kngl

People who are overly critical can be difficult to deal with. Sometimes the best thing you can do is redirect it. These types of people may not be aware of how they are perceived by others. In response to "we did things so much better at my old job..." you could say "It's appreciated to have a fresh set of eyes. Let's focus on getting you up to speed here then once you finish orientation you can come to the staff meetings and work with others to see if we could make changes." Or in response to her criticism of orienting with a young nurse you could say "Gretchen is a fantastic nurse and people here know it. It's great how nursing can encompass people with such different backgrounds and experiences. I'm sure you two will learn a lot from each other!" Kill them with kindness yet don't leave an opportunity for them to respond, hopefully she'll get it.

She's following the instructions of her assignment. I think you're well over analyzing what she meant by "actually respond". You berate her for not searching what has already been posted on the subject as if she's wasting your time yet you have no issue with trolling this thread and using threatening language against the OP and making cheeky comments about her instructor's choice of assignment? Go vent your frustrations elsewhere, you're wasting the OP's time. My thoughts on the OP's question: Smelling of smoke while counseling a patient is unprofessional just as it would be to have body odor or wearing jeans and a paint-stained t-shirt to work. As far as being overweight, I am not quick to judge as to why someone is overweight. Some people can be mildly overweight and still be very healthy active individuals. However if a nurse is counseling someone on diabetes or hypertension, it's best that they do not smell like cigs and a bag of McDonald's. If anything some patient's may find a slightly overweight provider can relate to them better on their struggles with weight vs a very thin provider who may not have to work very hard to maintain a thin physique.

I worked throughout school and had enough to cover living expenses. I took out loans to cover my tuition at a private catholic school and and made interest-only payments while in school. My stepdad also generously covered one semester of school. Despite all this I still graduated with about $60,000 in debt. I pay $1,500 per month towards my loans. 16 months after graduating and I am down to $42,000 left to pay. I currently save 6% towards retirement plus employer match, which I plan to increase once loans are paid. If I stay on track I will have them paid off in two and a half years. I live in mid-sized city (~250,000) near downtown and have enough to live in a nice apartment that I share with my boyfriend. Being able to afford a house and a new car are still many years down the road!

Thanks Goose, this is very helpful! Our surgeons do not order a post-op fluid rate. Some CRNAs clamp the fluids coming out of the OR and some have them wide open. This way I have a clearer picture of where those longer recovery patients should be.

I work in an ASC. I'm curious to know what is a good method for calculating a patient's fluid needs when undergoing liposuction and/or abdominoplasty. There are many things to consider such as NPO time, length of surgery, and amount of tissue removed, if they are tolerating PO fluids. A patient's I recently had underwent both procedures with a length of surgery at about 4.5 hours with a total of 2750 mL of crystalloid intraop. She spent an additional 7 hours in recovery and had one additional liter infused during that time. It was reported to me that she had approximately 1.5 L of tissue removed. Prior to discharge she was able to void but her hands were looking puffy so I capped her IV early. Can anyone help me have a better understanding of how to calculate fluid needs?

I worked as a new grad in an ambulatory surgery center. Truthfully I think the only way I picked it up so quickly was because I also worked there as a PCT before graduating. The daily pace can vary a lot! Some days there is down time and other days you are running your behind off. Priority setting and efficiency are key to caring for your patients safely and discharging swiftly when the patient is ready. Common situation: patient #1 has an 8/10 pain and a BP of 180-110s, patient #2's assessment is now 15 minutes late with no tech in site to grab a set of vitals, patient #3 is crazy anxious to leave after being there 10 minutes because they want a cigarette so badly...meanwhile they're still on 3 L of O2. Granted not every moment of every day is like this. You may still get to go home 2 hours early because you ran for 3 hours then poof where did all the patients go? I do believe it would be difficult for a new grad to transition to ambulatory surgery with no prior experience, but not impossible if you feel your priority-setting skills and efficiency are up to par. Good luck!

Progress note: "the wound be healed"

I work post-op outpatient surgery. This was a particularly busy day where I had patient after patient after patient. The PACU nurse I got report from is usually bare bones when it comes to history and only covers major things like heart/lung issues or diabetes. I charted this lady in. Usually I do a quick scan of medical and surgical HX but was running short on time this day (thus why a good report is SO SO important). I went to bring her family back to see her and noticed her blankets were off and she appeared to be shivering. I asked "You look cold, would you like a warm blanket?" Her response, "I have Parkinson's" :X Well crap...

Started as a BSN new grad in January 2013. Starting wage was $25.70/hr, with $1.50 PM differential. One year in and am now making $26.21/hr. I work in an outpatient surgery center in Wisconsin.