CNL2B 4,888 Views
Joined May 3, '10.
Posts: 578 (40% Liked)
You know what, OP? I'm done, too.
99.5% of the posters on this site mean well and have good intentions. It is the other 0.5% that is ruining it for the rest of us.
You answer a post, try to be helpful, and you get an eye roll, or a criticism of some tiny small aspect of your post that has nothing to do with the original post. In the name of what? What's the point?
The only thing I can think of is that these ridiculous posters are threatened and hold some sort of ownership over the site and don't think that new people with some stuff to say should be allowed on.
Well, I'm done. Signing out. Permanently. You guys win. You've ran me off.
If OP is planning on starting a program now, it is likely that she will have to be admitted to a doctoral level program. That is the point. Just because there are Master's Degreed PTs still out there doesn't mean that that is the level that most schools are training at now.
There's a push to make PTs doctorates but it hasn't come to fruition. Still masters in most places.
Do you have a bachelors? You might be abe to bridge right into a program with onw. Otherwise, why not just learn more and work with your daughter while still working as an RN?
Good luck to you and her!
APTA | CAPTE
Here is a list of accredited programs. All it takes is a simple internet search to find the info you are looking for.
It is my understanding that all PTs are now doctorally prepared. I did not go through all these programs listed but the 4 that are available in my state are DPT level programs. They require a Bachelor's degree so as long as you have a BSN and meet the other admissions requirements I think you would be eligible to apply.
There are PTA programs out there as well, which are Associate's Degree level programs to my understanding.
EMLA is great, along with the suc and I am for blocks as well.
I had someone go under GA for the other day for a circ. NOT good, in my eyes....
Keep your chin up. It's a hard spot you are in.
I get the not making bills thing. My husband had no work for 18 months and is just recently employed again. We, too, managed to not lose our assets (barely) on my salary but with three kids between the two of us, a mortgage, and a car payment, we got way behind. Now it's catch up with huge credit card debt. I can imagine that it's just as stressful for you, nearing retirement. My parents are in a bit of the same boat as well. My dad is retired (on disability), and my mom just had her hours cut back -- again. They are trying to figure out how they can live on pennies until she can pull SS/medicare. Her work doesn't offer medical so they are paying out huge amounts for a private policy that she needs.
It's just a bad time, historically/financially. It is really crummy to think that you (and many others!!!) went so many years as a college educated person with a good paying job, only to have the rug pulled out from under you. It feels unfair and unjust. I like to think of myself as a flexible, adaptable person, but sometimes "rolling with the punches" really gets you down.
So sorry for you, but I'm glad you are documenting this. Hopefully this will be something that you can look back on 5 years from now and be thankful that you came out on the other side a stronger, wiser person. (Doesn't it stink that that might be your only consolation, though?)
Best wishes. Keep us posted.
I'm not a pedi nurse but I sat in on my son's circ (outpatient at 1 mo, in a clinic). He got a local (I think lidocaine). He cried more from being tied down to the board than the procedure itself, for which I was thankful.
I would not have been happy with EMLA or hurricane spray as a parent. That stuff is topical -- doesn't go very deep at all. I doubt it would have been sufficient pain coverage for the procedure being done. It's also my understanding that you have to let EMLA sit there for 20-30 minutes for full effect. He also got some relief after he went home for a few hours with the local.
I can't tell you about meds you didn't ask about, but of the ones you did, this is how I do it (per facility guidelines):
Mag - 1 gm over 15-20 minutes, 2 gm over 1/2 hour
K - 20meq/hour MAX, must be on cardiac monitoring to run it that fast. The floors with no tele can run it at 10meq/hour only.
Calcium gluconate/chloride - I dilute in 20-30cc and put it on a mini-infuser. Usually goes in over 20-30 minutes.
I think this stuff is in most med books also (administration times.) That's where we get it from, mostly -- we've just memorized it over time.
I think you should go to management with the concerns you have with this intensivist. It is NEVER acceptable to hang up on another caregiver on the phone. It is NEVER acceptable to not listen to nursing concerns about patient that he is covering. This is an attitude that needs to be broken, and quickly.
