onconurseRT

:uhoh21: Yeah.. As a nurse, I would need a lot of "other MD orders" to occur prior to even starting to think about giving Lantus to someone with a BS of 20 or even 45. I personally would see the "20" and really not be thinking about how much more insulin I could give them. I personally have had a blood sugar of 28 when I was attempting to drive home after a long shift at work with no lunch and I felt like crap and then passed out! I was not a "happy camper" for several hours after that. That low of sugar makes folks feel REALLY BAD, nauseated in which they can and do vomit, have a massive headache and my muscles ached something horrible. I was not interested in my "HS snack" or fruit juice to say the least. As a nurse, I would need to see some stabilization of that pt and their blood sugar for a few hours before I would even contemplate insulin administration and that is exactly how I would approach the conversation with the MD. Good Luck....

:uhoh21: :uhoh21: :uhoh21: Yeah.. that is weird and a little scary!:uhoh21:

I believe in investing some money in a good stethescope which is what I did. I have had mine for 7 years and it was worth every single penny. I cannot hear with cheap ones. Be sure to mark yours very well and if a MD decides to "borrow" it, you should keep a close eye on them. Honestly, I have had several docs hand it back to me and say "wow.. that is a nice one..where did you buy it". I think that when they know you have invested the money ($300), they are more apt to give it back- at least that has been my experience. good luck

I think the poster was saying that basically these days, there is a really strict policy and procedure for needle sticks and there would be "questions" if you did not have gloves on. Hospitals (at least some) are not looking out for you, the nurse, remember that. I was taught to wear gloves for everything! I feel "naked" if I go to give an injection without it. I even wear gloves to change sheets. :uhoh21:

I was wondering if anyone can point me in the direction of an "acuity" system that is used in hospitals for just regular medical nursing. See, my hospital assigns pts to nurses based on their room number and could care less how much actual care they require. I worked in a hospital back in CA and there was such thing as "acuity", now, I don't even think that the word is written anywhere in the hospital where I work here in VA. Anyone know of a place I can view basic acuity Low-Medium-High?? Thanks

;) ;) Lets just say I thought it was funny and I chuckled. ;)

:yeahthat: :yeahthat: :yeahthat: I have seen it with my own eyes-- they will push and push as though it is their place to do it and I have seen new nurses cry over it. Not just to me but to many others who are new. This bothered me for about a year and then I started to picture myself (my love for nursing, my compassion for my patients, my drive to do a good job) as a big speed train racing down the hall with my face plastered on the front of it. I have said it before to someone that continues to push non-sense on me, "get on the train or get the he!! off the tracks." Hang in there and don't work there!

I live in northern virginia and one of the most populated areas next to DC. IF there was a 1 way train out of here I would take the next one... no offense to those who love this RAT RACE!!! It is not for me!!!! You can't really touch a "nice house" for less than $650,000.00 and the pay scale for nurses has not increased at the rate of the increase in cost of living. We pay $3.00 a gallon for gas and sit in traffic forever! Of course, everyone around you does not really know there is a lot of traffic because they are too busy eating, talking on the cell phone, checking their email, tuning their IPODs and reading the newspaper all at the same time as their race down the roads at 65mph. Physically driving their vehicle safely seems to be a real inconvenience here. I lived in the bay area of San Francisco and the cost of living was comparable and I made a LOT more there. I would not go back there either. I am ready for the normal life to return.

:lol2: :lol2:

We get breaks??:uhoh21: :uhoh21: :uhoh21: :uhoh21: :uhoh21:

What an unfortunate case. I wasn't able to read the entire section and all of the posts, but was there any legally binding information like a health care advance directive and living will prior to this deterioration and placement on a vent? I know she could always change her mind but was there one to begin with? I filled mine out at 20years of age. Why? So my family would not have to make the hardest decisions like that one and live with the question "Did we make the right decision? " for the rest of their lives. I highly encourage even the patients that are admitted for an infected hang-nail to complete theirs and make it legal. I did see posts regarding "patient advocacy" and I truely believe in that, however, patient advocacy started the first day of diagnosis (5 years ago) and the nurses responsibilities started the day of diagnosis as well.

