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FranEMTnurse, LPN, EMT-I Pro 53,815 Views

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  • Jun 23

    Ive worked with both. The most recent DO I worked with said basically DOs also get some more Chiropractic and accupuncture type of classes so they can do realignments and that kind of thing. DOs are supposed to be more holistic and less pill pushing but I've seen good and bad MDs and DOs so it really depends more on the person not the title.

  • Jun 16

    "I've worked here for 50 years, never seen any of them in or out of there.... some say its haunted with the souls of retired nurses"

  • May 25

    George stepped out of the hospital room and shut the door softly behind him. As his Faith Community Nurse, I had just stopped by to check in and asked him if it might be a good time to talk. "She just dropped off to sleep after the pain medicine," he said. "We can talk for a few minutes." We stepped to an alcove at the end of the hall where we found two chairs in a private spot.

    George's weary eyes filled with tears as he started to talk; he pulled off his glasses, wiping them rhythmically with the end of his sweatshirt before putting them back on. I offered tissues and encouraged him to tell me how things were going. "We've been married over 30 years now, and Kathy has always been so stubborn and determined. I admire that about her, but right now it is so hard. I think she hates me..." His voice trailed off and I asked him why he said that.

    He went on to explain that Kathy had metastatic colon cancer and was currently being treated conservatively for a perforated bowel which the doctors hoped would seal up on its own, given time, antibiotics and intravenous nourishment. But through the entire hospital stay, the medical team had been very discouraging about her prognosis, saying there was little else they could do in terms of interventional care.

    "Palliative Care came yesterday, and it did not go well." George sighed and almost laughed when he told me how strange the conversation had been with Kathy absolutely refusing to consider end of life care and the Palliative Care Team wanting to introduce the idea of hospice. Then his face turned dark again and he said, "That's when she turned on me! She said I am not on her side. I was just asking questions of the team, wanting to know what hospice means in a situation like this. She asked me to leave the room and said she could make her own decisions. She wants to get a referral to another medical center to be evaluated for more surgery. You know they won't do that! Why, she can't even be moved at this point."

    He cried for a few minutes and I reached over to pat his shoulder in an attempt to comfort him.

    "Even pain management is a problem. She keeps refusing pain meds and she is in so much pain. The Palliative nurse presented several options, including patches. What do you think of that idea? She says the pain meds will keep her from enjoying the grandchildren when they come in this week-end." George looked at me questioningly.

    As Faith Community Nurses, we are trained to listen, ask questions and help people to navigate difficult waters. Because of the common thread of faith, we are free to offer spiritual guidance as requested and as seems appropriate. I asked George if he would like me to pray for wisdom and he tearfully agreed, saying that would be helpful. After prayer, we read a few scriptures and then we discussed potential paths forward.

    What does a patient and their family need at a time like this? How can we see beyond the spoken words to the messages the patient and their family are relaying to us? How can we be true advocates for a patient who wants to make a different decision than we see as medically indicated? How can we, as professional nurses, find ways to be nonjudgemental and supportive in the face of limited treatment options?

    The patient needs to feel supported.

    Because Kathy was coherent and able to make her own decisions, she wanted to exercise whatever control she could. It was clear that she understood the severity of the situation, but she remained in strong denial, unwilling to do anything that she perceived as "giving up." She had always been a valiant fighter; her message to us was that she didn't want to change that in her last battle. As George and I talked, he became clear that she wanted him to be her advocate, always in her corner, helping her face the end of her life in the way that suited her best. As George said, "She always been determined. She's not going to change now; not when it matters so much. She wants us to remember her as someone who never quit fighting."

    The patient needs accurate and helpful information for her particular situation.

    Because Kathy's need for control was so strong and her suffering so intense, she came across as impatient and exasperated with staff that she didn't feel would bend enough to her way of seeing things. She made it clear she did not want IV drugs and that she wanted to go home so she could get stronger to have surgery. From that point, Palliative Care directed their energy to working on getting her pain under control with Fentanyl patches along with a shorter acting opiate. They tried their best to ask questions and listen, listen. Over the ensuing days, George began to act as her strong advocate, helping the staff to support her and acting as a go-between when needed.

