sored

Hi, You have to check the chart and use your best sense. If your patient is not eating, you hold the medicine and talk with the doctor. My first thought is still to give a short acting insulin that is easily reversed if necessary. It is still safer to give the short acting insulin and pass on to the next nurse your decision. They will be allerted to follow up. I hope I have helped.

Hi There, BG management is a complicated issue. I have read responses you have recieved and they go back and forth over it because it is complicated. Because there are so many hands in the pot, I go for holding any type of long lasting insulin when there is a short acting in place. I would choose to always check BG before giving any insulin just as I would choose to check blood pressure before giving an antihypertensive. I think it is the only safe thing to do.

I would not work there.

It just sopunds like too much. You are right to question.

Hi, I didn't check what state you write from. I am in CA. After 27 years I can only manage 4 patients at a time. In a 12 hour shift that amounts to probably 6 or 7 patients being turned around, discharged. I think technology is far ahead of our human ability to keep up. The ratios need to be lower. Only if we want to do well by the patient. You are not alone.

Hi Jenny, First of all, thank you for making the choice to be a nurse. Congrats. It is a wonderful calling. I appreciate your attention to certification and I will give you what I know. I have been a nurse 27 years, the last decade as a traveler and registry in CA. All over. The writers before me gave you the best advice. As I have experienced, there is no actual certification. Some hospitals require three successful starts. Some throw you out there just to get the task done. If you personally feel you need a bit more guidance I think you are smart to seek that out. Start with your lead nurse. She will direct you. The thing I hope you learn about nursing is that we all care about your success. Heck, we want to retire someday! State your needs. To put it short, I don't know of any very formal IV certification. It is not like having ACLS, BLS, or PALS where you get a transferrable card to present. My only other peice of advice to you is do not ever do something you are not sure of. Oh. and DOCUMENT!!!!! My best wishes, Diane

You are so crass.

YOU ARE NOT ALONE. THE CAVALRY IS ON ITS WAY. REMEMBER: THEY TELL YOU ON AIRPLANES IF YOU ARE TRAVELLING WITH CHILDREN AND AN EMERGENCY OCCURS GIVE YOURSELF THE OXYGEN FIRST OR YOU CANNOT HELP THE CHILD. THANK YOU. I KNOW.

Hi, and thank you for caring. It may hurt to see pain. You call it being close and I think it is better called empathy. Thank you for that. If you think caring hurts imagine how bad not caring would feel. You are strong enough. Listen to the senior staff around you that you respect. It is alright to ventilate. Your feelings are normal. Please remember it is better that you are there. The real stuff is painful. You are brave and capable. I know.

You sound so smart. Thank you for noticing the problem and thinking on your feet. You may not know what happened after transfer to ICU, but I am sure your patient's outcome was improved because of your diligence. Good Going! I can tell you were frustrated by not being heard. Rightfully so. But, if there is a next time, chart no orders recieved in the nursing notes, not orders. You did everything right and getting mad because someone in your care is not provided the attention necessary is maddening. But nursing notes. Writing in orders "no order" is almost like a doctor writing in orders "file incident report". I am glad you were mad. The ortho doc is a clear example of the complacency that seems to be a norm these days. Reed the books I listed in previous postings

Please read the books I mentioned. I don't know how long you have been a nurse so forgive me if my advice is what you already know. I have been an ICU nurse 20 years and I can still say I love taking care of people. So much. Never allow yourself to be yelled at. We are not cavemen and we have the communication skills to solve problems. When I was 23 a cardiologist cursed and screamed at me for nothing that was my fault. I was brave enough at that tender age to take this 50 year old physician in a private area and simply tell him that under no circumstance does he ever have the right to speak to me this way. He did apologize. Every one of us on this planet deserve to be treated decently. Remember working in the ER is hard because it is where adrenalin junkies and ego migrate, not to say that is necessarily you. But ER is where criticism abounds. If you like the work stay but don't let that get under your skin. Just as we are not cavemen we are also not robots. It is expected at times you will not do the perfect thing. You will also make mistakes. That has to be OK because we are human. A nurse who says she never made a mistake is a liar. Don't be afraid. Say you are sorry and listen. We all have to. Lastly, do not let them define you. You define yourself and be proud enough to recognize the pettiness of disrespect. I hope you teach by example, like the LVN. You'll be fine. Read the books. Read exerpts on the internet today.

My answer... R---Recognition E---Empathy S---Sensitivity P---Patience and Perseverence E---Everabiding Commitment To Eachother C---Compassion To All T---Thank Everyone Two books we all should read: "Nursing Against The Odds" by Suzanne Gordon. It is all about what you feel. "Notes On Nursing: What it is and what it is not" by Florence Nightingale. Although written 100 years ago her essays remain valid. Our tools and abilities have expanded but tenets are tenets. I wish this was required reading in nursing school. Both can be easily located on Amazon.com complete with excerpts. Let's all hang in there. Remember P is for Persevere. God Bless us all.

My answer... R---Recognition E---Empathy S---Sensitivity P---Patience and Perseverence E---Everabiding Commitment To Eachother C---Compassion To All T---Thank Everyone Two books we all should read: "Nursing Against The Odds" by Suzanne Gordon. It is all about what you feel. "Notes On Nursing: What it is and what it is not" by Florence Nightingale. Although written 100 years ago her essays remain valid. Our tools and abilities have expanded but tenets are tenets. I wish this was required reading in nursing school. Both can be easily located on Amazon.com complete with excerpts. Let's all hang in there. Remember P is for Persevere. God Bless