RDH-RN

It's funny - I have never and would never consider that term applicable to anyone else, just to myself. If it read like I was slighting non-bedside nurses, that wasn't at all my intent. I've had coworkers make the transition, and they all expressed feeling that way, though, and I'm finding I'm being equally hard on myself. The personal bias is only directed to myself. Thank you for the well wishes - I appreciate it very much!

Hello - For those if you that transitioned from bedside to insurance company, how did you deal with feeling like you weren't a "real" nurse? Or did you not? I'm being faced with this possibility due to health issues (post COVID syndrome) and am struggling with this...but if I can't breathe and have chest pain walking down the hall, I'm not much use to my patients and that's not the best for me. ?‍♀️

This is old, but I've just gotten back on here. It was clear. That was kind of my point. But, I was a brand new nurse with a bully for a preceptor who no one wanted to go up against. There were 3 other nurses in the nurses station that listened to that conversation; none of them intercede. Nine of them corrected her. None of them pulled me aside to tell me she was wrong, or explain the proper way to do it. It was also on night shift, and I wasn't about to call a physician in the middle of the night, as a new nurse, and tell him what ridiculous BS my preceptor was telling me to do. She repeatedly set me up for failure. And while something "should" have been clear and all the other "should haves" you mentioned, consider where I, the OP, was coming from and the position I was in. If I felt it was okay (I.e., SAFE), to question what she was telling me, I wouldn't have posted here and come here to ask for advice.

Oh, no, not four syringes--4 "units" of Heparin, as in, pull in enough Heparin into the syringe so that it hits the "4unit" mark on the syringe. I asked her to show me the math on how she was getting 4 and not 4000...she kept going back to the 100units/mL concentration (of the BAG!) not the 1000units/mL of the vial. Also, while she may have said "TB syringe," I think she meant 'insulin syringe.' Not that it matters terribly, since it's still not right...just wanted to report the story correctly. I did ask my unit supervisor if he could set up something with myself and one of the pharmacists...it's a delicate situation. I'm new, she's recently been promoted and quite honestly, used to being right and doesn't take constructive criticism well at all. She isn't a bad nurse, she just doesn't know everything, and for some reason, didn't want to admit she either didn't know about the drip or was telling me wrong intentionally. Bleh!

Thanks so much for the responses...I thought she was nuts, too! I'm a newbie on a med-surg floor, and even though "we rarely ever get Heparin drips" I've had two to deal with in the 3 months I've been there...everyone else seems as confused and nervous to deal with them as I do. I didn't even know you could program the bolus into the pump!! I have requested a one-on-one session with one of the pharmacists on staff to help me; hopefully they'll be willing to do so. @suanna--No, no policy to not give boluses; the opposite! (Give a certain bolus as determined by pharmacy, run the drip, PTT 6hrs after start time, adjust settings and re-bolus if need be, PTT 6hrs later, so on and so forth.) Soooo, since giving a bolus is main player in the game, I'd like to be shown/told how to do it correctly! Thank you for your help...if any of you could explain how to program both the bolus and the drip rate into the pump, I would be most appreciative!!

When giving a Heparin bolus, and the vial is 10,000 units/10mL (1000units/mL concentration), and the bolus is to be for 4000units, would you not draw 4mL into a syringe and give it IVP? (This is the bolus that precedes an infusion with a bag that is of a 100unit/mL concentration.) My preceptor told me that I was supposed to use a tuberculin/Heparin syringe and draw up 4 "units" and inject it subQ for the bolus. ???