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Karou has 1 years experience and specializes in Med-Surg.

Karou's Latest Activity

  1. Karou

    Night Shift Survival

    Blackout blinds + blackout curtains make your bedroom a dark den of delicious night. Blackout blinds are expensive but worth it! Eye mask, earplugs, fans for white noise as appropriate. Shower before bed to relax you (unless that makes you energetic, whatever works for you!). Some say eat or don't eat... I can't go to bed on an empty stomach so I have a small bowl of cereal or something similar. Phone on vibrate or silent. Make family members aware of your schedule. Eat before you go to work- high protein is best. Bring multiple healthy snacks to munch on. Drink plenty of water at work. I wear sun glasses on my way home to keep me night like and sleepy. I take melatonin sometimes on occasion for sleep. I love it. I'll post more tips if I can think of any.
  2. Karou

    No pain meds in ER??

    Oh yes! They come to the unit and we hear about it non stop, even once they've gotten their dilaudid here. I'm not sure if the change will last or if it's made any difference down in the ER. For the rare patient there truly allergic to morphine and needs the dilaudid, I feel sorry for them.
  3. Karou

    Nurse takes pic of patient's...

    What's interesting to me is that if this had been a male nurse taking pictures of his female patients genitals, he would probably have to register as a sex offender. There is more than a HIPAA or ethical violation here! She got probation and surrendered her nursing license. A slap on the wrist.
  4. Karou

    No pain meds in ER??

    Interesting. Our ER stopped stocking dilaudid as a way to be less appealing to drug seekers. Not sure how effective that has been. They will still do morphine and other drugs but dilaudid has to be sent from pharmacy (which it never is on time).
  5. Karou

    RN to Teacher

    There are a few different ways to get into teaching. Since you already have a college degree (BSN or ASN) it's not as difficult as starting from scratch. Start looking into your local colleges (maybe even online ones) and do some research into what it takes to get hired into the school districts around you. I have two teacher friends, both went the short route. One had a bachelors degree in French, ended up teaching that in a low income/poverty district that forgave her loans. The other was an LVN who disliked nursing, worked as a school nurse for a while, then went back to school for teaching. Do what makes you happy!
  6. Karou

    Thrown From the Tower!!

    I haven't read your other posts OP, I don't really care to. I am pretty full of your entitled attitude from this one alone. The part that tipped me over was your bragging about your husband and speculating that your supervisor is jealous of you, when there are clearly valid reasons as to why you are getting in trouble. This shows me that you don't take your job and responsibilities seriously. You would rather assume someone is jealous/targeting you then own up to your part in all of this. They probably want an employee who doesn't inconvenience them as much with frequent doctors appointments and tardies. I also wonder if this entitled attitude spills over at work and sours others impressions of you. You take very little accountability for yourself and are full of excuses. Since your husband makes such high income and you've said you aren't working for the money, you should have no problem being a stay at home mom and paying off your student loans. Good luck.
  7. Please don't have this attitude. Learning how to do an assessment is a critical nursing skill. Depending on what speciality/area you go in to, you will find yourself losing certain skills and relying on others. That doesn't mean you don't need to know the basic idea of how to do an assessment if something unusual pops up. I work adult med surg. Once in a blue moon we get a pediatric patient. About once every 6 months we get a pregnant woman. Each time I have to reach back in my knowledge and remember what I know about these patients, because these are not my norm. Same true if we happen to get a hip/knee, women's surgical, or neuro patient (none of which we usually get). You will always have a chance of getting "overflow" specialty patients, or being floated to a speciality department. As for your original question- the most thorough assessment I do is on admission. Head to toe, to butt cheeks and between those toes. I am so fast though, that an observer may not see everything I am doing or realize how thorough I am. I couldn't have developed a fast way to do this if it weren't for my basic knowledge I was thought in school. When necessary, I focus on one body part over the other (the complaining/problem area). This takes me around 30 minutes including med rec, history, ect (all of the required facility charting). I do my focused shift assessment in less than 5 minutes on each patient. I am also constantly assessing my patients throughout the shift, though they usually don't realize this. As for not using an otoscope... I had to do that recently!!! You never know what skills you will need on a given day. ICU nurses do the most in depth assessments, my guess.
  8. Karou

    Using both ports of central line

    For some reason when I worked in LTC, this myth of the "red port" being for "blood draws only" existed also. Two incompatible medications can run simultaneously through a central line/PICC line. That's exactly why a multiple lumen line is placed. Either port, or both ports may be used. The issue with allergic reaction shouldn't be a problem in your setting, because this patient (probably) has already had doses of both antibiotics and has not had an allergic reaction to them. If it's the first time a patient is receiving the antibiotic then it's an issue, and unless emergent, we will hang the antibiotics separately to monitor for symptoms of a reaction. Of course, you could ask pharmacy to time them so they don't end up due together. That's usually not a difficult thing to do. Sometimes it's not possible if there are multiple abx and they are frequent (q6) or run over a very long time (Zosyn and mermen are 3 hours in my facility, a high dose Vanc may be 2 1/2 hours).
  9. Karou

    What are the rules of what we can tell patients?

