I always document after. I don't want to waste time documenting when there are 5+ more assessments to be done, but my patients typically have 7am 9am and 10am medications. I suggest just writing down what you heard/assessed in red on your SBAR sheet. I wouldn't want to confuse two patients and helps cement it in my mind
Hi Jazmine! Really nice to hear from you! If you find something that works for you... stick with it! Routine is important :) Thanks so much for the comment! See you soon!! xoxo - Caroline
You mention many things that I use for time management and it is nice to see it reinforced with extra tips. Such a great service you are doing - and you're enjoyable to watch! Keep it up, please, thank you.
Hi Caroline! So glad I found this video. My first day on the floor will be on March 17th, so I'm trying to get tips on organization and anything else that may help me. I will have a coach/preceptor working with me for 12 weeks, so I won't be alone but I like to get different perspectives. :) So, thank you!
Thank you so much... I am a new nurse... God willing I will make permanency first week of December (almost 3 months). This is a true wake up call... from school to the actual field... I've cried a few times haha... and it is stressful organizing. As you stated it depends on where we work. I am in Puerto Rico & at a teaching hospital... yet wow... I love that you mentioned sticky notes... I was thinking that my last shift, so I need to buy some. I also read over some comments... "when to call the Dr" etc.. plus all the meds. I am on a Med Surge floor which is a tad chaotic at times & I am usually organized yet have found it a bit hard to organize myself. The most patients I've had at once has been 12.... and wow... they say if I learn there, I can work anywhere... we also have an area which is like ICU with max 4 patients (I like that better eventhough they are more critical, ventilators etc.)... I pray to be the best NURSE I can be, eventhough it's tough, plus critical thinking. ;-) Thank you for taking the time to make these videos... God bless you & your family.
Stacy Sepulveda Awe hi Stacy! It is so nice to hear from you! Thank you so much for letting me know that you like the videos! I appreciate it so much :) Don't worry, it will take a little time for you to know what you need to do to be organized... but yes, sticky notes are a staple for me. I still use them on a daily basis :) Keep in touch!! xoxo - Caroline
We work so different in Scotland from you :O In my ward anyway, we go and wait in the staff room until our shift start time to allow the previous nurse to get everything done before handover, each nurse from the last shift comes in and tells you about their patient: name; age; patient; burn; past medical history; observations; what they need done, what happened overnight; what meds they had etc. Once all the nurses have handed over to the full day team the ward sister allocates patients. they one nurse does the meds and IV's for the full ward and the rest go and wash their patients/checklist them for theater/ change their dressings. then the doctors come for a ward round and you get a second report from the ward sister after this ward round, things like who's going home, who's going for theater etc; and then we do our observations and do our charts and notes etc. We all get allocated first or second break and unless there is a life or death situation happening you have to go for your break at that time which is awesome because everyone gets a rest from the floor. I'd love to work in a burns unit in the USA for a few months to see how different you guys work from us :D
Thanks so much for sharing this! Yes it is very different here in the USA, but I love how it seems like you all work as a team. And it also seems like you can have different roles, different days :) That would change things up a bit! Thanks for the comment!! Looking forward to seeing you again soon!! xoxo! - Caroline
Hi there, in relation to bleeping the doctor. I found the SBAR tool really helpful S-Situation: state the patient's name, what they are in for and what the problem is B-Background: Give a history of the patient and any problems that have arisen whilst he/she has been in hospital A-Assessment: Give details of blood test results, sputum results, clinical observations etc. R-Recommendations: "Please come and assess this patient" and ask if there is anything they want you to do in the mean time. Sometimes I find having a little way of remembering helps me. :)
Love your videos! I am going to be starting nursing school in the fall and have a video request if possible. I would love to hear about your daily schedule when you were a nursing student in detail. For example, how early you woke up, arrived to class, frequency and length of studying, etc. I want to hear how other nursing students manage their time effectively.
LeeAnn Moore That's great! Thank you for letting me know you enjoy the videos. I really appreciate it. Right now, I wish you all the best in your upcoming graduation and may God bless your plans. Let me know what I can do to help. Keep in touch! -xoxo
I am 16 years old and I really love your videos it really helps me alot cause i also want to become a nurse when i finish high school and college and i am already taking nursing classes and this really helps me alot with what i am going to face
Alma Nel Hi Alma! Wow, South Africa!! My videos are going far lol :D Thanks for sharing & I look forward to hearing from you again very soon!! xoxo - Caroline
Thanks so much for answering my question! This video was so helpful! I'm a last semester nursing student who is graduating in April. I'm usually pretty organized at clinical but as we are moving into have more and more patients I find it a little overwhelming. I will definitely try out some of your tips this week during my clinical and on my first day of my internship! :) Keep up the awesome videos..You are so inspiring! xoxo
Hi Caroline, I love your videos! I find them really helpful and a good insight into the world of a registered nurse. I'm Scottish and training to become an adult nurse at Dundee University! I love my course and clinical placement, but as I am in 2nd year (the course is 3 years) I am finding myself looking to the future and wondering how I will cope when/if I qualify as a registered nurse with my own patients. Your videos are really comforting, they always remind me that organisation and time management are key in helping a RN cope with their shifts! Thanks again for the videos and keep up the good work :)
I love how you say you always do the "hardest" things first (or the most involved), when you start your day because it makes you feel happy! That is exactly how I am! I love to get the hardest out of the way, because you know if you can accomplish THAT....you can do almost ANYTHING!! :) Keep up the good work!
Hi LaVerne! Thank you so much for sharing!! I know, you always feel so much better when you have a few things off your mind :) Looking forward to seeing you again soon!! Much Love, - Caroline
What is your favorite unit to work. From the way you describe it you don't like the ER that much. When you describe your daily routine what unit were you working on. Can I be a regular RN staff nurse and go to the ER or ICU or OR and not need additional certification.
