NursinginProgress 3,837 Views
Joined Apr 20, '09.
Posts: 74 (35% Liked)
Sounds to me, her vascular system started shutting down out of anxiety. Not the first time to hear or see that. If you notice someone is dehydrated or nervous or anxious, talk to the patient and have them relax. Works every time. I do blood draws for research patients in an IVIG setting. No hemolyzing on my watch! Calm and relaxed environments help veins smoothly. That or the patient went on E for blood. Teehee!
I didn't realize that there was an IVIG section here, since I live and breathe it. I started out in IVIG as an LPN in an office infusion suite setting, now I'm an IV instructor and a RN with credentials!
Main things to worry are the following:
Proper rate: You can't go running all patients at the same rate. Gamma globulin whether its Privigen or Gammagard to Gammaked to Bivigam, you could cause side effects such as headaches, low flank pain during or post infusion or nausea and vomiting or even a nice CVA or MI. Even if it's someone who has been getting it for years. It's based on weight and also comorbidities. Go slow or say no!
IV Port Access: Please make sure the port is well flushed. 9 times out of 10, the two reasons someone has a port is because of chemotherapy or incredibly horrible vein access, so make sure you flush according to your protocol. Also, make sure it's a well sterile environment, God forbid you don't access it right and the patient ends up with an infection. Trick I use, a non sterile pair of gloves and an alcohol wipe prior to using a chloroprep kit. This allows you to feel the port and find your target without jeopardizing the sterile field.
Vitals: We all know taking vitals manually can get old and annoying, sure. But in an IVIG setting, it will and can save or at least alarm you of an upcoming turn of events. If you notice their vitals are elevating or decreasing slightly, that's fine. But if the first set of vitals are low and half way in the infusion it gets even lower, put their feet up and monitor. Also, check their pupils for dilation. If it gets higher and higher, lower the rate and definitely notify the MD.
Last but not least, Premeds: If a patient you've never started before tells you, "I'm a strange case, I'm allergic to everything. I this and I that and I get nauseous easily and suffer from headaches and sometimes I get diarrhea when the weather is grey and I've got 13000 other doctors that say I shouldn't get this. Don't run for the hills. Pay attention and if the md doesn't request it, be ready or at least ask why not. It's usually just Tylenol, prednisone and some sort of antihistamine taken by mouth or SoluCortef IV push. It's better to be safe than sorry.
I hope this helps you guys out there in the IVIG world. Need anything just drop a line, eh?
Hey there. I received my LPN from the Academy last year. It's a fast paced program and you gotta hang in there. I am in the LPN to RN bridge program at the Academy and it's tough but there's a lot of resources. Not sure about Keiser. Good luck!
Did the gen Ed classes. Not bad. Started the core class already, very fast paced and you have to know your P's and Q's. Good luck!
If you don't understand the class, textbook or teacher, google, bing or YouTube it. In today's techno world, resources are just a click or tap away. Good Luck and Happy Nursing!
Being nice is one thing, but exchanging numbers is borderline personal. Something to which as a student you shouldn't do. Although, your previous experience was innocent, not all stories end up that great. I knew a nurse in NC, that was very nice and friendly to people, to the point she ended up getting harassed and stalked. Be careful. Usually, I thank the patient for the kind words and tell them that unfortunately we are not allowed to disclose information like that and it's against policy. Good luck out there and stay safe.
I am currently in sunny West Palm Beach, Florida. I've moved all over the place for nursing. California was overcrowded and wait lists out the wazoo, I did score my CNA though. Thought about the online route, but California doesn't accept online nurses, apparently. The program I am in is at the Academy for Nursing. It's a year and about 15-16k, but if you apply for student loans and pell grants, cut it in half and that's about how much you'll pay out in loans. So far, the program is pretty decent. Parking stinks and traffic sucks, then again you're in the city LOL. Good luck!
Social life? What's that? LOL Social life for me is waving at a fellow nursing student and asking they are leaving so I can take their parking spot. LOL
Theres a few reasons to be a LPN.I decided for me, to take each step at a time in case possible problems occurred. You never know what will happen to you out there and how you will survive. Plus, I want to be that nurse that knows exactly what it's like to be a CNA or LPN. I've seen nurses who lucky for them went through the ADN program w/o a history, yet when they got out in the working world, they had no idea what to expect and looked down on the CNAs and LPNs and treated them like garbage. Besides, how do you really know if nursing is for you? At least, if you don't like healthcare, you'd only have wasted so much of time. Rather than go through it all and in the end be like,"Wow, this really sucks." LOL I became a CNA first, then became a LPN and now I'm doing a bridge to become a RN. Just an FYI, I could've easily gone straight through, but I chose not to. To each it's own and may the nursing light shine down upon you through your decisions.
