Content That CT Pixie Likes

CT Pixie, BSN, RN 33,456 Views

Joined: Jan 21, '07; Posts: 4,317 (42% Liked) ; Likes: 4,902

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  • Jan 29 '16

    Y'ALL I PASSED, I CAN'T EVEN..!!!! <3 <3 so excited!!

  • Jan 23 '16

    Quote from CT Pixie
    I love the smell of D&G Light Blue, even though it is very light, even the slightest whiff of it give me a migraine.
    I won't wear it the next time I go to CT.

  • Jan 8 '16

    Quote from TheCommuter
    Based on posting history, OP most likely works in a nursing home/LTC facility. This means no IV team, no in-house pharmacy, and nursing staff who might not be the most proficient at starting IV lines.

    Anyhow, the MD probably knows about the situation because he/she had to have ordered the midline placement. This happens all the time in LTC. I wouldn't worry about it if the MD is aware.
    I find it verrrry interesting that those respondents who are the most critical of this situation do not seem to be employed in LTC/NH field.

    TheCommuter and I have been there & done that. We know that often things do not move quickly when something like this comes up.

    NHs only have just so many few nurses who are certified (and proficient) to try starting IVs and this pt sounds like a tuffy one to start. TICK TICK TICK

    Another fly in the oint is that consent for PICC/midline insertion requires consent (guessing that pt can't sign). Oh, pt's son/dtr is working when 7-3 left a phone call message (maybe lucky if there's cell/text capability). But the family delays getting back to NH. TICK TICK TICK

    Let's hope that the pharmacy can provide IV ABT without having to call the insurance for IV drug and/or procedure authorization/approval. That's an adventure unto itself. TICK TICK TICK

    The contracted Pharmacy IV team has to be called & THEY schedule the insertion as they are able to provide advanced IV insertion-certified nurses. TICK TICK TICK

    Something like this situation requires unbelievable finesse to achieve. It is all dependent on getting all the celestial stars in perfect alignment. I say this with no meany-ness but you guys in ER/ICU/acute care have little to NO understanding how many hoops we have to jump thru to satisfactorily and effectively orchestrate this task.

    With the exception concerning appropriate and TIMELY physician notification, I'm NOT surprised about the time delay in this snafu. (My take is that the MD was most likely notified approp.)

    And just remember that this was the holiday season!

    To address OP's concerns - it is hoped that all the details in this situation have been approp documented. The orig MAR would be circled as NOT GIVEN and the IV ABT would be started just as soon as the new PICC IV site tape was taped down! A new MAR would be started & timed just as soon as the med was being started.

    I have only one possible questionable concern - could that pt NOT be sent out to a local hosp where Interventional Radiology coordinates new PICC IV insertions? That might have been an option but some facilities HAVE to go thru their own IV Pharmacy first. Just a thought.

  • Oct 12 '15

    I got the job!!! Accepted the position last week. I can't wait to start!

  • Sep 21 '15
  • Aug 23 '15

    Quote from Emergent
    One of the cardinal signs of a diverting nurse is working constantly. 'Super Nurse' is part of the profile for a diverter.

    See the article below.

    Drug addiction among nurses: Confronting a quiet epidemic | Modern medicine
    But working a lot, by itself, doesn't imply a drug addiction. It's true that some people with a drug addiction work a lot, but not true that all people who work a lot have a drug addiction. Like a fever, as a single sign it's very non-specific.

    I knew a nurse who paid cash for her son's medical school by working all the time. She was a wonderful Vietnamese woman who said her worst day as a nurse was easier than the best day working on her parent's farm in Vietnam as a kid.

  • Aug 22 '15

    I knew it was carter something, thank you!

  • Aug 9 '15

    Here's a sentence that I personally would like to become taboo..."It's so much easier on night shift because all the patients really do, is sleep". Seriously day shift! Seriously?

  • Aug 4 '15

    Quote from O9eleven
    Who's this Hemsworth person?
    A whole bunch of yum wrapped up in a Thor costume.

  • Jul 25 '15

    The trials and tribulations of High School.

    No, Grasshopper, you may not use a calulator until you have passed into middleagehood. Be grateful you still don't know how to use a slide rule.

  • Jul 25 '15

    In real life, if you want to convert from Fahrenheit to Celsius or vice versa, hit the "F/C" button on the thermometer.

