nrse76

Oh no...I know I could never just leave without relief (that's illegal right?) but it just seemed like no one cared except for me.

So...had my first needlestick today in an LTC. I'm just curious...when a needlestick happens at your facility what is the process because I feel like my facility really let me down. I'm a new grad so after it happened....the only though process in my mind was OMG. After going to the doctors, I found out that theres a one to two hour window in which HIV medications can best be given and they told me I should have left the facility as soon as possible. Now, of course if someone told me this, I would have pushed as hard as I could for anyone to come and relieve me of my shift right at the moment it happened. But, I told the supervisor I had to leave for the appointment at urgent care for 2 pm (about three hours after the injury). I was told to be there at 1:30 pm so I told the supervisor I would have to leave at 1 (which would have been 2 hours after the injury). Someone from the workman's comp hot line notifies the supervisor that I have an appointment at 2. So what does the supervisor do? I find out she tells the relief to come in for 2 pm. I can't teleport so I don't know what she was thinking. With narc count and report, I wasn't out of there until nearly 3 pm. She just says "ohh...sorry" Shouldn't the supervisor have relieved me of my shift...or the DON, or ADON...someone RIGHT AWAY.

Ok, thanks. That is what I meant- keeping each dose separate (like if the patient needs two ativan pills, crush those together but don't crush them with a tylenol too,). Is using the plunger to push the meds through the g tube via syringe alright (or does it have to be by gravity)?

I work at an LTC (new grad) as an RN and my employer told me they want to "quiz" me on med admin through g tube so they're going to watch me do one. I believe the patient I have has A LOT of meds through the g-tube, including gabapentin (which is in the fridge). So with the liquids like gabapentin and keppra, do I also mix them with warm water (just regular warm tap water?) So, please correct me if any of these steps are wrong. 1) get patient's vitals 2) look at MAR -go to the fridge first to get gaba - get a cup of regular, warm tap water 3) look at MAR again and find rest of meds (pop them out of packet without touching them wile making sure its the right dose, time, patient, route, and med) 4) individually crush each pill- how much water do I mix each pill with? 5) keep all meds in separate cups, including liquids In patient's room: 1) wash hands, get more warm water from tap if needed 2) put on gloves 3)tell patient that I will be giving meds- place towel on patient's stomach 4) look at patient's id bracelet 5) listen to patient's bowel sounds 6) check placement of g tube by putting about 10 cc of air and listening for the swish 7) do I need to check for residuals? 8) start with 30 ml of warm water in syringe, give a med,then 15 cc inbetween each med, and end with 30 mL A FEW QUESTIONS: 1) what about patient that would need like a 240 ml bolus of water, too. Do I do that before or after giving the medications? 2) Also, or g-tubes, is it okay to push the med through by syringe (it's not by gravity right? 3) do you suck the meds up through the syringe and go back and forth by closing and opening the port ------ or do you take the plunger out, give a med by the top of the syringe, put plunger back in and push the med through, take plunger out, etc. ?

So, I've been orienting at an LTC, which I've had a few problems with. I work part time days. Originally, I thought I was only on the subacute floor but then they wanted me orient a few days on the long term floor. Now, its come the time to get off orientation. They called and said after three more days of orientation on subacute, I'm going to be working on my own on the long term floor on saturday and sunday (which I've had about three or four days orientation there). The thing is no one ever told me I would be working the weekends like this. It always seems like I'm the last to know or the story always changes. How are weekends different from week days?

In the past week of just waiting and not working, I've seriously considered quitting just because of how unprofessional they are being. But wouldn't it look really bad to other employers to quit so soon? How would I explain this to another employer without seeming like I'm the problem? Without proper training, I'm really scared to make a mistake in the long run. I never imagined being trained by a nurse who has been a nurse for 4 months. She seems like she knows what she's doing for the most part but can't answer the more critical thinking questions I have or questions about what a certain med does. They also have paper charting and only two computers at the desk (and if the MD and NP are at the desk- which they often are, you can forget about those computers). I got a tiny slap on the wrist for being on my phone while trying to look something up about a med(really tiny- just a "don't use your phone")! How do they expect me to learn? I'll never get anything done if I have to lug a med book around all day. I'm already slow enough trying to make sure everyone gets the right pills.

So, I've been orienting at a long term care/ rehab for 9 days all together (over the course of 3 weeks). 8 of these days have been on the subacute floor and 1 on the long term floor. I'm a brand new RN with no previous experience- nothing! not a CNA or anything, which I told them during the interview. Within the last week, the staff coordinator apparently moved from full time to prn because she got a new job. I haven't been orienting this whole past week (not going into work) because she didn't call me back after trying to get in touch with her countless times! She basically forgot about me. So I finally call the receptionist, who directs me to the regular scheduler who asks me if I just want to start working already, which I politely replied that I was not so she gives me one more day on the long term floor. So the coordinator finally calls me yesterday and says to just talk with the DON about my orientation status, which sounds just odd. During the interview, I specifically asked how long I would get to orient because I'm starting from scratch. The assistant director told me 6 weeks, which I thought was very reasonable. Now, it sounds like they just want to push me onto the floor. To top it all off, I started orienting with a knowledgeable 16 year LPN. But after a few days, they told me I couldn't orient with him for absolutely no reason--- this LPN even asked the supervisor about it and she gave no clear answer. They put me with an LPN who got her license about 5 months ago (we both graduated at the same time but she got her license and started working about 4 months before me) I guess i get the whole routine of working there but there's things like wound vacs, trachs, that I dont have any clinical experience with. The paperwork is probably the most confusing part! I also never had to deal with 14 patients at once--which can be overwhelming depending on their needs! So, what do I say to the DON? Am I being unreasonable for wanting more orientation when I was promised 6 weeks? and wanting to orient with an experienced nurse who can answer my questions?