I feel so dumb... I got flustered - about a patient in respiratory distress

I can't believe I'm posting about this considering I've been an ER nurse for 4 months now... but I got really scared last week and I need advice.

If a patient is in respiratory distress, what do I do especially if the MD is nowhere to be found and my RN co-workers are busy with their patients? I'm new and I don't want people to die on my watch. Read

Day shift or night shift - Which do you prefer? Why?

There are pros and cons to choosing a preferred nursing shift. But what is right? I mean - if you haven't tried it how will you know.

What is your current working shift? Do you like it? What are the pros and cons of working your preferred shift? Read

LTC and loving it

Why does there seem to be such a stigma against LTC nurses? It almost feels like that is the bottom of the barrell. Even I thought (while working in LTC) that I needed to move up and out- twice- and hated it both times. I started in a hospital, hated being micro-managed, and went back to a LTC. I stayed for 6 years, got my RN and once again felt the need to move on up to the hospital- where I once again hate it, and for the same reasons! I have finally decided that it is okay to just say I love LTC, and this is where I want to stay. My dreams of being the charge nurse in the ICU and ER are gone. My focus in life is to be where I am happy, and that is with my old people. Read

Patient refusing Hospice

I have been a home care nurse for the past two years, prior to that I worked in the clinic setting. I am not, nor ever have been a hospice nurse. In my area, we come in and help the patient on a temporary basis until they are back on their feet. During the certification time for this patient he has steadily had a decline in health. I mentioned hospice to his wife several months ago and she was not receptive at all. He continues to get worse and now is pretty much bed bound. Last week his wife began asking me for details about end of life. I explained to her that this is not my area of expertise & asked again about hospice. She declined. This week she finally said she was ready because she had questions & needed help. When she mentioned it to him, he was adamant that he was NOT going on hospice. Read

It's Airborne: Contact Precautions Will Not Stop This Superbug

C. Diff, MRSA and VRE are just a few of the diseases hospitals have taken specific measures to reduce cross contamination. But what about the disease that is more viral than any other? The disease that spreads like wildfire via the “Butterfly Effect” infecting the staff, patients and visitors? The disease that does not have an incubation period, is airborne and can be just as detrimental to patient outcomes as MRSA? What is this new superbug you ask? Read More...

My buddy Joe

Do not take for granted the time that you have with your patients/residents; learn to listen to their story and open up your heart. Get to know who you are taking care of- and your career in nursing will go beyond what you ever learned in your study books. My buddy Joe taught me how to live in the world of Alzheimer's and see life differently. Read

Clinical tidbits I wish someone would've told me.

I'm a new graduate nearing the end of my orientation at my first job on a busy Stepdown unit at my local hospital. Although we don't deal with vents, we do most every common gtt (cardizem, dopamine, insulin, nitro etc...) and I'd say we have a pretty high acuity. It's not uncommon to have a code or near code situation on our unit during the night, and often times they don't even get called because we have the resources to manage them. I know my topic of "things I wish someone would've told me when I was a new-grad" is a common question on allnurses, but my goal is to narrow this strictly to clinical facts that you have learned over the years. Read

Would you work for a hospital as an Independent Contractor?

If you were able to work for a hospital as an independent contractor and made more money, do you think it would be worth paying your own malpractice insurance, health insurance, self employment taxes (quarterly) and social security? I am not asking if it is possible. I am simply asking for some feedback to see if you think it would be worth the extra effort if you ended up making more, say a net of about $5-$10/hr more. Read

Considerable Out-of-Pocket Costs in Last Few Years of Life

Out-of-pocket health care expenditures can put a significant financial burden on elderly Medicare beneficiaries in their last five years of life, according to a study published online Sept. 4 in the Journal of General Internal Medicine. Read

Hiring Process for VA (veteran's administration)

I applied for the VA in TN in July. Got a call for an interview the first week of August. Received a call 3 days later saying Ii had a tentative offer and had to do the whole process with vetpro and eqip and fingerprinting, physical.... I was sent a link for the vetpro and eqip 2 days later so that I could go ahead and start that process. I did that. A week later they called and asked to set up and time for fingerprinting and physical. Well the NP couldn't see me until September 5th, so of course I had to wait until then..... upon going and getting my physical and fingerprinting they let me see a sheet of things needing to be completed. It showed everything completed. The only thing I'm waiting on now is my drug test... Read

HEENT evaluation...oops that shouldn't be THERE!!

During my Fundamentals of Nursing re-demo of a HEENT eval today, I made a slight goof. My professor later told me she had to hold back her choking and giggles. While examining my "patient's" open mouth with a tongue depressor, I told her the VULVA looked good. Really? A vulva in the mouth? No, I meant uvula!! OMG, I said vulva? This should make quite the funny topic at the next faculty lunch! At least I didn't forget anything.... Read