prinsessa

I have worked all shifts and 7-3 is my favorite. 3-11 was too difficult because I never got to see my kids. I was always exhausted when I worked 11-7. I like 7-3 because I can still get home relatively early and the day goes by so quickly. I like being busy all the time. 11-7 could be busy at times but there were those nights where time didn't move.

But you should call the doctor first and get an order to hold it. If one of my patients is going for surgery, I will call the doctor in the morning (if there aren't already orders) and ask how much Lantus they want given before surgery. Many times if a diabetic patient isn't eating the doctor will order IV fluids and still want you to give the Lantus and sliding scale (if appropriate).

Don't feel bad. I have seen very experienced nurses hold Lantus without a MDs order. That being said, you should never hold any insulin without a doctor's order. If one of my patients is running low, I will sometimes call the MD to see if they would like to adjust the dose of insulin. A lot of the time the MD will say "Change the dose of Lantus from 25 units to 20 units." We have changed to giving Lantus in the morning at the hospital I work at. Sometimes if I don't feel comfortable calling the MD, I will call the pharmacy and ask them questions about meds.

I don't mind working the holidays but it annoys me to work a holiday and not get paid extra for it. For example, if you work Christmas Eve or New Years Eve, holiday pay doesn't start until 3 pm. I work 7-3 so I don't get holiday pay for either of those days, but I have to work them if they are my holidays to work. Not so bad if you are going to someone's house for either of those days but forget having something at your own house. We celebrate Christmas Eve so I usually switch with someone and end up working Christmas.

It depends on how long you have been working for my hospital. You start off with 24 days/year for full time employees. PTO includes sick days, vacation days and mandatory holidays (for employees who get holidays off).

When I worked at a SNF, one patient's cytotec came up missing several times. The DON asked several of us if we know anything about it. She also asked what it was used for. All I knew was that it was used for the stomach. I guess it can also be used to stop a pregnancy. I had learned that in nursing school but didn't really remember the other use. We had to start counting the cytotec every shift because I guess someone was stealing it. It is really unfortunate that someone would do something like that! Plus it just made more work for everyone else.

I haven't worked on many units but the least stressful for me was Mother-Baby. Yes, you can have 8 patients but I felt like I actually had time to do education. This was my final semester during nursing school so I wasn't technically a nurse yet. And most of them didn't take many medications. Most difficult was LTC. Try to handle 30 patients at a time. There would be times I would have to send several patients to the ER during my shift, plus try to give everyone meds at the same times, AND make sure no one falls! I really think that job is impossible!

We use tegaderm. It drives me crazy when someone applies a patch and doesn't document where they applied it or when. We even have a spot on our eMAR for notes. And the note will stay at the top of the MAR until someone else edits the note (we use EPIC). There have been quite a few times that I don't know a patient has a fentanyl patch until the patient tells me or I actually see it on the patient. So dangerous!

Become friendly with some of the doctors you work with. I know quite a few RNs (including me!) who got hired at the hospital I work at because a doctor recommended them.

I had patients who looked like they could die any second and it turned out to be a UTI. And the strange thing was that all vitals were normal. Not even a low grade temp. I have called MDs before and said "so-and-so just doesn't look right. Can we get a U/A with culture and some labs?" I have never had a MD say no. They know that we generally know our patients much better than they do....especially if they are just the doc on call.

I'm really good with dealing with difficult families/patients. Plus I remember random information from nursing school

I work on a skilled care unit in a hospital and we don't even give IV push meds. We remind the MDs that if the patient really needs IV push meds, they don't belong on our unit. Usually they will switch to PO meds unless the patient really needs to be transferred. I'm usually so busy that I don't have time to monitor patients that are getting IV push meds.

When I worked at a SNF we would send someone to the hospital if they showed any of those symptoms. It really could be anything from a stroke to a UTI.

I work 5 8s per week and it works for me right now. I have kids so I like being home shortly after they get out of school. I live very close to work so I get home in 15-20 mins. Plus I like getting off of work earlier on the weekends that I work. It almost doesn't feel like I work weekends if I am home by 4:30 at the latest. I still have time to go out to dinner or do other things I wouldn't be able to do if I worked until 7:30 or later. Sometimes I am so exhausted by the end of my shift I don't think I could stay another 4 hours.

Generally if a patient is going to surgery the MD will say to hold all meds except for Beta blockers and long acting insulin. When the NPO order is being put in there is a section for NPO except meds or pt may have ice chips. Usually the doctors don't even fill that section out so it is up to the nurse to call in the morning. I generally call the OR to see what meds they want given before surgery.