AngelRN27 2,254 Views
Joined Aug 11, '12.
Posts: 157 (29% Liked)
If you have issues with the tap water, your facility needs to fix that. The gut is not sterile, no need to use sterile water IMO.
I could maybe see it in a neutropenic patient, maybe.
Thanks for the advice, BuyerBeware. My choices are limited because (1) I need to stay local and (2) as per what I've been able to find on my own, there aren't really that many ACNP programs out there, at least not in my area. There are PLENTY of MSN programs (with varying tracks/"concentrations") but it's not too easy to come by a program for acute care. If it weren't for my specific end-goal, I'd go straight into an MSN program, but I don't think that any MSN programs will truly help me in attaining an ACNP as it now stands.
Again, I welcome any suggestions for other schools/programs out there... or if anyone that has pursued the route of ACNP has any advice at all, it is most definitely welcome. Unfortunately, I don't personally know any ACNPs so I don't have any mentorship as of now. Everyone is really going after FNP in my area and within my networks.
This thread should be moved to LTC; LTACH is not the same as LTC/SNF/Rehab/Nursing Homes.
The rationale behind starting distally and working proximally is that if you blow/damage a proximal vein (further up) then all veins communicating with that vein will run into that same clot/occlusion/injury. Therefore, whatever is being administered through that IV will not reach central circulation, OR could cause further harm if leaking into tissues (depends on what happened to that proximal vein).
I have been working at my current LTC facility as an RN for 6 months. I was just moved to the 11-7 shift approx. 3 weeks ago. The nurse-patient ratio you mentioned in the OP seems standard for this shift.
Night shift "responsibilities" are pretty much as mentioned above. A few meds at 12am (usually just a couple of nebulizer treatments) and then a relatively small med pass at 6am (mostly Omeprazole and Synthroid). In between you have miscellaneous paper work as well as chart checks which require a meticulous eye and a good knowledge of your facility's protocols/procedures, which will come with time and practice. Other miscellaneous tasks include hanging new piston syringes for feeders, changing feeds as necessary, cleaning/organizing/re-stocking med carts, possibly making the morning shift's assignment (depending on your facility), checking resident appts for the following day, refilling any low meds or narcs, etc.
You'll be fine, good luck!
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