Shimbo

They asked me to go home because the census was low and it was my turn on the unit for being staff adjusted and thanks for the advice I appreciate it

What do you think of the consequences of taking out the controlled substance and not administering it. I'm really worried about it. Should I discuss this with the charge RN tomorrow and call pharmacy to see if there was a controlled substance found in the outbox on Friday?

This Friday I had a situation that occurred regarding narcotics but I'll start from the beginning. I work on a telemetry floor which the nurse to pt ratio is usually 1:6, since it was the day after Thanksgiving the census was about 28 in a 42 bed unit which left me to have 4 pt at this time which is awesome. The day started out good I knew 3/4 patients so report was short. I start going in my usual routine doing my assessment on my patients, then I start charting then after that I take out my medications. One pt in particular was confused and yelling so when I was taking out my meds I took out Xanax for that pt. When I was about to give my meds the PCA asks me to help one of the patients which was the one that was yelling before but this time the pt was calmer. After that I started to give my meds to my first pt then I reached to the confused pt. I decided not to give Xanax because it was unnecessary, the pt was not trying to get out bed nor yelling and the pt had a tabs alarm to.. So I left the Xanax in my locked cart in which I was meaning to return after giving meds and so I moved on to my next pt.As I finished administering all my meds a code blue on my unit occurred which of course all of the nurses ran to the room to help out. Then 5 mins after the pt was sent into the ICU, my confused patient was not responding and the breathing was labored and the only way to check the BP was manually which the systolic was heard in the 50s. I immediately called RRT which then turned into code blue however in the chart the pt had DNR A paper but was not signed. In the end we were able to stand by the DNR because there was an order on the computer for DNR A so we stopped CCPR. This pt was 91 with cancer that has spread and the family member knew the pt was dying. Unfortunately in the end the pt died, this was the first time I experience a death while working. I had to do postmortem care and chart and call the sharing network. I discharged 2 pt leaving me with 1 pt left since my pt expired. I got 2 back to back admissions along with that. Mind you this I forgot all about the Xanax I left in my locked cart. In the end of my shift I usually take all of the meds that weren't given and put it in the pharmacy outbox in which the pharmacy techs pick up. I forgot I had the Xanax in the cart which I put that in outbox. I realized that I forgot to return the Xanax this morning at 4:40 AM and called my RN friend to see if the Xanax was there and she told me pharmacy already cleared the box. Then the night RN told me I was being staff adjusted which meant I didn't have to come to work. I asked my friend who was checking narcotics which luckily was one of my closest nursing buddies and told her my situation and to let me know if there were any discrepancys. She then texted me saying there wasn't any discrepancys, but I'm still worried especially since it's a narcotic. I know for sure that I put all unused meds in the pharmacy outbox but who knows if one of the pharmacy techs saw xanax and took it. I just feel extremely stupid because I didn't check the meds first before putting in the outbox. I just wish I return the narcotic right away or checked the medications I was putting in the outbox. Should I report this first thing in morning tomorrow?

Actually the day after my suspension, I got a job offer on a telemetry unit at well known Hospital. That was just a sign from God. Things work out in weird ways and the very next day I resigned from the nursing home job. Im going to take in this experience and learn from it. Im so thankful that I have a better opportunity at a teaching hospital. Thanks again for the advice

Thanks for the advice, I appreciate it. Im just worried that after this suspension.. the next mistake i do will lead to termination and that scares me especially since I would feel it would be hard to find another job with only 5 months experience

Hello, I am a new nurse working at a nursing home and this is my first nursing job and i have been working since July 2014 and today I got suspended. The patient I was taking care of was very sick to begin with. He was previously in the hospital for acute renal failure. The patient was 99 years old with acute renal failure and for the past week and a half the patient hasn't been eating well. He refused to eat for a good 3 days tried to encourage him fluids, but still refused. He was on aspiration precaution. He is DNR and DNH. On this very day I worked it was my 6th day working straight taking care of 30 patients by myself with 4 CNA's. I checked vitals 5 pm and the bp: 130/38 p:49. I don't know why I should of reported the pulse right away. Around 8: 30pm i rechecked the vitals and BP dropped to 74/50 P:44. I reported this to the supervisor and the doctor. I got suspended because I failed to report my first assessment right away. I wrote the order for the IV around 9 PM and the IV wasn't started till 11 PM. I am not IV certified so I asked my supervisor to come start the IV once i got the order and she came around 10 PM. It took about an hour to start it because the veins kept busting. That very night the patient died. The patient's family and the nurse practitioner and the doctor knew that patient didn't have much time too. I just need some advice. I don't know what to do, i just feel very discourage and its making me rethink of being a nurse. I worked so hard for my RN license and Im so scared that my license will be revoked. I don't know if I should continue with this job or if i should quit before I get terminated. Mind you this 3 days before (thanksgiving) my uncle had a massive heart attack and is still in the ICU and still hasn't woken up. I just need some guidance on what my next step should be.

