Sweetheart2005 ASN

Sweetheart2005 has 9 years experience as a ASN and specializes in Med surg/tele.

Sweetheart2005's Latest Activity

1. 

   What should I wear to pick up paperwork on my day off?

   Sweetheart2005 replied to medapop's topic in Nursing

   I wear whatever I’m wearing for the day. Just not like a slob or too revealing as others have said. Typically for me it’s jeans and a T-shirt.
2. 

   Pediatric vaccine gone wrong

   Sweetheart2005 replied to Kazed's topic in Nursing

   I’ve been out of family practice for five years now, but almost always went with the thigh up through age two as my injection site of choice. Seems easier to hold the younger ones effectively. I agree with the others. Some of these kiddos are strong! The other nurse should have stepped in to assist in restraining and provide specific instructions to dad on how she wanted him to hold. This was a difficult situation, and sounds like you did nothing wrong.
3. 

   Orientation. Advice on precepting

   Sweetheart2005 replied to Sweetheart2005's topic in Nursing

   She’s had two others before me. I know one of them discussed same concerns with the educator. Educator, management and charge nurses are aware of the situation. I was working a day with one of her other preceptors and she had addressed concerns while I was there with the charge nurse. I was nodding in agreement as I saw the same things. They say write these things down. Keep a log. Ongoing things that have been told to her time and time again. I do feel it would be helpful to keep a log regardless. As we go and discuss both as we go and find a time each day. It will help keep me better organized, focused to discuss barriers of moving forward. Even as a set aside a time for same day discussion with her. This is not the first time I’ve precepted. I typically love precepting. This one is a very difficult one, that has me about to loose my patience, and I’m usually an extremely patient person. I’m not criticizing to make myself feel better. I’m sorry if it’s coming across that way but that’s not the intent. I’m truly just extremely frustrated with the issues with the progression and concerned that not only she will drown but harm someone or not catch something that leads to harm in the process.
4. 

   Orientation. Advice on precepting

   Sweetheart2005 replied to Sweetheart2005's topic in Nursing

   Yes, and several of us have voiced the need for additional orientation that have precepted her. We have a new grad program where for the first two weeks that one of our best floor preceptors has a couple new grads and essentially floats. A couple med passes, assessments, requests the floor nurses to check availability to hang secondary IV meds, just the hands on pop up skills to transition into the orientation. She also takes time in the skills lab and focuses on educating different topics: stroke, cardiac stuff, respiratory etc. and how to care for them. They are confident in several skills. I mentioned a day to float might help. Do admissions, secondary lines that pop up. It won’t help with managing g a day, but she needs to know how to do these skills to work them into her day. Hopefully we can do some.
5. 

   Orientation. Advice on precepting

   Sweetheart2005 replied to Sweetheart2005's topic in Nursing

   I do coaching as I go. The intent is absolutely not to ty and have her fail without helping her out. Thank you for sharing that it may come across that way.
6. 

   Orientation. Advice on precepting

   Sweetheart2005 replied to Sweetheart2005's topic in Nursing

   I address my concerns as soon as possible in real time. One example of safety, she was giving lopressor to a patient, there were no ordered parameters and the heart rate was low. She planned to just give it rather than review history of heart rate and possibly question if it should be given. Thank you for your suggestions. Staying patient is becoming very difficult but I will try.
7. 

   Orientation. Advice on precepting

   Sweetheart2005 replied to Sweetheart2005's topic in Nursing

   Being an experienced nurse it was supposed to be 6-8 weeks, but it’s likely going to be 12 weeks. We will not be able to be assigned less patients. (General culture of how it works) and there are days half of the nurses have an orientee. Most new grads. Best I can do is take anything above what she takes on my own and watch with the others. Shes been taking the assignment for several weeks. When there is a very stable group with minimal need to call the doctor, communicate changes with the care team, she can do most of it. Anything that interferes with the plannned schedule and routine seems to be where the problem happens.
8. 

   Orientation. Advice on precepting

   Sweetheart2005 posted a topic in Nursing

   Hi experienced nurses. I’m a 5 year med/surg tele nurse at a community hospital. It’s A large unit. I just started precepting a new hire/rehire about three weeks ago. She’s at week six already. I’m told she’s been working at an office as a health coach, but was in hospital several years ago. shes been out of the hospital 8 years. Any tips on getting her better up to speed? She doesn’t seem to be getting it! She’s very good with the routine head to toe assessment and charting the routine daily required documentation, but that’s about it. It gets as basic as making sure she pulls two pills instead of one...always has to run back. Minimal critical thinking, time management skills, Where to find meds not just stocked in pixie, and some other everyday skills (discharge education, secondary bags often antibiotics, especially when not with current fluids and programming flush bag is needed) Responses to attempts at guidance is usually me repeating five times for her to still not get after multiple times with skill.... next day, five times explanation of same common skill. And “oh!” Like she’s heard it for the first time. I’m frustrated. Prior preceptors of hers experience same frustrations. I’m starting to keep a log of these to turn into educators and manager.
9. 

   Managing incontinence in the hospital

   Sweetheart2005 replied to love lilacs's topic in Nursing

   We use briefs and check out incontinent patients every two hours, more often per judgement if indicated, or if a patient is able to know they’re wet and tell us, when they say so. In combination will use barrier creams on those with known incontintinence issues. Those with more severe skin issues that briefs are a problem, we drape chucks around them almost like a brief but much looser
10. 

    What are your views on switching days with people?

    Sweetheart2005 replied to DesiDani's topic in Nursing

    It depends on what the person who’s asking is requesting and how it effects my schedule. If it’s something important (family need, appointment) and the person doesn’t ask often, I will agree to switch even if it inconveniences me if at all possible. Mostly I’ll switch as long as it doesn’t inconvenience me too much or benefits me. Especially with those who will try to return the favor. I’m for a person who will never return the favor, I will only switch if it benefits me. I’ll ask for a switch at times, but if I know far enough in advance I’ll request a PTO or unscheduled day.
11. 

