mdiada

Thank you SO much for the advice, guys! Honestly, for a while, I felt like this was all in my head, and maybe I was reading too much into the situation. But one thing I was taught as a kid is if someone is in a constant accusatory mindset, more than likely they are guilty of doing the same exact thing. As much as I love my job, it is far too stressful in ways it should not be, and the longer I'm there, the more I realize that. I'm finding out too much is going on that is, quite frankly, unethical and illegal, such as this situation with the other nurse. The clients are great, but this... this is too much. All I know is I worked my butt off for my degree and I refuse to have it put in jeopardy over "she said/she said," especially when the nurse flat-out ADMITS that she took a narc she had NO prescription for (who does that?!?! and WHY?!?! I mean, maybe I'm naive, but WOW!...) -- that just leads me to believe she's doing the same with other meds. So, I've put in several applications to various places, and *fingers crossed* someone will offer me a job soon! In the meantime, I'm definitely still keeping tabs on what's going on in that office. If something else happens, I'm going to have to go to our boss about my concerns. My conscience can't take it.

Thank you guys for your advice. I feel a little better knowing maybe I'm not crazy thinking this way. Another thing I forgot is last Thursday, when everyone in the office left to go home, the other nurse and I stayed after a little while longer to get some meds checked in. She said, "Now that everyone is gone, I want to tell you something..." and she told me that she noticed a pack of narcotics for one of her individual's went missing from her drawer. I didn't ask what med it was or when it supposedly went missing -- for some reason, I end up just stunned with the news about these meds because it's such a huge mess! But what I don't understand is why she didn't make a bigger deal about a WHOLE PACK of missing narcs for her individual?? At some point that individual is going to need those meds so it will be on her to answer the question as to where they are, and she claims she went through a whole DEA investigation years ago with a former coworker who was stealing meds and she NEVER wants to go through that again, but I just do not understand her response to this. And honestly, now I question whether anything is ever missing vs her just making things up to divert attention away from her? If that makes sense?? It's really difficult to gather any hard evidence except for what she says, and we are still working remotely from home a couple days through the week so I'm not always in the office when she is and vice versa. From the day she mentioned taking Adderall that was offered to her, I began taking notes. No nurse in their right mind, especially one who dealt with the DEA directly, would take narcs for which they have no prescription themselves. Do you guys think maybe it would be too soon to bring up my concerns to my boss? My concern is something is going to happen and I end up more involved than I want to be.

Oh I am, believe me. Especially after yesterday when I do believe I caught her off guard asking about the Adderall. Thank you for the advice!

