LargeMarge

Hi KCMnurse, I am just curious if you ever made any headway with this ? I am currently in my MSN and struggling so bad with the practicum/preceptor issue that I am actually considering trying to transfer to another program where maybe I would't have such a hard time finding a preceptor. Let me know if you had any luck ! Thanks, M

Thanks for explaining this, I saw that scene when I was very tired and loosely paying attention. I didn't know what the heck he was doing...

You have to document that the patient states they are unable to swallow the pill whole and it can't be crushed. Sometimes people can swallow the pill whole but coated in applesauce or pudding, but most likely they can't and to be on the safe side, you probably have to seek an alternative. I usually call the pharmacy first and see how else the pill can be supplied, liquid, suspension, or perhaps a capsule that can opened if appropriate. Then I call the doctor and tell them it needs to be ordered differently and give them the options I have already discovered are available from pharmacy. The doctor may not be aware of what the options are or what is specifically on the facilities formulary, so by getting the options for them you're hopefully saving them a step and getting your new order in place quicker.

About the time when your brain goes to mush......You know how patient's can't really see your face very much when you are wearing an N95 mask ? Well, I was just discussing with my coworker how this patient was completely blind, not partially blind, blah blah blah. Then she said she knew her from many years ago and went in her room to say Hi. 20 seconds after just acknowledging she was completely blind I said " Did she recognize you with your face covered by the N95 ?" of course she didn't she can't see..... doh.

Removing anything to do with oxygen or suction is a huge safety issue. If a cardiac arrest was to happen in the 2 minutes after she removed a critical piece of equipment, before the next nurse was around to "do their checks" that would COMPLETELY fall on the crazy manager. If I were you, I would contact your Risk Management department and relay all of this to them. She is putting patients lives at risk. I understand the concept of what she is trying to make happen, she is just going about it in a completely terrible and unacceptable way. Also, what does it say to the patient who see's this psycho removing important things from their room, obviously it won't make them feel comfortable and that their team is working together to keep them safe and provide great care. I am so sorry you have to deal with someone like that.

I think it helps to make sure you adequately hydrate while you are working the night shift and eat light, protein rich meals or snacks during your shift. I try not to eat when I get home in the morning, but also not go to bed hungry so that can be tricky. I usually have a good protein shake about 0500 that way I can get to sleep by 0900. I also try not to drink caffeine after 0200 at work so that it won't keep me up while I try to sleep during the day. I use the DOHM sleep machine and that has been a huge help blocking out noises like people cutting the lawn during the day and barking dogs. I also sleep with a light fan on and use a puffed out sleep mask since my room isn't completely so dark. If I wasn't so lazy, I would totally have blackout shades because I think that is ideal, I just haven't gotten around to that yet. I also HAVE to have really happy uplifting music on my drive into work, it will get me out of whatever funk I may have fallen into. Try to stay positive and remember, this isn't forever :)

I agree with the advice to start as a CNA. There are many opportunities for CNA jobs with flexible shifts and overtime if you want the money. You might not be able to at first, but eventually you might get a CNA job that has tuition assistance for their employees going to nursing school, so that would be helpful. Just plug away at the classes you need to get into a nursing program and then when that happens continue to plug away at those classes. With dedication and organization, you can do it :)

I love this :)

When was the last time you had some "me time" ? Vacation and nursing conferences have always helped me get back in tune with my true self at work. I think it is good to vent, especially here where many people understand and have probably had the same feelings at some point.

Between my current and last job I have seen both done, but I think if they are regularly receiving something that is not compatible and they have decent veins a second IV would be a good idea.

I agree you are only asking to be hung out to dry if using the "I was only doing what I was told" excuse and for your own protection find out the specific policy regarding what is allowed in what units. Doctors often have no idea about those things but you can bet they will always hold the nurse accountable. We were never allowed to send a patient out of the ICU to the floor with an A-line, cordis or any form of a stopcock in place. Too much risk for infection, bleeding out etc. and not fair to the nurse who might receive that patient on a unit with a lower level of care and no training on how to care for that line. At least now you know and can pass it on to the next nurse.

At my previous job 2 years ago the policy was for the nurse to rotate the ETT once every 24 hours and it was the night shift responsibility to do it and document.

It sounds like extremely poor management which is unfortunate because there are many positives to bedside report. I have been through 2 different hospital roll outs of bedside reporting and both were pretty bad. Is there anyone the nurses can complain to about how this is being handled ? Maybe your manager needs to be coached on how to talk to her nursing staff.

Hi, I'm writing a paper and have a little section on correctional nursing. If anyone has the time to answer these few questions, it is much appreciated. 1) What do you perceive as major concerns for the population you work with? 2) What is your typical day like? (and what type of facility) 3) What are your job duties?