Content That mercurysmom Likes

Content That mercurysmom Likes

mercurysmom 4,252 Views

Joined Jul 25, '11. Posts: 144 (71% Liked) Likes: 466

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  • Apr 25

    Here's what we posted at work
    Attachment 21765

  • Apr 25

    Quote from nursej22
    I was just a sweet young thing, in love with nursing, when I set off in my crisp white cap, white hose and duty shoes. A smart @$$ for sure, but not yet sardonic.
    Navy sweater, hair in a pony, no nail polish and just a touch of lip gloss, shiny nursing pin and brand new watch with a second hand that glowed in the dark! [emoji7]

    Now I wear black, my hair down, light blue nail polish, and I try not to curse.

    Not negative. Just a bit more broken in.

  • Apr 25

    I also wonder if she has some home meds that were abruptly discontinued. Over the years, I have discovered that many elderly ladies take meds "for their nerves". If they get admitted to hospital and these meds are suddenly stopped, they can go into withdrawl.

  • Apr 25

    I was just curious how others handled this type of situation.
    I am rarely caught by surprise when an otherwise sweet LOL suddenly turns into a raving lunatic. I actually kind of expect it.

    Some potential causes are UTI, constipation, hypoglycemia, sundowners syndrome, a pulmonary embolus, worsening illness, or even just being afraid and feeling helpless. A change in mental status should trigger inquiry into what could be causing it.

    UTI would be one of the more common causes, and constipation can be a contributing factor to UTI due to compression of the urethra by bowel contents, leading to incomplete bladder emptying and thus, urinary stasis. So maybe, your LOL's complaint about being constipated might not be too far off the mark. One of the more common symptoms of UTI in the elderly is altered mentation/delirium.

    Also consider the reason this person was admitted-for pneumonia. Her change in mentation could be related to a worsening of her condition.

    Another consideration is that often, elderly folks with milder forms of dementia compensate well at home in their normal, predictable environment, but once they are in an unfamiliar environment with different routines, the altered mentation is more noticeable. Family members may tell you that "Grandma has all her marbles" or is "as sharp as a tack", but that's in the home environment where she is able to compensate. The hospital environment interferes with this ability to compensate, and so you will see behavioral changes that would go otherwise unnoticed.

    So, to answer your question, how I handle this type of situation is first, I do what I need to do in order to keep the patient safe. Make sure the room is free of clutter, the patient is wearing nonskid slippers, and offer to toilet her. I will offer warm blankets, another pillow, PO fluids or a snack. I will offer a distraction, such as TV, or ask her about her life- her children, pets, where she grew up, etc etc. Once the patient is calmed down and safe, I will take a complete set of vitals, including a temperature; if diabetic, check a CBG; and I will then notify the physician of this change in condition. The physician may want to order a UA, or a repeat chest xray, as her change in mentation may be related to worsening pneumonia.

    I would then document the patient's behavior, the actions I took to ensure her safety, my assessment data, that I notified the physician, and whether any new orders were received.

  • Apr 25

    Sounds like delirium to me too, especially since it happens at dark-times.

    There's more to it than her just being a twit.

    Something I've done with twits is to say, "I'll leaving now. You cannot talk to me like that. I will be back later when you are calmer." Then I walk out and do come back later.

  • Apr 24

    Have you ever been taught that some patients' states of mind/levels of awareness can be static? Have you ever heard of Sundowners' Syndrome?

    Have you ever been taught that a sudden change in personality can be a sign of a physiological change? UTI? Sodium level?

    I find your post more than a little disturbing. And no, I have never told a patient to "cut the crap and stop being nasty," nor do I recommend it as an effective way to communicate.

  • Apr 23

    Student Advantage is not a "federal" program. At least here in Michigan everybody uses Certified Background which uses their own certified labs like Quest. Unfortunately, this factor alone will not solve the problem. Even moving across the country may not solve the matter because the OP will have to answer all these ubiquitous "name ALL the colleges you'd ever attended" and the likes.

    If OP is absolutely adamant about eventually doing nursing, one workable (though long) way is to get entry level non-nursing degree or certificate. The choice is wide from commercial CNA or MA schools to undergrad in PT, OT, speech, laboratory and the like. Most of these degrees require clinicals, but many, especially for-profit schools, have ridiculously lax requirements. After going that and working for a while the OP will be able to start "direct networking" in order to personally convince a school that the whatever could be dug up from the past can be safely overlooked. If not successful, the OP will get real work experience and exposure to dozens of other health care occupations not less interesting and less restrictive than nursing.

