smash222

Labetalol was a home med, the high BP was new ... And I understand the difference that she was taking the labetalol as a home med, but my thing was the fact that her admitting diagnosis was "hypertension, bradycardia, & near syncope"...

Has anyone heard that labetalol is the only beta blocker that doesn't cause a decrease in heart rate?? I had a patient who's blood pressure was in 200's, heart rate 40's-50's, and nothing PRN. She was already given her scheduled nifedipine, lisinopril, and something else in the ED, and when she came to my floor she was scheduled for the labetalol PO. My computer program gives me a warning if heart rate/bp too low for certain meds, but I knew she was brady anyway so I called the dr. His response was "so what's the issue?? What is your relationship to the low HR and the labetalol?" I said well it's a beta blocker and can further decrease her HR, to which he replied, kinda snickering, "oh really? You think?" All in all he ended up being really rude and told me to give it anyway, it will have no effect on her HR. I asked my charge and a few other people and no one has heard that. I gave it and just monitored her closely, she was tele anyway, but I was just wondering if anybody else has heard this. Thanks and sorry for the long post!!

And I am planning on moving in a couple years, just not quite sure where though.. Any places to stay away from/gravitate towards?

Really?! I would have thought sfl wouldn't be so bad as far as pay.. I know a bunch of girls are leaving my floor cause they just graduated the np program. What is "low" down here?

I want to know what your hours are, what kind of setting do you work in, and what your pay is like, with how much and what kind of experience? I'm a new RN but I don't see myself doing bedside nursing forever... And I want to get an idea of what to expect when I eventually go for and finish my masters.

Forgive me as this might be long but I really need to hear from other nurses.. So I've been at my job for 7 weeks now; it's my first job since graduation. I still have another 5-6 weeks of orientation, but I'm so overwhelmed and making stupid mistakes. I almost feel like I did better in the first 4 weeks of orientation and I'm progressively getting worse. The last week or two I've had a patient load of 5 (the max is 6) and the other day just really made me question my capabilities and love for nursing. My preceptor is great, but there are somethings that bother me and there's a bit of miscommunication because of the language barrier. Anyway, I'll give an example.. The other day I had 5 patients, one was being discharged soon so I sat down to finish her charting. I get a call from someone so while I'm on the phone and charting my preceptor tells me to go through the discharge and do the papers for her. I pointed at the screen and showed her there was no actual discharge order yet, but she just wanted me to do the papers anyway. I got off the phone after a minute and she walked away. Finished her DC papers and we have them to the pt and told her to call us when she had her ride and we would have someone take her down. We went to the break room to eat, come back and pt is gone. No official DC ordered were ever placed. Of course it was my fault, cause I should have put the orders in since the dr told me she was good to go, but I didn't know if I could put the order in myself. Then we came back from lunch and saw two of my patients had overdue meds. I forgot to do the admission charting for my new admit, I forgot to check on the lab results that were drawn earlier for another pt, I forgot to fill out a form for my new admit, etc. I don't spend tons of time with my pts, but she tells me I need to not stay in the room too long and learn to leave quicker when they're talking and asking questions. At this point I'm dreading going back to work and just feel like this job isn't for me. I love it most days, but I feel so incompetent and like I'll never be able to handle it when I'm on my own. I guess I just need advice or someone to tell me this is normal, or that I do suck and look for another job.