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FolksBtrippin BSN, RN

Psychiatry, Pediatrics, Public Health
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FolksBtrippin is a BSN, RN and specializes in Psychiatry, Pediatrics, Public Health.

FolksBtrippin's Latest Activity

  1. @JJBookman My question to you was "What is your point?" and that is also legitimate. You present a wide and vague criticism of nurses you work with. I can think of several reasons why you might do this and I am directly asking you what yours is. If you are their supervisor, get more info to determine whether education is needed. It would be your job to sit each nurse down and ask her about her rationale, and whether or not she called the doctor. If you are a coworker on the same level, it isn't appropriate for you to spend your work time asking the necessary questions and doing the necessary investigation to evaluate your coworker's clinical judgment. If you want to know what we think about holding a med in any particular instance, be specific. I can't and won't judge your coworkers based on the info you gave me. I also would appreciate your question more if you were asking about your own practice. I love to help other nurses. I gave you an example of when I would hold a med for SBP 119. I would probably call the doc, but not necessarily, like if I know I'm going to see the doc for rounds, or Doc and I had already discussed what might happen and I know she is going to be looking for my note. If that situation happened and you, as my coworker, started grilling me in an accusatory way about why I held the med and did I call the doc, I would be highly annoyed with you and rightly so. You might even damage your relationship with me. More than once, I have been questioned in an accusatory way by a nurse who was not my supervisor and who actually knew less about the situation than I did. Some nurses think they should do that, and that's unfortunate for the culture of the working environment. If you are actually concerned about patient safety, go to your supervisor and report your concerns.
  2. One thing to keep in mind, especially when it comes to blood pressure, is that fall prevention is a nursing responsibility, not the responsibility of the doc. While I agree that 119/62 is not a borderline pressure, if my patient is normally running at SBP 140, is telling me he feels dizzy, had a recent fall, and is taking propranolol for tremor I would probably hold the propanolol. Unless some other clinical finding made it necessary to take the risk of him falling and just give it to him. You can't just look at the MAR and decide that some people are holding meds inappropriately. You have to look at the whole picture.
  3. What is the point of this post? The decision to hold a med is based on the specifics of the situation. Nurses can and should hold medications sometimes for a variety of reasons. If you want to criticize a particular instance of holding a med here, then present us with all the clinical information. But If you want to make an argument that nurses should never hold meds without parameters, that's wrong.
  4. FolksBtrippin

    Multiple vaccine errors.

    Don't beat yourself up, but do solve the problem. Why did this happen? Are you frequently interrupted? Always doing 10 things at once? Medication administration needs to be prioritized over most of the other things you do in an office. Set some boundaries with the doctor if you need to. When you are administering a vaccine do not stop to pick up the phone or check something else. It's your responsibility to stay on track. I check vial meds twice. Once when I get them out of the fridge and a second time when I draw them up into the syringe. You need habits and practices that will stop this from happening again. The 6 rights (or 7 or 8 or whatever) are the bottom line, but not being interrupted is also important. Not rushing through med admin is also important.
  5. FolksBtrippin

    Gender discrimination in pay

    When I found out my male partner was making more than me, I demanded equal pay and I got it. Fight. Contact the ACLU. Good Luck.
  6. FolksBtrippin

    New Jersey License Status

    The best way to deal with the NJ BON is to go there in person about your problem. They are notoriously slow. Take your transcripts with you, every ID you have, and whatever else they want. The office is in Newark. Hopefully they are open. They demanded a copy of my divorce decree. For no reason. That's just one example of the nonsense they are capable of.
  7. FolksBtrippin

    new job, can I be denied job for benzo PRN

    Are they actually asking you pre employment what medications you take/ have taken? That would be inappropriate. If you are taking a drug test, you need to let them know what meds you CURRENTLY take. If it has been a month, it's too long to count.
  8. FolksBtrippin

    Doctor Derogatory Comments in the OR?