    Hospice isn't always possible.

    Hospice just wasn't an option at this time for Kathy and George. Sometimes, patients and families struggle to find common ground around the topic of hospice. Despite the best education and information Kathy adamantly refused to consider the service and Case Management began to focus, instead, on getting the necessary equipment in the home and supporting George so he could take care of her there. We made sure George had all the information he needed about hospice and about how to initiate that service should Kathy change her mind in the days and weeks ahead. He proactively interviewed a hospice team and got the number to call in his phone.

    Kathy ended up going home with George and a team of neighbors taking care of her. With her abdominal pain under control she began to take a few bites of food and appeared to enjoy being in familiar surroundings. They made a trip to the doctor via ambulance for her routine treatment and blood work. Their children and grandchildren came in from out of town. Kathy orchestrated the purchase of a new grill and then ordered up a huge cook-out while she sat poolside in the chaise lounge, wrapped up, holding George's hand, and enjoying the site of her family gathered around, enjoying life.

    Joy Eastridge, BSN, RN, Certified Lay Minister Parish Nurse UMC

  • May 6

    What better way to celebrate National Nurses Week than by winning? How about winning free scrubs or a free stethoscope courtesy of Medelita?!?

    scrubs-scope-medelita-


    Medelita has spent years testing and developing proprietary fabric technology for their scrubs to exceed your expectations as a nurses. Their scrubs are strong, easy to clean and fluid repellent.

    Medelita's Erka stethoscopes are manufactured in Germany. Made with the highest standards in mind, their Erka line of stethoscopes are easy to use, durable and functional.

    Now that you know the basics about Medelita's scrubs and stethoscopes, isn't it time to enter to win?!?

    Entering is as easy as clicking here and filling out the short entry form. During National Nurses Week we will be selecting winners for 50 pairs of scrubs and 50 stethoscopes. Keep an eye on your email inbox so when you win you can claim your prize! Winners will receive a unique coupon code in their email to be used at medelita.com and each prize is valued at $100! Enter NOW!

    Happy Nurses Week and good luck!

  • May 6

    National Nurses Week begins every year on May 6th and ends on May 12th on Florence Nightingale's birthday. These permanent dates enhance planning and position National Nurses Week as an established recognition event. As of 1998, May 8 was designated as National Student Nurses Day, to be celebrated annually. And as of 2003, National School Nurse Day is celebrated on the Wednesday within National Nurses Week (May 6-12) each year.

    We have provided a list of special offers, prizes, and freebies for you to enjoy during your special week. Let us know if we've missed any. We'll add it to the list.

    allnurses Nurses Week Giveaways (valued up to $14,000)

    This is the biggest Nurses Week giveaway allnurses has ever offered. It's our way of saying thank you for all you do every day. Join the month-long celebration by participating in fun nursing contests. Maybe you will be one of the winners sharing in prizes valued up to $14,000!! Yes, you read that correctly. This is the largest Nurses Week giveaway yet.

    National Nurses Week Celebration: 30 Days of Celebration / 8 Days of Giveaways (valued at $4,000)
    Go to the link above for a list of contests. One winner will be announced each day of Nurses Week. The 8th day is National Student Nurses Day with a special prize for our students. See details below about Medelita partnering with allnurses to giveaway $10,000 in prizes in the allnurses giveaway.

    Medelita - Scrubs & Stethoscopes Giveaway (valued at $10,000)
    During Nurses Week we will be selecting winners for 50 pairs of scrubs and 50 stethoscopes, valued at $100 each!!! (part of the allnurses Nurses Week Celebration)

    Online Discounts / Giveaways found Online...

    allheart- Love your curves! Buy any item and get 2nd item 40% OFF using coupon code 52118

    Amazon Nursing Books - Free Kindle Nursing Books!

    Amazon Prime 30-Day Free Trial - Try all Prime benefits FREE for 30 days!

