Latest Comments by OBNurseShelley

OBNurseShelley 2,269 Views

Joined Oct 14, '02. Posts: 248 (1% Liked) Likes: 17

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    Quote from FutureNrse
    You're welcome I'm just glad that I got it right.
    Your initial post showed me that I was looking at the problem the wrong way, probably because of the circumstances involved with me sister. She has never come to a point of understanding, and in fact is now mentally and emotionally damaged to an extreme that I fear is permanent. Maybe that was already starting to happen from the moment she heard that her son would not live. I just assumed that her reaction was normal, but considering how she is now, 4 years later, I'd say that her initial reactions probably weren't the norm either. I know everyone greives in thier own way, but with her, it was like she didn't hear anything that was said.
    After all this time, I'm fuzzy on some details but one example is that the baby was missing a valve related to his digestive system, and she could not understand why they couldn't do a transplant. His liver was destroyed, and again she wanted a transplant, and there were a host of other things as well. Now, I understood why she asked about transplants to begin with, seems like if somethings broke, you get a new one, right? But when the whole surgical team sat us down and explained why none of these things could be done, I could see thier point.
    My sister, on the other hand, started trying to find loop-holes in what they said, and started thinking up outlandish ideas on how to fix each thing. So, how do you explain to a normally intelligent woman that even though the afterbirth LOOKS like liver, you cannot cut off a piece and use it as a liver?
    So, I guess my question was aimed at this type of behavior, but I think your answer still applies. The understanding will come when they can accept it.

    Sorry to hear your sister is not coping well. Hang in there and support her the best you can.

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    Quote from FutureNrse
    I don't think she meant that she supports it either. I think she meant that if a parent has false hope, there is no need to beat it out of them. You've given them the facts, that there is no hope, the parent chooses to believe otherwise, so you leave it at that. The childs imminent death will be the turning point when the false hope fades. There is no point in making a parent accept the death until it happens. You've told them the truth, and that's all you can do.
    Did I get it right?
    Yes, that is what I meant, they will come to terms with the imminent death and eventually death on their OWN TERMS. It's the statment, "MAKE THEM UNDERSTAND" that hit a button for me. It's similar to dealing with a teenager, you can't MAKE THEM UNDERSTAND anything, you have to hope you've given them all the CORRECT information and they will choose to understannd on their own time.

    Thank you for clarifying my statement.

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    One of the talk shows had a mom on one time that this happened to. She delivered a boy that weighed 2-3 pounds and nearly 8 weeks later delivered a girl that weighed 5-6 pounds, the kids were now 9 or 10 years old and doing well.

    We did it once at a hospital I worked at in Kansas City, called Delayed delivery, they delivered teh first twin (non-viable) and then put a rescue circlage in and attempted to hold out delivery for the 2nd, unfortunately after 2 days she got infected and had to take the circlage and subsequently deliver. The perinatalogist I worked with at the time said it only has a <5% success rate.

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    That's right, I did not mean to tell the parents that at all, I just meant that sometimes it's ok for the parents to have hope, depending on the situation. Of course there comes a point when they need a reality check about a declining situation.
    I agree about consistanty and telling parents what you're doing and what to expect, for instance a non-viable pre-termer may appear to take a breath or move, when it's born, etc.

    Anyway, I still stay you never MAKE SOMEONE UNDERSTAND, you simply give them the facts and let them cope in their own way.

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    Quote from FutureNrse
    Years ago, my sister lost her newborn son to a birth defect. She knew about the defect prior to his birth, and had been assured that everything would be fine. Unfortunately, within hours of his birth, there were other complications, and an additional undetected defect that meant he had no chance of survival. The problem was that my sister refused to accept that her baby would die within 24 hours.
    What do you do when a patient is in denial and refuses to accept such a grim prognosis? How do you make a patient understand when there is no hope?

    You don't MAKE THEM UNDERSTAND, they will soon enough, just let them have hope and support them by answering questions and making them comfortable.
    Miracles DO happen and there's nothing wrong with having hope, sometimes it's all people need to cope.

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    LOVE THE RING, but definately creepy.

