|
during my emt class one of the students misread a scrip to assist the patient with their 0.4mg nitroglycerin tablet as "4mg nitro". the nurse saw him dumping nitro tabs into his hand and was like "hoookay pump the brakes, what's going on". he said afterword that it was surreal to know those dosages and procedures from the classroom but then for his brain to just turn to mush when a doctor was giving the orders. he was pretty freaked out. thankfully the nurse he was working with was actually paying attention to his student and caught it. it turned out to be just a powerful and sobering learning experience, instead of a tragic and pointless death.
|
#
?
Nov 15, 2019 23:14
|
|
|
|
| # ? May 17, 2024 12:03 |
|
|
Since I work in clinical research, this reminds me of the story of the nurse that worked at a large pediatric academic hospital that was used to odd dosages and weird medications that ended up giving a child a dose of something like 30x the normal dose because some doctor entered the order incorrectly - something like 30 pills she had to give this poor kid that ended up killing him. The nurse didn’t question it because they were so used to odd orders, but drat, what a tragic situation. Always ask if it sounds weird.
|
|
#
?
Nov 16, 2019 01:25
|
|
|
We had a nurse about to give 40mg of morphine to a peds patient, the doc accidentally put the decimal in the wrong place, and we were getting smashed in the E.D that night so everyone was kind of hovering over their own patients. We got lucky when she came into the med room and was like "I need to run over to the PACU to grab some more 4MG morphine vials guys" And the nurse she was talking to questioned what she was doing, to which she, without any thoughts of concerns was like "I need to give 40mg of morphine to my kiddo in bed 7" That kid would have gone for a wild loving ride to apnea land had she not mentioned that.
|
|
#
?
Nov 19, 2019 23:09
|
|
|
Critical thinking is truly a lost art.
|
|
#
?
Nov 19, 2019 23:22
|
|
|
Cacafuego posted:Critical thinking is truly a lost art. ehh... i'm inclined to think critical thinking is naturally impaired when you're overwhelmed and following directions. the doctor in the above anecdote contributed to the situation by writing 4.0; you don't decimal-zero on written scrips for this exact reason
|
|
#
?
Nov 20, 2019 00:19
|
|
|
i've been overwhelmed and felt my IQ go through the floor as a result, sure, but it's hard to imagine seeing a morphine dose as high as 40mg and not thinking twice about it in a patient who's not a heroin user or a cancer patient on chronic opiates though i've certainly done my fair share of dumb poo poo as well
|
|
#
?
Nov 20, 2019 01:19
|
|
|
pyknosis posted:i've been overwhelmed and felt my IQ go through the floor as a result, sure, but it's hard to imagine seeing a morphine dose as high as 40mg and not thinking twice about it in a patient who's not a heroin user or a cancer patient on chronic opiates That was the collective thought on the incident. Like I've internally questioned an order about giving someone 20MG morphine IM to an opioid dependent patient but considered the situation and felt it was appropriate at the end, to which the outcome was okay. But a kiddo and drawing up something that would probably knock out the most seasoned of opioid users on a pediatric should make you pause and at the very, very least consider asking the doc if that's what he ordered, rather than saying "hey, you hosed up the order doc put it in right so I can ease this patients pain."
|
|
#
?
Nov 20, 2019 03:40
|
|
|
trauma llama posted:What about atracurium instead? Yes, this is totally a thing someone did. Fortunately it had a better outcome apparently. Our vec comes mixed and ready. But yeah lol its got the hunters orange and PARALYZING AGENT WILL CAUSE RESPIRATORY ARREST everywhere on the vial so whoops! I had a vented patient that I changed my fentanyl drip on and made an order of magnitude error and gave this dude 25 ml an hour instead of 25 mcg an hour so he was getting 250mcg/hr for about four hours, with a co-sign no less. "Boy this dude is really riding the vent, I wonder if he's going to pass his breathing trial!" I realized what was I'd done and swapped him back to 25mcg/hr, let him cook off the high for about two hours and he was good to go. Must have been remarkably comfortable!
|
|
#
?
Nov 20, 2019 19:46
|
|
|
Roki B posted:Our vec comes mixed and ready. This kind of reminds me of the dumbest poo poo nurses do. It drives me crazy when people in the icu would run propofol at 50mcg/kg/hr for 3 days straight then expect their patient of wake up after a half hour sedation vacation. That’s not how propofol clearance works. God help you if you have been running fentanyl too. Dude needs at least an hour or so to wake up.
|
|
#
?