    True. Thank you for the correction.
  10. Karou

    What are the rules of what we can tell patients?

    I think a combination of nursing judgement and facility policy can be used to differentiate between what you should and should not tell your patient. I have no problem telling my patients their labs and how that relates to their care. If it's radiology, I am more cautious. I may or may not read to them the radiology report, but always explain that the physician will be the one to discuss it fully with them and that as a nurse, I cannot interpret the report. For what it's worth, my facility has an online patient portal where they can access this information themselves. I won't explain some sensitive things like imaging study that shows probably cancer, or lab results showing elevated tumor markets, ect... I wait for the physician to discuss that with the patient first.
  11. Karou

    New Grad Nurse Residency Salaries

    Pay rate for new grads in residency programs is 23.00 in my area. My hospital compares rates with others (supposedly) to have competitive pay. Negotiation is not an option. BSN makes no more than ASN. PCT's who have worked at the hospital while obtaining the RN make the same as brand spanking new employees. LPN/LVN nursing experience doesn't count either. We all start at $23.00. First raise is annual, just like all employees. I was just happy to have a job at all. I get an annual raise, plus shift differential and extra for being charge nurse, precepting, ect... Someone has to be the low man on the totem pole. Nurses with experience who have put in their dues by staying employees year after year, are worth more to the hospital and earned the higher pay. Because of their experience, they are much more valuable than a risky new grad. Can you imagine how offensive it would be for a nurse with 20 years experience to learn a new grad makes the same as them? We all start at the bottom and work up. Hospitals are so saturated with new grads desperate to get acute care experience that they can pay whatever they want and still have applicants. Often other areas can pay new grads more- rehab, maybe LTC, ect... You can shop around. I took a pay cut from my precious job to work at the hospital I do now (as a new RN gead(.
  12. Karou

    Best Units

    You will still see a lot of dementia patients in the ED, and ICU. Also ICU induced delirium. In the ED you don't have the patients as along though, and in ICU you have 2-3 patients. Women's services is probably safe. I don't see too many on the dialysis/renal floor at my hospital either, at least not compared to the other med-surg units. Don't know why. PACU means you don't have them for long, and they usually pretty sedated the entire time. Unfortunately, if dementia patients are your kryptonite, they are almost impossible to avoid and really limit your areas to work in. What about dementia patients specifically bother you?
  13. Karou

    Odd interactions

    The best solution to a creepy male patient with semi sexual requests is to bring in a male care provider. Funny how often that request then gets taken back by the patient!
  14. Wow. Who has the time to comb through someone's charting like that? Must be nice for whoever has that job!! That's such an incredibly minor omission that it's laughable that you received any punitive action for it. I have caught missed blood transfusions, missed time sensitive medications, missed discharge orders, ect... Those things I would make a fuss over. Missed orthostatic vitals? I may mention it to the nurse when I see them again, if it's something the physician really wanted done or was actually information they was needed. I see orders for orthostatics all the time that the physician probably forgot to D/C. I wouldn't act like the sky was falling for it.
  15. I work with some awesome people. The kind that can turn a nightmare assignment into a good shift. I start out positive- it's always going to be a great shift! We all help each other out. If I am running around like a chicken with my head cut off, someone will offer help usually before I even need to ask. I do the same for them. Have a great relationship with PCT's. All of our charge nurses are very helpful and involved. We bounce ideas off each other and vent in appropriate areas- like the break room. We vent a LOT, which can be viewed as a negative thing, but can be essential to get through a shift with those difficult patients and/or family members. Some discord between day and night shift. Nothing unusual just, "night shift doesn't do anything" sometimes followed up by, "so we need to add more tasks for them". I shrug and ignore shift drama because just like battles between different departments, it will never change.
  16. Then you can never give them any medication or treat them at all. Kidding! I have patients family members ask this sometimes when their loved one is too confused to tell me name and or DOB. You compare their name and DOB to their armband ID back to your eMAR.

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