1. Not getting the IV's and then refusing the IV start is likely not the only reason she was "fired". In most facilities, there is some progression to this unless it is a BIG mistake that is made. 2. If there is a fear, perhaps she needs to see someone outside of the hospital to work through that issue. If the fear is preventing her from performing her job and she just can't get past it, this almost appears to be an anxiety that is a bit more complex and much bigger than the task of IV starts. 3. I really stink at IV's. I try my hardest 1 time and if I do not get it then I find someone else. I kick myself for not getting it but I never give up and say "I can't" but I also don't torture patients and stick them 4 or 5 times! There is something to be said for the person that tries but has enough self realization to say "I need someone more experienced than myself for the benefit of the patient".

I as well have a thick southern accent and I do get the comment "you are not from here.. are you?" I live in the DC metro area of Virginia. I say "No maam/sir, my heart and where I grew up is in Texas but my husband has defended this country for 18 years and the military does not see state lines- home is where the air force sends you." Ending that with a very large smile! I have never had anything negative said to me after that. Your competence and knowledge will shine through and to be honest, you know what southern hospitality is and it will get you far. Respect for the person, polite behaviors and a genuine caring personality is something that many do not get to experience on the streets of what I call the "RAT RACE". Good luck to ya!

2 bottles of gatorade. On my floor there is this "Strict" policy of no food or drinks anywhere in sight of the rooms, desks, etc. We are not even allowed a bottle of water on the unit. It has to be neatly tuck away in our lockers which are in the break room clear on the other end of the hospital- literally! HOWEVER, I carry 1 bottle of gatorade with me and the other I hide behind a printer until I am ready for it. I work 8 hour shifts and that is my only chance for consumption. I could care less about the policy in place and I have made it clear that I either drink the gatorade or I will visit the ER each and every time I get off of work because I am hypoglycemic and dehydrated. I burn the glucose, calories and fluids too quickly! I lose about 2 lbs every time I work and I spend my days off trying to gain it back! :uhoh3: Good luck to you!

When entering the room your eyes should direct to the patient first. I would assess the patient, intervene with something for pain even if I needed to call the md for a 1 time order and have the secretary call the nursing supervisor to meet you on the unit to discuss the situation for family intervention. Good luck...

It has happened again today.... I received a direct "admit" at 1435 and I have to be in the report room at 1500. At that time I was also discharging a patient as well. I faxed off the admit orders that I had, started making up the chart, made the patient comfortable, helped her undress, went over the plan of care briefly so she knew what to expect for the the rest of the day. I started gathering all supplies that would be needed and then I was called to the report room at 1500. I was literally running down the hall ways to get as much done as I could. The oncoming nurse was irritated because I had not done the full admit paperwork (takes about an hour) and taken off 2 pages of orders. She huffed and puffed" and left the room.. again I felt so belittled. What more could I have done in 20 minutes that would have made this situation better?? Should I have offered to stay late and admit this patient for her?? When I ask the manager and charge nurse they say "pass it on..." but I try and I get a lot of grief for it. I am such at a loss right now

:yeahthat:

:yeahthat: TE=EricEnfermero]Is it written anywhere that you notify the lab or the pathologist for investigation of transfusion reactions? In many hospitals it is required. If the pathologist is clued into the situation, sometimes they can light a fire under the pt's attending.

Here is what I did... If you think you will not get too hot.. I bought some white, thin "long underware" that even look a little "trendy" for long underware to wear underneath. I still wear them now..... Another hint... I am an "involved" RN nurse... another words, if my patient has had a bowel movement (large) or is experiencing any other "leakage" I don't leave the patient to be cleaned up by an aid. I am the first responder on many "Code Browns" with my patients and 9/10 times I am able to grab a disposable gown for those "big ones". HOWEVER, I have been a victim of unexpected "projectile fluids" and my pant legs were covered with "stuff". When this occurs, it is always nice to have cover underneath your scrubs. I would hate to be standing there in nothing but a soaked uniform and a pair of string bikini's.