Nov 20, 2019 20:45
|
|
|
Cacafuego posted:Since I work in clinical research, this reminds me of the story of the nurse that worked at a large pediatric academic hospital that was used to odd dosages and weird medications that ended up giving a child a dose of something like 30x the normal dose because some doctor entered the order incorrectly - something like 30 pills she had to give this poor kid that ended up killing him. The nurse didn’t question it because they were so used to odd orders, but drat, what a tragic situation. The kid survived https://medium.com/backchannel/how-technology-led-a-hospital-to-give-a-patient-38-times-his-dosage-ded7b3688558
|
|
#
?
Dec 1, 2019 20:36
|
|
|
Good ball by Dixon posted:The kid survived That’s the one I was thinking of. Glad to know I was wrong about the kid!
|
|
#
?
Dec 1, 2019 21:01
|
|
|
Good ball by Dixon posted:The kid survived this was a really good read
|
|
#
?
Dec 1, 2019 23:06
|
|
|
I passed my CCRN last week and just wanted to brag a little, cause it was rough  . Also TL hope you're doing well in your CRNA program - you've got to be almost done right?
|
|
#
?
Dec 2, 2019 20:12
|
|
|
drat, I really need to sign up for the CMC. It was my professional goal for the year, but got sidetracked with this whole cancer diagnosis thing. CCRN was hard because of all the not heart things they want though to know. CSC was OK after a year of CVICU/heart recovering.
|
|
#
?
Dec 2, 2019 21:08
|
|
|
Anyone in here made the jump from nursing to health informatics? I’m burnt out of front line work and my career is going nowhere
|
|
#
?
Dec 27, 2019 16:58
|
|
|
i'm resuming school in two weeks, after a leave of absence of about six months. my head feels screwed on straight this time. it fuckin better be
|
|
#
?
Dec 27, 2019 18:26
|
|
|
my morning jackass posted:Anyone in here made the jump from nursing to health informatics? I’m burnt out of front line work and my career is going nowhere I moved to clinical research, but my wife works in MIS at our local hospital and is managing their implementation of Epic in many therapeutic areas. She works with a few nurses that are doing the same. If you have questions, I can ask around. It's really good for a stable, well paying career.
|
|
#
?
Dec 27, 2019 19:07
|
|
|
my morning jackass posted:Anyone in here made the jump from nursing to health informatics? I’m burnt out of front line work and my career is going nowhere I was close to starting an MSN in informatics a couple years ago, I talked to a girl I worked with who had recently spent a year working in informatics and it sounded... awful. Just going from meeting to meeting, all day every day.
|
|
#
?
Dec 27, 2019 19:33
|
|
|
Yarbald posted:Just going from meeting to meeting, all day every day. Yeah, that’s a lot of it. You trade the floor insanity for the drudgery of an office. For some, it will be a good trade off. For others, not so much.
|
|
#
?
Dec 27, 2019 19:54
|
|
|
I don’t even work in a hectic job, I work in a primary care clinic after years in public health. I enjoyed doing IMS stuff in a previous job so it seemed to be a good fit for my skill set. I was asked about doing my NP but I am not feeling it anymore. Cacafuego posted:I moved to clinical research, but my wife works in MIS at our local hospital and is managing their implementation of Epic in many therapeutic areas. She works with a few nurses that are doing the same. If you have questions, I can ask around. Does your wife do program planning and implementation or training stuff?
|
|
#
?
Dec 27, 2019 21:20
|
|
|
Is it a reasonable request to ask for a shadow shift before taking my first RN job on a med surg floor? I am getting good vibes from my manager, floor seems diverse, pay is very good (compared to similar jobs) and there is 3 months of guaranteed preceptorship. All around seems like a solid first gig but would still like to test the cultural waters
|
|
#
?
Dec 27, 2019 21:49
|
|
|
Yes I would say it's fair. Also 3 months of preceptorship is pretty long for med surg!
|
|
#
?