Hey there Carolyn. Have you ever wondered what it would be like to work in a surgical ward. My mom used to work there and she said it was one of her favorite rounds she has ever done.
+Andy Rusin Hi Andy! I've never really been interested in surgery... I don't like to watch them & almost passed out at the first surgery I ever saw. I also don't like the feeling of being in a room & not able to leave. I really just like the floors :D But everyone is different!! Nice to see you on here again!! xoxo - Caroline
+Kayla Adams my mom is a nurse at a nursing home and she says although she gets a 30 min break halfway through her shift on the floor she only treats it as a quick bathroom break/water break because she says if she were to take the whole break she'd be waaay behind on her rounds
I have been a nurse for a few months only. I am never sure when to call a doctor. I know that when there is a critical lab or change in pt. status I have to call, but when it comes to labs, I never know if I have to notify them. For example, the other night I had a pt. with sodium level of 152 which is high, but not critical. High sodium would mean that the pt. was getting dehydrated, but his BP wand urine output were fine. The doctor that was on the case never calls me back so I didn't even bother to call him. When I asked my fellow nurses about it, they said that they don't call at night unless it's critical. Then I felt bad because I feel like I am not doing my job right. It's just never black and white. So could you please make a video about when to call the doctors? Just to give me an idea. Thank you so much in advance!
Agulek Wywieszka Hi Agulek! It is so nice to hear from you! I loved how things were so clearly outlined in nursing school... and then we join the real world and things are hardly clear cut at all. It is hard to know when to notify the doctor, but one thing that I do is compare the new lab results to old lab results... I know that this does not help with every situation, but this will help a lot when it comes to labs :) It is hard to create a video about this because it is dependent upon so many factors, but if I think of a way that I could properly display it in a video I will definitely create one for you ;) I hope this helps at least a little! Let me know if you need anything else!' Much Love, - Caroline
Hey, feeling the need to add my 2 cents to this one since at our hospital calling on night shift is kind of a hot topic right now. Our docs will always round on day shift so if the issue can wait 12 hours, so can my call. We always try to combine our calls as well so if another nurse needs that doc, they will ask everyone and pass the phone over when they're done. This is a situation in which I might address a non critical issue since the physician is already on the line. In your situation, I would also would question why these results are available on nights, when was this lab work ordered, at what frequency etc in determining if the MD wants to hear about it or not. You mentioned your pt was asymptomatic, to quote one of our MDs from today "I treat patients, not numbers" I would likely wait. Lastly, when in doubt, call, it is your license on the line, document who you called and when to cover your tail should anything go wrong.
Polish Girl In Florida this is one of the hardest things to get used to! I work icu days, but have heard of similar issues experienced with our night shift. I notice that before our night doc is paged, everyone will say at that point if they need to talk to the doc. Really good idea, less pages/calls for the doc. They usually have a lot of ground to cover with minimal support if that, so excessive pages can be frustrating. That being said, your license is always on the line. If something happens because of a lack of reporting, you are the only person who will be hit. And oftentimes the hospital will not cover you for liability (you may want to look into personal insurance liability coverage, just in case... I've paid for it every year and have still not needed it). I'm always careful about electrolytes- Hypernatremia/hypo can effect your brain and cause seizures. We get concerned at 150s. They may just even change some fluids around to drop it. Ive learned that you can see trends over time that can indirectly warn you of possible scenarios/deterioration. For example the MEWS score (not sure if you use that?). They have this in our system that rates VS on the floor, and the charge will be paged if the number goes up to a certain number. Your patient may look fine but can be a ticking time bomb waiting to crump. Another example- wow this patients heart rate is trending up and now tachycardic; pressures are trending down; diaphoretic; lethargic; increasing temps, white count trending up..I'll call the doc and get blood cultures for possible sepsis. Treat that early and you can save a life. Just examples. Look at your labs in conjunction with each other in addition to your assessment; everything is interrelated somehow. You're like a detective, to figure out what the underlying issues is sometimes! Not a lot of urine output with this? How is their kidney function? Could be in ARF. Also on high dose vanco and you see a trough is higher? They may be in kidney failure from it. The longer you work on the floor, the more experience you get and you start to see things repeat themselves that you have learned from/witness that can allow you to put different pieces together to be proactive instead of reactive. That's what's fun with nursing, it keeps you on your toes. You will never EVER know everything. Our veteran nurses always say how much they learn about new things all of the time! Technology and EBP is a huge part of that. It's awesome you're reaching out to others to get their opinion- Dangerous nurses are the ones who just assume and make the wrong choice. I ask other peoples opinions all of the time, but have learned that whenever I ask other people what they think, there's something off to me that should just be reported. Always trust your gut. Always. I annoy our docs all the time and almost always page them or hunt them down every shift regarding concerns. At least they know, and the worst thing that can happen is that they get irritated lol. On the floors, your Sodium may not even be rechecked until the next morning. And if there is an issue going on, things can change quickly. Maybe they need to have their sodium checked every six hours, or fluids adjusted. Or simply nothing lol. But then what do you have to lose ? I like how we have modified our rounds. During bedside report, both day and night nurses look up all current/significant labs together to address concerns. It has been such a help to have electrolyte protocols in place so if you have only slightly off elytes, you can automatically put in the replacements yourself. I also remember how hard it is to have 4-6 patients on the floor, it's incredibly easy to not see things/address stuff with the doc when you want, let alone get your stuff done without pulling your hair out. In all units, things can just be missed or forgotten about. That's why I agree with looking at labs at start of shift. If anything just within the past 12-24 hours. It's a 24 hour job, you do the best you can on your shift! And that's all that you can do :) It all takes time. But protect yourself and how hard you worked to get your license, and of course advocating for your patient at all costs. Page out and then document that you did so. Then it's on the doc if they want to call back or not. Not calling back during a legit concern? Get your coworkers involved and your charge. Things will get smoother and less stressful over time, I promise!!