    Amazon Prime Student 6-Month Trial - 50% off Amazon Prime for students who want to become nurses

    ANA - "Nurses; Inspire, Innovate, Influence"
    Free Webinar: Emerging Technology and Its Impact on Nursing Practice

    Wednesday, May 9, 2018
    1:00 p.m. - 2:00 p.m. EDT
    Earn 1 FREE CE!
    REGISTER NOW!
    Registration Deadline: May 8,2018,7:00 p.m. EDT

    Best Nursing Degree - They are giving away $300 in Visa gift cards to Inspiring, Innovative and Influential nurses who are nominated in different categories. Nominate a nurse here.

    Burntown Fitness - Get 10% off a 2-week unlimited package through May 13th by using code NURSESWEEK10BURN

    Cinnabon- As supporters of the Daisy Foundation, from May 6-12, show your name badge and get a free classic cinnamon roll, MiniBon, or four-piece BonBites at participating locations. Look for your closest Cinnabon location here and ask them for specifics about Nurses Week offers in your area.

    Disney World - Disney World loves their nurses. They are offering discounts to nurses (also teachers & military personnel) at the Swan and Dolphins resorts. Call 800-227-1500 and mention the code DREAMS. Be sure to also mention you are a nurse!

    Dunkin' Donuts - Participating locations are offering a free 16 0z. Dunkin' Dark Roast iced coffee May 6-12, between 4 p.m. and 10 p.m. with a valid health care ID

    Einstein Bro's Bagels- Nurses wearing their scrubs or ID badge can go to any participating location and receive an Espresso Buzz Bagel and Shmear on the house, May 11

    Jigsaw Health - The Magnesium People are offering discounts for bulk purchases

    Lydia's Uniforms - In addition to numerous sales, Lydia will give you $5 off with mailing list sign-up

    Medisave - This equipment supply store is offering 5% off with a rating on Google or a like on Facebook

    Nature's Gift - This aromatherapy product company offers a 10% discount to all healthcare professionals with license verification

    New York & Co - Nurses get a 15% discount at this retail clothing store with a badge

    Nurse Mates - 30% entire purchase + FREE SHIPPING! Use code NURSESWEEK18

    PDQ - Nurses receive 50% off their total check on May 8th by showing their badges

    Puckett's Restaurant & Grocery- Puckett's in the Chattanooga, TN area will be honoring nurses with Nurse Breakfasts for a discounted price, starting on May 7th. See their website for more details.

    Scrubs & Beyond - Celebrate Nurses Week with 20% off!

    Shoeline.com - Save 30% on Nurse Mates using coupon code 'nursing518' - expires May 31, 2018

    Shoes.com - Offering $5 off with their reward program sign-up

    Sleep Number - Nurses can take 25% off their purchases with license verification

    Sprinkles Cupcakes - free sweet treat with a badge at participating locations

    Theratape - This kinesiology tape supply company offers discounts to healthcare professionals

    Uniform City - Nurses Week! 20% OFF Entire Site

    WGU - Western Governors University has scholarships available and no-fee application during nurses week for additional schooling.

    Blaze Pizza: Select Florida locations are offering nurses with ID a $5 Build-Your-Own pizza offer Monday. Check the location nearest you for details.

    Chick-fil-A: Although there's not a nationwide promotion, select locations are offering nurses a deal Tuesday. The Indian River Mall restaurant will give nurses with IDs free eight-count nuggets from 11 a.m. to 6 p.m. Tuesday and the standalone Vero Beach location will give nurses with IDs a free chicken biscuit for breakfast or chicken sandwich for lunch.

    Applebee's Grill & Bar - Check with your local restaurant for participation

    Pandora - Nurses enjoy 25% off total purchase on Sunday, May 6th. Check your local store for details.

    Just added 05/09/18:

    Jaanuu Scrubs: Beginning May 6, nurses are welcome to create a short video, or a written story and photo, with a fellow nurse who has made a positive impact on their career and life. Materials may be uploaded directly to the contest site (www.jaanuu.com/nursetonurse), which can be accessed through the Jaanuu homepage. Alternatively, they may be uploaded to entrants' Instagram accounts with the hashtags #NurseToNurse and #contest.