My apologies for this being such a novel! There's a lot on my mind and I'm not sure who or what to do at this point, so I'm going to let it out here and maybe one of you wonderful people can offer some advice. I've only been a nurse for about a year and a half, but managed to land a job working as an RN in an office-setting managing the medical care side of 30+ individuals. There is one other nurse who was hired earlier this year. When management picked her, I was ecstatic because she brought SO much nursing and leadership experience to the table that I frankly lack, and she has taught me SO much ever since. We balance each other out really well, and it was wonderful. Until I started noticing some things. Early on, I noticed she was very accusatory of others and argumentative. For instance -- she accused me of going through her desk (we share an office room), and she wasn't really rude about it, but she stated that she had noticed some things on her desk moved around on several occasions, so of course she blamed me. Well, I understand why she would accuse me because we do share an office; however, I am not the only one with access to our office, and I really have no desire to go through anyone's things, so I point blank told her I never go through her stuff. What got me she had rummaged through another person's desk to "borrow" an ethernet cord. I didn't realize where she had obtained this cord until she told me. Now, I'm not the one to start drama by ANY means. Typically, I stay to myself and stay away from all the drama, even though that makes me out to be a sort of oddball to everyone in the office. I'm not there to start crap-I'm there to take care of my people. But the fact that she went through someone's belongings to "borrow" (steal) a cord just really threw me. Then another instance. We receive medications from our pharmacy routinely, and one of her individuals had a pack of antibiotics that were sent in and then discontinued. Rather than waste those antibiotics, she kept them in her narcotic drawer with the excuse of "you never know when someone might need those" and "they're just antibiotics." Granted, yes, they are "just" antibiotics, but they were not HERS to keep. As a nurse, I really do not care what medication it is, if the medication has been prescribed for someone else, they are simply not mine to take. Maybe I'm too black and white with that, but that's how I see things. Anyway, so a few weeks later, about the time she accused me of going through her things, she said the antibiotics had come up missing from her drawer. I simply shrugged my shoulders because I honestly had no idea where they were. Then, not too long after that, we received medications from the pharmacy as we usually do. Some of them were narcotics for her clients, and this was a day she was not in the office, so I simply locked them in her narcotic drawer and left a message for her stating what I left and where. What was odd, though, is I noticed in the back of this drawer was a pack of antibiotics stashed away. It was the same pack she said had gone missing. I didn't say anything, didn't do anything, because I didn't want her thinking I was "going through" her things -- I was just placing narcotics in her drawer. So I just shut the drawer and locked it and let it go. Some other things have happened, but I'm going to focus on the most recent, more concerning incidents. We have a med tech/med runner in our office whom this other nurse has become relatively close with. She knows more about the med tech than I do, that's for sure. Well, several weeks back this nurse told me in private that the med tech/med runner had offered her extra Adderall that her son had left over when his meds had changed. Her reason is she believes she has ADD but her doctor will not prescribe the meds for it just yet, so she took a couple Adderall, and halved them. I was stunned but I kept silent trying to figure out what to say. I don't have a single bit of proof and it'd be her word against mine, so I'm really not even sure who to go to. I wasn't even sure if this was something she was simply telling me to see if I'd go to someone about, if that makes sense. I have been keeping my eyes and ears far more open around her, and this passed weekend I thought of something. We have coworkers who are coordinators over our individuals. They assist us in quite a bit. Well, one coordinator is under the other nurse, and their individual had a prescription for Adderall which was discontinued and changed to Ritalin about a month ago. Last week, the med tech and I were discussing this coworker of ours and how this coworker has yet to bring in the discontinued Adderall to our office to be wasted. The other nurse was out of the office that day, so the med tech asked the nurse if the Adderall had been brought back. According to the med tech, the nurse said yes and that it had been wasted. Thing is, I never signed off with her that those were wasted. We do not have an electronic system that requires two nurses ID's to waste medications, we use paper. And I never signed off on those. So yesterday, I asked this nurse nonchalantly if that discontinued Adderall had been brought back, just to see her response. Her first response was no, but then she stopped, closed her eyes, shook her head and said she wasted them but they were never brought in to the office. Once again, I had NO idea what to even say. I'm just overwhelmed with this right now, and maybe I'm thinking too much into it??? Yeah, probably not... but then I got to thinking and I wondered if she said the med tech gave her Adderall when really she actually took what she "wasted," and I'm not close enough with the med tech to ask her anything about this. This is the same nurse who claims she's been through the ringer with the DEA over previous coworkers stealing meds and she values her license too much to jeopardize it. Why would she admit to taking nonprescribed Adderall? While I am very black and white on prescription meds, keeping the discontinued antibiotics was one thing, but taking Adderall??? And why would she waste Adderall that never touched her hands? If that Adderall is missing, I sure has hell wouldn't sign my name to a waste sheet when it never reached my hands. I would try to get to the bottom of where it is and WHY it hasn't been brought back TO be wasted. Guys, what do I do if all I have are statements with no other hard proof of anything going on? Remember I haven't been a nurse for very long, and this is the very first time I've ever experienced something like this, and to put it lightly, I'm VERY concerned!

Does anyone know of any good RN to MSN online programs with decent tuition?

