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nurseburst ASN, BSN

Telemetry, Step-Down, Med-Surg, LTC
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nurseburst is a ASN, BSN and specializes in Telemetry, Step-Down, Med-Surg, LTC.

nurseburst's Latest Activity

  1. nurseburst

    Question regarding minimum staffing

    So, what may end up happening especially considering there is no one to watch the monitors is that someone may go into a lethal rhythm, the one and only person there will not see it and that said person may have an MI or God knows what else. When this happens, they will probably be REQUIRED to have someone sit at monitors 24/7. But unfortunately, it will happen after something really bad happens. Also, if there is a code what is one single person gonna do? I realize that you can press that code blue button and a ton of people come running but the best that single person can do is do chest compressions until help comes. That isn't exactly ideal... I don't understand where management thinks this is okay. You are caring for very sick and ill people. You need more hands, brains, and eyes!
  2. nurseburst

    PACU Fellowship

    Hello fellow nurses! I have worked on a Step-Down telemetry unit for almost 2 1/2 years and feel it's a good time to move to a specialty. My hospital has opened up a PACU fellowship which I can apply for. Any tips, tricks, advice regarding what may be important to brush up or read? Also, it includes a panel interview which I am not experienced in doing. If you can provide any tips for it, I'd greatly appreciate it. Thanks!
  3. nurseburst

    What does a Brain Navigator do?

    Thank you for your response. That gives a clearer picture of what Nurse Navigators do!
  4. nurseburst

    When is it time to leave nursing?

    I agree with seeking counseling to pin-point what is going on. I am sorry you are unhappy. I hope you find your happiness!
  5. nurseburst

    I have made a huge mistake...

    I would say no to swing shifts. I simply cannot do it. I have worked night shift for almost 2 1/2 years now and have also been asked to work day shift. I would LOVE to, just so I can see (and remember) how day shift feels vs nights but I have to keep a pretty good sleep schedule or I suffer (and so do those around me... sorry. 😅) You have already agreed to help out twice. Politely say no and you can explain that the swing shifts are too difficult on your body. It's why I don't work threes in a row every week.
  6. nurseburst

    How to be organized in med surge clinicals

    Good question. It is tough to get a routine down and just know that. We also use powerchart at my hospital (aka Cerner). First thing is first, add your patients to your list so they show up on the care compass. The care compass shows you upcoming tasks that need to be completed. This is useful but this isn't all you should look at. You can also see most recent orders/lab results here in Care Compass as "Nurse Review" it there. This is awesome because sometimes patients have been here for a week or more and it can be hard to filter through old/new orders. Get your SBARs. Along with the SBAR, a lot of us night shifters use a separate sheet that we can quickly add Room #, Med Times (including if they need insulin, BP & HR to be closely reviewed for BP meds, etc), Procedures to plan for, K/Mag Sliding scale (Something we do at my hospital) and also charting check-offs. I've included a copy of my "cheat sheet" and I recommend if you want to use it to make your own or customize it! 🙂 Many other nurses simply fold their SBAR and on the back they write these things. So, it's complete preference. Labs are important and procedures too but what is your patient here for? What should we focus on? These are what you should write down on your SBAR. For example, if your patient is here for CHF: What was there BNP on admission? Strict I&O, Wts... Are they on IV Lasix or PO? What did their CXR reveal on admission vs now? If the patient is here for CKD or AKI: What is there BUN or Creat? Is it coming down? Are they getting fluids or are they a dialysis patient? You may not see these patients because they are usually on tele! But as you move along, you will learn what to look for. In the meantime, ask your preceptor/instructor what THEY would look for? By having a good picture you can kind of establish a POC (Plan of Care) for your day. It's a lot as we are essentially a coordinator for all of a single patient's care. What's the plan for discharge? That's also another thing to write down and have an idea of. Usually, at night, I come in and review charts as much as I can so I have a good idea of what's going on with my patient and I develop a plan on my cheat sheet of what I need to do during the night. But, at any time... that can change. You may have to call rapid on a patient. Your patient may need an additional dressing change. There is so much you simply cannot plan for. So, do the best you can with knowing when meds are due (unless orders change), procedures, labs that we are monitoring closely, is there a change in labs, look for new issues with your patient. After I develop a plan, I see the patient that needs me first, (High BP, pain, etc.) This is where prioritization comes into play! And you will learn this as you go. If I can assess during my medication pass, I do. If not, I come back. We have hourly rounding at our hospital, every 2 after 10 so I keep up with when I was last in a room to make sure I am checking on them frequently. For my sicker patients, I am rounding more frequently. Just breathe. You are going to do fine. It takes time and some working out kinks to get a routine down. You cannot always fix or address everything and that's ok. Just keep your patients safe, provide the best care you can, and ALWAYS ask if you are not sure about something. Sorry long-winded. 😄 Have a good one! Cheat Sheet 1.docx
  7. nurseburst