    What lies beneath was good

    Stir of Echoes, awesome

    LOVE THE EXORCIST TOO

    BUT MY ALL TIME scariest MOVIE FOR ME was, Arachnophobia, I AM TERRIFIED OF SPIDERS and my friends MADE ME go see this at the theatre, I left before it was even half-way over and sat out in the lobby the rest of the time, I was a wreck for about a week, and the manager thought it was funny to throw plastic spiders on people when they were leaving, I almost had to be resusitated!

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    I looked into this a few months ago, however in order to get the required card for healthcare providers, you would have to go to a facility and be checked off on skills, to me this was a waste of time, might as well just go to the class.

    I suppose there's no replacement for hands-on demonstration and practice, but when I find one I'll do it, since my knees can't tolerate the floor.

    Fortunately, the intructor I had last, let me do my demonstration with the dummy on a chair so I didn't have to kneel, Worked great and I was able to still practice and demonstrate the skills appropriately

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    I am an RN with 3+ years experience in L&D, I have been travelling for the last 2 years and now looking at getting a staff position again. I keep hearing of everyone getting bonuses and moving expenses and other nice things, but I'm not seeing this offered. I'm looking at the Kansas City area, but I may be looking at other locations later on next year.

    Aside from California, which is paying good but it's ridicuously expensive to live there, who else is paying sign-on bonuses and decent pay rates?

    Any info/opinions you have would be great!

    Thanks
    Shelley

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    AngelfireRN and canoehead like this.

    These stories are really interesting to me and some unbelievable, it just floors me what people will do to get some drugs.

    I am constantly complaining about pain documentation, because I work L&D and for the most part it's NOT applicable.

    THat doesn't mean that I don't treat pain, but it's treated in a completely different way.

    Patients typically are given pain medication when they ask for it, however that can depend on a LOT OF FACTORS.

    So, I have a hard time asking a patient what her pain number is, when she's 9cm on admission and how is that pain affecting you and and what would be your pain goal and would you like medicice? SORRY charlie, usually too late.

    Anyway, my point was Pain has a COMPLETELY different meaning in MY job.

    I admire you ED nurses for what you have to go through!

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    I work as a traveler and I have never been anywhere, where assessments change based on an epidural analgesic, typically in recovery they're assessed similar that everyone mentioned, then get routine vitals on PP.

    HOWEVER: for spinals using duramorph, they're typically assessed (after recovery) every hour for 8 hours, then every 2 for 12 hours. Then every 4 for the next 24 .

    It's my understanding the medication used in epidurals is NOT long acting and there should be no reason to assess these patients for breathing every hour, after an epidural has been turned off.

    Maybe, I'm missing something?

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    Quote from becca.utns
    Hi, just wondering if anyone has actually had a patient who used the hypnobirthing technique and how well it worked. And your thoughts on it.

    Thanks!

    Just like all the various methods of dealing with childbirth, it depends on the person. I have taken care of patients that chose this method and found that it worked really well for them, by the end of their labor they were so far out there, it was amazing to watch..........I think it takes a lot of mental control and not something that everyone is capable of, but even so, some of the techniques can be helpful for everyone.

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    Frontier School of Midwifery and family nursing has an MSN program for CNM and NP.

    The website tells you a lot, im in the CNM program, and I've been very happy.
    www.midwives.org
    SHelley

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    i dont know of one, but im in grad school for midwifery, what are you studying? I just started my program in November, it's distance learning, I'm really enjoying it so far

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    HUGE ROOMS with COMFORTABLE beds for post-partum and dads! I definately like the idea of a floor pharmacy, or at least a tube system! ah well, keep dreaming this is fun!

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    This is a cool thread, I too am always looking for new places to try out, currently working as a travel nurse, and exploring the country, native of KS, which is nothing exciting to speak of there, and then drove out to northern california, and i have to say, Utah was pretty, and so was wyoming, and of course, northern cali is beautiful, but really expensive to live.....im definately thinking of checking out oregon and washington, currently out near boston and new england is great too, but i couldn't handle the winters here year after year...

    here's another site to check out what places fit you

    http://www.bestplaces.net/

    thanks for the info, everyone!


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