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bgxyrnf

bgxyrnf MSN, RN

Med-Tele; ED; ICU
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bgxyrnf has 10 years experience as a MSN, RN and specializes in Med-Tele; ED; ICU.

bgxyrnf's Latest Activity

  1. bgxyrnf

    Shift Report: Listening, no writing...

    I don't write things down in report because I have a chart to look at which is much more reliable than the 'game of telephone' that is verbal report. I'm just looking for a brief description of how the shift went and any atypical events that occurred as well as an idea of how well the patient responds to nursing interactions. I'm also looking for outstanding orders and overdue meds and anything else that needs to be addressed in the first hour of my shift. All of the details that so many people like to give/get... that I'd prefer to get from the chart which is the ONLY formal documentation.
  2. bgxyrnf

    Blood specimen from iv sites.

    I can tell you something that really pisses off the parents... Me walking into their room and drawing a specimen from the existing IV after multiple unsuccessful sticks by the floor nurses. I'm curious: What's your proposed mechanism behind how pulling blood from a lie might make it fail?
  3. bgxyrnf

    Blood specimen from iv sites.

    Recently I've prevented three needless PICC lines by placing a GOOD peripheral IV with ultrasound guidance which lines were sufficient for drawing blood as well as infusions. The illogical basis of this claim drives me bonkers...
  4. bgxyrnf

    Do you ever get concerned about certain users on here?

    I don't worry about any of the posters here... I don't know any of them beyond what they choose to share on the internet and their stability really isn't of much concern to me. Statistically speaking, there certainly must be posters on these fora who'd warrant DSM diagnoses if examined by a qualified professional. There must be bigots and bullies and narcissists and egotists and on and on and on... it would be silly to think otherwise.
  5. bgxyrnf

    Blood specimen from iv sites.

    Absolutely untrue... and frankly, an illogical assertion from a mechanistic viewpoint.
  6. bgxyrnf

    Blood specimen from iv sites.

    1) And what defines a "hard stick?" -- one aspect of my job is to start lines and draw labs on patients deemed "hard sticks..." many of whom I can get without any difficulty at all. Am I that good (no...) or are they not really "hard sticks?" What an asinine qualifier to put into a quasi-official document. 2) Only an 18 or a 20? So you can never draw out of a line on a kid or infant (not to mention the LOL w/ spider veins)? And consider this... your boss is presumably contending that the typical butterfly needle (21, 23, or 25) are not acceptable... and it's inherently illogical to state only an 18 OR a 20... if a 20 is acceptable then everything larger is also acceptable... Your boss may or may not be aware that arterial lines are most often (in my experience, of course) 22g catheters... and are routinely used for blood draws on critical patients in the ICUs. 3) 10 minutes? This sounds like a random number that's based on sounding nice rather than an objective, data-validated requirement to ensure no hemodilution. 4) Draw and waste 5cc... yeah, that's the first reasonable thing that she's told you... though again, consider pediatric patients whose total permissible daily blood draw can be 5cc. She is your boss, of course, and you should certainly follow her mandates but don't fall into the trap of setting your career practice on what is arbitrary and invalidated procedure. Keep an open mind, read voraciously, and think... does it make sense? Regardless of the articles and my experience, the notion that you can't draw blood from small catheters or from IV lines has never made sense to me, even when I was brand new and was being told this by a senior nurse... and it's turned out, of course, that it didn't make sense because it was wrong.
  7. bgxyrnf

    Blood specimen from iv sites.

    I started that post... and I routinely draw blood out of lines that are days old... The line to which I was referring in that post was >40 days and was still being used for daily lab draws. The only lab which demands a fresh stick is a blood culture set.
  8. bgxyrnf

    Misuse of the ER

    It also frustrates me sometimes. The flip side is that when one of my beds is taken by a walkie-talkie, calm and cooperative patient with a non-emergent complaint, it means that the ambulance rolling in with screaming dude in restraints and covered in feces isn't dropping into that bed...
  9. bgxyrnf

    Mandatory Hurricane Evacuation - Can I be Forced to Work?

    I agree... Kinda like the attitude that caused me to volunteer to be the first nurse contacting a possible Ebola case and then joining the later-created Ebola team. We are part of emergency services and, like the cops and firefighters and National Guard, don't get a pass when things get dicey. If push came to shove and I were concerned about the facility's preparedness - or lack thereof - I might choose to go but I would expect that I might be sanctioned or terminated for said decision. Nobody ever said that nursing is risk-free. Cops run toward the gun shots, firefighters run into burning buildings, and nurses care for the sick and injured - even in risky circumstances. In all these cases, the level of acceptable risk ultimately up to the individual but if it deviates from the assessment of the employer, the government, or the public, there may be unpleasant consequences.
  10. bgxyrnf

    MSN working bedside nursing

    I know several nurses who've gone back to get NP licenses and continue to work as bedside nurses.
  11. bgxyrnf