Hey Caroline! I have been watching your videos and I think you are AMAZING. Thank you for your motivating words and actions you are a true inspiration. Please forgive me but I do have some questions. I am 22 years old. I declared nursing as a freshman but when I had to withdraw from human anatomy I did not believe that I would be able to get through the nursing program. (I do have some prerequisites such as statistics, Chemistry, developmental psychology & general education classes but i do know that there are other prerequisites that are required.) So i switched my major and graduated four years later with a business management degree. Truly that was not what my heart wanted nor was it what I was set out to be. I am now here today applying to nursing schools and I do know that some schools do not accept students to take anatomy more than twice within ten years. Your videos make me believe that I can do this no matter what hard ships I will run into. This is what I truly want so I will work my hardest for it but I just need help trying to have some guidance if I should take an accelerated track to receiving my RN license or is there another track that I can go? I understand you are very busy but any guidance I would truly appreciate. Thank you for all that you do! Stephanie
Question. What are these assessments you have to do. Do have to do assessments on patients every time your on. Are these basically head to toe assessments. Do you have to assess them before discharge. Do you assess them when they get admitted like take their vital signs, get a blood count.
This is helpful for me as I am about to start my first job as an RN! What is your daily routine BEFORE you get to the hospital on the days you work? Also any tips for a new RN starting onto a step down unit? -Bolana
I definitely agree with your routine. I love getting assessment done first. Our computer program is so terrible...we use ARCIS! :( the work list it self takes more time than the assessment. It's frustrating when you spend so much time on the computer and away from your patients. They picked the cheapest system, it's so sad.
Great time management skills!! I worked in a hospital in the beginning of my career and found that the schedule that the hospital had us work was extremely difficult. We had group report the second you clocked in, it was in one large room so you had to hear every patients report; all assessments had to be completed in the first hour, and meds were usually at 7, shift started at 6:45 and meals were at 8. Crazy, stressful, and frustrating way to start the day. Only thing I wonder is how do you give a report to the oncoming nurse in front of the patient without the patient hearing something too soon; such as lab results or x-ray results or diagnosis if they haven't seen their doctor yet, or HIPPA, if family is in the room?
1 year left til my BSN! I'm in my pediatric clinical rotation right now and it has been the hardest clinical for met, yet! Relating to pediatric patients, how to talk to them, how to get my assessment/VS done is hard! Any tips on excelling in peds clinical rotation?
Jessica Fowler Hi Jessica! lol, yes it can be extremely challenging to complete your assessment & VS with peds! Some children will be easier than others of course. And the same method that worked with one, may not work with others.I honestly found that finding a nurse who was excellent with most children and then modeling them, was very helpful. Try to find a positive role model & do what they do :D I hope this helps!! xoxo - Caroline
Do you have any experience in long-term care? How do you think it would be for a nurse to transition into a hospital after working in that area of nursing?
nia jones Hi Nia! Really nice to hear from you! I have a video that I think will answer this question for you :) Here is the link: ua-cam.com/video/pV9Yt4b3uFc/v-deo.html If you have any more questions, just post new comment!! I hope this helps a ton! xoxo - Caroline
Do you have any specific tricks you use to stay organized with 6 pts? Like a daily outline so you know who to give meds to first? Thanks;) P.S. you're so beautiful!
Andrew L. Edwards Hi Andrew!It is really nice to hear from you! I always start with the most critical patient and if everyone is ok... then I start with the one that has the first medication due. If all of my patients are ok and all of their medications are at the same time, then I start in numerical order :) Then, using a sticky note, I go to each room at and give my patient their medications, perform the physical assessment and document it. Tracking my progress with a stick note. If I get sidetracked, which happens of course all the time, my sticky note reminds me where I left off :) Here is an inspirational video on how to manage high nurse/pt. ratios. Below the video, I have all of my "how to" videos :) ua-cam.com/video/m4l6O4y08Ro/v-deo.html And of course, I have to recommend my book: New Nurse? How to Get Keep and Love Your First Nursing Job... which can be found on Amazon. Because I go into a lot more detail there :) The main thing is to stay focused & positive. Also, some days will be easier than others... and we all have days where our pt. load can literally be impossible.... just be easy on yourself and always show up for the next day :D I have found that I learn the most during the hard days. I hope this helps!! xoxo - Caroline
You know, All we can do is all we can do... I usually apologize and then explain the necessity of them waiting to get full treatment. I also mention that it is best to take care of this now... so that they don't have to come all the way back or wait for hours at a dr.s office on a different day. Also, little gestures go a long way.... asking them if you can make them more comfortable in any way... more water, juice, snacks? Many times, if people like you... they will be nicer ;) I hope this helps! Let me know if you need anything else! Much Love, - Caroline
Hi thank you so much for this video I loved it. I'm a new nurse and I started on days for training but was forced to do night shift so things went from being structured for me to super crazy. I feel like I just get slammed with admits all night that I get so busy and forget the more important things of my job like doing my assessments carefully especially since majority of my patients are copd or chest pain. I know it sounds silly but I'm honestly still panicking when I go in the room to do my head to toe assessment. Mainly because I work on an observation unit and I get people of all ages and all problems it's never consistent for me so I never get good at a focused assessment. I'm just running around on my feet playing waitress and charting and passing meds. I hate feeling like I don't do what's important for my patients. Do you have any advice for me? I would appreciate any feed back. I love your videos you really inspire me and give me confidence.
@@TDArocks2long shifts but you get 36 hours in 3 days close to 40 hours and then you are scheduled to be off 4 days but you can pick up a day or 2 if you want.
