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mercurysmom, RN 6,082 Views

Joined Jul 25, '11 - from 'New England'. mercurysmom is a Disabilities Advocate; Consultant. She has '27' year(s) of experience and specializes in 'Early Intervention, Nsg. Education'. Posts: 160 (71% Liked) Likes: 538

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  • May 8

    Quote from elkpark
    Please don't think I mean this in a bad way, but you might benefit from a psychiatric evaluation. The behaviors you're describing could possibly be a treatable psychiatric disorder. Best wishes!
    I agree! Also, consider this. You HAVE an immune system- did you ever catch some type of contagion BEFORE taking micro? No? Guess why? Because you have an immune system.
    Does one train for a marathon by avoiding all types of physical activity? Neither does one maintain a healthy immune system by avoiding all contact with the outside environment. You're also killing yourself with all the bleach fumes.
    Seriously, see someone about this- your degree of phobia is extreme and unhealthy.

  • May 8

    I am noticing an increasing number of posts lately by soon-to-be graduates (or prospective students) casually mentioning that they are attending a 'prestige' school. I'm not sure where this is coming from. (Besides bragging of course)

    Just know that nursing school rankings (if that's how you are determining the prestige of your school) matter not a whit to the overwhelming majority of employers. What employers care about is:

    Did you pass NCLEX?
    Can you do the job?

    PERIOD

    Dropping $80 - 120K on a 'prestige' school when you can get the exact same degree from your state university for half the price is just plain foolish.

  • May 7

    I in CCU and was caring for a patient who had an intra-aortic balloon pump, a ventilator and a few more odds and ends of invasive monitoring. The patient was scheduled for a CABG (in the days before interventional cardiology) and the anesthesiologist was there to evaluate the patient. It was just before 7am shift change, and the attending anesthesiologist had shown up instead of one of the residents. He wasn't pleased to be doing the pre-op evaluation himself, and was pretty unpleasant. Finally, he told me to "Sit him up so I can listen to his lungs."

    The patient was large, had a tube in every orifice and the big fat line from his femoral artery into his aorta made sitting him up a very bad idea even if I could have managed. Balloon pumps were relatively new then, and it was possible that the anesthesiologist didn't understand the contraindications, so I started to explain that "If you help me roll him over, I'll hold him so you can listen to his back."

    The anesthesiologist threw a tantrum the likes of which I have rarely seen, screaming that he was a very important doctor, "Just like Dr. Aardvard (our medical director), and if you wouldn't ask HIM to help you turn a patient, you shouldn't be asking ME."

    At that point, I heard a voice over my shoulder -- Dr. Aardvard -- asking, "Ruby would you like me to help you turn that patient?"

  • May 7

    Quote from SaltySarcasticSally
    An MD gave an injection he ordered and wanted me to document it. I didn't see him drawing it up or administering it so I wasn't at all comfortable signing off on it and I declined to do so.
    While I both draw up and administer the majority of meds that I give myself, sometimes a physician I'm working a case with (anesthesia) will draw/adminster the med. Since I'm right there seeing what s/he's doing and also knowing what meds I had stocked on my cart, I'm comfortable signing off if the physician doesn't (which they actually will most of the time). But I would never do that under the circumstances you described.

    Something similar actually happened to me when I worked in the ER when I was a "newish" nurse. A not too polite physician told me to chart some med or other as adminstered to patient A. Since I hadn't even been in the room, I declined. He then tried to order me to do it (throwing in a mini-tantrum to boot). (No, thank you )

    Being that I'm a bit of a smart***, I asked him at that point if it wouldn't look unprofessional if the chart read "unknown medication administered to patient A by physician B at unknown dose, adminstered at unknown time, at unknown route/site, using unknown technique", (Signed, Nurse Snark) and that it would be better that he who was privy to all the details, charted it. (I wouldn't have responded to in such a rude manner, if this particular physician hadn't had a previous history of being quite obnoxious). And strangely enough, we got along just fine after that incident. Oh, well... People can be funny sometimes.

  • May 6

    You are 18 years old. Way too soon to kiss ANY dream goodbye.
    These are questions for your academic advisor.
    Completing your nursing pre- reqs at a community college is an excellent plan.

    Take deep breaths.. listen to your advisors. You are FAR from lost.

  • May 6

    Quote from Elizabeth777
    Okay, so I'm a long-time lurker, but when I saw this thread, I had to actually create an account and post.

    I have been exactly where your daughter was, as I started college when I was 14 and, no, I didn't home school. I graduated with a bachelors in a double major shortly after I turned 19 and just passed the NCLEX in the past few weeks after going through nursing school. I am 22 now and I absolutely think that taking the time for a bachelors first was invaluable. While I can imagine that your daughter is highly intelligent and that shouldn't be wasted, there is a lot of growing up to do between 14-18, even if she doesn't think so.

    I wouldn't have been a good nurse if I had somehow managed to circumvent the requirements and gone early. My years volunteering in the hospital, and later working as a CNA, matured me immensely. I wouldn't give up the 4 1/2 years I spent as a CNA while in school for anything, as that shaped me as a person, much more so than school did.

    So, while I can definitely understand why your daughter wants to rush through and get it all done, it just isn't a good idea. Have her get a bachelors in a related field. Mine was in biology, which took care of many of my nursing credits. She may be able to comprehend things well above her age, but only time and experience can give her the maturity that she really needs.
    This is such a great post, I wish I could like it more than once.

  • May 6

    Okay, so I'm a long-time lurker, but when I saw this thread, I had to actually create an account and post.

