kristinc312

Right, I do understand that. But there was at least one case where there was a paralytic given immediately prior to extubating a patient.

The one that really bothers me was where he used paralytics, I believe along with versed to do what I’m sure was a terminal extubation. Why the paralytic? Trying to make it easier for family to watch? Or covering up something? I don’t work ICU or hospice. But that isn’t a normal thing to do, right?

I work as a clinical nursing manager in a 28 day behavioral health/drug treatment program. As you can imagine, a large portion of our patients come in with pending charges, previous convictions, etc. And although we ask during admission pre-screen in they have any outstanding warrants or pending charges, it's not uncommon for them to fib and end up admitted with active warrants. We do not turn our patients in. We've had situations where police are tipped off by a member of the public as to their location, and the sheriff will call and ask if we have that patient. In that case, we do tell them if that person is in our facility. I would think this is something, especially in an ER, that is has a clearly spelled out policy written on how to address. You should check with your supervisor or P&P's for your individual facility for guidance.

I just wanted to add one more thing. Make sure that, as a new charge nurse, you are leading by example. Make sure that you are not one of the ones sitting at the desk playing on your phone. I try really hard to ensure that I display the attitude and work ethic that I expect to see in my staff. I've seen/had supervisors who are not doing anything at the moment, can see that I am busy, and will ask me to go take care of something that they could have done. This makes me lose respect in that supervisor. You could ask any of the staff that I supervise, and they will most likely tell you that I work my butt off. Not suggesting that this is an issue in your case; just my philosophy as a nurse manager.

As long as someone continues to answer those lights, they will be content to "wait it out", knowing that if they ignore it long enough, you or someone else will do it. You need to address them with this issue directly. If it continues to be a problem then disciplinary action should be started.

I went to school to become a surgical tech, without initially planning to become a nurse. I absolutely loved working in the OR, and after a few years, I went back to school and became an RN. The benefit to this was I had a guaranteed position in the OR as a new grad RN. This was important to me, as I absolutely hate med-surg and other areas of bedside nursing. The OR is not an easy area to get into as a new grad. Some downfalls to this route are that I never got the med-surge experience such as managing multiple patients, IVs, patient assessment, passing meds, etc. I think this is a liability when trying to leave the OR in the future; it's hard to explain having been a nurse for X number of years, but unable to start an IV, or know how to complete a med pass. As someone else mentioned, you also need to consider the availability of OR jobs in your area. Many of the people I graduated from tech school with had a hard time finding a job. In a rural area, it may be near impossible without having to commute to a larger city. Finally, you need to evaluate your personality, to determine if you'd do well in OR. It can be an unfriendly environment to newcomers. Very many strong personalities, nurses set in their ways, and many surgeons out there who can be abusive towards staff. It's a decision that only you can make, but I figured I'd offer my thoughts, having taken the route you are now considering. Good luck!

I am a clinical nurse manager at stand-alone dual diagnosis hospital. My DON has asked me to do some brainstorming on how we should set up our annual competency fair. Last year was somewhat of a disaster, and didn't really accomplish anything. There is a list of about 10 topics she wants to cover and we have about 7 people available to teach. i would like to do something that is organized, convenient for both shifts, and is actually informative. Can anyone give me some ideas on how to set this up?

Thanks for responding. I had read that information on the certification site. I was just wondering how they determine if I have worked enough hours. Didn't know if it's something I should be tracking. I would like to take the exam in May if I'm eligible, so I'm just trying to make sure I have my ducks in a row so that I don't find out at the last minute that I'm not eligible to take it.

This is my first time posting on here, but I have a question for someone who is familiar with requirements to sit for CNOR certification. I have been a CST since 2007, and an RN circulator since May 2013. I want to be able to become certified as soon as possible. I've worked part time since May of 2013, and then PRN since July 2014. Will I be able to sit for exam after my 2 years (May 15') without having worked full time for the first 2 years? Also, should I be keeping track of data, such as the number of cases or weekly hours I worked?