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I agree with Whispera about going to a family doctor. I was diagnosed with ADHD in high school and have been taking Adderall since then, and to this day I have never been treated for it by a psychiatrist. There are a lot of family practice doctors in my area that specialize in or treat ADHD. If something were to happen and you had to take a drug test you would definitely need a current prescription. I would probably take it anyways because YOLO, but that's probably not the best idea when it comes to protecting your license.

Our spinal drains are placed by anesthesia or neurosurg in OR and managed by vascular surgery post-op. We also level and zero at 4th ICS midaxillary line per our protocol.

I also work at a large teaching hospital and come across this occasionally. We have a doc on call on our unit, so I just page them to come suture it.

I agree with the PP, and would like to add that if you have questions, you need to ask them! Even if she is going too fast. Pull her aside and tell her she is going too fast for you to learn, and then ask the questions you need to ask. She might not even be aware she is going too fast for you, and she will never know if you don't tell her. Unless you are going so slow that it creates a problem with time management, she will most likely make adjustments for your learning style. However, it's not acceptable to have been there for a month and still be afraid to touch a patient because you have no idea what you're supposed to be doing. I don't mean to sound harsh, but preceptors on my unit would start questioning their preceptees' abilities to be assertive and a safe nurse (if they hadn't started questioning that already).

I don't know what I would have said to him, but I definitely would have notified my charge RN, who would have then called the police (my hospital has its own police department) and notified management.

This EXACT same thing happened to me when I was in my ICU internship as a new grad. All I remember reading on that vial was 50 mcg/ml…completely ignored the "2 ml vial" part. And I definitely pushed all 2 mls when the order was for 50 mcg. Thankfully nothing happened to my patient! Definitely a learning experience though!

YES!! I hate having to travel with my patient. Even if it's a quick and easy CT head (takes less than 20 min to get there and back). Don't even get me started on MRI and IR. Having to leave the unit to get anything besides food/coffee makes me want to die.

Intubated patients tapping on the bed rails to get your attention ...and the doc won't give you any more PRNs for sedation/pain. I. Can't.

What was the rate of the fentanyl?

I work in the ICU, and have bags of fentanyl, versed, etc. hanging "unsecured" when a patient is on a continuous gtt for pain/sedation. The only pumps that require a key to access are the PCAs and epidurals. All other narc infusions hang on the pole just like NS and IVPBs. I've never thought about the security of that before now, but as far as I know there haven't been any incidences of someone grabbing a bag of fentanyl off the IV pole and running out (at least at my hospital).

If a patient is alert and able to state their name, date, where they are, and why they're at the hospital then they're A&Ox4. This is assessing their neuro status, not their mental status.

I work in an ICU and we hang it via gravity and run it wide open.

From the Texas BON website: [h=1]Licensure Eligibility[/h]To check your eligibility for renewing your license, please review the following: Been convicted of a misdemeanor? Been convicted of a felony? Pled nolo contendere, no contest, or guilty? Received deferred adjudication? Been placed on community supervision or court-ordered probation, whether or not adjudicated guilty? Been sentenced to serve jail or prison time or court-ordered confinement? Been granted pre-trial diversion? Been arrested or have any pending criminal charges? Been cited or charged with any violation of the law? Been subject of a court-martial; Article 15 violation; or received any form of military judgment, punishment, or action? NOTE: You may only exclude Class C misdemeanor traffic violations Source: https://www.bon.state.tx.us/licensure_eligibility.asp

We also do this in the ICU I work in, minus the code meds (don't get me started on that one ). All patients are hooked up to the portable monitor and VS are continuously monitored by the RN when transporting patients to a procedure off the unit or to a med/surg floor if they have tele orders. We also can't travel alone - either a tech, RT, another RN, or MD must travel with us. A patient going to the floor that doesn't have tele orders isn't hooked up to the portable monitor and a tech can transport them without an RN. Our RN to patient ratio is 2:1, so when I leave the unit with one of my patients I give report to another RN on my other patient, and I try to give report to a nurse who's patients are relatively stable. When tele patients are transported to the ICU they are disconnected from their tele monitor, connected to the lifepak monitor from the floor's crash carts, and transported to the ICU being continuously monitored by the rapid response RN. The primary population in our ICU is surgery/trauma, so many of our patients are younger and often without extensive cardiac history or other comorbidities. However, I have never thought twice about putting any of my patients on the monitor when leaving the unit.

This right here says to me that this unit/facility doesn't value their employees. Maybe I'm "spoiled" by working in a large hospital that has a lot of resources, but I think it's ridiculous for you to have to find a replacement for your shift under these circumstances. Especially because you notified your boss of the situation as early as you possibly could - like, you could have just called in sick, but you let them know what was going on like I'm sure you're encouraged to do. Don't go to work and go see your grandmother. You made an effort to find someone to cover your shift, but you couldn't. Like a PP said, take the write up and keep your head down for a couple months. Family comes first. It sucks that this unit/facility isn't more understanding of situations like this, but I would rather get written up than miss being with my dying family member. I don't know what the job market is like in your area or if this type of behavior is typical of hospitals/etc. in your area, but I would start looking for a new job.