jonamb

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1. Shoulder dislocation in elderly patient

   jonamb replied to doones_1's topic in Geriatric

   Spontaneous fractures, unfortunately, do occur. We had a LOL once who was just walking down the hall, went to the floor for no apparent reason, and BAM...broken femur. And she had been a good walker...steady, good posture...it was the craziest thin...

2. is this abuse

   jonamb replied to southernlady48's topic in Geriatric

   Definitely sounds like verbal abuse. Just because the res. was showing no s/s of SOB does not mean she did not feel like she was SOB. How many times have we seen res. c/o something while showing no symptoms (think pain -- I've seen people say they ...

3. Who can witness a waste?

   jonamb replied to MQ Edna's topic in General Nursing

   Where I work, we also just have a rolling cart with a lock box and sign out sheet for narcs. A waste must be witnessed by someone with a license. It doesn't seem like good company policy to allow a waste to be witnessed by someone not familiar with...

4. Admin Tyl and Vicodin w/ in 4 hr

   jonamb replied to 1st edition's topic in General Nursing

   In the LTC where I work, the max dose of acetaminophen was decreased from 4000mg/day to 2500mg/day several years ago. We need to get an order from the doc if the pt. requires more (sometimes they will write for a max of 3000mg, sometimes 4000mg). M...

5. Admin Tyl and Vicodin w/ in 4 hr

   jonamb replied to 1st edition's topic in General Nursing

   Sorry, I just reread your original post, and realized the order says she can have one or two Vicodin every four hours, meaning that she can have up to 1000mg acet. In this case, she could technically receive Vicodin and Tylenol within four hours of ...

6. Admin Tyl and Vicodin w/ in 4 hr

   jonamb replied to 1st edition's topic in General Nursing

   I would take the order to mean that she can have up to 650mg acetaminophen q4 hrs, whether it be Tylenol or Vicodin. Therefore, if she had Vicodin, I don't believe she would be able to have Tylenol for another four hours, and vice versa. However, i...

7. Nursing Home/Assisted living nurse question

   jonamb replied to OKRN's topic in Geriatric

   I'm an LPN, not an RN, but I do know that where I live in Michigan nursing homes do pay more than hospitals. RNs that I've spoken to have told me that starting wages in our three nearest hospitals average about $17-$18/ hr. and it's close to if not ...

8. Gotta Love Mom

   jonamb posted a topic in Humor

   Someone was passing this around work the other day and it made me smile... Stephanie was so happy. She was young, healthy, successful, and she was about to wed the man of her dreams. She was happily planning the wedding she had always fantasized ab...

9. Dumb Halloween joke

   jonamb posted a topic in Humor

   One of the residents at the LTC where I work told us this joke the other night.... Why don't witches have babies? Because warlocks have hollow-weenies. :thankya: I know, I know, cheesey. But I have to tell you a little bit about this res...

10. Female Foleys... I STINK AT THEM>>> HELP!!!

    jonamb replied to RNOTODAY's topic in Operating Room

    Have you tried turning the pt. on her side with her knees bent (imagine the position her legs would be in if she were sitting in a chair)? A veteran nurse taught me this, and sometimes it makes things easier to see. I work in LTC, and the landmarks...

11. How about your favorite Old Wives Tales related to health?

    jonamb replied to NurseyTonyaLPN's topic in Humor

    These posts made me think of my mother-in-law. She had some good ones.... 1) For teething pain, give the baby a chicken bone to chew on. She did this with my son once and I about freaked! She apparently wasn't the only one who did this, though. I...

12. Soy vs. Cow's Milk-Based Formula

    jonamb replied to daisybaby's topic in Ob/Gyn

    Thought this was interesting, so I just wanted to relate my experience with soy based formula. Both of my babies were formula-fed. My first baby did just fine with regular formula. The second one, however, had a terrible time with it. The biggest...

13. Skin Tears........

    jonamb replied to BIG T's topic in Wound

    In our facility, we have a variety of dressings to choose from. Most nurses opt for transparent dressings (Tegaderm, Bioclusive) that can be changed every 3-5 days for skin tears. I have found that these dressings are usually good for small tears o...

14. Am I just overreacting? (CNA vent)

    jonamb replied to Megsd's topic in Geriatric

    I know what you're going through, and I'm sorry to say, these two CNAs that you are talking about are not going to change. And I'm assuming going to your supervisor won't help either, since they are both long-termers and obviously have been getting...

15. showers on nightshift and time for residents to get up in the morning?

    jonamb replied to FROGGYLEGS's topic in Geriatric

    In our facility, all baths are sceduled on 7-3 and 3-11. 11-7 will occasionally do a bath if the resident has been refusing on other shifts, if they (resident) is awake and agreeable at the time, and if there is time (and of course the occasional "t...