By the posts that I have seen, it it appears as though there may be a "system" problem there where you have decided to work. From my experience as a new grad, I know that my "emotions" are many times hanging on by a thread because there are so many personalities, new information and a lot of frustration. Working with other individuals that do not respect your time and your willingness to "get the day started" would be and is highly frustrating for me. Maybe the "team" or there lack of on that unit is not the right fit? Perhaps as you continue working there you may see other "problems" that are hard for you to ignore and maybe a place where you may decide is not right for you. Good luck..

I am posting this on behalf of myself and 2 other "newer" nurses at work. We need HELP! I received report on my patient load at 0700 and I work 8 hours. I received a report that a patients "drainage tube needs to flushed "daily"" and the night nurse reports to me that it was being done at 2000 in the evening since the patient has been on the unit for days and it is written that way on the report kardex. NOW, in between A THOUSAND "daily" medications, doctors rounding during the day, radiology/lab and pharmacy interruptions all with that important "patient AM care" that the RN's do during the day, I must have not RAN MY BUTT off enough in the 8 hours, I did not get time to do the "drain flush". I got a tongue lashing from a PM nurse at 1500 that "daily" means only 7-3pm. She was bent out of shape :angryfire and states "well.. I am not doing it... when you are done here you can go do it yourself.. you should not leave that for me to do!" :angryfire She was rude for the rest of the report and ordered me to stay late and do the procedure:o I got up and I did it. I felt as though my 8 hours of hard work was for nothing and to be honest I felt lower than dirt. NOW, this is a trend on my unit, evidently. I spoke with another newer nurse who has had the same issue. Pm's receive the same # of patients day shift does, with a significantly less amount of meds to pass, no AM care, few doctors, and minimal procedures. Another new nurse on the unit is experiencing the same attitudes and we feel like we are just being "pushed over". I can't always give a "nice, pretty patient package with a little bow on top" in which nothing else needs to be done that day. How can we stand up for ourselves? Does "daily" only mean 7-3pm? What is wrong with saying "I did these 10 things for this patient, I could not get to 1"? I rarely leave anything and will stay 1-2 hours late taking off routine orders written at 1430-1530 by late rounding MD's just so I don't have to listen to the PM shift complain. How can I (we) get out of this cycle? We feel like we are powerless because we do not have the "experience" or NERVES to tell them.... "this is a 24 hour hospital facility.. I can't do everything." Please help us! Thanks :uhoh21:

:yeahthat: Yes ..this does work. I have seen this work. Most managers are interested in that "OT" part of the budget.

Yes.... "nursing is something that I enjoy and respect and there are so many possibiities. It is vital that as a nurse, I find my fit- as I am sure every nurse strives for. My "fit" is a place that finds my contributions important and fellow co-workers respect the good work ethic that I have. I believe this unit may not be a good fit for me....." This is a phrase that I can repeat in my sleep but have not used... yet! Long story! Good Luck to you! You will find your own words... just look at what is important to you and bring that across in your message.

Are there any other professions in the United States that encounter this same problem- no lunch, no potty, no drinks for 8-12 hours long? Does anyone know?

At work I push around a lap top that is on a cart with wheels 9-13 hours a day. I record all infomation, MARs are there, orders completed there, etc. Now, my hospital wants all nurses to carry phones. I carried one yesterday and in 1 med pass in 1 room I was called 5 times on the phone and had to start the medication pass in that room 5 times. I have MD's calling and asking me privacy information on the phone as I am in another patients room. While in patient rooms, I hear nurses in hallways now talking about Mrs "Jones" diarrhea and Mr "Jones" new orders for meds, procedures and psych problems. I'm just wondering why nursing has turned to this? I spend more time in front of a computer and on my "cell":uhoh3: than with the patients! Does all of this really help us? How do I juggle patient care and privacy when my hospital is doing everything it can to put me in a bad position to accidently disclose information? I feel the nursing station is the appropriate place to discuss information quietly. Dashing down the hall way with some rushed MD on the line complaining that they have to listen to you run clear down the hall to get to a chart for information is not my idea of helpful at all. What do you think?