jodispamodi, BSN, RN, EMT-B, EMT-P 1,623 Views
Joined Mar 7, '08.
jodispamodi is a RN.
Posts: 176 (61% Liked)
Depends on facility policy and patient physiology, some places do allow you to draw off IV (I've never woked anwhere that allowed that but I know others who have), In rare cases if the patient has poor access but a good IV docs may allow draw off the IV as thd best chance of getting a sample. As far as the labwork, how long between the low to high to low, it very possible the K+ replacement brought him up that high but with diuresis from the lasix could have easily dropped him down again, I've seen patients with K+ all over the place and we draw usually 12 hrs to 24hrs, so the lab results may have been very accurate.
Perhaps its time for a family meeting with you NM, and/or director of unit to explain what has happened (spilt his meds), how it has been handled (we gave him mord pills which he took) and to gently explain that patient has memory issues and may be confabulating about getting the pills. Thats the most professional way to attempt to resolve this.
Kudos to you OP for accomplishing what you have. These are my thoughts on your situation.
You mention the surgeries you had and that you look different, is it possible you're self esteem is low? I say this because often when one has low self esteem they tend to perceive things differently, your comments you considered bullying make me wonder if perhaps it could be perceived differently? You don't mention any specific instances of bullying so its hard to say but where you getting hard assignments because of your status on the totem pole as opposed to how you perceive you look?
You mention you were at work when you had some bad thoughts, and had to go to the ER, came back were assigned a buddy and that didn't work out. Is it possible the stress of a full time job was too much? Also was the perceived bullying in relation to patient care? It sounds like you were very close to the edge (probably longer than you realized was noticeable) and other nurses stepped up to ensure patient safety? Again without knowing specific scenarios its impossible to guess but I'm just throwing scenarios out.
Also it sounds like you were successful at your per-diem job, why not try to stay per-diem for awhile and allow yourselt the ability for more downtime and decompressing if needed?
Lastly, do you mention any of the above when being interviewed? are you sure references are giving you a good reference, and the job market is kind of terrible right now, so it may not be YOU, it may just factor into a lot of competition out there.
Finally, I give kudos not only to you but to the director of your previous place, it sounds like they supported you and gave you the opportunity to try again (many places would not have)
I wish you the best.
Trying to leave the room, lol. its like that and the report one yes "just get me the heck outta here"
Why on earth would you want to buy an IV pump for HOME USE?
Anything is possible, with 20/200 vision (I assume corrected), it would be hard to get a position in some types of nursing, like where you would have tele, IV pumps, etc, but there are other types of nursing and possibly some adaptive equipment you could use
I would contact a few nursing schools and just ask outright. I think its possible, in certain types of nursing. Best of luck.
Honestly I'd be careful about LTC, if you can get on the sub-acute or rehab unit thats better but the ltc and memory floors can be quite difficult depending on how they are staffed, and not the greatest for developing good habits. What about a doctors office or ambulatory setting. Best of luck
OP, it also matters if the patient is aymptomatic or symptomatic. So when calling the doc, revert back to your SBAR (this was the exact reason it was brought into healthcare to facilitate communication between doctor and nurse as we tend to have different communication styles so for example:
Hi Doc, this is D. Mellilitus LPN at Old Peoples Home. My number is xxx-xxx-xxxx,
(Situation) I am calling on Hi Sugar room 320-A, (In ltc you don't really need the room number) we just checked his blood sugar and it is 500. I notice he has 6 units of novolog, and 12 units of lantus due with no sliding scale.
(Background) he has a R BKA, esrf, dialysis patient, and diabetic retinopathy.
(assessment) he is asymptomatic at the moment, aox 4, his VS are..., he denies hunger, thirst, shakes, (hyperglycemia sxs, etc)
(Recommendation) I see he doesn't have a sliding scale ordered, and I'm not sure if you want me to give him his current insulins or possibly adjust the dose? Please call me back at xxx-xxx-xxxx with any orders. Thank you,
That isn't exactly how the conversation would go but hopefully you get the idea. ALWAYS have all your info in front of you before you make the call. Be succinct, don't be afraid, and if need be write out what you are going to say. Also look back over the past few days and see where patients sugars have been, very important to communicate that with the doctor. Good luck.
I have done "random acts of kindness" but rather than saying "in memory of" I just say, "to honor someone special" and leave it at that.
When Someone passes unexpectedly on the unit (if its my patient) I just ask no one talk to me about it for a bit until I can get my game face back on. I offer the deceased a silent prayer and take a moment to reflect on just how precious life is. Then I move on.
Is their HCP invoked? are they able to make their own decisions? That is the determining factor.
Well, you have to remember the majority of them have dementia and being in the hospital is a huge environment change and they are around all these unfamiliar people who are telling them to do stuff, or take stuff, etc. I'm positive its very frightening for them and they don't understand your logic (the bathroom is not in here its down the hall, because wherever they come from the bathroom IS there) So they strike out of fear and to defend themselves. I had many elderly ladies screaming "rape" and becoming combative when they were having peri care done. I used to explain to all my aides that they had to remember for that patient it is rape, they come from a generation where body parts are private and also we are cleaning them, especially late stage dementia when hygiene is not something they can do for themselves any longer-if it were me I'd be screaming and kicking too- but I had my aides explain it, go slowly, and tell the patient each step of the way what we were doing, from we're rolling you over now, you're safe to I'm putting cream on your bottom so it doesnt chafe. Usually with this approach the patients were much calmer and easier. Aides are very busy so I always made a point of being present as an extra set of hands and reminding them to go just a tad slower.
In my experience I think elderly might be quicker to hit, or pull hair etc but for them its a defense and very rarely did they cause serious injury. With adult psych patients I saw much slower to hit or become physical but much more likely to cause serious injury. There was a nurse in my area killed a few years ago.
Good morning nurses!
I am new grad working in psych, about 2 months in and I love it. It's a big passion of mine. I speak to a lot of the nurses on the unit and pretty much all of them say they have been hit, punched, choked, spat on...etc.
Anyone here that works psych that has never been hit or spat on working on their unit? Just curious. Thank you!
I think this is real, I googled the OP, even if its not I love a scenario where candy is the biggest issue in facility.
I've only done 1 group interview, frankly it was a waste of time.
My surname can also be a first name and my first name is spelled differently (not weird just uncommon). People are forever mixing them up and I have hated being called by my last name since I was a child. It just sounded rude to me. That being said, I have never gone screaming howler monkey over it. I usually just sigh and correct the person and move on.
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