So I am going into my second week off of orientatjon, and I literally go in every night preparing myself for the day shift nurse or night supervisor to list all the things I had done wrong the previous night. I had 6 weeks of training, but honestly the first week was the only true training anyone gave me. After that, the nurses who were with me basically left me on my own, so when I has questions, I never knew where they were. And I made several mistakes through training, which, after I broke down twice in front of the supervisor, I was told that whatever mistakes were made were actually on the nurse who was with me. That didn't help much because the way they were acting left me feeling harassed almost. There is just so much to process every day, and the population I'm caring for is made up of people woth disabilities - it is so far from the hospital setting that 99% of my clinicals were. I mean, is it normal to feel like a failure every day?? Will this ever get better? I beat myself up over every mistake because the very last thing I ever want is to hurt my patients in any way. But I cannot get over this feeling of being a failure 😔

I'm sure I'm not the only one to ever go through the wide range of emotions that come with graduating nursing school. But honestly, I don't ever remember being this scared about anything in my life. In just a couple weeks, I will be graduating from nursing school. I already have a job lined out that is on the same floor I've been on as a Nurse Extern and a CNA. Last summer, I externed on the floor and my preceptor went to the manager about how well I did with the patients, and that led to a formal job offer as a CNA from the manager herself. Now the manager has wanted me as a nurse ever since the beginning of this semester, which I accepted, but the nervousness and incredible fear of actually being a nurse is finally taking over. Everyone in my class is much more outgoing and talkative than I am, and they are all so excited about getting on the floor. I am much more shy and quiet and still have issues with confidence. It makes me wonder if my personality is even cut out for this. Plus, I'm so terrified that once I'm on the floor, something will go wrong that I will have missed, or I'll end up freezing from being so overwhelmed. Does anyone have advice on how not to psych myself out completely? Even better, are there really any nurses who are more shy and reserved? All the nurses I've seen throughout school are more A-type personalities, so it has left me even more confused

I'm doing my rotation on the cardiac floor and need help with thinking of at least three learning experiences and activities to achieve those objectives. I'm kind of at a stand-still and any help would be appreciated. Thanks!

So, I've FINALLY made it to the last semester of nursing school!! So far my classes are going really well, but what a long road it has been... In about 2-3 weeks we will be starting our practicum hours. Does anyone have any advice on what to expect or do? I know it will be different from regular clinical days. What I'm worried about is that I have never been able to do much of anything during clinical except hang IVs, pass meds... I haven't even been able to catheterize anyone! I simply never had patients that needed things like that. And now I'm doing the 120 hours, and I'm nervous that I don't have enough experience to even do the hours, if that makes sense. Can anyone offer words of wisdom or a simple "calm down, you got this"? Haha, thanks!

I know the steps to CPR have changed -- compressions first, then give breaths. But we just had a test in my Med Surg class that had a particular question that, to paraphrase, said: "you come across an unresponsive person lying on the floor, what is the FIRST thing you should do?" the answers were along the lines of: 1. shake the person and shout loudly 2. check for a pulse 3. check for breathing 4. i forget what this answer was originally, the answer was "shake and shout," because of course, you have to check for responsiveness FIRST. but the phrasing of the question (i.e., "unresponsive") threw everyone off and we all figured that if you know someone is unresponsive, then surely you have already done the "shake and shout." needless to say, my teacher thankfully accepted another answer. but the answer she accepted was to check the pulse. the way i was taught just two months ago at the hospital i work at was that you ensure unresponsiveness, check for breathing, and then check for pulse. which one is it?

Thank you for the help! I appreciate it so much! But to be honest, I've already done the Google search with inpatient vs outpatient, and like I said, I may just well be overthinking this (which always seems to happen!), and I've found nothing. Literally nothing. The only thing I can think of is that in outpatient setting, trach care may not be as sterile as it should be, like it is in the inpatient setting. Thing is, my teacher requires references for all this information, and as of yet, I've found not a single thing that really states any differences between the two, not even when using the databases. About to pull my hair out, haha!

Please? :-)

So I'm working on a paper regarding trach care, and one of the questions asks to compare outpatient and inpatient care. Maybe I'm overthinking this, but can anyone tell me what the differences are and/or provide a link where I can find the correct information? Thanks!

Yes, we practice quite often. But another thing that got me was the doctor's order I used to check off with simply had two medications that were IV. Neither one said IVPB, so right off the bat, and as silly as it may be, it confused me so much that I couldn't think. I was unbelievably nervous, as well. My anxiety has gone through the roof this semester. We have only skilled off twice so far, but both times I have failed. My nerves were NOT this bad last semester! Nothing I do helps, either. í ½í¸• I don't know what to do.