    What does a Brain Navigator do?

    Thanks, Swellz. Still waiting for an answer hopefully and just don't know anyone who works in this field to ask. I like to know what I am applying for or interviewing for before hand.
  8. nurseburst

    I hate being a sitter

    I don't understand this. We see it all the time where one tech WANTS to work the floor and another WANTS to sit. We simply adjust the assignment. We've also had one sit for half a shift, and the other work the floor. I really don't see what the issue is with doing that!? Also good luck to you in the future! I agree with the above: Network!
  9. nurseburst

    Forgot to document an output

    I agree with verene here. It happens. I see a ton of strict I&O orders as we get a lot of CHF and Dialysis patients on our floors. It happens way too often unfortunately. I've seen in physician notes: "inaccurate I&O" and it can make it tough to know if a patient is OK to go home yet if the physician thinks they are still overloaded but more importantly accurate weights are even more important. But it's tougher with your patients on fluid restriction due to hyponatremia. Give yourself a break, you are still learning and trying to get your flow down. You did tell the oncoming nurse the accurate output so don't worry!
  10. nurseburst

    What does a Brain Navigator do?

    Hello fellow nurses, I apologize if this is a dumb question or has been asked before. There are some big changes coming to my current hospital and over half of the current nursing staff on my unit will, well, have to go do something else somewhere else. With that being said, I am looking at other positions inside my current company and outside. There is a job posting for a Brain Navigator within a Hematology/Oncology clinic. From what I have gathered so far is that this nurse literally navigates the patient and their families from their first appointment, treatment, and so forth. I just want to consider if I'd be a good fit and if it's something I'd enjoy doing. Any of you folks a brain navigator, have been, or have a better understanding? Thank you! 😊
  11. nurseburst

    2019 Nursing Salary Survey

    Got mine in. Look forward to see the results.
  12. nurseburst

    Study like a Nursing Student

    Tip #1: Study in a way that works for you. I used Quizlet more than ANYTHING. Tip #2: Make at least one friend in your class and become best friends during your journey. You have no idea how combining one or more brain really makes a difference! Tip #3: Learn how to manage your time and take BREAKS. Your brain needs a (little) rest, ok? Tip #4: Apply difficult concepts to scenarios or connect it to something else (even if it makes no sense) it usually helps it stick better. Mnemonics!
  13. nurseburst

    I Love Night Shift

    Hahaha!!! I definitely do need to make friends with some musicians like you and can you believe that the nearest walmart to me closes at like 1AM? WHO DECIDED THAT WAS A GOOD IDEA!!!! lol But people watching at 3am... I totally dig this idea.
  14. nurseburst

    ACLS....is the exam hard?

    I am doing mine Tuesday... and starting to freak out lol! I am trying to prepare a bit for the class but have never been in a real code so I feel like I am going to be like HUHH?
  15. nurseburst

    I Love Night Shift

    I have to say I actually really enjoy Night shift for all of these reasons. My only complaint is on off days I feel kind of 9ff come 3-6 am because not a soul I really know is awake and it's kinda lonely LOL! And yes traffic is actually bad for me but it'd be the same if I worked day shift! I also get more time with my patients at night (hello less to no procedures.... )
  16. nurseburst

    Charting has to be done no matter what?

    Hahaha. I am seeing this more and more, not to mention being asked to go do documentation like 10 - 20 days back... Are you kidding me?