    You can always report anything. There are things you should report and things you should not report. You should always report patient abuse.
  9. FolksBtrippin

    Nursing check-in: How are your numbers???

    My unusual situation is that I am working in a state psych hospital that has had an outbreak of covid that peaked in April. Our geriatric unit was hit hard and 6 out of 27 long term patients died. We have lots of positives in the rest of the hospital and these patients are kept separate from the other patients, but most of them are not very sick. I am working temporarily to assist with the problem. They call us the COVID nurses.
  10. FolksBtrippin

    Frazzled New Nurse Stuck on Rotating Shifts

    I'm sorry you are going through this. No one should have to rotate days and nights. It isn't safe for patients and it's very hard on employees as well. This is well documented. Hospitals that require rotating shifts have a power imbalance that sacrifices patient safety for scheduling convenience. It sounds like they don't care. If you can make the change by going to occ health as someone else suggested, that's great, but if it doesn't work, I do recommend going to a hospital with a policy that you either work days or nights and not both. Edited to add: HR never wants to lose an employee. It's very expensive and time consuming to hire someone new. That having been said, nursing managers will try to get away with a lot. If you start looking elsewhere when you are unhappy, HR will start getting calls for references and they will know you are serious. Let them know what the problem is beforehand, and sometimes they can get you what you need in order to stay. This depends on market and other factors you can't control, but it is a negotiating tool.
  11. FolksBtrippin

    Not digging outpatient

    I find that people who talk about losing skills are usually not actually talking about real nursing skills, but technical stuff that anyone could learn in a day. You are a nurse, not a technician. Apply the nursing process with your patients. Doing that in any setting, is your nursing skill. Everything else is a Youtube video. Not sure what your role is in outpatient, but I am certain that if it were just a bunch of technical stuff it would be done by an MA, under a physician. Outpatient tends to be a lot of education and triage. You are teaching people how to care for themselves, and you are the gateway between that person and the hospital. To educate them well, you need to know a lot about their dx. You need to be up on the research. You are the expert. Start reading and read every day. You need to have excellent assessment and the ability to triage. Don't be the nurse who sends every person to the hospital who calls with a problem. Learn to get info over the phone, what questions do you need to ask? Is this a doctor visit, urgent care, emergency room or do you need to educate the patient and keep her home? These are skills you didn't need in the hospital and you should be working on them now. If you're not up for it, then go back to inpatient.
  12. FolksBtrippin

    Mask refusal on unit

    I deal with this all the time. It has to come from management. Many people believe that they need to pull down their mask for telephone calls or they won't be heard. There is near zero public health education in our nation, and people are very reluctant to be educated anyway. It has to come from their supervisor or they're not going to care/believe it.
  13. FolksBtrippin

    2 Nurse Verification of SubQ Insulin

    We do it.
  14. FolksBtrippin

    HELP! Don't know what to do.

    I think that you first need to get your authorization to test (ATT) from your state board of nursing. Once you get the ATT, start NCLEX practice tests and see where you stand. If you are not scoring in a passing range, it's okay, but you need to start practicing. If you are scoring very low, I would recommend taking a formal NCLEX course. If you are close, but not solid, it is probably good enough to just use an NCLEX practice app that you can get for your phone. Good luck!
  15. FolksBtrippin

    Graduate asked to work in PCA position?

    I would have appreciated knowing the tech's job better from the beginning. When you have a good idea what their workflow is like without delegated tasks, it helps you delegate more effectively. I would recommend that you stick it out and see it as a valuable part of your orientation.
  16. Feeling like you can't breathe when you wear a mask may be real, but it is also a psychological symptom that can be overcome with gradual exposure and intentional relaxation or CBT, like other real experiences that have a psychological origin. Asthmatics may be more prone to this psychological symptom as they are more likely to have had traumatic experiences in which they felt they couldn't breathe. We can be sensitive to that without pretending that it's hypercapnia. If we pretend that this is hypercapnia, we are actually making it worse for people who need our support to overcome their fear.

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