Shilpa James Hi Shilpa! I have never worked a 6 hour shift before... so I'm sorry, I cannot help with that. However, I do have a video on what it is like being an agency nurse!! Here is the link: ua-cam.com/video/BeSDdSW1HME/v-deo.html I hope this helps!! Let me know if you need anything else! xoxo - Caroline
I have questions about working in a hospital. Since you have experience with it I have a question or too. A lot of nurses pass meds in nursing home do a lot nurses pass meds on medsurg floor,ICU,Er and other units in the hospital. Do all hospital units have a waiting room, Do you have nursing assistants in the hospital in the units to help you out. Do you have a lot of charting and paper work to do in the hospital as well.
Do you ever get wigged out like something weird is going to happen or your missing something? I am nervous with this because a lot of times I think I don't pay enough attention to detail. I want to offer the best care I possibly can.
what happens if you havent finishing charting or documenting by the end of ur shift? do you stay over and get paid overtime and will that get you in trouble?
Hi Erika! I keep it short & to the point... Like: Hi Dr. Smith, This the nurse taking care of Mr/Mrs Wilson in room 401... Then go on with my speech ;) I hope this helps!! xoxo - Caroline
hello, I'm an Rn new grad and the pay is btw $25-28/hr (VA) starting depending on the state you work. There are night, evening, weekend, and holiday differentials. Being a dr. and being a nurse to me is very different. Of course drs do get paid more, but i believe nursing is more rewarding because you get to spend the most time with pt and you have the most impact. doctors treat the diagnosis, nurses treat the pt. i hope this was helpful, good luck in what ever path you chose =)
you can make a lot of money as an RN, depending on how hard you hustle and your flexibility. can you do float, PRN, travel, extra shifts, different shifts, nights, a specialty. Also, it doesn't make sense to be a nurse first. The schooling is TOTALLY different. There aren't any bridge courses from nurse to doc so uou have to start ALL over. And the schooling and subsequent residencies, etc for M.D. takes years. And nursing isn't a prerequisite for M.D. A registered nurse carries out the doctors orders. You have to have a lot of skill and use critical thinking to carry out these tasks. This line of work is honorable and professional. There are an endless amount of credentials you can get for your skill set and expertise. And the avenues of nurse are vast. Although nursing is a respected profession in the U.S., M.D.s usually receive much more respect and money. Their jobs usually come with many more responsibilities and critical management of people's lives. Hopes this helps.
+Alyson G Hi Alyson!! 12 ish 😬 I say 12 (ish) bc we are supposed to work 7am-7pm... However, I usually never finish until 7:45-8... sometimes later. But you know, your up moving around all day... you usually feel pretty good ☺️ I hope this helps!! ❤️ - Caroline
Really good I love the structure of the floor aswell please play some of your audios it's so important to start the day positive love the video going to use post it now love you xxx t
Hi im noelia😊 do you guys have a lot of papee work? so u also deal with a lot of blood? Will i have a lot of job opportunitys if i only get an associate?
Way to simplistic an explanation of a day as a nurse. After 30 years of nursing I'm sure I do more than meds and make rounds. You never speak of pain control, wound management, prepping patients for the OR or recovering patients, if you do that, Starting IV's , give blood, rounds with Doctors (which we do in ICU). Precepting new nurses or teaching students. Speaking to the thousands visitors or multiple consults from physicians. Calling the lab, Xray, US, OR, PACU, MD's. End of life care, massive amounts of patient education that needs to be done before discharge. Dealing with other disciplines besides nurses. PT, OT, speach therapy, discharge planner, social worker, palliative care or wound care/ostomy nurses. Don't sell yourself short.
I always document after. I don't want to waste time documenting when there are 5+ more assessments to be done, but my patients typically have 7am 9am and 10am medications.
I suggest just writing down what you heard/assessed in red on your SBAR sheet. I wouldn't want to confuse two patients and helps cement it in my mind
Hi Jazmine!
Really nice to hear from you!
If you find something that works for you... stick with it!
Routine is important :)
Thanks so much for the comment!
See you soon!!
xoxo
- Caroline
You mention many things that I use for time management and it is nice to see it reinforced with extra tips. Such a great service you are doing - and you're enjoyable to watch! Keep it up, please, thank you.
googoogjoob7 Aww! Thank you too! I'm glad you enjoy this video :)Would love to see you here soon so keep in touch! xoxo!!
Thank you so much for this video! I'm starting my first day on a medical unit tomorrow with patients. I'm a new nurse :) This has helped so much!
+ali600n
I'm glad to hear that! :)
Thank for letting me know it helps.
I appreciate it a lot.
-xoxo
Hi Caroline! So glad I found this video. My first day on the floor will be on March 17th, so I'm trying to get tips on organization and anything else that may help me. I will have a coach/preceptor working with me for 12 weeks, so I won't be alone but I like to get different perspectives. :) So, thank you!
Thank you so much... I am a new nurse... God willing I will make permanency first week of December (almost 3 months). This is a true wake up call... from school to the actual field... I've cried a few times haha... and it is stressful organizing. As you stated it depends on where we work. I am in Puerto Rico & at a teaching hospital... yet wow... I love that you mentioned sticky notes... I was thinking that my last shift, so I need to buy some. I also read over some comments... "when to call the Dr" etc.. plus all the meds. I am on a Med Surge floor which is a tad chaotic at times & I am usually organized yet have found it a bit hard to organize myself. The most patients I've had at once has been 12.... and wow... they say if I learn there, I can work anywhere... we also have an area which is like ICU with max 4 patients (I like that better eventhough they are more critical, ventilators etc.)... I pray to be the best NURSE I can be, eventhough it's tough, plus critical thinking. ;-) Thank you for taking the time to make these videos... God bless you & your family.
Stacy Sepulveda Awe hi Stacy!