    Extra Person Wearing PPE

    Sweetheart2005 replied to Sophie Garcia's topic in Nursing

    It may anger them it may not. It wouldn’t bother me, but my hospital is doing well for us as far as covid stuff goes. Not perfect but better than many. Do you know Which patients are likely to need a PICC in advance? I know the IV team at my hospital usually have a really good idea a day or two before, just don’t know when orders will be placed or if it’s for sure or still deciding the need. If you are worried about the frustration of other nurses and know what is anticipated, if there are mostly non covid that need a PICC I would say have her join you. If there’s one that is, would she have access to a computer? Maybe you could give her assignments related to IV therapy to do during that time? Something interesting to keep her occupied. don’t you need a second set of hands placing the PICC though to pull off the turns are? Then I would say take her in (depending on your PPE policy).
12. 

    Switching units

    Sweetheart2005 posted a topic in Nursing

    I’ve been feeling like it’s time to try something different. I work in a community hospital on a medical unit (we have two med surg units, one is focused more on medical, one more focused on surgical but we do overlap patient types sometimes) With hospital changes with covid, we merged into one unit and created a covid unit (non critical care need) and have been bouncing metered the two mixing up staff. I’ve been getting several surgical things. NG tubes, things that would more be on the surgical side and I’ve been enjoying them. I’ll pull a surgical nurse for diagnosis specific questions or assessments I’m unfamiliar with, but much of the tasks are similar between units. I'm currently dayshift, but I do some flip flopping and pick up on nights sometimes. Not particular on which 7-7 shift I work. any advice? There’s currently a part time night shift available (I need full time) and suspecting a night shifter might go part time in a couple months. Should I contact the manager or the charge nurse to put a bug in their ear? I’m very interested in moving over there for a bit of change in patient diagnoses, learning something new, but don’t want a drastic change in settings.
13. 

    Non-patient care nursing jobs

    Sweetheart2005 replied to Ashley.edwards26's topic in Nursing

    What about family practice? It's more task oriented and routine. Lots of vital signs, blood draws, immunizations and phone calls (test results, scheduling, prior authorization and triage). Where I life there's s pretty significant pay difference between the two specialties though. Many duties are the same as a medical assistant.
14. 

    Alarm fatigue

    Sweetheart2005 posted a topic in Nursing

    I work on a med surg unit at a small community hospital. It's a 43 bed unit, but onenofnknmy two med surg units in the hospital. Bed alarms.are always so sensitive. We used to have a policy that allowed for nursing judgement. A patient who was alert and oriented, fall risk.and ringng appropriately and waiting on assistance to get up did not need a bed alarm. It was per nursing judgement. Now we have a policy which everyone that is a falls risk isnon a bed alarm. This is my first RN job and in the hospital setting. (i worked in a PCP office as a medical assistant and LPN) is this common practice? Also we recently changed our bed alarm system. We had them hooked into the call bell system, like a regular call bell. We also have a staff assist alarm, which we use for emergencies (codes, rapid responee, falls--anythjng we need more nursing hands immediately) Bed alarms are noe hooked into the staff assist alarm. It's already started the point t (after 2-3days) response to the staff assist is a slower when we see a nursenor aide isnin a room of a known impulsive patient. Any thoughts on suggestions to management,? Patients are worried and confused sleeping even less, and thiknirs a fire alarm.or something.
15. 

    Burning out

    Sweetheart2005 posted a topic in Nursing

    I'm a med surg nurse in a small community hospital. I have about 2.5 years RN experience (medical assistant and LPN in a family practice prior) I work the medical side (medical and surgical is divided in my hospital). We occasionally get surgical patients, but not frequently. My shift is 3am to 3pm. My choice of shifts. I feel I can prep better for.my day and know patients better before families and doctors are asking questions It's a 43 bed unit. The goal is a 5-1 nurse ratio, but it's consistantly been a 6-1 ratio. (7-1 or even at times 8:1on nights, assignments switch and bump at 7am when traditional dayshift.starts). Our unit is consistantly full, our charge nurse is supposed to be free but often has to.take a full assignment. There are two Ides on the unit. Patient t aquity is getting heavier. Sadly, I am one of the experienced nurses until 7, depending on which all is working, the next in line may have 6-9 months experience. Several of us have been working overtime on a regular basis. Time and Half and bonus pay isn't enough anymore..its a nice incentive but jot worth our sanity. (they they can't force anyone to work extra hours). Some days I want to look for a new job, others I want.to stay. I like med surg nursing. They have hired, jut tends to be they hire one, one or two get ready to leave before that one is off orientation. I love my coworkers and we're a great team, but it's becoming more stressful. I dont know if I'm looking advice or just venting to nurses who may have been in a similar situation.
16. 

    Helping Med/Surg Nurses

    Sweetheart2005 replied to annemariemiller's topic in Med-Surg

    You will have a preceptor for a period of time. Do you know how long? Ask questions when you don't know something and be observant. Request assistance from the other PCT on your unit when you need an extra hand (large patient, limited mobility) or the primary nurse taking care of them. Nurses over see PCTs but they are not your boss. They should respect you and your time. Also respect the nurses and their time as well. We can do your job, we can't do yours. Some nurses do others won't. I always appreciate if I ask a nursing assistant to do something and they are swamped that acknowledge the request and if it's gonna be a while let me know. I know they're busy but I don't know what all they have on their "to do list" Patients tend to appreciate taking a little extra time when you can. Let Them know your available to help them.