Kaltia

Assert more, a huddle will not solve this assign tasks, like the others said pick who ever is being oblivious at the moment. Direct, don't make it optional. As far as still working the floor just make sure that when you do you follow your own advice and answers lights, you'll have no issues if you do. ive learned to do this myself recently, as I have a CNA whose very problematic. She doesn't enjoy it, but after she lost the first time she tried to buck me on it, she knows better than to challenge. You're going to get some looks the first few times, stick to your guns and insist calmly.

I did end up declining the contract. So far no issues but it was Definetly a lesson in what to check for. I'm grateful it didn't go any farther before I realized the issue.

I'm particularly concerned about the language related to breaking the contract which involves paying back certain undisclosed costs to the company. They tell me it's situational. When I ask for examples and concrete numbers I can't get them. It's not that I have any reason to worry about needing the break the contract but I don't feel comfortable signing to pay for things that I don't know what they are or how much. I can't believe they don't have numbers on what the cost would be. I aced the interview, I really like the sound of this facility but I feel really uncomfortable with the phraseology and they don't seem willing to rewrite it to be more specific. i already had the recruiter read through it with me and most things they're willing to fix but this is the one issue, I'm really stuck on.

Am I being too picky? I was sent my first contract today and was appalled at the language as written. It's so broad, so much legalize and the company isn't giving me straight answers. I'm really alitle concerned are all travel contracts putting all the blame for all things on the nurse?

Perfect all of you!!!!! Great parody of life and. AN

It's not really about route here but the fact that it's not specified. It's not a valid order without a route. Clarify the order, based on what little we know of the patient, I'd guess they'll get more of the med if it goes through the g-tube, however, it probably needs to be switched to a non-sublingal form.

Zofran as first line. it works for alot of people. Pherengan as back up, I find its more it or miss than zofran but for the few that zofran doesn't work for, phenergan usually works beautifully.

Good to know, I was frankly concerned about getting the amount of fluid through the same tubing, but the packaging info does make sense. I went with two sites two lines as the IV pumps I'm working with do not run concurrently. And I frankly didn't know before now that some pumps could. at least I'll know for next time.

If you have sitters often enough even consider this you're doing well Unless it's a 1 to 1, sitters are either family members, friends or hired by family or staff from the facility the patient came from

If you had an order for two IV fluids that are compatible and it state that both IV fluids are to be run not just one or the other and they are to be run concurrently, would you consider that two mean two separate lines or would you think you could piggyback them together? My view point is it's two sites, two lines but I've run into some confusion about it so I'm curious for other opinions

Actually what confuses me here is how the op ask for opinions on a "ethical dilema" and then states they don't care, never had any doubts about it in the first place. 95% percent of patients tend to like their pain meds too much, not a big hairy deal. It doesn't sound like you actually saw too much one way or the other, so I'd just play ignorant, while reminding the patient that smoking of any kind is not allowed due to fire risk.

Suspected abuse doesn't mean that he doesn't have feelings for his family. Especially with a child I'd be worried about him blaming himself for the family getting into trouble. Very complicated issues here and not something you can deal with, he needs social services child psych eval ect. I would not try and discuss anything with him related to the abuse, especially with young children, it's very hard to question without influencing them and is far better left to a professional. Not to mention the legal issues esp if he needs to testify. or the fact that it may not be abuse. If he talks to you be supportive listener only. Distract and entertainer like you would for any other kid. Worse thing you can do is tip-toe around like oh no there's something wrong

I might hold 1 dose and see if the behavior changed but after that definetly call the doc . It sounds like your charge just wasn't willing to call for whatever reason ie she's already called this guy 3 times during the night ect. But regardless this order need clarifying . And also remember the patient can refuse if they're alert and oriented

I'd tell him I wasn't aware that the elderly health risk to Patients on ativan were so severe that the risk of them breaking a limb or smashing their head open when climbing out of bed didn't take priority. then I'd add sweetly, "According to the report I recieved ativan has been working well for this patient, however, if you decided to take him off the ativan, he will need another PRN medication of your choice for agitation." and walk off. Honestly if I listed the number of times that I could have felt belittled by a doctor? Never ever take yelling personally. Usually you just happen to be there.

Research the hospital and location. Find out what's there and about costs. See what there is for activities and such. You will need support and people around you. cThat about what I make staff nursing in a small hospital. Sounds low for travel but could be fun too. Just be aware travelers don't get orientation or much of one. You will be expected hit the ground running regardless of situation. Overall id say go for it just do your research first

This is while you always run your piggy backs on secondary tubing as they are designed to be run. I always set thr pump for kvo of maintain ex fluid so I will have a few mins to get in there once the antibiotic is done. as far as using the old tubing, just completely take it out and reprime pretend your starting from scratc

I love Demerol and it's tends to be very effective when I've given it. I know it has it's issues like anything else but IM Demerol seems to really really work for pain. Usually have only run across it with allergy issues to everything else but it does seem to have far less of attachment issues that my patients on dilaudid have. Honestly I wish it was used more or that more pain meds were IM. Whether it the drug or the route or both, it's dang effective.

