Meeshie

Is it possible that she doesn't want her kid to talk to other kids with diabetes and realize that they have more autonomy over their disease care than she does? After all, it would be mighty inconvenient if the kid started bucking the system the mom set up and talking to other kids with the same disease but differences in how they do their care might spark that. So if kiddo doesn't realize there are other kids then....... Ya know?

CPMs have become popular in certain parts of Florida because the laws are not friendly for v-bac patients. You can't v-bac in a birth center - you need an OB and a hospital. However, a good portion of providers in some areas won't agree to v-bac so..... patients that want it are going to CPMs or lay midwives for home births.

It's reasonable. Those antibiotics are unlikely to impact the results and the fluid from the chest tube isn't the same as sputum but..... I thought Mexico vaccinated? If they have that vaccine scar then they'll always test positive and since I know darn well the patient has had multiple chest x-rays (and if they showed a TB issue someone would have said) then... so, it depends on if he has the vaccine scar.

Safe Harbor doesn't exist but here's the thing - every single state has somewhere in their laws that hospitals have to provide safe care. It's just one of those things. So when hospitals don't? You can do something about it.. it's just hard and it sucks and it takes every nurse standing up. There was a hospital in Florida not too long ago - they tried to make a med surg department go to 10 patients per nurse. The nurses refused on safety grounds and they were fired. A major nurses union stepped in (not theirs - the hospital didn't have one) and offered to sue on behalf of the nurses using safety as a rationale. They won the lawsuit. The nurses got their jobs back and back pay and the hospital couldn't flex that far again. Am I recommending going that route? Not for a new nurse without contacts in the hospital. But what I'm saying is - it's possible. Its just hard as heck. The hospital is called Monroe Regional if you want to google the case.

My first two years nursing I've done three hospitals. I stuck a year out at a large organization that I hated. It was disorganized, the ratios were awful, management was difficult to work with, turn over was very high. I went to a smaller hospital closer to home and it seemed better for a little while but in many ways it became worse when season hit. Safety just wasn't a priority for that hospital at all and the amount of sentinel events and deaths was a bit terrifying. Since then life has changed. I'm at a large network and I work a pretty high acuity and I'm happy with what I do. A lot of the happy as to do with my co-workers and management. Moral of the story - big and small can all have problems. In less than three years I hopped through three networks. Is that ideal? Probably not. Still - you do what you can live with. If you're miserable and you can't live with what you're doing? Find something else.

You mentioned a union at one point in all of that. If there is one - then you can request a rep any time your manager wishes a private meeting that could impact your job. Weingarten rights. However, if you feel that you are not able to grow in your current position then you should begin the process of applying for other positions. The goal is always to give excellent care. If you cannot do so there then it's time to job hunt.

DNV is interesting. I worked for a hospital that had DNV as their regulatory agency. One of the more interesting parts of it is that it rounds yearly on the hospital instead of biyearly. That means that the hospital is almost all in a cycle of "getting ready for inspection." Not really a bad thing in some ways but kinda annoying in others.

My advise to you is that if you do decide to go with a residency and a contract - take the contract to a lawyer. Not all of them are actually legal or enforceable. If yours ends up being one that isnt then it becomes much easier to break. "Talk to my lawyer" tends to work wonders if you decide you want out of the contract for some reason.

Google the words "New grad rn residency job" and plenty of hospitals will pop up that are happy to take on a new graduate and train them.... for a contract with an obligation to work a certain amount of time.

As long as the cite you use gives you something you can print out.. you can print it on your computer as a pdf and then upload it. Generally speaking, I use NurseCE4Less for all my CEU needs. It doesnt automatically transfer but it gives me the certs to upload and you can buy a year membership pretty cheap.

Often time over count discrepancies are caused by pharmacy. They stock and then update the count wrong or forget to update.

That.... looks pretty normal. I wish it wasn't but..

If this is really an issue for you I'd avoid oncology, to be honest. I did women's oncology and ran into a few patients we scheduled for abortions, even later term ones.. knowing that you have a very small amount of time for treatment for a fast moving cancer can cause patients to make a variety of decisions and abortion is one of them. Not to be morbid but I even had one patient that was awaiting chemo treatment the next day who had the bassinet in her room with her child that had aborted late term enough for this to be an option, so she could say a final goodbye before she started treatment. It happens.

I read another article on this. It was pretty specific in that it said that the child had not yet been declared brain dead and that the final test would be done the next day prior to removal of life support. So.... not brain dead.. not a miracle.. just science.

I live in a tourist area so we have "season" above and beyond the flu season. During season we could live at work and no one would complain. I had a 137 hour biweekly paycheck a couple of months ago and that was low compared to some of my coworkers. However on off season? We make our 3 shifts a week, most of the time. Sometimes we get put on call for one of them. The money difference is hard but you get used to it or you pick up a second job somewhere else.

They're changing the NCLEX again. It's in the testing phase now. It will be 100% case studies and not only will students have to pick the correct answer.. they will also have to pick the correct rationale to prove that they understand what they're answering. Roll out in 2019 at last guess which means anyone entering school now will be facing the new exam but the schools aren't teaching for it yet since the board hasn't released anything official to use. So that'll be fun.

At my facility we send the patient down with the unsigned (but filled out, if possible) consent on the front of the chart. We know the surgeon isn't coming to the floor to explain anything so....

Policy varies widely hospital to hospital. When I worked on an inpatient high acuity oncology floor we typically ran PRBCs at around 2 hours as long as we had good access or the patient had CHF or fluid overload issues.

That one is slightly easier than the program I was on. And yes, it's as hard as it seems but you can do it if you really want to.

There's no way of knowing. However, you're not as likely to see something like "what is this?" as you are "This is the EKG of your patient, which medication is contraindicated?" Or "You patient is on blahblah medication, the EKG is this, the vitals are this. What do you need to do?"

Make an appointment to speak with your manager... and then.. ask. "Given my years of service and excellent record I'd like to discuss the possibility of an increase in my pay" Be prepared for a no. You don't always get a yes. Be prepared for a plan B if you get a no, too.

You're right that nursing is a 24 hour job. However, your next shift already has 12 hours of work to do. If you find that the shift previous to you is leaving a lot of things undone for you to do and it's a consistent issue then you need to say something. It can be as simple as "hey, don't forget to hang that mag that was due before you leave please?" If it keeps being an issue then the charge has to get involved. It also helps to not leave patients with the expectation that something will be done at 6 if there's no logistical way that that's likely. "I'm sorry but there won't be time to do somerandomthing at that time. I could come back at 5 and we could do therandomthing or we could do it now while I have time." It they don't like either option then them refusing is also an option. I realize that both the things I put down require some level of assertiveness and that they can make people uncomfortable to do at first. However, some assertiveness becomes necessary.

Practice makes perfect. The more of them you do the smoother it will start to go.

Maybe they mean ECCO cert from the AACN (for the crit care one)??

Call other schools and see what they're willing to do and if they'll take any credits? They may not be willing to do anything but you won't know unless you ask.