AbigailJo

Good luck Kathy! Let me know if you hear anything!

Hi all, I've applied for NYU Adult-Gerontology Acute Care Nurse Practitioner Program Spring 2020. I received an update today stating I've been waitlisted. Has anyone else experienced this? Any idea how many people apply/get accepted? I'm curious how long it will take them to accept or reject me. I am still holding on to hope, as NYU is my 1st choice. Any insight would be welcome. Thanks in advance. Abby

Awesome suggestions! Thanks so much for your thoughtful insight!

Hi all, I’m currently working at a teaching hospital in NYC that is very good but slightly disorganized when it comes to workflow. I am trying to brainstorm how it could be improved. From my perspective, the residents are very overwhelmed and completely unsupervised on nights. When they admit patients there are usually no “standing orders.” It’s very much thrown together. Simply a diagnosis, diet order, some home meds, and a handful of things specific to the patient like oxygen. This leaves the nurse with no choice but to call the resident each time the patient requests something. “The patient has a headache, could we get an order for Tylenol” etc. How does your hospital handle this issue? Do you also have to call each time you need something? Or do you have a system in place to prevent this? It seems extremely inefficient for both the doctor and the nurse to constantly have to page back and forth for simple things that could be anticipated. Thanks in advance!

The reason it "keeps coming up" is because band 5 is $33,500 usd. My question is about the fact that where I live, I'd be around the poverty line at that salary. I'm asking what's different between here and there that makes that a living wage there. Hopefully someone else has some insight on the answers to this.

Hi everyone, I'm curious about living in the UK on a nurses salary. Is it worth going through the paperwork and visa process? I saw someone say that the salary is NHS band 5 which is around £25,551 a year, which is $33,500 usd. This seems low. How does this compare with the cost of living in the states? Is it lower in the UK? Can a single person live on a nurses salary without being in a stressful financial situation? Thanks in advance!

Hi all, disregard this message. I found someone at work who let me interview them!

Hi all, I am currently in school pursuing my masters and one of our assignments is to interview a nurse who has a degree in informatics. I work night shift and it's difficult to find someone at the hospital to interview. I was hoping someone here would be willing to answer a few questions about their job. any help would be appreciated! Please give me a little background about where you work, what your job description is, what you went to school for. Please include your official job title. Types of nursing information expert may be considered but not limited to, Nursing Clinical Information Manager; Super User, Director/Manager Clinical Education; Chief Information Officer; Quality Assurance or Performance Improvement Nurse; Nurse informaticist, Nurse Abstractor, Compliance Nurse. It doesn't have to be extremely specific if you'd like it to be more anonymous. 1. What degree did you pursue to get your current position? Please include any relevant experience. 2. How do you value "best evidence" and do you believe it is valued as a way of providing care at you job? 3. What safe guards and/or decision making support tools are embedded in patient care technologies and information systems that support safe practice at you job? 4. What are some technologies that have improved patient care. 5. Name some groups in the hospital that depend on data/informatics and how. 6. Please tell me what challenges you have faced in dealing with other disciplines who may not understand the need of nurses/nursing 7. please share an example of how garbage in/garbage out impacted a decision related to your information/data collection 8. Please give me an example of how the lack of inter professional collaboration impacted your role 9.Please describe a typical day for you in this role Thank you for your help!

Thank you all for your replies. I didn't realize this was such an uncommon practice. I am new to IV medications and the people around me act like this is proper practice. I will contact the pharmacist tonight and write down her recommendations. In addition, I do have access to Lexicom. I'll use this going forward to compare with the orders I receive.

The patient had normal saline running at 75 ml/hr on a peripheral line. She was NPO and yes I had lab values. No tele. None of our IVPB orders come with rates. I was told by my nursing manager that this is is how it's done throughout the entire hospital. When I asked the charge nurse if I should call the doctor to ask him the rate, she laughed and said how would he know he never hangs IV meds. This is why I came here, to get help. The order was for: 1 bag Sodium Phosphate 3 mmol/mL in a 50ml bag 3 bags Potassium Chloride 20 mEq / 100 ml 3 bags Magnesim Sulfate 2G / 50 ml I was told by the charge nurse to hang the sodium phosphate at 25ml/hr.

Hi all, I have recently started working on a Med-Surg floor. Most of our patients have many IVPB, but the problem is we are never given the rates to run them. Or worst yet, the rate listed is wrong. As some who is new, it's very scary to me to think I could possibly run something too fast. This morning, the doctor ordered one sodium chloride, 3 magnesium, and 3 potassium. The only one that had a rate was the sodium and it was 50ml/hr when another nurse told me it should be 25ml. I ran everything very slow out of fear of running the sodium and potassium too fast. The result was, I had only hung 2 of the bags before dayshift got there and I could tell she was annoyed that I didn't finish them. She pointed out I could have gotten another pump and ran more than one at once... but wouldn't this mix meds? How is am I suppose to know the rates? What are some IVPB you need to run slowly? How do I know what I could run at the sametime without causing an adverse reaction? I'm so worried about causing a problem for my patient, and I also want to be a thoughtful coworker. Thank you for your help.