    Mandatory Uniforms

    I know it seems like it would be helpful but in practice, it really isn't. 1) Most of us know who's who... and even if you don't, the roles are generally pretty obvious... the doc(s) is the one giving orders... and is known by the primary nurse... and often by the rest of the team... the RT is the one with the ventilator... and heading straight to the head of the bed... and bagging the patient... unless anesthesia is there which is very obvious since they're the one with the intubation stuff (outside of the ED, anyway)... the radiology folks are the ones with the big machine saying, "are you ready for us... can we get in here?"... and the nurses... they're the ones pulling meds, repeating back verbal orders, starting lines, positioning the patient and all that other stuff. 2) And the truth is, there are usually far more nurses in the room than there should be... and many of them, at least on the floor, have little to offer outside of running for supplies (a vital role, to be sure) and it doesn't really matter what color scrubs they're wearing... I look up to the nearest person and say, "Could you please get me xxx?" and they say "yeah" and either get it or delegate. Working in a hospital that does have color coordinated unis by role and one that doesn't, it seems to make no practical difference that I can discern. As I stated in my prior post, though... it's just window dressing... I'll wear whatever color they want me to (though I will push for my preferred style and pockets... I carry my equipment in precise locations and have often said to a doc or nurse or RT who's asking for something... "my right thigh pocket... toward the back..." or something similar)
  12. bgxyrnf

    Mandatory Uniforms

    I work two jobs... one has a strict uniform requirement while the other does not. I don't really give a rip one way or the other. They're just work clothes and I'd be just as content in hot pink as I would be in jungle camo While I get an annual allotment of uniforms from the one place, I pay for my own Aviators just because they are a vastly superior product to the Cherokee crap they give us.
  13. bgxyrnf

    What do you hate about nursing and why?

    In both of my facilities, uniforms are also worn by PT, OT, Rad, RT, and clinical pharmacy. In one of them, we're color coded; in the other, people wear whatever they choose.
  14. bgxyrnf

    I made a medication error. What will happen to me?

    It most certainly does mitigate the error. The fact that the patient was fine means that on the broad spectrum of med errors, from very minor to very serious, your was in the lower third IMO. Not all med errors are equivalent and the fact that there was no harm at all is mitigating. Sure, you made a mistake... and it's not OK... but it DOES happen... and nobody got hurt.
  15. bgxyrnf

    Is nursing school really awful?

    I don't know why but a lot of nurses love to perpetuate this notion that nursing school is some terribly difficult, emotionally abusive, and brutal experience. I'm sure that some people do have that experience, just as in every other field, but for many of us, it's not any of those things. I personally found it fairly easy with supportive classmates and instructors. It certainly was much easier than engineering school which was both more competitive, more difficult, and much longer. And in terms of abusive and stressful, it paled by comparison to USMC boot camp. From what I've heard of the service academies, nursing school wouldn't even rate in terms of rigor and stress. My point being, everyone's experience is their own. Some people, and evidently you've met a number of them, experience it to be much worse than did I but I know many nurses who express opinions such as my own... and there is definitely an element of trying to scare the uninitiated. Nursing school just wasn't that big a deal.
  16. bgxyrnf

    Am I Too Old to Go to School?

    It absolutely can be done but there are a couple bits of reality that you need to accept: 1) The time available for a return on investment is relatively short so, depending on your family finances, you should be very, very careful about the financial costs and opportunity costs associated with this decision. 2) Age discrimination is alive and real and ~could~ impact your ability to gain meaningful employment. I would assess your health, fitness, energy level, and even your apparent age and appearance to get some sense of how likely you are to face this (illegal but common) barrier and then take whatever steps you can to enhance/improve those characteristics. For example, in the months before I began job hunting as a new grad at the age of 45, I experimented with treatments and makeup to mask the dark bags under my eyes. I paid for an upscale hairstylist to give me a modern 'do and was very careful about other signals of aging... posture, word choice, and other grooming issues that I normally don't worry about. 3) Health and fitness matter in this profession, particularly depending what you end up doing. Particularly as a newbie, many or most nursing roles entail 12-hr shifts which are spent mostly on your feet. Again depending on the facility and role, you may find yourself requiring significant core and upper body strength to perform the patient care that's necessary. How are your knees and hips and feet and back? Have you ever suffered any kind of back injury or chronic back pain? 4) Touching on finances... are you in a position to fail? What I mean is simply that, with all of us, there's a chance of failing the program, failing to pass the NCLEX, failing to find a job after graduation, or failing to find a good job (this latter was what happened to me). It took me 2.5 years of working 200+ miles from home for substandard wages and even worse benefits in a pretty crappy situation. Fortunately, I was in a position to withstand the conditions until I was able to find something better but I had become very discouraged and was starting to think that I had chosen poorly in becoming a nurse in my mid-40's. As things ultimately turned out, at least to this point, I'm very pleased with my decision and consider it one of the 3 best choices of my life. ~~~~~~~ I am all for rejecting the stereotypes of aging that pervade our culture but, as with all stereotypes, there is an element of truth in them and it's important to honestly assess your personal situation and not just blindly accept the "you can do it!" encouragement that so commonly follows posts such as yours.