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  1. Davey Do

    Davey Do

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    Has 42 years experience. Specializes in around 25 years psych, 10 years medical.


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  2. Hannahbanana

    Hannahbanana, BSN, MSN

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    Has 51 years experience. Specializes in Physiology, CM, consulting, nsg edu, LNC, COB.


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      330

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      782


  3. JKL33

    JKL33

    Platinum Members


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      328

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  4. toomuchbaloney

    toomuchbaloney

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      317

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      4,962


Popular Content

Showing content with the highest Reactions since 05/24/2021 in all areas

  1. 5 points
    One thing seems to missing here...There have been numerous studies that show that 12 hour shifts are more prone to errors and detrimental to your patients and yourself. Most centered around critical areas such as ICUs and ERs, but they routinely show that nurses start to lose focus after about 6-8 hours. Perhaps we shouyld address this...
  2. 5 points
    Grow a spine and just tell her. I swear a lot of the problems people have with coworkers on this forum could be solved if they just spoke up.
  3. 5 points
    You: I changed my mind, I don't want to orient..... not for 12 weeks anyway. Educator: Well for how long? You: *whatever your limit is Educator: I really need you for 12 weeks You: Well can I not orient at all? I don't really think I want to do it anymore. And go from there.
  4. 5 points
    "I don't want to be a preceptor", worked for me. Of course, I had a reputation for being a pain in administration's... ...neck.
  5. 5 points
    Neonatal Abstinence Syndrome was recognized over 40 years ago at Harlem Hospital. NY where they pioneered many treatment approaches: quiet non-stimulating environment, swaddeling, low voices, skin-to-skin contact, and the use of volunteer cuddlers. They were one of the first to use Morphine to ease symptoms in infants with severe withdrawal symptoms inconsolable by swaddeling, intolerable to touch, difficulty feeding, etc. Neonatal abstinence syndrome (NAS) is a treatable condition that newborns may experience as a result of prenatal exposure to certain substances, most often opioids. Neonatal opioid withdrawal syndrome (NOWS) is a related term used today that refers to the symptoms that infants may experience as a result of exposure to opioids specifically. The Four Categories For Pregnant Women Who May Use Opioids: Those taking medication for pain due to a medical condition who are being monitored by a physician and are not addicted. Those on medication-assisted treatment (MAT) who are in recovery from a substance use disorder and are managed by a physician. Those misusing opioid pain medications with or without a prescription and who are addicted. Those using illicit opioids (e.g., heroin) and who are addicted. Prior to birth, engaging pregnant women with opioid use and other substance use disorders in substance use treatment and other services during prenatal care can decrease or prevent negative birth outcomes associated with NAS and NOWS. A supportive, nonjudgemental attitude with support from Social Work staff as part of a treatment team and nursing follow-up post hospital discharge leads to better outcomes. Symptoms of NAS and NOWS The signs a newborn has NAS depend on what drugs the mother used, how much and how often she took them during pregnancy. One or more of the following can be signs of withdrawal: High-pitched cry Shaky, tremors Cranky, restless Hard to get or keep asleep Feeding problems Overactive sucking Diarrhea or frequent stools Vomiting Fever Dehydration Severe diaper rash Stuffy nose or sneezing Sweating Seizures (convulsions) Skin irritation of face, heels Stiff baby Yawning Poor weight gain Patchy color of skin Image from the American Nurse: Caring for infants and families affected by neonatal abstinence syndrome The onset of the symptoms varies. Newborns exposed to heroin or other short-acting opioids will typically show symptoms within the first 48–72 hours after birth. Those exposed to methadone or buprenorphine, which are longer acting opioids, will often present symptoms later than 72 hours, but usually within the first 4 days. The severity and duration of the withdrawal symptoms can be influenced by exposure to other substances, including tobacco and barbiturates along with poly-substance use. Pathophysiology of Neonatal Opioid Withdrawal From: FDA ADVISORY COMMITTEE: Neonatal Opioid Withdrawal Syndrome Infants with NAS and NOWS are treated through non-pharmacological methods (such as rooming-in with mothers after birth, breastfeeding, swaddling, skin-to-skin time, and minimizing stimuli in the environment), as well as pharmacologic methods (medication) when warranted. There are numerous scoring systems to help identify severity NAS and guide medication treatment: Finnegan NAS -most extensively used, Lipsitz Neonatal Drug-Withdrawal, Neonatal Narcotic With­drawal Index, Neonatal With­drawal Inventory, and MOTHER NAS Scale. A new Eat, Sleep, Console (ESC) NAS assessment scoring method has been introduced using regular assessments of the infant’s ability to eat, sleep, and be consoled to determine the need for pharmacologic treatment, a family friendly approach. Substance use contributes to parenting challenges and has the risk of impeding development of the nurturing parent-child relationships. At the extreme, NAS can lead to infant abuse due to a parent being overwhelmed with a screaming, unconsolable infant. In the U.S., the National Rate of NAS per 1,000 Newborn Hospitalizations in 2017 ( lists rate per state) was 7.3, while in my state - PA, the rate is more than doubled to 14.8. As a prior Home Health Central Intake Manager serving the Philadelphia 5 