    IMHO, the situation like described is a pretty good illustration why MJ must be legalized and accepted yesterday. I do not (and physically cannot) use it, but seeing a talented young woman whose life was won in years-long battle against cancer doing social work (which she hates quietly) instead of nursing (which she dreams of) ONLY because she literally has choice between Marinol every day and TPN for unknown length of time is heartbreaking. It is just so plain wrong.

  • Apr 23

    It seems like you went to a party, drank responsibly, wiggled a little on the dance floor, and didn't cause drama... that sounds like social success to me. I'd avoid the specific people who caused problems, rather than socializing less, personally... but that's just me. Some of my closest friends started out as coworkers.

  • Apr 22

    Quote from Leaemilyy
    Whenever a body fluid is described as "cheesy" or "creamy" .. Gag
    Hmm... You mean like smegma?


  • Apr 22

    Quote from LadyFree28

    Nurses move up in status (ie management) but not in their knowledge base and lack basic competence-I'm a Pat Benner fan.
    Peter Principle?

  • Apr 22

    I feel smoking weed is the most innocuous intoxicants to indulge in; however as nurses we are paid a premium for our good judgement. By smoking marijuana and jeopardizing our careers that good judgement becomes questioned. Marijuana is still classified as a schedule 1 drug and as such cannot be prescribed, and can get us fired or our licenses suspended.
    Hell, I went to college in the 1970's that's all I gotta say on that subject. Now a nice glass of wine to relax me and the warm feeling of a touch of stress incontinence I'm doing okay.

  • Apr 20

    The chapters are supposed to be read before class!

  • Apr 20

    Quote from dd05434
    This. Things in the medical world are being updated constantly, and sometimes what's in the current edition of the book is now outdated.
    Former faculty here, this is correct. By the time a book goes to print, the information may be 5-7 years old.

    And it is up to the instructor if she wants people to pay attention in class, to participate actively in the discussions if any, and not to just sit & high-light in the book but instead take notes in class. The notes from the lecture should supplement your reading of the text. Same goes for using powerpoint as the only "note" students take.

    By not going to class you will miss out but that is your choice. Why not go and take notes, make an outline. You could prepare a tentative outline before class, after you have done the assigned readings and if anything is not clear after you read, be sure to ask questions.

    I have had students who read other textbooks in my classes

  • Apr 20

    I am not even a school nurse but d*** straight I've called CPS on kids with poor parenting.

    Working retail in high school with a parent that thought the toy aisle was baby sitting... Oh you are looking for little diaper wearing Susie? Yeah the PD took her.
    Working at a movie theater during high school doing Star Wars when someone realized Phantom Menance its way too loud and scary for their 18 month old so they brought them out to the front lobby and left them there crying. Movie ends over 45mins later... Oh you are freaking out that you can't find your little baby? Yeah the police took him when I called them for an abandoned baby.
    Working at Starbucks in college and parents feel its a perfect place to drop off their kid to wait until the other divorcee parent shows up, usually its hours later... Oh you were looking for a little 4yr old boy? Yeah CPS has him, don't yell at me or CPS will love the police report and your eyes will love my pepper spray.
    In the ER you left your 3 small toddlers sleeping/playing in the lobby while you went to visit someone... Oh you are looking for all of your kids you JUST left right there to go to the vending machine over 2 hours ago? Yeah CPS has them.

    Mind you I have always asked the police what they want me to do like stop the movie and find the parent, page the parent more times, search the hospital with security, etc... Cops/CPS have always said no they will come get them. One time I discussed it with a CPS worker and he said no that this is at least now on their record so if anything ever happens again they have a track record so these children can be protected. It also makes it where the parents now have to appear before a judge and usually are required to attend parenting classes.

    So if the parents don't ever respond then heck yeah threaten CPS or better yet send them out 911. It isn't a school nurse's responsibility to baby sit people's children. They are nurse NOT CHILDCARE

  • Apr 18

    Okay, I'm a guy, I can't help it I was born this way. But I was raised to always be respectful and good mannered; it is not unusual to be the only male staff member on my unit and I take it as a sign of respect to my colleagues to place the seat down. I have, and will continue to ask other males to please replace the toilet in the down position for the women that are there to cover my back and assist me in much more significant tasks. Really this is so trivial, how often have your coworkers saved your butt can't you help keep theirs dry? A little perspective please.