ventmommy 7,160 Views
Joined May 3, '10.
Posts: 350 (59% Liked)
Are you sure it's RN to EMT-B and not EMT-P (EMT-P would make more sense to me as pretty much anyone with common sense and a capacity to learn can be an EMT-B).
EMS is amazing! The scope of practice is different between EMT-P and RN. EMT-P is 100% protocol driven so you need good assessment skills. Your patient has a crappy airway? You decide to intubate or perform RSI. Patient has coarse crackles and SOB? You assess their level of sickness and give Lasix, morphine, and/or CPAP.
I can't say enough wonderful things about EMS.
Oh Geezus! Noooooooooooooooooooo!
I also had to get rabies vaccines and antibiotics for a feral cat bite. There is ONE ER that does rabies vaccines out of the 12 hospitals in my area. And every shot had to be done through the ER.
All I can say is wait til you get that bill. Immunoglobulin is EXPENSIVE. My minivan, bought new, cost less than the total of this cat bite.
Performed audits and inspection of the restaurant to ensure the safety of customers and employees
Interacted with customers to ensure a possible experience and obtain feedback on ways to improve.
Employee scheduling to ensure adequate staffing and provide quality service to customers.
Educating the team on the vision and goals of the restaurant
Most of the trach kids I know IRL have oxygen tanks at home in case of accidental decannulation, plugging, or major desat that requires resuscitation.
I just got fired from a case I worked for one week. Why do parents hire nurses. Do they expect you to ****** be their kids playmate. Especially when the kid is special needs. Actually I think the mom fired me because she was jealous her son liked me more than her. Also they would micro manage me it's like get a life. And if you don't want anyone handling your kids don't ask for a nurse. I blame the agencies. They make it to easy to hire and fire nurses and the family can replace you at the drop of a hat. They should make it so it's hard for them to get another nurse.
You sure can! No experience is needed to do the vast majority of the volunteer positions in hospitals. Exceptions would be pet therapy, music therapy, etc. I work in a children's hospital and you would not be able to be a NICU cuddler until you are 18 but you could do most other things!
That is totally unacceptable, in my parental yet experienced opinion. How can you assess your patient in a dark room?
If the PEEP is set to 8 and actual PEEP is only 4, then the cuff is not properly inflated. How dangerous is this? That depends on the child. PEEP improves oxygenation and prevents atelectasis. If the child has issues with oxygenation or issues with atelectasis, then you could be creating problems.
This is a beautiful article. More doctors should be honest with parents that there are things that are worse than death.
I heart you, Kitiger RN.
Your post is perfect.
If the child is too unstable to be away from a CPT machine and cough assist machine for a few hours, he's probably not a good candidate for going on random outings.
The items necessary for diapering the kid are a nursing concern if he isn't a baby/toddler. Incontinence of bowel and bladder is an actual condition. Our go-bag contained diapers, wipes, chux pads, butt balm, and a change of clothing. The go-bag was checked nightly by the evening nurse.
The mom seems a little overbearing and is probably trying to get some level of normalcy in her life. That being said, nothing makes it seem like you are being told to act like the mom or the babysitter. You are there to keep the kid healthy and safe. If the mom wants to go somewhere and take him, you are there to help her do that. A vented child can't be in the car with just a driver so it's not like she can just send you home for the day and go on her merry way.
Is there any actual scholarly research that documents why new nurses (new to nursing, not new to an agency) do not belong in private duty settings, especially with inexperienced parents and high-needs children?
I talk about this topic a lot when talking to parents of MF/TD children and someone said that she was planning to hire a new-grad nurse that is her friend. She got back to me and said her friend wanted to see research on this matter.
I countered with all the normal logical stuff (a quick trach change on a sim-baby is not the same as a trach change on a squirming, crying child; no one to help in the event of an emergency; the 6-hour vent class for an agency doesn't teach enough to troubleshoot and correct a technical problem; because she is an inexperienced parent - her child is still in the hospital - she is unable to fill in knowledge gaps that the nurse has).
If anyone knows of any legit research, please let me know. If this hasn't been researched, why do you think it has not? How do states with experience requirements justify their rules if there is not adequate research.
Not that it's a nurse's job but here are some things that maybe can be suggested to the family that aren't horribly expensive that can help.
Sprinkle FOOD-GRADE diatomaceous earth on carpets, floors, sofas/upholstered chairs, mattresses. Brush it in, then vacuum. Even better if it can be left for 24-48 hours before vacuuming but I know that's often not possible.
Place shallow dishes of water with some dish soap in corners. It's even more effective if you can put them beneath a nightlight. I don't know why, it just works. If the fleas are bad, the dishes will need to be emptied every 8-12 hours.
If you have an SPCA, pet food pantry or some sort of local cat rescue, you might be able to get a few doses of Advantage Multi or Revolution donated to the family.
How can you possibly not do anything not on the 485? My son's doesn't say anything about hygiene, diaper changes, ordering supplies, stocking supplies, checking the go bag, etc.
I checked with two parents of children with service dogs. One child has trach/vent and the dog is for seizures. The child is neuro intact. It does not say on the 485 that the nurse is responsible for the dog but it's part of the rules/responsibilities that the parents gave to the agency. At school, the nurse is responsible for picking up poop and giving the dog water. At home, the parents do it unless they are asleep or not home. The dog is responsible for alerting the caregiver that the child is about to seize so that the nurse or parent can take appropriate action.
The other child is blind and hearing impaired. The dog knows sign language! He does not have a nurse but I thought you might be interested. At school, the teachers and his aide are responsible for picking up poop and giving the dog water. At home, the parents and the aide are responsible.
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