county area, my staff processed 300+ Maternal Child referrals monthly with ~ 50 having + drug screens on referral. Our Mom Baby nurses were successful in teaching parents how to care for their infants; few required rehospitalization. Registered Nurses link moms and babies for followup at OB and Pediatrician appointments along with other resources as needed: free cribs, diapers, formula, shelter resources and counseling through Philadelphia's Maternity Care Coalition. The Michael Smerconish daily newsletter 5/25/21, published the following article whose authors are Registered Nurses associated with the School of Nursing at the University of Pennsylvania. They recommend a Nursing First Approach to caring for infants with NAS. Treating Newborns in Opioid Withdrawal: A Nursing-First Approach Further reading: National Center on Substance Abuse and Child Welfare: Neonatal Abstinence Syndrome Caring for infants and families affected by neonatal abstinence syndrome Neonatal Abstinence Syndrome (NAS) Toolkit Clinical Guidance for Treating Pregnant and Parenting Women With Opioid Use Disorder and Their Infants - able to download. HRSA’s Home Visiting Program: Supporting Families Impacted by Opioid Use and Neonatal Abstinence Syndrome Video: Advances in Neonatal Care -EBP Brief on Eat, Sleep, Console EATING, SLEEPING, CONSOLING NEONATAL ABSTINENCE SYNDROME CARE TOOL
  6. 5 points
    Wait, what? She didn't reiterate her threat to report quitter RNs like yourself to the BON? I'm disappointed! Also: Told you so. 😉 Well, the end is in sight. Until then: .....forget all of this. Don't entertain it. Just shut it down. I sense that you have some internal desire to let her know of her wrong ways. Don't bother--I don't mean that in a negative way; it's just that you are not going to make her feel bad about her behavior. Stop trying. Try to talk to her as little as humanly possible and if she approaches you with these very lame attempts to make you feel like something is wrong with you, shut it down. Don't have a weird look, don't use an upset tone of voice, just be matter of fact and say something like, "Hm. Not sure what you're referring to; I don't feel particularly tired;" then move on with your business before she can reply. Don't stay there and engage in her nonsense. Please take this as friendly advice: You need to learn a big lesson from this. You need to guard yourself more right from the outset of new professional relationships. Don't engage stupidity and if you're not sure whether something is truth or stupidity (e.g. your belief that she was telling you the truth about resignation being a reasonable reason that someone would be reported to BON)--ask around on the down low!! Find out the facts rather than listening to lies and being manipulated by the likes of her. To some significant extent, we teach people how they may treat us. That can either be good or bad, depending on what we teach them through our own behavior. Again, I mean this kindly but you MUST stop engaging others' drama and stupidity. You just have to button up a little or you very well may have similar troubles as soon as you run into the next person willing to take advantage of you and manipulate you. Best of luck moving forward.
  7. 5 points
    Honey, it's vicarious trauma. None of us are immune. I have an endless loop of potential horrors in my brain that are a result of prehospital, ER, and Afghanistan experiences, magnified a thousand times over after having my daughter and now doing all those what-ifs related to her. It's part of the reason I stopped working as a trauma educator (that, and peripartum cardiomyopathy (PPCM) that left me with some issues) and I now work at home, where the worst thing I see are sad stories in charts. It helps, a little. I just couldn't see one more dead kid. I probably need to see a counselor at some point and fess up to the VA that I am not as okay as I like to think. Therapy is a great suggestion! I have a lot of coping skills, but my brain likes to pipe up with the "yeah, but what if" stuff, and all my hard-fought perspective and gratitude goes out the window. I don't have any answers, but I totally understand how it feels when you can't unsee what you have seen.
  8. 4 points
    In the future, simply say "I have never worked in XYZ environment but I'm eager to learn." It relays you don't have that experience but you're open to being taught and learning to master that unit or skills required for the job. It's usually not a problem that you don't possess certain skills as nurses change all the time, it's the ones who think they know it all and don't want to learn that pose a problem. None of us know everything and there's always room for improvement. Good luck to you.
  9. 4 points
    I could go on and on until the cows come home on all the facility improvements and employee benefits which came into being the first few years of the conglomerate takeover. Similar antics to big box store moving into a community and monopolizing the local/regional market. It's all good until it's not*. Also, that corporation got your hospital for a song and a dance, after cleverly convincing them and everyone in the community that they were already bankrupt and terrible at managing everything. So I wouldn't blink at them spending millions. Whatever they spent was both for show and for eventual additional profit, not out of the goodness of their hearts because you and your worker friends deserved a raise and some new equipment to use. I've directly witnessed this scenario and have some behind the scenes info to go with it. *[I used "it's not" on purpose, having previously been taught to use "it isn't" as a better alternative so as not to sound like "it's snot." In this case, it's both "not" and "snot." So I figured...why not. 😂]
  10. 4 points
    This sentence is pretty much always the red flag that says, “[sounds like “wool shirt”] coming right up!” Many people are saying all kinds of nonsense. The link to the article by the well-known antivaxxer was nonfunctional on my tablet this morning, but his reputation precedes him.
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