CTnewgrad826

The majority of the hospitals here in CT hire new grads. Try Yale, Bridgeport and Hartford hospital

So I was looking for some advice regarding this situation I've found myself in. I will be moving out of state and therefore began looking for a new job. After sending out several applications I got two calls back from two different hospitals. Hospital A called me back and gave me what I would describe as a pre screening phone interview. From there I was asked to come in for an in person interview which was scheduled a few weeks later. Maybe a week later Hospital B called and I had a phone interview with them where it was decided right off the bat that they were interested and my references just needed to be checked out. A few days later they called saying my references checked out and I was being offered the job. Knowing that I still had a few weeks to wait for the interview with Hospital A, I asked to come tour the facility before I made a decision which they were okay with. So fast forward a few weeks I had my interview with Hospital A which seemed more of a "this is how the unit works" conversation versus an interview and I was explained the next steps of the hiring process and told to get in contact with the nursing manager if I had not heard back from HR regarding my references in a week or two. I decided Hospital A was my first choice and am very excited about the potential opportunity. So now fast forward to the week after the interview with Hospital A, I still haven't heard anything from HR. I go to tour Hospital B as planned and let them know that I'm still waiting to hear back from Hospital A and asked if I could give them a definite answer in about a week. Now I may be stupid for limiting myself to a week but mind you I've already pushed off responding to Hospital B's offer for 3 weeks now. I want to be respectful of their time and get back to them sooner than later. My plan now is to email the manager from Hospital A telling them that I was offered another job but Hospital A is my top pick and ask if they have any update on my application status as I want to be respect of Hospital B's time. My worry is even if Hospital A says they're interested still I won't have an offer by the date I told Hospital B I'd get back to them by. Any advice or input as to what you would do in this situation?

Right time seems to be the most applicable here but if it were to be stopped after 3 doses why did it continue to show up in the MAR for days after the fact? As you stated multiple people involved in this error

Graduated BSN program 5/24/14 Application sent 5/15/14 Received ATT 6/6/15 (after calling BON to expedite process) and scheduled NCLEX that day Studied for about a month NCLEX 7/1/14, 75 questions probably took me about 2 hours Quick results 48 hours later- Pass Started applying for jobs maybe April-May but more seriously in June Interviewed between July and August Hired for first RN job in August, started in September 2014

Are they getting a goods night sleep? May be some recurring delirium. Regardless I would contact the doctor right away as clearly they need to be evaluated further and a med rec needs to be completed. As for the patient leaving if they were to elope, what does the policy say to do? I work in a hospital but I would follow my patient and have someone call security in the mean time. You'd likely have to call the police however if this isn't outlined in the policy. I'd try to keep the patient occupied during the day though. Stick to a routine, make sure they're sleeping at night, walking around and getting exercise during the day. Keep them oriented. Give them tasks to do. Make sure they're eating and what they're eating is good for them.

Those patients should be wearing a gown and gloves when out of their rooms just as we have to wear them into the rooms. Unfortunately sometimes we let these things slide especially for the confused patients as you said.

Depends on how much you make but if you have basically nothing else to pay for (house, kids, etc) you should easily be able to do that within a year. That's awesome you're doing that for your parents!

Wear business attire, change into scrubs for the shadow. Good luck!

I believe the med was sotalol (betapace)

This happened to a patient of mine. Turned out to be related to an older cardiac med but I can't remember the name of it...while it may be something else consider looking into it!

Like you've mentioned it's all circumstantial on the patient. Fingersticks don't need to be checked for metformin as it works differently from insulin as we all know. If they're on a sliding call however yes. BP meds I'd still be hesitant not checking...I don't necessarily check after giving the med though I agree that would be overboard. Finally sats I just stated we check ours only during vital rounds...if your orders are to check once a week then your covered. I had seen you posted in LTC, but now that you've specified the patient population/acuity a bit more I can too specify my answer. And I didn't mean offensive by asking if you were a nurse, hope none was taken! Seems you'll be working with management to come to a better arrangement for every one. Good luck!

Blood pressures before every blood pressure medication...what happens if their blood pressure was 80s/40s and you gave them the med without checking? Pretty sure your patient just tanked... Fingersticks before every meal and bedtime if diabetic, potentially every 6 hours if NPO, on steroids or a couple other circumstances. Again, you give their before meal time insulin without checking first? Into a coma that hypoglycemia patient goes... Sats are only checked at scheduled times during vitals unless patient seems SOB, new onset confusion, decreased consciousness, etc. I'm confused by your post honestly. Are you a nurse?

Great advice above. My biggest advice would be to cluster care. How my shift typically goes is I get report using a brain sheet I've developed to work for me. At the bottom I have empty space to write my "to do" list for each patient with check boxes so I can physically check off when I do something...this includes vitals, tele strip, fingersticks, meds, etc. I then prioritize my patients and go see each one while doing my head-to-toe assessment. This usually leaves me with about 30 minutes to chart afterwards so I get through a couple patients flow sheets. Next I make my first med pass, again prioritizing the patient. Depending on the circumstances this usually takes me an hour to get through all my patients. At this point I typically am able to finish most of my charting including education and notes. I then round back seeing if anyone needs help with their meals or to go to the bathroom, in pain or whatever. I then will go back and make sure I've completed all the orders, read old notes to try to figure out what the plan is for the patient if I haven't already and prepare myself for report off Eventually it'll be time to do another med pass. Finally I make sure my brain sheet is filled out appropriately in order to give report because I refer to mine the entire time, otherwise I would most definitely miss something. Point is, many things such as giving report come in time and take practice! Come up with a better brain sheet that works for you and get yourself into a routine. Know that each shift is definitely not going to go as planned but do your best to go with the flow. Utilize your aides! You can do this! Good luck!

I just wanted to reiterate that you should by no means be "more at ease" next time you do this. Although your patients may be on the same exact drug/dose, giving medication prescribed to someone else is ILLEGAL. Talk to pharmacy ASAP and use only the patients specific med pack until this problem is solved.

By giving a med with another patients name on it you aren't following the "right patient" rule and I think there could definitely be consequences if the state catches this...not sure exactly what they would be but I would definitely be concerned for my license just as you are. I agree with the PP, see if the pharmacy can send up the meds w/o names eliminating this problem all together.