It is so nice to hear from you!
Thank you so much for letting me know that you like the videos! I appreciate it so much :)
Don't worry, it will take a little time for you to know what you need to do to be organized... but yes, sticky notes are a staple for me.
I still use them on a daily basis :)
Keep in touch!!
xoxo
- Caroline
We work so different in Scotland from you :O In my ward anyway, we go and wait in the staff room until our shift start time to allow the previous nurse to get everything done before handover, each nurse from the last shift comes in and tells you about their patient: name; age; patient; burn; past medical history; observations; what they need done, what happened overnight; what meds they had etc. Once all the nurses have handed over to the full day team the ward sister allocates patients. they one nurse does the meds and IV's for the full ward and the rest go and wash their patients/checklist them for theater/ change their dressings. then the doctors come for a ward round and you get a second report from the ward sister after this ward round, things like who's going home, who's going for theater etc; and then we do our observations and do our charts and notes etc. We all get allocated first or second break and unless there is a life or death situation happening you have to go for your break at that time which is awesome because everyone gets a rest from the floor. I'd love to work in a burns unit in the USA for a few months to see how different you guys work from us :D
Thanks so much for sharing this!
Yes it is very different here in the USA, but I love how it seems like you all work as a team.
And it also seems like you can have different roles, different days :)
That would change things up a bit!
Thanks for the comment!!
Looking forward to seeing you again soon!!
xoxo!
- Caroline
used to be like that here too.
Hi there, in relation to bleeping the doctor. I found the SBAR tool really helpful
S-Situation: state the patient's name, what they are in for and what the problem is
B-Background: Give a history of the patient and any problems that have arisen whilst he/she has been in hospital
A-Assessment: Give details of blood test results, sputum results, clinical observations etc.
R-Recommendations: "Please come and assess this patient" and ask if there is anything they want you to do in the mean time.
Sometimes I find having a little way of remembering helps me. :)
Awesome!
Thank you so much for sharing!!
xoxo
- Caroline
I was about to ask for tips on taking report but I see you already have a video.. that's awesome! thanks!
HUGO RODRIGUEZ Awesome!
Yes a lot of peps requested in the past... so I did post one :)
Let me know if you need anything else!
Much Love,
- Caroline
Love your videos! I am going to be starting nursing school in the fall and have a video request if possible. I would love to hear about your daily schedule when you were a nursing student in detail. For example, how early you woke up, arrived to class, frequency and length of studying, etc. I want to hear how other nursing students manage their time effectively.
I am planning to become a nurse, I am a senior in highschool. I enjoy watching your videos! :) Thanks!!
LeeAnn Moore That's great! Thank you for letting me know you enjoy the videos. I really appreciate it. Right now, I wish you all the best in your upcoming graduation and may God bless your plans. Let me know what I can do to help. Keep in touch! -xoxo
I am 16 years old and I really love your videos it really helps me alot cause i also want to become a nurse when i finish high school and college and i am already taking nursing classes and this really helps me alot with what i am going to face
So glad I discovered your video's. I'm from South Africa and I'm now busy with my 3rd year degree in nursing.
Alma Nel Hi Alma! Wow, South Africa!! My videos are going far lol :D
Thanks for sharing & I look forward to hearing from you again very soon!!
xoxo
- Caroline
***** are you on facebook?
Thanks so much for answering my question! This video was so helpful! I'm a last semester nursing student who is graduating in April. I'm usually pretty organized at clinical but as we are moving into have more and more patients I find it a little overwhelming. I will definitely try out some of your tips this week during my clinical and on my first day of my internship! :) Keep up the awesome videos..You are so inspiring! xoxo
Lose yourself- Eminem.. its a good song in my opinion and helps me keep motivated as a CNA before I start work
Hi Caroline, I love your videos! I find them really helpful and a good insight into the world of a registered nurse. I'm Scottish and training to become an adult nurse at Dundee University! I love my course and clinical placement, but as I am in 2nd year (the course is 3 years) I am finding myself looking to the future and wondering how I will cope when/if I qualify as a registered nurse with my own patients. Your videos are really comforting, they always remind me that organisation and time management are key in helping a RN cope with their shifts! Thanks again for the videos and keep up the good work :)
I love how you say you always do the "hardest" things first (or the most involved), when you start your day because it makes you feel happy! That is exactly how I am! I love to get the hardest out of the way, because you know if you can accomplish THAT....you can do almost ANYTHING!! :) Keep up the good work!
Hi LaVerne!
Thank you so much for sharing!!
I know, you always feel so much better when you have a few things off your mind :)
Looking forward to seeing you again soon!!
Much Love,
- Caroline
What is your favorite unit to work. From the way you describe it you don't like the ER that much. When you describe your daily routine what unit were you working on. Can I be a regular RN staff nurse and go to the ER or ICU or OR and not need additional certification.
Awsome. Thanks for your helpful suggestions and wonderful energy. Best wishes
Hey there Carolyn. Have you ever wondered what it would be like to work in a surgical ward. My mom used to work there and she said it was one of her favorite rounds she has ever done.
+Andy Rusin
Hi Andy!
I've never really been interested in surgery... I don't like to watch them & almost passed out at the first surgery I ever saw.
I also don't like the feeling of being in a room & not able to leave.
I really just like the floors :D
But everyone is different!!