    I have been exactly where your daughter was, as I started college when I was 14 and, no, I didn't home school. I graduated with a bachelors in a double major shortly after I turned 19 and just passed the NCLEX in the past few weeks after going through nursing school. I am 22 now and I absolutely think that taking the time for a bachelors first was invaluable. While I can imagine that your daughter is highly intelligent and that shouldn't be wasted, there is a lot of growing up to do between 14-18, even if she doesn't think so.

    I wouldn't have been a good nurse if I had somehow managed to circumvent the requirements and gone early. My years volunteering in the hospital, and later working as a CNA, matured me immensely. I wouldn't give up the 4 1/2 years I spent as a CNA while in school for anything, as that shaped me as a person, much more so than school did.

    So, while I can definitely understand why your daughter wants to rush through and get it all done, it just isn't a good idea. Have her get a bachelors in a related field. Mine was in biology, which took care of many of my nursing credits. She may be able to comprehend things well above her age, but only time and experience can give her the maturity that she really needs.

  • May 6

    If you daughter wants a bachelors in nursing (BSN), she can't do the "bachelors" part first and then go back to the "nursing" part. And while she could do another bachelors while she waits to turn 18, she will still have to attend a nursing program (BSN (traditional or accelerated), ADN or diploma) in order to become a nurse. Nursing is not an add-on program that she can decide to do on a whim. Nursing school has both theory/lecture and clinicals integrated in a specific way--one can't pick and choose what classes according to their own timeline.

    In addition, clinicals start almost immediately in nursing school, and can't be missed. Keep in mind that almost no hospital wants a minor doing clinicals on the floor...too much liability. Volunteering as a candy striper as a teen is one thing, but nursing students are assisting/performing procedures, giving medications and are responsible for patient care.

    She could start knocking off pre-requisite/co-requisite classes such as Anatomy & Physiology, Microbiology, Public Speaking/Communication (yes, very much required), Statistics, Ethics, and other non-nursing classes. But for the actual nursing program, she most likely will have to wait until she is 18.

    Sorry if this isn't what you--and she--want to hear.

  • May 6
  • May 6

    From what you have described, TAC around 2 months old and the onset and nature of the rash I do not think it is a CHG allergy. The true allergic reactions to CHG I have witnessed tended to be fairly quick, either upon minutes of the very first application or within several days. The allergic reactions tended to present as more generalized raised redness vs a small rash turning into larger one. CHG can be very irritating to open wounds and does tend to present as a small rash which tends to grow.

    I have seen several rashes like what you have described. Reddness that first appreared to be scratches that turned into fullblown rashes...

    After investigation we found that in fact in our case they were scratches, the patients were scratching the dressing sites and although in most cases the transparent dressing remained intact the skin was still slightly damaged underneath. We found that the CHG and/or moisture was actually irritating the small wounds and turning them into rashes rather than an actual allergic reaction.

    We connected the dots when we remembered similar rashes from shaving, which we only clip now and the fact the rashes first presented as redness in symmetrical lines...plus several of the patients were witnessed scratching.

    Our solution was in three parts;

    I.

    a) We made sure that after the CHG cleansing, the area was thoroughly dried.

    b) Skin barrier was applied and allowed to thoroughly dry.

    II

    a) A padding barrier in the form of gauze and Kerlex or netting was used to prevent direct scratching. Since it is only a barrier and not a dressing it could remain in place for the full 7 days.

    III

    a)The transparent dressing was substituted for a sterile gauze dressing for 1 week to allow the wounds to heal.


    You are right on thinking that changing a gauze dressing q48hrs is going to get super expensive. If the solutions I and II do not work I would recommend having the line DC'd and replaced at another site. You do not want to spend a fortune on changing dressings nor do you want the rash to develop into cellulitus. Replacing a TAC is far cheaper than having a Nurse out there every other day doing dressing changes.

  • Apr 27

    Quote from CCU BSN RN
    Abdominal pain started 2h after eating mcdonalds. Admitted to tele for a full cardiac workup. Arrived with 4 more burgers in a mcdonalds bag and was irate when told he was NPO for stress test or cath in AM.
    Oh, the guy who ate half a dozen of doughnuts 6 hours before surgery, on the premice "I was told that I can eat everything if I can see through it". He could see through those holes in the doughnuts just fine, so he thought he figured it all right...

  • Apr 11

    Quote from blondy2061h
    Ativan 0.5-2mg IV or PO PRN nausea, vomiting, pain, anxiety, insomnia, patient request, RN discretion, or any other complaint

    Pharmacy didn't verify that order for some reason
    Former night nurse here. I can dig that order.

  • Apr 11

    I had a fresh post-op ortho patient who had orders to ambulate in the hallway 3x/day. Pretty simple, right? Try doing this on a double BKA!

  • Feb 16

    Quote from Amethya
    I think the same way, but stupid grandmother was like "Insurance this, insurance that." And would keep calling some random person and talking bad about me in front of me and I'm like, really? What I say, goes. So I'm thinking that I'm going to say this to the next safety committee meeting that I don't care what family says, if the child is having an emergency, I will call 911 then call parents.
    If they want to go down the $ road, a funeral costs WAY more than an ER deductible.

  • Feb 16

    Heck, if I have a diagnosed asthma student with respiratory distress to the point where they cannot speak AND has had no response from their inhaler AND neb? AND mom is 30+ minutes away? Oh, I'm calling 911. Actually I would be calling 911 first, then I'm calling Mom to tell her to meet the ambulance at the hospital instead.


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