    Qualified entries submitted either way will appear on the contest page with a dedicated link to each story. Friends, family, and coworkers are encouraged to vote and spread the word about the #NurseToNurse campaign. All entries and votes must be submitted by Sunday, May 27. Every qualified entry will receive a $20 Jaanuu gift card, one per person. The top ten entries will receive $500 Jaanuu gift cards, one each for nominators and nominees. The entry with the most votes will receive the grand prize: an all-expense-paid trip-for-two to Los Angeles including a spa getaway and a visit to Jaanuu headquarters ($4,000 value). Top ten and grand prize winners will be announced on or before June 1 on blog.jaanuu.com.

  • Apr 29

    I almost have an obsession with fresh air and sunshine. It drives me crazy when family members keep their curtains closed during the day. No, it's not about privacy. And as we live in a moderate climate, keeping windows closed, I have to have windows open a little even if it's cold.

    I am very healthy, seldom sick, so must be fresh air and sunshine!

  • Apr 29

    Quote from ruby_jane
    Delightful! Actually, fresh air and sunshine were about all we had to treat tuberculosis until the advent of streptomycin and isoniazid.
    Here in KY, we have an old abandoned TB hospital, Waverly Hills. If you
    happen to be a fan of shows like "Ghost Hunters", than you may have heard
    of it, as it is said to be one of the most haunted buildings in the world.

    Anyway, if you ever take a tour of the building, you will likely be treated
    to a nice history lesson as well. One thing you will learn is that the patients
    were often taken to a large terrace off of the second floor of the building,
    just to bask in the fresh sunlight and air! It was indeed one of the main
    treatments that was used!

    That, and good food. The patients were fed very very well. Fresh sunlight,
    air, good food, and low stress.

  • Apr 29

    Nursing focus and objectives were the same in the early 1900s as they are now, however elementary in comparison they may seem. Safe patient care and treatment are of utmost importance and has been since nursing began. Nurses who read the questions I will share from the book, Lippincott's Nursing Manuals, State Board Questions and Answers For Nurses written in 1927,may raise an eyebrow, but these issues and questions were taken just as serious as the ones we study today.

    The chapter titled, "Hygiene and Bacteriology", is about the preservation of the health of the individual (nurse) by "personal prophylaxis". In this book, personal hygiene is categorized as a branch of medicine. Most of the questions are about how a nurse should conduct herself/himself.

    Question: "What general and special hygienic precautions should be observed by nurses during their training and while practicing their profession in order to preserve their own health?"
    Answer: "Maintain normal resistance of the body by being clean, get a reasonable amount of sunlight, fresh air, sleep, exercise, pure water, and digestible food. Avoid infection by wearing sterile clothes, maintaining a rigid technique to avoid infecting surroundings after handling infectious equipment. Sterilize the hands and immunize such as taking the smallpox typhoid vaccines and diphtheria antitoxin".

    While making the reader giggle, there is good advice in the answer. The fact that it is actually an exam question may seem foreign to us, because it seems obvious to us. Good hand washing is drilled into us as a society from childhood, not just as nurses.

    Question: "What are nature's best common destroyers of disease germs?
    Answer: "Fresh air and sunshine are nature's best common destroyer of disease germs".

    Fresh air and sunshine are wonderful, but sometimes we need a bit more help to destroy those germs.

    Question: Name several factors which may predispose a person to disease".
    Answer: Gluttony, excess alcohol or other stimulants, fatigue from muscular exertion, loss of sleep and exposure".

    This issue takes us back to basics. Actually, these reasons for disease are often not talked about in the doctor office, instead, a pill is given, or a surgery is performed. Human behavior hasn't changed, addictions remain the same. Although we now know there are many more factors involved in a person being predisposed to a disease such as genetics, as is the human condition to be self-destructive.

    Question: "What keeps our body warm?
    Answer: "We are kept warm by reason of the heat generated in the chemical changes that take place in our body tissues".

    They knew there was a chemical process, but hadn't yet discovered much about metabolism and the use of ATP by our muscles to generate heat.