Nice to see you on here again!!
xoxo
- Caroline
+Kayla Adams my mom is a nurse at a nursing home and she says although she gets a 30 min break halfway through her shift on the floor she only treats it as a quick bathroom break/water break because she says if she were to take the whole break she'd be waaay behind on her rounds
Kayla Adams
That's a total exaggeration truly!!! Nurses just complain a lot. I'm a nurse that doesn't happen
I have been a nurse for a few months only. I am never sure when to call a doctor. I know that when there is a critical lab or change in pt. status I have to call, but when it comes to labs, I never know if I have to notify them. For example, the other night I had a pt. with sodium level of 152 which is high, but not critical. High sodium would mean that the pt. was getting dehydrated, but his BP wand urine output were fine. The doctor that was on the case never calls me back so I didn't even bother to call him. When I asked my fellow nurses about it, they said that they don't call at night unless it's critical. Then I felt bad because I feel like I am not doing my job right. It's just never black and white. So could you please make a video about when to call the doctors? Just to give me an idea. Thank you so much in advance!
Agulek Wywieszka Hi Agulek!
It is so nice to hear from you!
I loved how things were so clearly outlined in nursing school... and then we join the real world and things are hardly clear cut at all.
It is hard to know when to notify the doctor, but one thing that I do is compare the new lab results to old lab results... I know that this does not help with every situation, but this will help a lot when it comes to labs :)
It is hard to create a video about this because it is dependent upon so many factors, but if I think of a way that I could properly display it in a video I will definitely create one for you ;)
I hope this helps at least a little!
Let me know if you need anything else!'
Much Love,
- Caroline
Hey, feeling the need to add my 2 cents to this one since at our hospital calling on night shift is kind of a hot topic right now. Our docs will always round on day shift so if the issue can wait 12 hours, so can my call. We always try to combine our calls as well so if another nurse needs that doc, they will ask everyone and pass the phone over when they're done. This is a situation in which I might address a non critical issue since the physician is already on the line. In your situation, I would also would question why these results are available on nights, when was this lab work ordered, at what frequency etc in determining if the MD wants to hear about it or not. You mentioned your pt was asymptomatic, to quote one of our MDs from today "I treat patients, not numbers" I would likely wait.
Lastly, when in doubt, call, it is your license on the line, document who you called and when to cover your tail should anything go wrong.
Polish Girl In Florida this is one of the hardest things to get used to! I work icu days, but have heard of similar issues experienced with our night shift. I notice that before our night doc is paged, everyone will say at that point if they need to talk to the doc. Really good idea, less pages/calls for the doc. They usually have a lot of ground to cover with minimal support if that, so excessive pages can be frustrating. That being said, your license is always on the line. If something happens because of a lack of reporting, you are the only person who will be hit. And oftentimes the hospital will not cover you for liability (you may want to look into personal insurance liability coverage, just in case... I've paid for it every year and have still not needed it). I'm always careful about electrolytes- Hypernatremia/hypo can effect your brain and cause seizures. We get concerned at 150s. They may just even change some fluids around to drop it. Ive learned that you can see trends over time that can indirectly warn you of possible scenarios/deterioration. For example the MEWS score (not sure if you use that?). They have this in our system that rates VS on the floor, and the charge will be paged if the number goes up to a certain number. Your patient may look fine but can be a ticking time bomb waiting to crump. Another example- wow this patients heart rate is trending up and now tachycardic; pressures are trending down; diaphoretic; lethargic; increasing temps, white count trending up..I'll call the doc and get blood cultures for possible sepsis. Treat that early and you can save a life. Just examples. Look at your labs in conjunction with each other in addition to your assessment; everything is interrelated somehow. You're like a detective, to figure out what the underlying issues is sometimes! Not a lot of urine output with this? How is their kidney function? Could be in ARF. Also on high dose vanco and you see a trough is higher? They may be in kidney failure from it. The longer you work on the floor, the more experience you get and you start to see things repeat themselves that you have learned from/witness that can allow you to put different pieces together to be proactive instead of reactive. That's what's fun with nursing, it keeps you on your toes. You will never EVER know everything. Our veteran nurses always say how much they learn about new things all of the time! Technology and EBP is a huge part of that. It's awesome you're reaching out to others to get their opinion- Dangerous nurses are the ones who just assume and make the wrong choice. I ask other peoples opinions all of the time, but have learned that whenever I ask other people what they think, there's something off to me that should just be reported. Always trust your gut. Always. I annoy our docs all the time and almost always page them or hunt them down every shift regarding concerns. At least they know, and the worst thing that can happen is that they get irritated lol.
On the floors, your Sodium may not even be rechecked until the next morning. And if there is an issue going on, things can change quickly. Maybe they need to have their sodium checked every six hours, or fluids adjusted. Or simply nothing lol. But then what do you have to lose ?
I like how we have modified our rounds. During bedside report, both day and night nurses look up all current/significant labs together to address concerns. It has been such a help to have electrolyte protocols in place so if you have only slightly off elytes, you can automatically put in the replacements yourself. I also remember how hard it is to have 4-6 patients on the floor, it's incredibly easy to not see things/address stuff with the doc when you want, let alone get your stuff done without pulling your hair out. In all units, things can just be missed or forgotten about. That's why I agree with looking at labs at start of shift. If anything just within the past 12-24 hours. It's a 24 hour job, you do the best you can on your shift! And that's all that you can do :)
It all takes time. But protect yourself and how hard you worked to get your license, and of course advocating for your patient at all costs. Page out and then document that you did so. Then it's on the doc if they want to call back or not. Not calling back during a legit concern? Get your coworkers involved and your charge.
Things will get smoother and less stressful over time, I promise!!
Hey Caroline! I have been watching your videos and I think you are AMAZING. Thank you for your motivating words and actions you are a true inspiration. Please forgive me but I do have some questions. I am 22 years old. I declared nursing as a freshman but when I had to withdraw from human anatomy I did not believe that I would be able to get through the nursing program. (I do have some prerequisites such as statistics, Chemistry, developmental psychology & general education classes but i do know that there are other prerequisites that are required.) So i switched my major and graduated four years later with a business management degree. Truly that was not what my heart wanted nor was it what I was set out to be. I am now here today applying to nursing schools and I do know that some schools do not accept students to take anatomy more than twice within ten years. Your videos make me believe that I can do this no matter what hard ships I will run into. This is what I truly want so I will work my hardest for it but I just need help trying to have some guidance if I should take an accelerated track to receiving my RN license or is there another track that I can go?
