RotorRunner

Great coworkers, only working 3 days a week, flying in a helicopter when I do have to work...

Thanks for mansplaining her sexual harassment story. You're also making a pretty ridiculous false equivalency by bringing up fellow nurses, I mean "girls", asking you for lifting assistance.

Why were you looking in her chart? Unless you were the nurse in direct care of the patient you never should have opened it. Personally, if I had a family member admitted to a floor I worked on I would stay far, far away from it. You cannot discuss any aspect of her care with anyone in your family unless you have her express permission.

You have lots of good answers already but I'll throw my hat in. Flight nurse and medic here. The priorities are always always always A, B, C. It's nice to note that the patient is posturing and to know the proper terminology for it, but it's not particularly helpful in this scenario. Is the patient maintaining his/her airway? Yes? Move on to B. No? Open the mouth using a jaw thrust maneuver (c-spine c-spine c-spine) clear the airway with suction (as needed), insert an adjunct if possible, and assist ventilation with a BVM and 100% O2. Rendezvous with an ALS crew and transport rapidly.

I would have been shocked if you showed me this as well. CPR is lifesaving. Why would you, as a person who is assumably healthy enough to be working as a nurse, not want to be resuscitated? Now, if I have metastatic cancer, that's a different story. Or if I'm 90. But there's a reason we do CPR...it work. It saves lives. I know people who have survived sudden cardiac arrest with 100% recovery.

Well, in the Mayo case, the family sound as if they were absolutely difficult to tolerate. However, if they were treating the patient as if she were legally able to make her own healthcare decisions then there was no reason why they should not have let her leave AMA or transfer to another facility. If you're in your right mind, of legal age, and not threatening to harm yourself they can't hold you hostage if you want to leave. Hospitals aren't prisons. To me it sounds like a pissing match (pardon my French) that got out of hand.

You're describing a patient with poor perfusion. Even if her BP "runs low", in this case, she is clearly symptomatic with poor perfusion. This would be a definite case where you need the physician to evaluate. I don't want to sound dramatic, but the signs and symptoms you are describing are ominous.

Uh, yeah. I'm surprised this person wasn't fired on the spot. That is completely unprofessional and unacceptable.

Disagree with this. You are perfectly entitled to wear gloves every time you enter a patient room, but that is not standard precautions. I only wear gloves when there is a likelihood of encountering open skin or bodily fluids. Wash your hands before and after all patient contact and there is nothing to be afraid of. OP, your nurse was off base.

Your idea of presenting a reputable source is a...YouTube video? Let's see some peer reviewed research that backs up what you're saying. Anecdotes and YouTube videos won't cut it. If you make inflammatory, controversial comments on a public forum without backing them up, you're going to get called out on it.

I can tell by reading your posts that you are a thoughtful, intelligent person. Don't be so hard on yourself. The advice given to you here has been really good so far, and I just echo the suggestion to go to a good local community college and get a math tutor. Pursue CNA training as well - that will be a good start if you want to be a nurse. You can do this. Just because you've not been successful with math before doesn't mean you can't NOW. Go for it.

Yes, quite comfortable. I've been a flight nurse/critical care transport nurse for a few years now and it is an essential skill. Would recommend a book called "Rapid Interpretation of EKGs" by Dale Durbin as a resource.

You were exactly right. I would've done the same thing. Your coworker doesn't have the right to say that her sickle cell patient isn't in pain. Pfft. Kudos to you for doing the right thing and advocating for your patient.

I think starting off in med surg is great. And chances would be good of landing a travel contract with a year of med surg and a year of ED experience. Some agencies may require more experience...you'll just have to do some more research.

Congrats on the new career! From my experience, you will not be able to travel to an ED without ED experience. You're going to need at LEAST a year experience in a specialty before you can travel to another unit with it. At least.

This is where you lost me. I am an atheist, and over the years I've had patients and family members of patients ask to pray with me countless times, and I hold their hands and listen as they pray. I've been told by patients and their families that I am an angel. I've been blessed more times than I can count. Do I believe in any of this? No. But I believe in the power of belief, and the comfort it gives my patients. I treat all my patients with dignity and respect. It has nothing to do with religion. I take offense when you suggest that my lack of religious belief makes me lazy, or somehow less compassionate. It's just not true.

It depends on the reason for the arrest. Remember your H's and T's. Fluids won't help in certain situations and can in fact be detrimental if you send the patient into flash pulmonary edema.

Your language is pretty offensive and unprofessional, FYI. I don't even know what is being argued in this thread at this point. The plan B for a CNA in a nursing facility is call for help. Unless the Oklahoma state board of nursing approves tourniquet applications by CNAs and your facility protocol allows it, you will be applying pressure for uncontrolled bleeding. EMS will operate under their protocols when they arrive. You are simply incorrect about the rate of compressions for CPR. And the rationale has been explained.

Okay, I'll bite. What kind of wound are you expecting to encounter in the assisted living setting that would benefit from a tourniquet? I'm a flight nurse and have used a tourniquet only a handful of times for extremity amputation. Most bleeding will be slowed enough with direct pressure to give you time until EMS arrives. Tourniquets, when improperly applied, can cause severe damage to the patient.

140 bpm is too fast. No way you're getting full recoil, which means the heart doesn't have enough time to fill. It's counter productive. Tourniquets have been in and out of favor even in the EMS world over the years. I would never expect that sort of bleeding control to be taught in this setting. It's not part of AHA CPR, in any case. I can't even imagine when you would need a tourniquet in a SNF... Just follow the protocol at your facility.

ACLS, PALS, TNCC. Just for starters.

It's irresponsible to go to work under those conditions. Especially if you work around the elderly, the very young, or the immunocompromised, as most nurses do.

I started in the ED as a new grad. I did my practicum there and was offered a job before graduation. Years down the road as I moved on to leadership roles I oriented a couple of new grads in the ER. Most did very well. There's no reason why a new grad RN can't be oriented to the emergency department with proper guidance and training. Obviously, you won't be working in triage for some time. That's a particular position that requires a couple years of experience assessing patients. Congrats on the job and starting out your nursing career! Best of luck.

CVICU. If they are willing invest that sort of effort into training you, take it. You can't go wrong by gaining critical care experience. It'll be a learning curve for sure, but it will be rewarding. PCU experience will likely not count for CRNA school. They are going to be looking for critical care experience. A year or two of CVICU experience in a level one facility will be perfect.

That's is completely absurd and they are trying to take advantage of you.