    Question: "What is the legal status in some states of the public drinking cup?"
    Answer: "The public drinking cup is very properly forbidden by law in many states".

    Wow, hard to imagine that at one time everyone in town shared a water cup. Cholera and diphtheria were spread this way. In the early 1900s, Jersey City, New Jersey began to sterilize water which led to the decrease of disease across the United States.

    Question: " What substances antagonistic toward bacteria does the body contain?"
    Answer: "The body contains alexins, or opsonins, and antitoxins".

    What we know about our immune system is vastly more than the above-mentioned molecules.

    Conclusion

    We hear that the "good old times" was simpler. Compared to our overstimulated, wired world, it was. The tradeoff is that we have a greater knowledge of the how the body works as well as state of the art treatment. Imagine in another 100 years what the medical field will look like. Someone will be looking at our NCLEX questions and giggling or scratching their heads. We can only imagine what diseases won't exist anymore, what we will be using for treatments, or how those treatments will be accomplished.

    I hope you have enjoyed reading these questions as much as I have. Look for more articles that will take you back in time!

  • Apr 29

    Nurse: Did you tell the patient about the prostate exam?
    Dr. Worf: I told him I was "Going boldly where no man has gone before."

  • Apr 29

    Let me point you in the direction of "burn resuscitation," which is the general term for the first 24-48 hours of care for a serious burn. It focuses mostly on fluids...we do not actually just pump then full of fluids without monitoring their response...and what to monitor for.

    Like any emergency, focus on the ABCs: your patient's Airway was managed...why do you think this could have been necessary? What sequelae from the burn could have made this necessary? Do you think giving someone a lot of IV fluid and pain medicine could affect their airway?

    How would you monitor their Breathing? (Honestly, this one is probably beyond the scope of your pathophys class and requires a basic understanding of ventilators to fully grasp, but look up "indications for chest escharotomy" for one line of thought.)

    How would you monitor their circulation? Burn patients lose a lot of fluid that can't be measured...how do you know that some of their blood is still perfusing their vital organs *especially* now that the patient has been sedated with diprivan (Propofol...the milky white stuff) and you can't do a full neuro assessment?

    If you can answer all that, your next step is trimming it all down to fit on one slide I am glad you're trying to get a good understanding of this, but it's broader than your experience in the ED led you to believe. (Once you become an RN, take an ABLS class and come work in the burn unit!)

  • Apr 11
  • Apr 11

    Quote from OldDude
    Monday thru Friday, no weekends, nights, or holidays. A week off at Thanksgiving, 2 weeks at Christmas, a week for spring break, Good Friday, and 2 1/2 months in the summer.
    Yep.
    Add to that that my daughter is in the same district, has the same schedule, and I am walking-distance from my house, so I lose no time commuting. Honestly, even my worst days here are way better than when I worked at the hospital (and I've worked at several of them, with some really great people).

  • Apr 11

    This forum!!!!

  • Apr 11

    I may have told this story before here, but it's one of my favorites...when I was a school nurse, my favorite part was (as some have mentioned) the adorable ridiculousness of little kids. One time, I was giving one sobbing first-grader the "oh, you're such a big girl, this is no big deal!" encouragement while cleaning up a scraped knee, and she stopped crying just long enough to look at me and declare, "I am NOT a big girl, I'm only 6, I'm just a little kid, and I HURT MY KNEE."

  • Apr 11

    I am not a school nurse but I am a nurse who can cheer you up.

    School nurses make an impact on lives of children
    Studies show schools with school nurses have http://www.rmc.org/wpdev/wp-content/...school...2.pdf :
    1. Higher immunization rates
    2. Less sick call ins
    3. Better nurse to student rations revealed smaller percentages of teen moms study also showed increase in earlier prenatal cares
    4. Decline in absentee with greatest impact form 3rd to 5th grade
    5. Parents gained more information about their little snowflakes (yes you all taught me this word and meaning)
    6. Students who received specialized education had reduced anxiety symptoms when having anxiety attack.


    In my book you all are worth your weight in Gold and I am grateful to you all.


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