I understand you are very busy but any guidance I would truly appreciate.
Thank you for all that you do!
Stephanie
Question. What are these assessments you have to do. Do have to do assessments on patients every time your on. Are these basically head to toe assessments. Do you have to assess them before discharge. Do you assess them when they get admitted like take their vital signs, get a blood count.
This is helpful for me as I am about to start my first job as an RN! What is your daily routine BEFORE you get to the hospital on the days you work? Also any tips for a new RN starting onto a step down unit? -Bolana
I definitely agree with your routine. I love getting assessment done first. Our computer program is so terrible...we use ARCIS! :( the work list it self takes more time than the assessment. It's frustrating when you spend so much time on the computer and away from your patients. They picked the cheapest system, it's so sad.
thank you for this video! I am on my third semester and this will help structure my day a lot better:) thank you!
HUGO RODRIGUEZ Hi Hugo!
Awesome!
Thanks so much for letting me know!
See you soon!!
- Caroline
Can you please do a video on how to assess Patients
Great time management skills!! I worked in a hospital in the beginning of my career and found that the schedule that the hospital had us work was extremely difficult. We had group report the second you clocked in, it was in one large room so you had to hear every patients report; all assessments had to be completed in the first hour, and meds were usually at 7, shift started at 6:45 and meals were at 8. Crazy, stressful, and frustrating way to start the day. Only thing I wonder is how do you give a report to the oncoming nurse in front of the patient without the patient hearing something too soon; such as lab results or x-ray results or diagnosis if they haven't seen their doctor yet, or HIPPA, if family is in the room?
1 year left til my BSN! I'm in my pediatric clinical rotation right now and it has been the hardest clinical for met, yet! Relating to pediatric patients, how to talk to them, how to get my assessment/VS done is hard! Any tips on excelling in peds clinical rotation?
Jessica Fowler Hi Jessica! lol, yes it can be extremely challenging to complete your assessment & VS with peds! Some children will be easier than others of course. And the same method that worked with one, may not work with others.I honestly found that finding a nurse who was excellent with most children and then modeling them, was very helpful.
Try to find a positive role model & do what they do :D
I hope this helps!!
xoxo
- Caroline
Hello Caroline, thanks for the great video! What other ways do you use sticky notes during your day besides to page the Dr.?
Why do you need to check your labs and vitals in the morning. Where are they usually at in the patients chart.
Do you have any experience in long-term care? How do you think it would be for a nurse to transition into a hospital after working in that area of nursing?
As a High school student, what should I be focusing on to become a RN? academically and outside of school?
nia jones Hi Nia!
Really nice to hear from you!
I have a video that I think will answer this question for you :)
Here is the link: ua-cam.com/video/pV9Yt4b3uFc/v-deo.html
If you have any more questions, just post new comment!!
I hope this helps a ton!
xoxo
- Caroline
Do you have any specific tricks you use to stay organized with 6 pts? Like a daily outline so you know who to give meds to first? Thanks;)
P.S. you're so beautiful!
Andrew L. Edwards Hi Andrew!It is really nice to hear from you!
I always start with the most critical patient and if everyone is ok... then I start with the one that has the first medication due.
If all of my patients are ok and all of their medications are at the same time, then I start in numerical order :)
Then, using a sticky note, I go to each room at and give my patient their medications, perform the physical assessment and document it.
Tracking my progress with a stick note.
If I get sidetracked, which happens of course all the time, my sticky note reminds me where I left off :)
Here is an inspirational video on how to manage high nurse/pt. ratios.
Below the video, I have all of my "how to" videos :)
ua-cam.com/video/m4l6O4y08Ro/v-deo.html
And of course, I have to recommend my book: New Nurse? How to Get Keep and Love Your First Nursing Job... which can be found on Amazon. Because I go into a lot more detail there :)
The main thing is to stay focused & positive. Also, some days will be easier than others... and we all have days where our pt. load can literally be impossible.... just be easy on yourself and always show up for the next day :D
I have found that I learn the most during the hard days.
I hope this helps!!
xoxo
- Caroline
Love your videos, you are a thinspiration to me
This was very insightful!
Thank you so much!
Hi Caroline! What type of nurse do you currently work as?
I work as a Tele nurse.
Which means remote telemetry or cardiac monitoring :)
I Love it!!
Talk to you soon!!
xoxo
Merci!
Melanie Lavoie Hi Melanie! Thank you very much. Merci! -xoxo!!
how do u deal with parsents that are really upset and just wanna go home especially if they live an hour and half away
You know,
All we can do is all we can do...
I usually apologize and then explain the necessity of them waiting to get full treatment.
I also mention that it is best to take care of this now... so that they don't have to come all the way back or wait for hours at a dr.s office on a different day.
Also, little gestures go a long way.... asking them if you can make them more comfortable in any way... more water, juice, snacks? Many times, if people like you... they will be nicer ;)
I hope this helps!
Let me know if you need anything else!
Much Love,
- Caroline
+empower thanks
very insightful video! thanks for sharing:)
Hi thank you so much for this video I loved it. I'm a new nurse and I started on days for training but was forced to do night shift so things went from being structured for me to super crazy. I feel like I just get slammed with admits all night that I get so busy and forget the more important things of my job like doing my assessments carefully especially since majority of my patients are copd or chest pain. I know it sounds silly but I'm honestly still panicking when I go in the room to do my head to toe assessment. Mainly because I work on an observation unit and I get people of all ages and all problems it's never consistent for me so I never get good at a focused assessment. I'm just running around on my feet playing waitress and charting and passing meds. I hate feeling like I don't do what's important for my patients. Do you have any advice for me? I would appreciate any feed back. I love your videos you really inspire me and give me confidence.