Well. I wanted to shoot straight out of LPN school to The RN program, but the pre-requisites were that one needed to be working as a LPN and provide a letter. Took me 6 months to find a job and 2 months to start. I graduate next year in August. I was afraid that if I don't go back to school now, I'll never do it. Good luck and Happy Nursing!
Realization didn't hit until about an hour ago at 2am, that I'm officially back in Nursing school. I am currently attending a bridge program at Academy for Nursing in West Palm Beach, FL. It has been my experience with this school previously, that they OVER prepare you (I know ... you can never be OVER prepared for nursing but they did!). I stared at the syllabus of all the Med/Surg and Pharm Chapters to remember for our 1st exam tomorrow,for a good 10 minutes and thought to myself, I'm sure my Cortisol levels have increased, BP has elevated and my respirations are becoming shallow and my hair is going to look like hell tomorrow.
So my question to you RN, BSN, MSN, FNP, ARNP, CRNA and every other titled person from the RN food chain is.
How did you do it? Mentally? Physically? Spiritually? ..survive this?
Any guiding words or motivational quotes would be "PERFECT!" So that I can relay the message to my classmates and shine a little light.
I appreciate your time reading this as procrastination for studying is lurking behind me. LOL!
Well, prior to becoming a LPN and able to afford anything, I went to Walmart and purchased these tred-safe nursing shoes for 15.00. They were so comfortable and I could dance in Crisco and wouldn't slip and fall and easy to clean. Once I became a LPN, I purchased the infamous Danskos in Patent Leather (oh..so..shiny..) at our local Uniform store. So, I totally understand the need for comfort, style, and budget for the survival of nursing school and the career itself. Good luck, stay happy and keep nursing! ^_^
Well, right now, I am working Fri, Sat, and Sun 3-11pm shift as a LPN in a facility thats like a box of chocolates, never know what you're going to get. Since I am going to school Mon - Thur.it was tough adjusting to the massive paycheck change, but it's only temporary for something better! So, Bring on the admissions!?!?! Who cares about Saturdays off? Doesnt matter if you know what day it is anymore?!?Woooooot!?! (Gotta keep motivating myself here. LOL)
Patient, 72 y/o female, alert and almost and I thought was oriented (har har), wound dressing from left antecubital to palm area due to laceration of unknown, in tact, no drainage or blood to note at this time. (Stay with me now)Go in, take report, introduce myself, she asks what time I'd see her, said I'd come around 4pm since 5 o clock meds would be due, pt states fine, no complaint. Exactly 4:03pm, call light issued, dressing is half way off, blood everywhere. Immediately cleaned with NS, new dressing, tolerated medication administration w/o incidence while I was in there. (Hey, kill two birds with one stone right?) pt asks, when would I check on her again, (gut feeling kicks in...light bulbs are coming on..well in my head anyway.) I stated around 8pm. Pt states fine. No issue or complaint, 7:59pm I stand outside her room where she couldn't see me because something just wasn't right anymore. 8:00pm hits, pt looks at the clock, looks at her cellphone (oh yes, this one was a savvy one), presses the call bell. (still watching her) 8:02pm, she starts squeezing the life out of her arm, pulling off the dressing and literally prying her laceration open. I immediately walked in and was ... A little unprofessional. I told her very sternly, "Oh my God, really? I saw what you did! You're opening yourself up for infection! Blaaaaahhhh!?!" pt states, "you should come on time." Changed the dressing to tegaderm and never gave her an exact time after that. Came shift change, I explained everything to the 11-7 shift and the nurse and I agreed to post the sign, "Time is of an importance." outside her room, since this was a reoccuring situation. LOL
Ok, I will be honest. When you are a new grad nurse, it will be difficult to find employment in large populated cities. For example, I live in West Palm Beach, fl. Sunny, beautiful and it would appear as though everybody and their mother is a nurse. It took me 6 months to find a job, 30 minutes away. With a little bit of patience and alot of flexibility, you'll get what you want. But, to answer your question regarding, is it worth it? Yes. Is it easy? No.
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