kskarzin91

My facility gives $1 more per hour to BSN nurses. Highway robbery comes when you try to get more money for your MSN. Because I believe it's $2 for a freaking masters

Our ice machines are not available to patients families. There is a key code on the door to our kitchen. And we don't use reusable pitchers only styrofoam cups that are single use only. They don't leave the patients rooms. If they need a refill the old cup is thrown away and we bring them a new on. As far as an ice pack they are also single use. I would have no problem if a student filled a new ice pack from the ice machine. If the pack would need to be refilled we would then fill a styrofoam cup and take the cup into the room to refill the ice bag at bedside. I have to side with the student on this one. There's no difference in filling a new pack directly or filling a cup them the ice pack. It just adds another step and honestly I believe adding steps would increase the chances of contamination. But like previous posts have stated the ice never comes in contact with the skin so really it's a pointless argument. I probably would spend time on more important teaching points with students than this.

I think it's weird nurses can not start IVs. Every person with RN behind their name can start one at my facility because of issues like this. All this policy does is delay care and make RN incompetent of a task that is fully within their scope.

We are not required to clock out for lunch. If we do not take a lunch we write it in a book and get 30 minutes of time for it. I take lunch everyday and work a 36 bed med surg unit with 5-6 patients. I make sure my patients needs are taken care of and tell the unit clerk I will be taking a break but will have my phone for questions. Our CNAs can handle turning and basic needs while the nurse takes a break. And then when the CNA takes lunch the nurses do total care until she/he gets back. It is the norm to take a lunch for everyone and if we see someone struggling the charge will tell them to go take a break and cover for them. And normally someone else will help her double team that nurses patients to help them catch back up. We normally have at least 6-7 nurses working days or nights. There's no staffing difference between the two because care is pretty evenly distributed between days and nights. I've worked both. Nights draws all the labs and hangs the majority of antibiotics. And day shift of course does discharges. I was actually busy at night than I am now during the day on most days.

Wait I should add my facility uses PICCs that are approved for smaller barrel syringes. I wasn't thinking that this might not be the case for every facility. Never mind answered my own question.

So why dilute if it's not required to dilute? I mean you can use a 3 ml syringe on a PICC and flush behind it. And it's just fine.

Our epic care plan are hospital templates developed by lovely education department. So you type in COPD and a list pops up with check boxes beside it. Check the ones that apply. Bam done. After that you should chart progressing or complete daily but most nurse click reviewed and are done with it.

Each patient has their own vial of sliding scale or 70/30. And pharmacy sends up lantus. Our unit is a 40 bed GI/ diabetic floor at a medium sized hospital. We give so much insulin a multi dose shared bottle isn't realistic. We'd be ordering a new bottle a couple times a day at least so it works out better if everyone has their own and takes it home with them when they leave.

I've had several speeding tickets and one was doing 60 in a 35 when I was 18. I think at one point I had 5/7 points on my license. None of them have hindered me in becoming a nurse. My insurance was high as heck until they fell off my record though.

I agree I worked nights for over a year and we re in the rooms a lot at night. I also hate waking that sleeping dementia patient to do something. I perfected my ninja nursing skills in those rooms.

Tried to quote but my phone would not let me. She never said the patient was stuck 8 times only that he had 8 IV meds back to back. I think another point of frustration for the patient is that he already had a working IV so the extra stick for the second IV might not have made sense to him. Most patients are pretty understanding about being stuck when their IV goes bad because they know they need one but even if he said I understand before you stuck him he might not have truly understood the rationale being the second IV. A lot of people will say they understand what you are teaching them because they do not want to look dumb. That's why some form of teach back is so important. Now will 8 IV meds back to back i can see where the thought of having a second might be helpful but I'd only stick a second time if I had multiple IVs that were not compatible. Other a 250ml bag and piggy backs or secondary's would be a lot more convenient for everyone. (The IVs you were hanging could have been incompatible I'm not assuming they could have been hung together or that you didn't check I'm just over explaining I suppose )

Ok so what was the point? If you've understood the history or diagnoses of a patient and it is an abnormal finding so you reported it to your instructor. You have done your due diligence. The responsibility falls on the primary nurse. The S3 you have as an example is not an urgent finding. It's not a OMG I have to call the doctor now thank you so much for saving that patients life finding. It's a oh hey that's cool to hear and pick up on finding. Were you there the extent of the shift? Were you present during every interaction the nurse had with the doctor? This is what I was talking about regarding students making a mountain out of a mole hill in the grand scheme of things. That finding while interesting is a small expected finding in a lot of people with different condition. It seems you are alarmed that that finding didn't set off an alarm in the nurses mind and honestly it wouldn't in mine. I can only speculate but considering you were not in that nurses shoes or following her entire patient load you had no grasp at that point in time where her priorities were or should have been. Wait until you graduate and are working to judge.

I went to Augusta tech ADN program and graduated in December 2014. They are not NLN accredited. That accreditation is a voluntary one. As long as the school you are in is regionally accredited you can transfer those credits. I am now getting my masters degree and it hasn't hindered me at all. I work at university hospital and all of my classmates were hired within a month of passing NCLEX. I also work with several students from the graduating class after me and they are all great. If you can survive that program you will do just fine.

Ok First let me commend you on obviously doing research and being knowledgeable about your patients condition. Ok an S3 is abnormal, yes. Kudos on hearing that lub dub dub. What interventions should have been in place? Had the patient had an echo? What was the EF? What past medical history do they have? What was their admitting diagnoses? Really if the patient was admitted with CHF or had a history I really wouldn't bat an eye about an S3. Charted it yes but got worked up enough to call a doctor, no. It's expected. I'd be more concerned about lung sounds. Don't hang a floor nurse out because you found something you think she didn't address. She may not have time to explain she understands your concern but the Team is aware. Students in my past working experience sometimes make mountains out of mole hills. Come up to me like they've seen death when the patient they're following has a bloody BM or vomits or says they re in pain. It just creates extra headaches because the patients read the students face and get freaked out. Then I have fires to put out.

I don't believe there is a culture of blame at my employer. We have a QARM reporting system. It's used after every fall, medication error, sentinel event or any error. There was a situation where a doctor ordered a heparin drip on the wrong patient. It was reported through QARM system. The QARM system is seen as quality control and normally the one who made the error or the person following them who catches it reports it. I've been QARMed by the blood bank before because I drew a type and screen before the previous one was out of date. about 6 hours early. It would have expired at midnight. I didn't feel victimized or blamed. I honestly didn't know that it was policy not to and I thought I was following orders because it was ordered to be drawn by the physician. But now I know. It is use and viewed as a way to make care better. I was talked to by our nurse manager in a non threatening way and it was made clear it was a chance for her to educate me on why I shouldn't have drawn it.