Hi there, I am going back for my MSN this fall, and I'm wondering if there would be any opportunity for a Public Health RN-MSN to join an organization full time and assist the planning and execution of trips abroad. I have always been interested in serving undeserved areas of the world in the past, and have volunteered out of the country before. I am trying to find a way to bridge my desire to get a masters and travel to assist people in developing countries. I just need to find the pathway. Thanks in advance for your help, Abby

It just depends on their situation. I am grateful for Excelsior. It took me 2 years to do the prereqs and the nursing courses including the FCCA. I am currently on the CPNE wait list. I would have rather done a more traditional route, but the reality is I couldn't. Working full time, this was the best option for me. I also have student loans from my LPN and wanted a route I could pay cash for. This was far and away the best financial option. It's not perfect, but there are ups and downs to every school. It just depends on what you need to fit your own lifestyle. If you're able to take time off work and pay for a traditional school, that might be a better option.

Another home care nurse here, and yes we do it. We usually take them with our phones and email them to the Doctor. Our patient knows and watches me delete the photos after I send them. The doctor comes only once a month and I do wound care everyday. They need to be updated frequently and they want a photo. The patient's name or any identifying features are not included. It could literally be anyone in the world as far as someone seeing it could be concerned. I have to look out for my patient. For the Doctor, he thinks the best way to closely monitor it is via photo and I agree.

Thank you very much everyone for your advice! I have left this case and told my nursing manager exactly why. Thanks again!

Thank you for your help!

Libby, this is amazing advice. Thank you so much for your help!

I need to vent. I work in home care for a medically fragile child. I love it. I love the family and the staff. We do not clock in and out. We simply write our times on our notes and they must line up with the other nurses since they won't pay two of us at once. The main day shift nurse and I have bonded and I really like her as a person. She is an excellent nurse. We are in the same RN program and I gave her all my study material and videos I bought for $300. I truly like her and I want her to succeed. However, she chronically shows up 15-60 min late day after day. The family has asked me more than once to "cut her some slack." She's a single mom. The previous night nurse even went as far as to not document her proper times and didn't get paid for the extra time she was here covering. I refused to do that. Ok, I'm not a heartless person. I get it, she's trying to get her kids to school. And if it's once in a while, fine. Anytime I bring it up that I am not ok with constantly staying over *everyone* says, "yeah but she has kids." Why is my time less valuable than someone with kids? She can come and go as she pleases? She can't be the first nurse in history to have to get her kids on the bus before work. Also, I am working 14 hour shifts for the next two months because she has to leave 2 hours early to get her kids from daycare. I complained to my job and they talked to her about making her shift start later so that she could get to work on time. I am fine with that if it's scheduled. She didn't want that. But yesterday she showed up 70 MIN LATE. She didn't even text me until she was 40 min late to say she's be there soon. So, I came in at 5pm stayed until 9am because of her tardiness, then had to come back in at 5pm to do it all over again! I really like her, and I don't want to ruin a nursing friendship especially with someone I see so often. Im not a fan of awkward shift reports. I don't know what to do. If I report her, I look like a child hating jerk. If I don't I have to accept that I'm getting walked all over because my life is somewhat less because I'm not a Mother. She's putting me in such an awkward position! I feel like I can't win! Any advice is welcome!

Hi all! If I'm giving cool mist over night to a trach patient and run out of "sterile inhalation water" am I able to sub "sterile water for irrigation?" is is there a difference? Will it harm my patient? Thanks!

Have you been studying the syllabus? Or something more? How do you feel about the information so far?

Hi all! I'm suppose to be taking Reproductive health at the end of the month and I am really struggling to get started. This will be my 5th exam. Could anyone share their experience with me (within the limits of Excelsior) so I could get some motivation? How it compared with other exams, how long you spent studying it, ect. I tend to put things off that scare me. Reproductive Health has never been my strong subject. Which is pretty discouraging since I would love to work in L&D some day. Thank you all very much for your help and support. Being completely online and feeling isolated, these threads have helped me immensely!

Awesome job! This one was more stressful for me then some of the nursing exams. You're on your way to putting those two letters next to your name! Congrats!

Yes, I believe he wants to die but will not go on palliative care because it's against his wife's wishes. It's a very sad situation. He was a person who had a lot of control over his family and business and now has no control. Thank you very much for your comments! :)

I'm so sad and suprised by how many negative and scarcastic comments this post got. I asked for help and advice from veteran nurses, and I was mocked. This patient declines total care from our nursing staff. He gets no oral care, no bed baths, no hair washes, he lays in soiled sheets and shirts for days, no range of motion, he is on a ventilator and gets no cough assist, no chest percussion, no nebulizer treatments, he refuses all bowel medications leading him to go 7-12 days before evacuating (unless he gets a bowel obstruction and then refuses enema/suppository/ER), he will not allow to be turned, he has pressure ulcers that he does not want dressed that are now tunneling. I could go on and on and on and on. Does he have a right to refuse treatment? Absolutely. Do I have to participate in his death by refusal? Absolutely not. The doctor I work with put it perfectly, "it puts you in a tough spot, because your job is keeping him alive but he's refusing anything that will" I never implied that I wanted to "chain him the the bed" to preform care. I actually said that I was thinking about leaving this case. As for getting too close to this case, yes I'm sure I did get too close. It's very hard not to when you work 40-50 hours a week with someone for 3 years in their own home. That's not a crime, simply a reason to change cases. Which was politely suggested by some, and I'm very grateful for this. In the end, I documented my little heart out. And I put in for a transfer. I still care for my patient, nothing can change that. But now I'll do it from visiting and phone calls. Thank you very much for everyone who took time to answer my question!

Thank you for your thoughts! I'm not able to PM back, but you've been very helpful!