The issue with the respiratory order (CPAP/BiPAP?) - IMO, it is absolutely the RT's responsibility to be checking their orders and doing their own work independently. They have a license too. If you have an RT that covers your unit and isn't floated 15 other places, this should be an expectation. This is one of my pet peeves, actually -- I have worked places where RT is great and they do everything, and I have worked places where you have to call them for every little thing. (I'm also a little confused in that it was a new order but the patient was on it the night before -- what's up with that?) Is it your responsibility to notify RT for these kinds of orders? Is it something the clerk could have done, but missed? Did RT not see the patient for the entire shift anyway? Were they supposed to be following the patient? I would talk to management as well about the RT role and what the expectations are. Yeah, maybe you dropped the ball (maybe....not 100% sure on that, especially since the patient was fine) but RT should have picked it up and ran with it.
Being overworked and exhausted does no one any good. Man, I feel for you. I have seen this kind of crap go on and on 100+ times at a number of facilities. I wouldn't pin this on you, actually -- your system is a crappy system -- obviously it failed here. I hate it that this kind of stuff gets pinned on nursing all the time -- and actually, you pinned it on yourself!
Let me give you a piece of my very best advice. Ready? Here it is: DO NOT TAKE FULL RESPONSIBILITY FOR SYSTEM ERRORS. Learn to recognize yourself as simply being a piece of the problem, and don't personalize it. This was you in this instance, but it easily could have been one of your coworkers. This involved other departments and other caregivers. If you keep on pinning this all on yourself, you are opening yourself up for disciplinary action for issues that aren't entirely yours. Don't do that.
Did you do an incident report on this? I feel that it warrants that, since an ordered treatment went 8-12 hours without getting implemented -- if we missed 8-12 hours of an antibiotic, we'd have to write it up. I see this as being a similar scenario. Hopefully you did, and somebody that can actually do something about it will examine the situation and try to fix how things operate around there (I wouldn't hold my breath, though, unless you have some managers that are really good at/like operations.)
Anyway, that's my two cents.
Are you orienting this person? If you're not, I would stay out of it.
She obviously doesn't want help -- at least, she doesn't want help from you. She has her own license. She has the right to figure it out on her own if she wants to. The only way I would get involved with what she is doing is if it was something that wasn't safe practice.
Likely this person is hurting herself and her ability to get up to speed, especially if she doesn't have previous inpatient experience (sounds like she doesn't if she's only been in OR and management.) Let her do it. You can't fix her attitude. She will either pick it up on her own quickly or fumble around until she does. Either way, it's not really your deal.
These terms (BLS/CPR) are often used interchangeably. If you took a CPR for healthcare providers I think you are probably covered. I wouldn't go ahead and take different one unless I was specifically asked.
I don't know about more negative either as I haven't been on here all that long. From my experience, the negativity that I have seen comes from 3-4 regular posters only, who seem to be very careful to get just snarky enough to not violate the TOS. Other than that, everyone else has been great.
I'm not sure what hating your job has to do with having/not having a BSN. Care to rephrase? What "job" are you talking about specifically -- bedside nursing, or other areas? I'm not sure what you are asking.
Seeing that I don't really know what you are asking, I'm going to answer any way I want -- no, I don't hate my job. Some days, I feel the burn (out.) Some days, it's all good. I love my coworkers. I work in a great, supportive environment. That has made the difference between me having a horrible day and going home in tears -- it's really, really important, and I am really lucky to work with the people that I do.
Retention is a huge issue, especially considering the cost of training in a new nurse. People are hanging on to their jobs more than ever now, though, with the market. I'm wondering if having people quit is less of an issue than it was 5 years ago.
If what the above poster is true (with you giving 30 mEq of KCL PO = 1200mg), For a K+ of 2.6, getting 30 mEq PO + 40 mEq of IV KCL isn't all that much, especially with normal renal function. It's also not uncommon to administer by both routes at the same time. What I am not seeing is how fast you administered the 1L bag of fluids with the 40mEq KCL in it. Did you put it on a pump as IVF at a certain rate? That should have been fine.
You didn't rapidly infuse a bag of IVF in with 40 mEq of KCL in it, did you? That is the only mistake I can come up with in this scenario.
It shouldn't be used at all. It inhibits platelet aggregation and thromboplastin formation.
"Wound infection requires surgical debridement and appropriate systemic antibiotic therapy. Topical antiseptics are usually avoided because they interfere with wound healing because of cytotoxicity to healing cells." -Emedicine
You'll get lots of arguments, purveyors of witchcraft and voodoo still use it.
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