YumCookies

If the patient is alert and oriented, is able to elevated the HOB themselves, and has been educated on the fact that the HOB must be at 90 degrees with eating/drinking I see no problem with it.

Depends. In general, I prefer the forearm and will look there first. In the ED setting: If I need a large bore, labs, and something quick, I like the AC (unless I can find a juicy forearm one). I will go right for the AC if I suspect the patient may need a CTA further down the line. Sometimes, patients come in so dry and dehydrated that the only option they have is the AC! For difficult sticks where I am lucky to get any gauge: I like the hands and wrist, even fingers in desperate circumstances. Yes, it gets valve-y in there, is inconvenient for the patient, and increases risk of infiltration. However, there is little adipose tissue in the hands therefore making the veins a little easier to see and palpate.

I've had patients at risk for urinary retention who ended up having >500cc in their bladder and needed to be straight cath'd when the previous shift tells me "Oh he's peeing all the time." Yes he may be peeing frequently and the patient may tell you that if he is independently voiding but what is his actual urine output each void?

I do. I pushed IV vitamin B once. I couldn't find a push rate in my drug book so I pushed it over 5 seconds or so. I thought "Oh it's just vitamin B, it probably doesn't even matter." Wrong. The patient yelled bloody murder because it burned so bad going in. I immediately unclamped her IVF and it subsided. So yeah, I look it up and if I can't find it I call pharmacy. xD

Hi all, I've been a nurse for about 3 years and have worked at my current position for about six months as a float pool nurse. Most of the charge nurses I work with are fantastic and supportive, however, there are a few that I feel micromanage. How can I make it clear that I'm perfectly capable of doing my job and gain some trust? I've had some issues with charge nurses micromanagement in the past, and it makes me feel so incompetent and disrespected as a nurse. It's one thing to ask "Ok it appears patient is c/o "x", what do you need? How can I help?" vs "Ok what I need you to do is x, y, z." when I don't need that direction and know exactly how to handle the situation. I like to think my co-workers can trust my judgment as I trust theirs. If I have questions or need a second opinion, I'll always ask. This is a floor that I float on pretty regularly so they know me pretty well. Perhaps the charge nurses are just trying to do their job and I'm taking it personally when it isn't? Would really appreciate some feedback on this. Thanks for reading. 😊

I just started doing float pool nursing a few months back - I float to the med surg units (telemetry and orthopedics), ICU, ED, adult psych, detox floor, and day surgery and will take a full assignment on those floors. Most days it feels like I'm flying off the seat of my pants lol...on the plus side I am learning a LOT and I'm not sucked into the unit politics/drama. I also like the variety and I'm having a lot of fun! I was pretty intimidated at first but you just have to ask questions and advocate for yourself if you need to.

I would never accept a patient friend request, no ifs no buts. As far as the name on the ID badge, our ID badges have our full names on them with our credentials. I have covered my last name with a sticker for my privacy - anyone can Google YumCookies RN on the board of nursing website and find out where I live - I'd rather not give them that opportunity. :)

A few months ago, my 80 year old lady rang her call bell to tell us that the patient next door walked into her room, peed on the floor, and left. She was a good sport about it - she laughed and said she just wanted to make sure he was okay.

I go by the mL amount on the tube.

Thank you for posting your experience. The worst med error I have ever encountered was when I had a patient that had an insulin drip on one pump and on another pump had IVF and apparently had an IV med run as a secondary during day shift. When I was about to change the bag of the insulin drip three hours into night shift, I realized the medication attached to the pump was an antibiotic. I looked at the rest of the patient's IV setup and found the insulin bag connected to the IVF as a secondary. I completely freaked out - naturally. I wanted to puke, cry, and poop my pants all at once. Thank freaking GOD my patient was alive. I felt pretty crappy for not catching this sooner but I was grateful the patient was okay. I knew I needed to move on from this to get through the rest of my shift and care for my other patients. Anyways, I think what completely baffled me the most is this drip went on for several hours with two RNs cosigning to titrate the drip every hour, merely looking at the medication and rate on the pump. Since this incident, especially with high alert IV medications, I not only look at the pump but look at how everything is set up. Unfortunately we learn at our patients' expense sometimes, and the best thing you can do is forgive yourself and learn from it.

Interesting - I would've done just this to cover my own behind. I don't want to be at fault if the patient's BP happens to tank after getting Dilaudid.

I would've waited until the patient was back in bed for the above reasons.

About one week, sometimes two weeks. I would keep doing what you're doing.

I read your other post, and I think the bigger issue you need to tackle is your anxiety. How long have you been a nurse? Have you recently started a new job?

I don't know about an ice pack - all I can really think of is bringing ice cold drinks to clinical to keep yourself cool. If personal hygiene is a concern, you could bring a travel sized antiperspirant.