  • Jul 4 '15

    Quote from hherrn
    Hey floor nurses-

    ER nurse with a serious question. The question only applies to nurse who have access to the ER's computerized chart.

    Why don't you just read the chart?.

    It has all the details you ask me about. In fact, I haven't memorized all those details, I just peruse the chart as you ask me.

    I don't mean read the whole chart, I mean scan it for the details you want. I have no idea why you need to know ahead of time what size IV and where it is, but it's charted.
    As far as a history? H & P, last visit, etc, is all at your finger tips. As far as what time each med was given- when you ask I open the MAR, and read you the times. I even say "I don't know, but it's been charted, I will open the MAR an look". When I say that, I am hoping you will get the hint that it would be faster for you to have already done that. Somehow, you always miss the irony.

    Please don't say that you don't have time. That doesn't make sense. Think about the difference between reading something, and having it read to you. I can scan a chart for 2 minutes, and know just about everything. Add to this the fact that I really don't know all the details you want- I just kind of guess. As an ER nurse I may have received that same PT with a 1 minute report. It's all I need.

    There is no question that it is faster and more accurate to scan the chart.

    So- why don't you?
    I would like to extend your proposal to the report that happens on the "front end" of the ER patient transfer - the one that happens between EMS and the ER. Why should EMS be wasting everyone's time calling ahead? What info could they provide that can't be found in the paperwork they leave when they drop the patient? You'll be able to see what lines (if any) are present, whether or not intubated, etc. when the patient rolls in. When was the last epi given? It's right there in the paperwork... just scan the paperwork for 2 minutes and you can know just about everything.

  • Jun 19 '15

    Update: talked to my current babysitter, she said she's willing to keep my son on the nights I work for a weekly fee. It'll only be for a couple months since I have to go through orientation for several months on day shift before I transition to nights. By that time my husband will be within a month and a half of graduation.

    thanks for your advice, guys.

  • Jun 18 '15

    Let's look at this from his perspective. He's working his buns off on nights, and going to school during the day, all while being a husband and a father. Then you tell him you have a job offer for nights. It's clear that his night job is secondary to his schooling, so in order for the child to be taken care of, the obvious choice is for the night job to go. He's putting in what appears to be a Herculean effort to provide for the family, and you want to throw a wrench in the gears. Perhaps it's to his credit that his only reaction was a "smug" remark?

    Could your husband be a complete anal sphincter? Maybe. Might you be a whiny, emotional child? Maybe. It sounds like your marriage needs some guidance and support, in any event. I would wholeheartedly and sincerely advise you and your husband to set up a family meeting. Try to figure out what is going on, you're both adults and should be able to put away the emotions for 30 minutes. Perhaps you two have a spiritual adviser or a wise friend you both can seek some counsel from? Maybe counseling would be an option. Perhaps you guys simply need a vacation? In any event, there needs to be a bit more communication in your life, at least from looking through this tiny window you've posted about.

    Ignoring all the emotional issues, here's some practical thoughts. You and your husband need to sit down a few nights this week and put a budget on paper. Perhaps you can live on one income if you cut back on the lifestyle? Cutting out the mani-pedis, Starbucks, golfing trips, and the classic car project for 6 months might free up enough cash. Maybe sell a motorcycle and some jewelry to create the extra income to power through?

    If you can't make it work on one income, then you'll probably need to suck it up until your husband is finished with his schooling in 6 months. Your husband's education needs to be the priority because it solves many of these logistical and financial issues you're facing, assuming, of course, he's pursuing an education in something that makes him employable and generates a steady income. Once he gets a job in his field of study, that frees you up to pursue a day job or a night job, and let's you choose your place of employment. However, for the next 6 months, you don't have the option of working nights because your family simply can't afford it.

    Now put the computer away and go talk to your husband. We are anonymous strangers who don't have a clue what's actually going on, and our advice is probably terrible. Seek some wise counsel from an in-real-life person. Create a list of priorities (marriage, communication, your employment satisfaction, his education, income, child) and determine which are the most important, then use this list to help guide you through the next 6 months.

  • Jun 14 '15

    You can call me an oddball if you wish, but I like to know about patients with behavioral issues before I meet them. I also appreciate heads-up warnings regarding bizarre family dynamics or tendencies toward crazy-making.