Please tell me there are other nursing students who fail their skills the first go around!? First semester, I failed only one skill, but this semester I've failed every one. I don't know what it is. This past time was over IV push and IVPB. I did really well on IVPB, but I was sooooooo nervous drawing up the med and read 1 mg to 1 mL, and idk how, but obviously it caused me to fail. Ugh!!! With each failure, I can't help but question if I can even do this. This whole semester I've questioned it, and even my own parents question it which makes it so much worse. :-( I just really need to know I'm not alone in this, that there are great nurses out there who failed numerous times and still succeeded. :-(

For some reason, I'm getting so confused by IV pump settings, and I *know* it's easier than what my mind is making it out to be. For skill off on IVPB, we are all going to have one 100 mL bad of fluids to use, so that already gives us the VTBI. But what about the rate? For example, if Meropenem is being used, and the rate of administration is supposed to be over 15 to 30 minutes, then what would the rate on the pump be set to??? I'm sorry in advance for such a silly question, but so far this semester, IVs have totally messed with my mind and I can't ever get a handle on them! Thanks! :-)

So if a 250 mL bag is available, and the order is 200 mL for 2 hours, what would be the VTBI and what would be the rate?

I am so very confused by the IV pump and i don't know why. Ok, so if the doctors order states 200 ml for 2 hours, what would be the VTBI and rate? Someone please explain this to me!!!

Is there anyone else, be it a current or former nursing student, who has severe anxiety? I know in my heart that nursing is my calling, but this anxiety is almost getting the best of me. I totally freeze during clinicals and even when skilling off. Tests I do fine in, but the actual application is what throws me off. I'm so worried it will be my downfall. It's not that I don't know the information, it's that I constantly second guess myself and absolutely freeze. :-( anyone else have this issue and how do you not let it psych you out?

So Monday begins my second semester of nursing school and I am absolutely nervous as crap! My classes are Med-Surg I, Pharm I, and Behavioral Health. I was told by others that if I can make it through Nursing 101, then the rest will be cake. Well, I have a hard time believing that. I was literally just ONE point from earning a B last semester, so I don't think I did all THAT well, considering we only had one class -- Fundamentals. My questions are: how do you even begin to study for Pharm? What has helped you guys in ANY of the classes? What about Med-Surg? What advice would you guys give me to stay afloat this upcoming semester?

"Bad" as in just totally had an off day and every little small mess up you could make, you made, with the teacher around to witness. Today was AWFUL. Every move I made, there my teacher was. It wasn't on purpose, I know. But still I don't know what was going on with me, but I am extremely bummed out by it because the last few, while I was not perfect, I still did pretty well. By the way, this is my first semester of nursing school. Really, just some encouragement would be great.

Yes, that is what I was thinking, but what got me is we just had clinicals recently, and someone in my group was in this exact same position with a patient having those symptoms, and the first thing our professor had her do was check blood sugar. It makes total sense that getting blood sugar up is the most important, but my answer was really based on what actually happened in my group. I will keep that bit of info on NCLEX in mind. That helps a lot, actually! Thanks for that! :-)

So I just took my fourth nursing exam, and one question asked about a diabetes patient who had symptoms of lethargy and weakness. Well, two of the answers made sense, with one saying to ch3ck the blood sugar first, and the other said to give sugary foods and whatnot. I finally settled on the first answer of checking blood sugar, and it counted it wrong. Can someone explain to me why it wouldn't be appropriate to first check sugar levels before doing anything else?

I cannot remember if the med administration window is 30 minutes or an hour before and after the scheduled time. Can someone shed some light on that for me? Thanks!

Last night was my second night as a CNA. I have had my license for over a year but I worked at an Assisted living facility. Ok, I am not the greatest and I get that, but the way the nurse was last night almost makes me want to not even go back. People have to start somewhere, no one gets a job no matter what it is and the education they had and automatically remembers everything or does everything right. But that is how I felt last night, like they were angry because I made mistakes... I am new!!!!!! Ugh!!!