wooh 36,211 Views
Joined: Feb 12, '04;
Posts: 4,980 (74% Liked)
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RN & Critter Mama; from
TPN or did you maybe mean TPA? I'm really struggling to figure out how TPN would do anything other than lead to one heckuvan infection
It's not something you do frequently, but if there's a lot of clots coming out, it's generally preferable to keep the tube patent and draining.
Wait til the day you're asked to instill TPN through a chest tube. That will really freak people out! (It sure did me the first time I saw it, was not sure I should be trusting that surgical resident. )
How did they get a diagnosis from a Kidneys, Ureters and Bladder X ray and not a AXR?
I don't think it was intended to NOT recognize nurses, but to recognize the whole health care team.
Agree with the post that if you're quitting to get the job, you need to quit for good. If you are covered under your employer's health insurance, it will come out if you're still smoking, at which point you're looking at misrepresentation which can knock out your insurance AND your employment just when you need your insurance.
As for obesity...
That day's already here. Employers are gearing up for it. The problem is, what will they base it on. Now I'm screwed either way, because I'm fat no matter which charts or graphs you use. Or just looking at me.
BUT, what worries me, is healthy people that are going to get caught up in the "obese" thing. My employer had a "health fair" and they of course check your weight on a height weight table, check your BMI, check your waist hip ratio, body fat percentage. Very few people in my department and our regular docs made it through without being fat based on at least one test. Two of our nurses that work out regularly, are almost ALL muscle, their body fat percentage is in the basement for women, both got nailed as OBESE on their BMI. So they'd better get some more fat on them and quit working the weights or they'll have to pay for being "unhealthy." Quite a few of our folks that are regular runners got nailed on at least one of the things, often the hip waist ratio JUST making it to call them obese. And a few notices that they were holding the tape measure MUCH MUCH tighter on their hips than on their waist. Almost like they get a bonus if they can find you unhealthy, and don't you think that if someone has to pay the insurance company lots more money for being unhealthy in some way, the company is going to find a way to "prove" you're unhealthy?
We need to leave nursing to the folks who are ready to accept it as it is: hard work, poor working conditions, long hours, and underappreciation from management. The nurses who can't take the heat are dragging us all down...
I have no problems telling a physician their patient will NOT have IV access unless they order a central line or PICC. If you want to extend those 72-96 hrs for "a few" until you can get another site, ok... but I have issue with bending rules indefinitely when my patient's safety is in question.
Those guidelines aren't in place to make our lives more difficult. How do we expect nursing to be elevated as a profession if we don't follow IBPG?
I've hung blankets over windows to block the sun. And I'd think occasionally taping the eyes closed would be a good idea.
Just make sure on PICC lines to try a dressing change before using the super expensive Cathflo. Sometimes there's just a tiny kink under the dressing that's the actual "clog." I've actually had orders for the Cathflo, and before using it, changed the dressing and was able to save myself a bunch of time and the hospital a bunch of money.
If you're A&O before you get a bed alarm, it will take only about an hour after the bed alarm before you're no longer A&O. That loud alarm every single time you adjust your position? I'd prefer a broken hip to living with the alarm.
I have to say that I think this is another area where "customer satisfaction" shouldn't be such a huge factor in evaluation. Educators are much like as a floor nurse, where often I have to tell people things they just do not want to hear, and do things they just do not want done. Sometimes I'm going to make people very unhapppy and very unsatisfied for their own good. Educators often have to do similar. Some of the nursing instructors that I just hated were the ones that looking back made me a much better nurse. I'd have probably given them a poor eval if I'd gotten one for them, and it would have been a shame since in the end, I actually learned more from them than from ones that I liked. School, much like the hospital, isn't a trip to the spa. It's not all about making one feel good. And it's time that schools, like hospitals, spend more time focusing on their purpose instead of "customer satisfaction."
You know for a fact that if anyone wanted to torture you for information, that all they need to do is stick you in a room with a beeping IV pump that you couldn't turn off.
Sorry about your sides! But you know what I'm talking about... sometimes "code brown" just isn't enough to describe the situation you're dealing with! This was one of those "flowing off the side of the bed like Niagara Falls" type of events!
He picked her up on discharge and demanded the medical directors name and number, screaming he wasnt going to pay the bill and that he was going to get us all fired.
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