Latest Comments by KelRN215

KelRN215, BSN, RN 54,866 Views

Joined Oct 19, '10 - from 'New England'. KelRN215 is a Infusion Liaison. She has '10' year(s) of experience and specializes in 'Pedi, Home Infusion'. Posts: 6,432 (58% Liked) Likes: 13,703

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  • 1
    rn1965 likes this.

    When I worked in the hospital, we weren't allowed to "request" any weekends off per year. We worked every 3rd weekend and, if you needed one of your scheduled weekends off, it was your responsibility to find someone to switch weekends with you. If you were getting married and your wedding was on your weekend, you had to find someone to switch with you.

  • 1
    ufgatorjax86 likes this.

    Given the choices between living in those 4 cities, I'd choose Colorado. Hands down.

  • 0

    In all of my jobs, I think I've only been drug tested in the 2 where I touched controlled substances the least. Working as an aide in nursing school where I had no access to any drugs and at my current job, where I've touched a controlled substance twice in 2 1/2 years (when doing PCA hook ups for patients being discharged on hospice). When I was a staff nurse in a hospital giving narcotics and benzos on a daily basis, a home health nurse and a school nurse with a cabinet full of drugs like Ritalin and Adderall, no drug tests.

  • 0

    Have you seen the protocol? The drugs are not necessarily the same every cycle.

    I am not familiar with any lung cancer protocols because I have always been a pediatric nurse but I can tell you that there are 2 common chemo drugs in pediatric ALL- methotrexate and cytarabine- that are given at high doses at one point in treatment and then at lower doses at other points. Doses can also change throughout treatment because of unacceptable side effects. For example, doses of cisplatin are often decreased if children develop hearing loss.

    I would suggest reviewing your patient's protocol.

  • 0

    I got through college primarily on Sallie Mae loans. 10 years after graduating, I finally have my balance under 30K.

    I agree with Sour Lemon that $1000 is such a small amount, I'm not sure taking out a private loan would be worth it. There may be other options.

  • 2
    elizabethgrad09 and Meriwhen like this.

    Quote from SN67
    I believe it should be at 2000. The medication runs for an hour and is done at 1200.
    Incorrect. A medication given every 8 hours is to be given 3 times a day. If you time it by time done, you're going to be 3 hrs behind by the next day.

    It is generally acceptable to give a medication within +/- 1 hr of the time due, though. So you could give the medication at 2000 if you're trying to, say, move it to a more manageable schedule at home and are moving each dose by 1 hr. (Side note as a home infusion RN, please think of this kind of thing if your patient will possibly be discharged on IV antibiotics.)

  • 0

    Quote from midwifemae
    Had you done your practicum yet? Did you graduate in May when the job was offered in March? What a great turnout for you!
    No, I submitted my application when I was just starting it. I had also done my pediatric clinical on that floor though and I was pretty set on where I wanted to be. I was actually going to start submitting my resumes to other hospitals in different parts of the country right after spring break but I never needed to because I got the one job I applied for. This was 10 years ago. The job market may be different today.

  • 1
    Here.I.Stand likes this.

    Quote from jennylee321
    That's a good question, I don't know exact rate because I imagine it would depend on age of the child, but I do know that those with Duodenal or jejunal tubes are meant to be on continuous feeds, never bolus.
    I've been a pediatric nurse for 10 years and this has always been what I've known too. You can't bolus into the intestines, only the stomach.

    Rates would depend on the age/size of the child. There are older/adult sized children who are on continuous feeds via J at 100 mL/hr or more but a baby's rate could be 20 mL/hr.

  • 9

    Quote from dura.mater
    Prof is very health-conscious and concerned about the percentage of obese nurses- pizza and bagels were also vetoed but maybe coffee and tea would go over well. And fruit and cheese/crackers sounds good...
    *****

    When I worked in the hospital, we LOVED when anyone gave us baked goods. It is not prof's job to police the unit nurses' diets.

  • 0

    I feel like it's the opposite in pediatrics. But when a child is a DNR, it's generally because they have a progressive disease and are expected to die in the relative short-term, not just someone who's lived their life and doesn't want to be resuscitated.

    I will say our Resuscitation Status orders are very specific though. We had a long term patient when I worked in the hospital who was an adult but had been ill since she was a child so was still treated at the pediatric hospital. Her DNR order was no compressions, no cardioversion but intubate if parents were not present at the time until they could come in and make a decision.

    Our orders usually specify whether or not to: bag, deep suction, intubate, perform compressions, give arrest medications, provide electrical cardioversion, insert chest tubes and maybe some other things I'm forgetting.

    I find that people have a really hard time with what comfort measures only means in pediatrics. When I worked inpatient, I took care of an 8 year old when he became CMO and the medical team was still ordering daily labs, q 4hr VS and all kinds of other things that weren't for the child's comfort until our CNS said "enough."

  • 0

    The only "duty to warn" law I am aware of is a result of Tarasoff v Regents of the University of California and applies to mental health providers who have a duty to warn a potential victim if their client discloses an intent to harm the victim.

    So I don't think management necessarily has a legal obligation to inform staff they are just caring for registered sex offenders but if one of these clients expressed intent to attack a nurse or another client to a staff member, there would be a duty to warn.

    In most states, the sex offender registry is public record.

    I am a pediatric nurse and, in my 10 years of nursing, I have only ever encountered 1 sex offender. It was a teenage patient who had abused his sister. EVERYONE was well aware of his status before he was admitted and he had security planted at his door. He may have had a sitter in the room too. But, again, this was a children's hospital. He was an older teenager- maybe 17- and many staff had feelings that he should have been admitted to the adult hospital next door.

    If we ever had a patient whose parent was a convicted sex offender, I imagine that parent may not have been allowed on the premises of the hospital, if the hospital were aware of his/her status.

  • 2
    Davey Do and Penelope_Pitstop like this.

    Quote from Goofaroo
    The potassium bolus protocol is ordered for below 3.5
    When you say bolus are you talking about just a PRN PO dose?

    And what is the frequency of the order? 80 mEq of KCl in a day would be a lot. 40 mEq is a lot in a single dose. Typically you shouldn't give more than 20 mEq in a single dose.

    Potassium Chloride - FDA prescribing information, side effects and uses

  • 1
    Noctor_Durse likes this.

    One C+ is not going to prevent you from getting a job. I got a C+ in some class in college. I forget if it was Pathophysiology or Pharm. Maybe Patho. I didn't study much that semester when I turned 21 and was busy doing 21 year old things.

    Beyond my new grad program, which only needed my transcripts as proof that I graduated, no job I've ever held has been concerned with transcripts or GPA.

  • 0

    When I worked in the hospital, we had a hospital pension, which was automatic and you were vested after 3 years, and the option to contribute to a 403B. It's up to you if you want to contribute to a 403B on top of the pension.

  • 3
    audreysmagic, Ruby Vee, and TriciaJ like this.

    Also, for the OP, in most situations, family consent is not needed to withdraw support from a brain dead patient. Brain death is determinant of death in all 50 states. In the case of Jahi McMath, she was not removed from support not because her mother refused to consent to the removal but because her mother went to court and filed an injunction against the hospital to stop them from withdrawing support.

    When I worked in the hospital, we had a case of a small child with DIPG, a 100% fatal brain tumor. The child's parents refused to accept that she was dying and insisted on traching her. The hospital's Ethics team sided with them as a trach wasn't going to change the child's outcome. She later was declared brain dead, while vented through her trach in the ICU. Family was given a specified amount of time that they could bring in other family members to say their goodbyes and they were told that, since she had died, she would be removed from the vent.


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