FranEMTnurse, LPN, EMT-I Pro 53,815 Views
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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.
"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"
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
What better way to celebrate National Nurses Week than by winning? How about winning free scrubs or a free stethoscope courtesy of Medelita?!?
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!
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.
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!
Delightful! Actually, fresh air and sunshine were about all we had to treat tuberculosis until the advent of streptomycin and isoniazid.
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."
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!)
A code situation
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.
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."
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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