Relax, don't stress. Your scores look fine. Speaking from experience you can pass with far worse. Dont overdo. Three most important thing study the Kaplan review book for content, watch the Kaplan rationale videos, and do qbank. Kaplan is the closest to the exam questions so focus your time there. Good luck

relax, I think people make these situations worse by stressing about this. Getting into a conflict with some one over any religious issue especially prayer is never worth it. If a patient says they're praying for me, I'll just say thanks and continue on. If they want to pray with you again, I tend to just go with it. My reasoning is it doesn't matter whether I believe in whatever "deity" is involved, what matters is the patient believes and it helps them. so I am caring for the patient regardless. Plus for a lot of older patients their religion is a major coping mechanism, a major part of their framework for every day life, I don't want to diminish that, or make them feel uncomfortable. and if they are really religious or act like they would enjoy it. I bring up having their clergy or a hospital chaplain visit with them. say whatever you feel okay with. for some religious patients I've had, "I'm praying for you" is almost reflexive sort of like saying have a nice day but with more of a I care about you feel. I tend to treat it as more of polite greeting phrase than anything else.

I'm torn between wincing and laughing when reading this post. so many patients have the same reasoning, why can't I just take my tylenol, advil, ect? As I point out to them, I am the medical professional charged with your care right now and it is not safe to have you taking something I don't know about or the doctor does not know about, regardless of how many times you've taken it safely at home. I will happily let the MD know what's going on and let them know what you're asking for but in the hospital you cannot do it on your own. I am concerned that someone two years into nursing school does not seem to realize the nuances of giving medications and the cascade of events that one simple action can set off. nothing irks me more than Iv fluids that were not ordered by thinking of the patient but just oh let's throw Normal saline up there. medical school does sound like it would suit you better but beware even as a resident you will often get slapped down by the attending for ordering just that simple tylenol and often with good reason. The best anology I can come up with for you is this. Nursing care is sort of like being a watchman on the walls of a castle about to be attacked. you cannot relax your guard, and when you see that an attack is coming you'd dam well better make sure that you passed that message along and kept on it till it was acted on. You aren't the commander, you aren't the king, you won't win the victorious sortie but you are the one on whom all the rest of that happening depends. that's where your autonomy comes, when you make that call even though it's 3 AM and you know you're going to get yelled at because you just have that gut feeling that something is going wrong. You can suggest all you like but ultimately, you cannot win that war by charging into the fight.

It's protocol on my unit not to give the same pain meds together. With a dependent patient I doubt it would have hurt anything and in the mentioned case I'd highly suspect the patient of self treating. I might give together if the order was very specific but otherwise I try to keep any pain meds sedation things seperate by least an hour. I find that even with the dependent patients it forces them to be little more honest about the amount if relief. And in a lot of cases throne is all they need

No I beg to differ. The hardest part of nursing is dealing with family regardless of patient age. Do use your brain, and your gut. Those feelings are important. doctors will yell, not put their charts back and in general act like asses, not that nursing staff is except from such behaviors either. It doesn't mean you did anything wrong personally. Ignore the rants that usually silences them fast. the worst thing that can happen is the patient dying in which case you already know what to do so relax. im not asking questions in report to torment you. As long as you keep in improving I won't actually be mad. I just know that those ridicules things I just ask will be ones you don't forget again. God knows I did the same thing once.

I do not understand this. With the exception of a few absolutely crazy shifts, I refuse to not make time to pee. that 1 min to hold still and go is important to my sanity, let alone the physical issues. I often find myself coaching others on taking the couple of minutes it takes to deal with this rather than trying to avoid it. It's not worth it. and you don't really save that much time either

Snacks, water, bathroom breaks, and actual breaks if possible. You will need tons of water, 12s are the worst for needing fluids, they're like a dessert. Sleep you can't do much during the day when working nights. It sucks but you do get used to it. other than those if it's continuous seeing your doctor would be good.

It's because everyone forgets names sometimes even with whiteboards. And if a patient is climbing out of bed I don't always get a chance to ask their name. Hon, sweetie, sweetheart, dear are just faster and I try not to use them all the time, I also us sir, and Mammam. But the endearments used apprioately and occasionally are fine. I've certainly been called all of the above too. I don't mind as long as it isn't constant. I did have one case where a patient was referring to me as sweetheart continuously and I simply ask them to use my name instead, which they did. Coworkers are harder, I tend to just retaliate with a nickname or endearment for them too. Usually takes very few times for the point to sink in.