Stacey1234

My answer will probably take more than one person. I work in acute care so that is usually available 1 open the patients airway ABCs 2 vital signs. Since you will need this for calling the md 3 notify md since you will need orders for meds 4 Epi subq 5 Benadryl oral 6 methypredisolone iv oxygen will not help if the airway is blocked and iv access will not help if the patient is not breathing Immediate action is necessary and these questions are tough. As always the right answer is not right. The most correct answer is right a la nclex

I have been trying to find the answer to this as well. Unfortunately I couldn't find any real evidence or a proper explanation of the mechanism behind the process. I am orienting on a surgery floor and after telling my mentor about my patient with a slightly elevated temp, she asked me what I had done to reduce it. I told her I had given Tylenol and taken off some blankets. She asked me what else I couldn't have done ... I suggested using cold compresses on the neck and chest (I remembered doing that on my peds rotation) she said there was one more obvious answer but I was at a loss. She said that deep breathing and using the spirometer could reduce fever and looked at me puzzled like she was amazed I didn't know that? I had never heard of that before and tried to find it online. She brought it up while discussing my progress and she saw it as me lacking knowledge of nursing interventions. I still don't see how it would work other than improving lung function and reducing chance of infection. But I don't see how it could rapidly reduce a fever!

Last week I heard other nurses talking about a peg tube to suction. I am still very new so I inquired and said that I had never heard of that before. The other nurse (also new) seemed as though it was completely normal, but I thought it was odd. Looking back on the situation I probably thought it was strange due to the reasons you mentioned, damage to the mucosa etc. From what I'm reading online it seems like a rare and short term occurrence.

I feel your pain. I am not even done orientation and I already feel like walking out!

I can totally relate to your experience. I am currently orienting on a busy surgical floor. We are underfunded and are frequently understaffed. I am having a really hard time finding my stride. Yet the other new hire orienting with me is well on her way and so far has been very successful. She always seems to know what is going on when I am lost. My preceptor is very busy (last shift we had 18 patients to manage, since we were short two RNs, which she says happens often). She was so busy and I felt like I was very little help to her, she didn't give me any patients to care for, I think she didn't want to have to worry about me messing anything up. I don't feel like I am learning what it is like to have a full patient load or even a partial patient load. I have three weeks left of orientation, but I don't feel ready at all. Although I preceptored on a surgical floor. It was on a very organized unit with better nurse/patient ratios. I am finding myself falling apart on this unit. I have my doubts about my ability to be successful on this unit. I am trying my hardest but feel unsupported. My mentor even snapped at me last shift and it was a confidence killer. I'm hoping I can make it by the end of orientation but I don't think this unit is a good fit for me. I guess it happens from what I'm reading in this post

I just started my first nursing job. I moved to a new province and I can't believe how different it is from what I'm used to. I've never done anything other than verbal report, on my new unit the charge nurse does the recorded report, most of the time you can't tell who they are talking about or can barely hear them ( a lot of the unit nurses verbalize this). There are no kardexes so I find myself starting my shift and having to look everything up on the computer for each patient and make my own notes. There is no handover and the night and day nurses don't even see eachother before leaving, so there is no opportunity to ask questions. I am still orienting so I am hoping I will get used to it? I just don't feel like it's safe or effective. Any tips for a new nurse starting out in a new environment ? I made myself a kardex-like form, I think I'll start showing up at work early and filling it out before report.

I just started orientation on a surgical floor that does team nursing. It's ok on day shift (1 RN and 1 LPN share 8 patients) but on night shift its totally different. On nights there is only 1 LPN on the unit. The RNs start out with 9 patients, do assessments and meds until 2400h THEN it changes to team nursing where 2 RNs share ten patients. ( you end up losing half of the patients you had before 2400h and gaining new ones). The meds and bells are shared between the two nurses and I find myself answering bells, giving meds to patients and charting on patients I barely know anything about. I feel that there is no accountability and I am not providing patient centred care. My unit has very high turn over and I'm starting to figure out why. I would much rather have my own patient load and get everything that needs to be done for them. I am still new to the floor so I am hoping I can get used to it eventually.