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Content That tigerlogic Likes

tigerlogic 3,742 Views

Joined Apr 13, '12. Posts: 227 (41% Liked) Likes: 239

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  • May 11 '14

    If you're referring to assessing the IV while the vasopressor is still running, rather than how to flush it after it's done, we typically assess for signs of infiltration/extravasation and let the pump sense occlusion.

    We don't assess for blood return as part of a routine IV assessment as it's a fairly worthless assessment. There's certainly an argument to be made for a more thorough assessment when running vesicants through a PIV by also assessing for blood return, although there really isn't any clear evidence that blood return accurately differentiates between a patent IV and an infiltrated/extravasated IV.

    Another advantage of the carrier fluid is that if your IV does infiltrate/extravasate it's usually going to take some amount of fluid volume before it becomes apparent to an assessment, so if it takes 3mls instance to become noticeable it's better that those 3mls be mostly saline vs concentrated vesicant.

  • May 11 '14

    At my hospital we use the white port of the swan for our pressers. We call it 'The VIP' port, LOL. Love it!

  • Jul 17 '13

    Hey there! I just came across this and thought I'd throw in my two cents I currently work in an ED in PA, and have been working on things for just over a year to come to Australia. I'll finally be going over in late Aug/early Sept (FINALLYYYY!)
    It was a huge swamp of confusion when I started trying to figure out where to begin! I contacted a recruiting agency after a bit of research--- HealthStaffRecruitment. I've kept in contact with them the entire time, and they always pointed me in the right direction. You will have to apply for an Australian nursing license, and I'd start with that first, because it takes the longest (mine took about 7 months to come through). They have all the instructions on their website (just google AHPRA Australia) as to what you will need to send. You'll need a criminal background check, all of your official transcripts from school, birth cert, copies of ID, all that stuff, and a signed declaration (the link is on their website) that your schooling was taught and assessed in English. When you gather all this (the gathering was quite the process), send it! hah.. You will have to have your US nursing license before you apply though, because you must have it sent directly to AHPRA from the nursing board of whatever state you are working for (link is on your states nsg board website... mine cost about 40$). Now I know you want to migrate, but I think the best route is to get a work and holiday visa (info on the Australian Immigration Website). It's quicker, cheaper, and you'll get there faster--- and perhaps by doing this you can find sponsorship if a hospital enjoys your company This wasn't too bad-- you need a physical, chest x-ray, and bloodwork... but don't do any of it until they instruct you to. It took about 2 months to come through. Depending on where you want to work you will need to consider your experience. I work in the ED so I needed 2 years... I believe med-surg is at least 1 year, all other specialties are 2 (someone correct me if I am wrong!). You will also need to do one additional US criminal check (as it has to be within the last 6 months when you start the job hunt) and also an Australian Police Check. HSR (the agency) will point you in the right direction for all of this-- they are awesome!
    Well, I am off to work now, actually!! I hope this helps, and feel free to contact me if you have any questions!!!
    Julianne

  • May 11 '13

    Yet another example of why a well-educated RN holds the line between "just following doctor's orders" and the safe provision of the medical plan of care. Good spot. And yes, it can absolutely be just as critical for an adult as a baby.

    On the other side of the coin, when my 135-pound teenager was admitted to a famous children's hospital post trauma we were awakened every hour by the IV pump alarming that her hourly fluids were completed. Apparently they had a protocol that no more than one hour's worth of fluid was dropped down into the volutrol, to prevent accidental fluid overload in small people, and when that ran dry, the pump beeped. It was as if I were speaking Urdu to explain why this was unnecessary in an adult-sized person with no cardiac or renal pathology. No critical thinking skills in that department, I guess.

  • Apr 30 '13

    I have the same experience about once a month. Kind of feels what I imagine waking from a coma feels like( the kind of coma they awaken from in the movies- all at once an with your hair clean and make up applied)

    Having worked nights for nearly all of my 30+ years in nursing- it's a special topic to me. Did my MSN thesis about night shift, and am currently involved in a GIGANTIC study about how institutions impact the sleep of night employees. I have a third and fourth study planned out in my mind, too!

  • Apr 30 '13

    Where I work is a source of pride for me (both hospitals at which I work are highly regarded, both locally and nationally), so if the subject comes up, I am not shy or embarrassed about telling people where I work.

    It's what area of nursing that I am reticent to share, because then they insist on sharing their birth stories with me. Generally I don't mind, but once in a while I actually have somewhere else I need to be.

  • Apr 14 '13

    Quote from CT Pixie
    call your current loan company(s) and see if there is anything that can be done. I have a friend who was unable to pay her entire monthly loan bill but she didn't want to go into default. She called and they worked with her. I believe they put it on hold under a hardship thing and then when the monthly payment were to start again they worked with her and lowered the payments.

    Do this before you get in too deep. I can't promise they will do anything but it can't hurt to give it a shot.
    This.

    Loan companies are often willing to work with borrowers if contacted early. It may be possible to negotiate a lower monthly payment or deferment. As already stated, there's no guarantee they'll do anything...but they won't be as willing to work with you if you've missed several payments and are about to default.

    And yes to the more hours/second job, getting a roomie, and budget tightening already mentioned.

    Also, you want to do whatever possible to avoid defaulting, late payments, etc., as these WILL affect your credit rating for at least the next seven years. And as someone who's had dings to their credit...trust me, you don't want them. Seven years is a looooong time to suffer for your mistakes: bad credit affects you in more ways than you'd realize.

    Last, readers should consider this a cautionary tale. I won't tell anyone where to go (or not go) to school or whether they should take out loans, as those are decisions that people need to make for themselves. But definitely consider how hard it is for new grads to find jobs, as well as the fact that the salaries offered in most places are not going to be as high as you'd hope, before signing on for an expensive program and/or student loans.

    Best of luck.

  • Apr 14 '13

    "Midgets are fighting in my crotch."

  • Apr 14 '13

    Quote from exit96
    I just completed week 4 of orientation. So far so good. I wonder if you had floor experience prior to ER?...I am not qualified to say much d/t my limited experience there, but I was med/ surg RN prior, and I, in my short time in ER do not know why they would hire someone without med/surg experience. No offense, I am just seeing now how a solid background is essential, and most beneficial. My $.02
    My manager hires new grads & experienced er rns. She generally doesn't like non-er rns, says it takes too long to untrain them from the floor to think emergent. In my limited 5 years, i'd have to say i agree with her. Non-er rns don't seem to last or mostly don't move as fast or turn on a dime like new grads who're properly oriented. My $.02

  • Apr 14 '13

    Ha ha I've never seen 0 but the thought that it could exist makes me smile

  • Mar 31 '13

    I don't think a "new" study was necessary considering that the British study that claimed to link the two was found to be fraudulent.

    The doctor that was in charge of the study lost his medical license for it.

  • Mar 31 '13

    I like the Next Care waterproof bandages as well. They stay on really well.

  • Mar 31 '13

    Second skin works very well to cover minor skin breaks and it won't wash off. Agree with tait on next care clear/waterproof bandaids, very good.

  • Mar 28 '13

    Are we talking about baby sitting the staff or the patients?

  • Mar 28 '13

    That sounds very familiar. Were all peds nurses really.


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