I have been struggling to find a job for quite some time and I was finally hired at a nursing home. I was skeptical because I don't see myself working in LTC and heard many negative feedback on LTC but i was in desperate need to get some nursing experience and also to pay off my loans and other bills. I had about 2 months of orientation which was great until the last 2 weeks. I had trouble with doing admissions along with my other responsibilities. When I was off orientation for a month I have gotten written up 3 times two were not carrying out orders right away and another for not signing off all meds in MAR.. mind you this some of the meds i forgot to sign was colace or tylenol. I also got in trouble for doing overtime. I also float on different units which it takes time knowing your parents and how they like to take there meds and also treatments as well. I know I need to be more cautious with my med pass and i need to establish a better way for my time management.. however its hard for me to focus on 30 patients to myself on one unit. From working these 3 months..i have learned its a dog eat dog world in which when something goes wrong.. they need someone to blame. Some of the nurses that I work with are sneaky and basically reported me to DON in which I have gotten written up. I had a meeting with my supervisor and my preceptors saying that they will support me through this time and what things i need to improve and if i need help ask them which was great. However i just feel so overwhelmed, stressed out, i find myself not sleeping well, and i rarely take my lunch breaks. If I get written up 2 more times that may lead to suspension or being fired. I really don't want to jeopardize my license. Im debating if I should quit now or wait another 4-5 weeks to see improvement, since my supervisor told me that these next 5 weeks are very crucial for me. This is my very first full time job as a RN and i just feel completely upset with my situation. I really do love being a nurse and taking care of my patients, however I hate feeling this way. I also feel like im being taking advantage because in this month im scheduled to work 7 days straight on different weeks and i have been working 4 weekends in a row as well. Please i just need some advice that will help me through this situation. I just want some input please.

As of now I can live off at a LPN since Im still living with my parents. All i need to pay for now are my student loans and car payments. Im questioning about working the nursing home because i think a 2 year contract is pretty long for a nursing home

I want to get people's opinion about this. I am a registered nurse who graduated last year. I just started working at an agency about a month ago as a home health nurse. Im getting LPN cases and getting paid at a LPN rate with no benefits which sucks, but i just need experience. I was just interviewed today for a nursing home and the VP of HR really liked me basically offering me a job however I need to sign a 2 year contract. It isn't official yet because I still need to get interviewed by the Nursing Director, but I still have a good chance of getting hired. I really was looking forward into working at a Hospital, but it has been difficult for me for the past year. I also had an interview with one of the top hospitals in NY around 2 months ago, however when I spoke to the nursing director recently, they haven't made a decision yet. This hospital interview is for an OR program which I would absolutely love to work for. Im not too sure what to do because if I do get an offer at the nursing home and accept it that means I can't work at a hospital until 2 years later and knowing that I still may have a chance of getting hired at the NY hospital is making me feel frustrated about this situation. I just feel restricted by a 2 year contract at a nursing home. Also i want some input on those who have worked at nursing homes.

I get paid LPN rate and for now im only working 2 shifts a week, but they recently told me that i'll have more cases in the next 2 weeks which will add up to 40 hours. I took this job strictly for experience, so hopefully this will help me land a hospital or nursing job more easily.

I am a RN who graduated in May 2013. I have been struggling to find a job for a year. I recently started working at this agency as a home health nurse. Even though I am considered as a RN, the cases that they have been assigning me are LPN cases. I was wondering if working for this agency will help assist me on finding a RN job at a hospital even though I am not receiving the "real RN experience". I parenthesized that because the experience I am getting is LPN experience. I am assigned to cases in which I would take care of patients individually at there house (this is not considered VNS) and so far 2 of my cases have trach tubes and one is completely paralyzed so I would provide full care for this case. Im working here just for the experience in the hopes of finding a RN job at a hospital or even at a nursing home. I have been feeling discourage about not finding an RN job yet, just need some advice.

I graduated May 2013 and received my RN license in the end of September 2013. Since then I have been struggling on finding a job. Recently I am working for an agency although I am considered an RN at the agency they have been assigning me LPN cases. Do you think that this will help me onto finding a job at a hospital? I still feel discourage that I haven't found an RN job that provides me stability yet.