beverages can be damaging to the plastic of the tubes. Not sure how accurate that is, I just try to avoid it now out of fear! Good luck, I hope that helped a little bit!

As a three year travel RN, I can say that each assignment is still daunting at the beginning and has plenty of I'm-out-of-my-element moments. At one point during nearly every assignment I have felt very alone and as far away from home as can be. Getting through that just takes a little bit of time and positive self-talk, but I would never, ever, ever subject myself to this lifestyle without having a strong foundation of nursing knowledge and experience. There were 10 nurses in my recent orientation and it was many of their first assignments. Of that group, only TWO of us still work here. The others had their contracts cancelled because they couldn't hang and weren't picking things up quick enough. A lot of times, landing the job isn't the hardest part. We're all very replaceable. I also think people really look at all of the perks and overlook the frustrations, challenges and stress this lifestyle brings with it. "But at least you're making a ton of money and you live at the beach!" Ugh, just stop.

Absolutely take the job! Like others have said, completing an online RN to BSN program is VERY do-able while working full-time. That is the point of online school, it's flexible to fit your schedule/lifestyle! If you're worried about tackling both at first then just put school off for a year or so. If you play your cards right, the University you're working for will probably offer incentives or tuition reimbursement. As for the ratios, take that as a really great opportunity to learn prioritization and time management. It will give you invaluable experience that will benefit you for the rest of your career. I started on the East coast with a 1:7 ratio and I work in CA now with the 1:4 ratio and 1:3 when I'm on a step-down unit. What a difference! It takes a lot to stress me out these days!

I lose years of my life to all of "The Real Housewives" shows. Guilty as charged. I also love crime shows like 48 Hours Murder Mystery and Dateline on ID!

I don't really think that there is any "perfect" unit. In my experience as a staff nurse for two years and a traveler for three years, every unit has pros and cons. Management really has a direct hand in unit morale. Do you have any nurse friends who work on other units and love their jobs? Maybe they could help you get your foot in the door. Or you could shadow some nurses in different areas? Is travel nursing an option for you? I can put up with anything for three months! Sometimes I cry when I walk out of door on my last day because I'm sad to leave. Sometimes I run out of the door. Fast.

I'm not sure what state you're in, but in Maryland you can apply for your CNA license after you pass the first semester of fundamentals (RN program anyway). No exam required. That was at least the case back in 2008. Your BON website should be able to shed some more light on the situation. Have your instructors not mentioned anything about that? I remember my instructors openly telling us that.

I could not disagree with this mindset more. You can't respect someone you don't know? Do you apply that principle to your patients as well? You're saying that everyone has to work really hard to earn your respect just because they have less experience and knowledge? Wouldn't that make your politeness and manners fake if at your core you really don't respect them until they've met your requirements? The best nurses I've ever worked with were the experienced ones who took me under their wing, offered opportunities for me to learn and didn't get frustrated when I was a new grad and lacked experience. I'm a much, much better nurse for having worked with them. I respect everyone in the workplace and that means I understand that we all have our weaknesses and we all have our strengths. Whether that individual works in environmental services or is the attending physician. I'll do anything in my power to promote teamwork on each shift or offer help to someone who looks like they need it. It comes back to you and it makes the shifts much more enjoyable. Would you want that new nurse that hasn't earned your respect yet to care for your loved one? It's about patient care lest we keep forgetting. Personally, I like to deliver great patient care with a side of fun and a dash of comradery.

What kind of staff meeting lasts from 8am until 9:45am?? There couldn't possibly be a worse time to schedule a meeting. At my hospital when you call any unit between the hours of 7am and 10am (or 7pm and 10pm), an automated voice messaging system comes on and advises to call back later if it's not an urgent issue as those are peak medication administration times. I can't see how your license would be in jeopardy over this without your manager and coworker taking some heat, too. That being said... IF YOU DIDN'T CHART IT, IT DIDN'T HAPPEN! Especially regarding medication administration! I assume you have scanning/barcode system or else you would have penciled it into the paper MAR. There are a lot of audits that are performed and administering a medication without a scan of the patient and/or medication or changing the administration time (two hours later??) are a huge red flag to anyone sifting through the reports. You've essentially over-ridden the safeguards that make eMAR's so effective and reliable. I can understand why that could be concerning for a manager. Communication breakdown is one of the biggest reasons for sentinel events and that's what happened here. What if it was a high-alert medication? Real-time charting is the best way to go when possible. I'm not saying that you're the only one at fault and I'm sure your coworker had the best of intentions. Your manager sounds evil. I hope things work out well for you and this situation!

For someone who isn't a nurse who's calling themselves a nurse to come to a forum to ask for advice from nurses, I think you should be less defensive. He/she drew a conclusion from what you stated. If it was misinterpreted, then you should help us understand and not get snippy. I actually interpreted what you said the same way.

How are there no sterile caps? That's crazy! Honestly, I have no idea what's better. You could use the cap of the sterile saline flush if you don't compromise its sterility? I do that sometimes... And can we all just collectively cringe for the patient who disconnects himself and walks to the bathroom and you walk into the room to find the tubing laying on the ground still infusing? Ahhhhh!

I agree... it's engrained in my habits, too. I can't stand it when people connect the tubing back onto itself instead of using a sterile cap either. However, in an emergent situation like the poster stated, I'm definitely going to push the epi and not waste 15 seconds scrubbing a hub.

My patient who everyone knew was a repeat call light offender said this on blast at the nurses station in earshot of everyone: "Oh, hey. Can you just find Jane for me and see if she can bring me some cream for my crotch rot?" One of those moments when everyone just looked at each other and absolutely nothing had to be said. Did I find him cream for said crotch rot? Yes. Did I request a different assignment the next night? Yes.

I've been a traveler for three years and my best advice is to learn how to be both assertive and easy-going at the same time. You have to remember that you're supplementing a hospital because they need you. That means they expect you to come in, pick things up quickly and not stir the pot. It should be an easy transition for both parties. It's unfortunate and frustrating at times, but we're not always "valued" like the full-time staff. Blending in is key! Don't get walked on, but don't expect a red carpet either. A good evaluation is really important because that will help you to lock in future gigs. If you've had two bad assignments then maybe you need to do some evaluating (both of your expectations and of what your recruiter is bringing to your experience). Remember that recruiters need you. You are their product and, ultimately, their source of income. It sounds like the relationship you have with your recruiter got off to a rocky start. If you can't mend it, find a new one! It should be a symbiotic relationship! I would recommend going with a recruiter who you know someone already had a good experience with. Befriend other travelers and soak up the information they provide! It's invaluable and always evolving! Also, recruiters have nothing to do with scheduling. They are basically the liaison or middle person. They find and secure the contractual stuff and then you're on your own. You can contact them for help, but don't always expect an immediate, real-time response or quick fix. The most professional way to handle issues is to go directly to the hospital contact person for travelers. Keep your recruiter in the loop, but don't expect them to be the fixer of your issues. Most of the time they have no idea what you're even dealing with. Like NedRN said, watch out for penalties! They can be outrageous and come out of no where. Just try to go with the flow. If something doesn't feel right or you need clarification, ask in a professional way. Avoid being demanding and difficult! If you need some more guidance, just ask! We are a small and supportive community!