Dec 27, 2019 21:57
|
|
|
my morning jackass posted:Does your wife do program planning and implementation or training stuff? She used to do the training stuff for a different EMR, which is how we met, but now she’s doing the planning/implementation as they’re transitioning to Epic. They’re pulling a lot of nurses into the project as SMEs who are supposedly going to do the unit by unit training as the implementation rolls out. They’re supposed to have the opportunity to return to their units once the implementation is complete hospital wide.
|
|
#
?
Dec 27, 2019 22:05
|
|
|
hobbez posted:Is it a reasonable request to ask for a shadow shift before taking my first RN job on a med surg floor? I am getting good vibes from my manager, floor seems diverse, pay is very good (compared to similar jobs) and there is 3 months of guaranteed preceptorship. All around seems like a solid first gig but would still like to test the cultural waters Absolutely. I was told that not asking for a shadowing experience is a bad sign in an applicant, honestly. That sounds pretty nice all around though.
|
|
#
?
Dec 27, 2019 22:19
|
|
|
Ravenfood posted:Absolutely. I was told that not asking for a shadowing experience is a bad sign in an applicant, honestly. That sounds pretty nice all around though. What? That sounds nuts.
|
|
#
?
Dec 28, 2019 02:18
|
|
|
I can see where the logic comes from. If you don’t shadow it can seem short-sighted. What if you hate the unit and can tell right away? On my unit, you have a short interview with HR over the phone. Then a real interview with our unit manager and the director of monitor beds. Then if you make it past that, you shadow for 1-2hrs. Then if you didn’t give us heeby jeebies you get a peer interview.
|
|
#
?
Dec 28, 2019 03:30
|
|
|
No place I’ve ever worked for has had shadowing opportunities. Med/surg is p much the same everywhere, and three months is a good amount of time for orientation. If the vibes feel right why not just go ahead and apply?
|
|
#
?
Dec 28, 2019 04:16
|
|
|
my morning jackass posted:Anyone in here made the jump from nursing to health informatics? I’m burnt out of front line work and my career is going nowhere I work in nursing informatics. My bedside background is med-surg and ICU. I've been doing it for about 6 years now. Informatics is the poo poo. What do you want to know?
|
|
#
?
Dec 28, 2019 04:58
|
|
|
Hughmoris posted:I work in nursing informatics. My bedside background is med-surg and ICU. I've been doing it for about 6 years now. Did you get an informatics degree while working?
|
|
#
?
Dec 28, 2019 16:07
|
|
|
Hughmoris posted:I work in nursing informatics. My bedside background is med-surg and ICU. I've been doing it for about 6 years now. I mostly have an interest in UI and workflow in EMR for primary care. When I worked in public health we used an open source platform and I really enjoyed liaising between our RNs and the app analysts and project leads who worked on developing the EMR. What do informatics jobs for RNs look like usually? What opportunities are there for advancement? It may be hard to answer this if you are American, but what are the differences in job availability/pay/etc between private and public sector jobs?
|
|
#
?
Dec 28, 2019 19:58
|
|
|
combee posted:Could people please share what they did for work/income during their studies and their experiences please? Is it a good idea to start working in healthcare/hospitals as soon as you can to make connections? I worked in a humanities computer lab at uni throughout school cause it was chill, they worked around my classes, and I could do homework at work when it was quiet. No one I went to school with really benefitted professionally from healthcare work during their studies. Most of the available jobs were in places people didn’t want a career in anyways. Your final placements matter the most. Do what you need to do to get the money you need and succeed academically.
|
|
#
?
Dec 28, 2019 20:12
|
|
|
A lot of my costudents waited tables. It is not dissimilar to nursing - time management, lots of people getting mad at you for things outside your control, being on your feet, shifting priorities.
|
|
#
?