Loved this! Thanks
love your vids! I want to be a RN as well.. so do you actually work 12 hour shifts?? please answer:)
TDArocks2 Hi Love! Yes, 12 hour shifts 3 days per week :)
Hello, wow long shift haha, thank you for the reply! Your videos definitely inspired me
@@TDArocks2long shifts but you get 36 hours in 3 days close to 40 hours and then you are scheduled to be off 4 days but you can pick up a day or 2 if you want.
Cn u advise on managing 6 hr shifts..and hw to wrk as an agency nurse?
Shilpa James Hi Shilpa! I have never worked a 6 hour shift before... so I'm sorry, I cannot help with that.
However, I do have a video on what it is like being an agency nurse!!
Here is the link: ua-cam.com/video/BeSDdSW1HME/v-deo.html
I hope this helps!!
Let me know if you need anything else!
xoxo
- Caroline
I have questions about working in a hospital. Since you have experience with it I have a question or too. A lot of nurses pass meds in nursing home do a lot nurses pass meds on medsurg floor,ICU,Er and other units in the hospital. Do all hospital units have a waiting room, Do you have nursing assistants in the hospital in the units to help you out. Do you have a lot of charting and paper work to do in the hospital as well.
Do you ever get wigged out like something weird is going to happen or your missing something? I am nervous with this because a lot of times I think I don't pay enough attention to detail. I want to offer the best care I possibly can.
I bought your guide on how to study and wasn't able to download it. I emailed you and didn't get a response.
what happens if you havent finishing charting or documenting by the end of ur shift? do you stay over and get paid overtime and will that get you in trouble?
Silly Question: how do you start the conversation when paging a doctor?
Hi Erika!
I keep it short & to the point...
Like: Hi Dr. Smith, This the nurse taking care of Mr/Mrs Wilson in room 401...
Then go on with my speech ;)
I hope this helps!!
xoxo
- Caroline
I love your channel! You're awesome and beautiful :)
+Eymari Yinalen
Hi Eymari!
Thank you very much.
Looking forward on hearing from you again soon.
-xoxo
You are so inspring!
Summer Goodlow Hi Summer!
Thanks so much for the comment!!
Really looking forward to seeing you on here again soon!!
xoxo!!
- Caroline
:) Thank you
Summer Goodlow Your welcome!! xoxo!!
how often do you have to wipe pts?
Hi, i'm confused if whether I should work as a nurse or should I proceed to med school Hahah by the way how much do nurses earn monthly?
hello, I'm an Rn new grad and the pay is btw $25-28/hr (VA) starting depending on the state you work. There are night, evening, weekend, and holiday differentials. Being a dr. and being a nurse to me is very different. Of course drs do get paid more, but i believe nursing is more rewarding because you get to spend the most time with pt and you have the most impact. doctors treat the diagnosis, nurses treat the pt. i hope this was helpful, good luck in what ever path you chose =)
you can make a lot of money as an RN, depending on how hard you hustle and your flexibility. can you do float, PRN, travel, extra shifts, different shifts, nights, a specialty. Also, it doesn't make sense to be a nurse first. The schooling is TOTALLY different. There aren't any bridge courses from nurse to doc so uou have to start ALL over. And the schooling and subsequent residencies, etc for M.D. takes years. And nursing isn't a prerequisite for M.D. A registered nurse carries out the doctors orders. You have to have a lot of skill and use critical thinking to carry out these tasks. This line of work is honorable and professional. There are an endless amount of credentials you can get for your skill set and expertise. And the avenues of nurse are vast. Although nursing is a respected profession in the U.S., M.D.s usually receive much more respect and money. Their jobs usually come with many more responsibilities and critical management of people's lives. Hopes this helps.
How many hours do you work a day?
+Alyson G
Hi Alyson!!
12 ish 😬 I say 12 (ish) bc we are supposed to work 7am-7pm... However, I usually never finish until 7:45-8... sometimes later.
But you know, your up moving around all day... you usually feel pretty good ☺️
I hope this helps!!
❤️
- Caroline
can you send me some links for the audios
Really good I love the structure of the floor aswell please play some of your audios it's so important to start the day positive love the video going to use post it now love you xxx t
what type of nurse are you?
Karlee Drzazga I work tele/step down units :D
But I also float... so sometimes I work in the ICU, Mother/baby or med surg.
xoxo
- Caroline
Hi im noelia😊 do you guys have a lot of papee work? so u also deal with a lot of blood? Will i have a lot of job opportunitys if i only get an associate?
What floor are you on?
Way to simplistic an explanation of a day as a nurse. After 30 years of nursing I'm sure I do more than meds and make rounds. You never speak of pain control, wound management, prepping patients for the OR or recovering patients, if you do that, Starting IV's , give blood, rounds with Doctors (which we do in ICU). Precepting new nurses or teaching students. Speaking to the thousands visitors or multiple consults from physicians. Calling the lab, Xray, US, OR, PACU, MD's. End of life care, massive amounts of patient education that needs to be done before discharge. Dealing with other disciplines besides nurses. PT, OT, speach therapy, discharge planner, social worker, palliative care or wound care/ostomy nurses. Don't sell yourself short.
After 3 years as RN... I wish I did something else becuase nurses in my town has no rights...
You can be my nurse any day.
could you do a skincare routine? you are gorgeous!!!
Thanks Angel!! Probably just the lighting 😂 but yea can & will try to do it soon!! Thank you for the compliment & video request!!
See you soon!!
Why do you have to wait for all your patients to be fed. Isnt that more of the nurses aide job.
Is your husband also in healthcare?
I wish you would be my nurse Darling
I am single i want nurse ❤😍😍