Dec 28, 2019 21:27
|
|
|
Fun Times! posted:Did you get an informatics degree while working? To give a broader overview of how I got started: I was working in the ICU with an ASN when I landed an interview for an Informatics position at a neighboring hospital. I got the job, and during the next year I earned my BSN through an online program at my University. At this moment in time, I still have just the BSN. My experience and list of projects have gotten me my past two Informatics jobs. I'm sure there will be two sides to this argument but I always tell people to try and get an Informatics position before dropping cash on an Informatics Masters degree. First to see if you like the field enough to devote the time and resources to an advanced degree, and also to get your foot in the door. The field can be competitive and it can be hard for people with no experience to land a job. my morning jackass posted:I mostly have an interest in UI and workflow in EMR for primary care. When I worked in public health we used an open source platform and I really enjoyed liaising between our RNs and the app analysts and project leads who worked on developing the EMR. What do informatics jobs for RNs look like usually? What opportunities are there for advancement? It may be hard to answer this if you are American, but what are the differences in job availability/pay/etc between private and public sector jobs? In my 6 years of experience, at two different health systems, I've found that an Informatics gig can be what you want it to me. I have strong technical skills compared to the majority of my colleagues, so I take on a lot of the fun with data analytics, clinical decision support tools, etc... I've built standalone custom apps to help bedside staff tackle specific issues. I've been an EMR builder, and also provided direct support to the end-user for implementations and Go-Live. There is a ton of stuff to do in the field, just depends where your passion and strengths lie. For advancements within a health system, its pretty much staff level, manager, director, and CNIO. I'm sure there are a ton of opportunities in the private sector but I can't speak to those.
|
|
#
?
Dec 29, 2019 00:51
|
|
|
I take the NCLEX in 2 days, having graduated from my Grad Entry MSN program in December. I excelled in the program and believe I'm the only person in my cohort (one of 2-3 of 65 at worst) to graduate with a 4.0. I've been using the NCLEX prep stuff that was part of our program to study for the boards, but I've gotten to a point where the adaptive nature of the prep is throwing esoteric questions of the more difficult types (SATA/Order) almost constantly, and it's become more demoralizing than helpful (it's almost completely focusing on Peds and OB now, which are areas I don't care for, and thus don't perform as well in). I know my program has an 88% first pass rate and I'm def in the top of my class, and that several folks on here have said the NCLEX is the easiest test they took in their nursing education, but I'm still anxious. I almost feel like the last few days before I go in I should just take it easy and rest and maybe just do some light review. Any tips / thoughts?
|
|
#
?
Jan 14, 2020 16:43
|
|
|
Marathanes posted:I take the NCLEX in 2 days, having graduated from my Grad Entry MSN program in December. I excelled in the program and believe I'm the only person in my cohort (one of 2-3 of 65 at worst) to graduate with a 4.0. I've been using the NCLEX prep stuff that was part of our program to study for the boards, but I've gotten to a point where the adaptive nature of the prep is throwing esoteric questions of the more difficult types (SATA/Order) almost constantly, and it's become more demoralizing than helpful (it's almost completely focusing on Peds and OB now, which are areas I don't care for, and thus don't perform as well in). Drink a beer. Go for a walk. Do anything else. You'll be fine.
|
|
#
?
Jan 14, 2020 17:16
|
|
|
You can get a masters in nursing before taking the NCLEX? Holy moly.
|
|
#
?
Jan 14, 2020 19:37
|
|
|
Fun Times! posted:You can get a masters in nursing before taking the NCLEX? Holy moly. It's not the conventional route, but there are several programs (like the one I did) that combine pre-NCLEX license classwork with masters level coursework. Such programs are for folks that already have a bachelor's degree in a non-nursing field, that don't want to just get another bachelor's degree. Such graduate entry programs are (generally) longer than a conventional master's program (my program was 7 semesters as compared to a conventional 4 for a MSN that someone would get after a BSN).
|
|
#
?
Jan 14, 2020 19:46
|
|
|
Marathanes posted:
What Roki said. You’ve got this. Chill before the anxiety kills you
|
|
#
?
Jan 14, 2020 20:37
|
|
|
I'm transfering my license from Canada to USA and I'd really rather write the NCLEX again than continue with this bureaucratic nightmare. At least the NCLEX ends eventually. Fyi if you sanitize your hands too much your fingerprints wear down and your livescan fingerprint verification is rejected
|
|
#
?
Jan 14, 2020 20:47
|
|
|
|
| # ? May 17, 2024 12:03 |
|
|
i think older masters-entry programs had you sit for the nclex after the "more or less an absn" first phase, before moving on to the "more or less an msn" phase, but i did hear some newer programs don't have as sharp a divide. i didn't know any were putting the nclex off until the end. that could be better; more flexibility for scheduling and personal preference about how long to study
|
|
#
?
Jan 14, 2020 21:08
|
|