MellyOne

An odd combination of questions, but what the heck... 1. Who is typically responsible for providing PPE for agency nurses doing extended (8-12 hour) shifts with clients in the clients' homes? 2. On that note, does the provider of said supplies change on a case by case basis? For example, do I bring my own PPE if I am sick, but expect it to be in the home if the child is sick? 3. The sewing question-anyone have any ideas/patterns/resources they could refer me to so that I may fashion something useful to hold O2 tanks, vent and tubing, oximeter, etc. in an organized fashion onto a stroller? The kids I'm caring for now all have strollers with a handle that goes all the way across the back and down the sides. I know I could make some standard bags, but am wondering if there might be a better way...I just brought out my sewing machine after a good many years and feel compelled to make some useful stuff. :) Thanks in advance for your replies!

Thanks for your input everybody! I have been seriously considering acupuncture, and my chiropractor even does it in his office. I've used a pro-tens and electric acupuncture before, but I'm sure it's not quite like the real thing. I am a homecare nurse who works peds, but unfortunately for me, there are few children that have lifts in the home and my primary client is a growing adolescent with spastic cp and is quadrapalegic... I have an opportunity to work with the "littler folk", but I'd like to stay with my primary client too. I get as much help from her family as they are able to give, which I am forever thankful. I will be starting my final clinical rotation in the fall (in the hospital), but I do not believe I will be able to work peds. By golly, I'll try though!! I'll have to try to convince one of the instructors that they need to precept in one of the children's hospitals around here :) . I had a patient on my last rotation that required assistance urgently; it was me and another gal who had to lift this 300lb para, wonderful person, just really really heavy and couldn't help much. I dread that scenario in the future... How do you use magnetic therapy? I am learning more about alternative therapies as time progresses, and I am also under the care of an herbalist (who does mind-body skills therapy as well). I've heard of it of course, but I've never really looked into the specifics... Again, thanks for the advice!

Ok, I'm at a loss. I have intense upper back/neck pain. MRI shows vertebral abnormalities and degenerative changes, and I'm not sure what to do to get through the day with work-lifting and turning and doing all the other things we do as nurses (I do extended shift home care) without tearing up or having episodes where I briefly get woozy and the world goes dark. I go to PT, have more meds than I'd like to admit, use TENS, ice, heat, see a chiropractor, massage therapist, and several other practitioners to try to get through this. It's now officially chronic. I know this is not a place to give medical advice or referrals or whatnot, I have all of that. I want to know what you, as nurses, have tried, and what has worked for you personally. I know how to lift properly, and I do medically supervised weight training. I have used a rib belt and a low back brace, which has rigid support. The kicker here, theoretically I'll be graduating with my RN (eligible to take the boards anyway) in December, but that is contingent on getting through one more semester of clinical. However, if I'm having trouble lifting a little over 50lbs, what's going to happen when I work with the big people (ie. adults :) )? I'm getting so frustrated, and a little depressed. I love my job. The sad thing is that I've only been a nurse for a little over a year. I don't want it to end like this. Please help if you can-my brainstorming on this topic has been reduced to a minor spring shower.

I had a patient have an anaphylatic reaction to a med yesterday, went to ER (I'm in home care), they gave her prednisone, albuterol and epi and I had given her 2 doses of Benedryl prior to transport. Shortly after the epi, she had a 2.5 minute generalized seizure. She had not had one that lasted that long before according to her parents, and she hadn't had one at all in several years. Anyone experience this before? Is there any link between Epi and seizure activity in mildly susceptible individuals? Or could it have been a continuing reaction to the inital med? She is an adolescent child with extensive medical history (Trach, GTube, VP shunt). I'm confused and concerned...

Does that mean then that, if I only have one client/patient per day (8-12 hours shifts SN) that I cannot deduct if I leave from home? I'm so confused! I've been reading on the IRS website, but I guess I may have to talk to a CPA or something... What I've gotten out of it is that if you are going to a regular location as your regular job, such as an office or hospital, you cannot deduct mileage. However, if you go to multiple sites to assignments that likely won't continue for a year or more, then mileage is deductable...HELP! I'm so tired of getting soaked every year by taxes...last year we (dh and I) had to pay an extra $7000, so for the majority of the year we ate a lot of ramen...

As for mileage, do we deduct from our starting location or from our agency office location? I just started doing HH, and boy has it been a learning experience! BTW, I leave from home and go back to home...I very rarely go to and from the office.

I just looked at the Pearson website, and both the education (the one that botched the SAT scores) and vue (the NCLEX testing) components were listed as being part of their services. Ouch.

I agree...just because you're Bipolar or if you have DM or Lupus as a nurse-you're still a nurse and if your disease/disorder is controlled, it should pose no problems. Be aware of your ups and downs, enlist the help of those who know you well, and call in sick if you're dangerously manic. Good luck!

Just curious, would it be of any benefit to get my ACLS, PALS, IV Cert. and so on as a new grad LPN? I'm still in school for RN and graduate in December, but I'm working as an LPN now, searching for a new/additional job and wonder if the expense of the classes are really worth it. Thanks!

Don't stress too much...you know what you need to fix. We have dosage calc tests before every clinical rotation, and I'd say that as many as 40% fail them the first time around. Second time, they usually pass. Not a huge deal. You can do it! PS Stress can make missing those little points a little easier...just another reason to relax and just do the best you can :)

Amitriptyline...just personal experience-helped me with PTSD...probably better for you long term than either Benadryl or Ambien You've really got to talk to your provider or a psychiatrist about this...I understand some anxiety, but sounds like this is wearing on you...hard to get your head in the "right place" if you're lacking on sleep, which may only make things worse Once again, no medical advice-only personal experience

Right...well, thanks anyway...I suppose this isn't one of those "opinion questions" Added: Thanks flasandy42, sounds like it's do-able in theory...Wish I knew what was going on...so far I'm labeling this as idiopathic...

This is probably the most stupid question I've ever asked, but is it a good idea to work in a hospital when WBC is low-beneath the "acceptable range," with neutrophils low and lymphocyte % high? No dx yet by the way.

Thanks everyone for the help. I think I'll just suck it up and give it a shot-I guess I could always take it again with accomodations if the first time w/o doesn't go well. Could be worse, and likely I'll feel even better if I pass it without assistance.

When I started to register for the exam, I came to a page that asked if I needed accomodations. If I check 'yes' then I have to supply a dr.'s note detailing my diagnosis, the tests that were administered to come to that diagnosis and their results, the things I did in school that were related to this diagnosis and their effectiveness and so on. It seems like too much information to be giving out, and then I have to wonder if I should have checked yes to 'having a physical or mental disability that could potentially endanger the lives of patients or the individual.' This is all so very confusing. What constitutes a disability that could endanger patients or myself anyway? It was on the automatic disqualification page, which really makes me nervous!

I was wondering, if I were to request special accomodations for taking the NCLEX, does the reason for requesting those accomodations become public knowledge? Basically, I need to know if I can "hide" a disability from my current employer and future employers. I also don't want to be refused my license because of this disability-I am no threat to myself or others, but I find that test taking in a private room is incredibly helpful-I've been doing it in school for a while now. My thoughts are this: risk failing the written test due to many possible/probable distractions vs. risk employment or BON related issues in the future. Please help! Thanks!

Thank you all for the help! I appreciate it!

I'm looking for advice. Mental illness appears to run in my family, though only one or two individuals has ever sought treatment-really there have only been 2 of us who admit that something may be wrong. One of my family members, my aunt, does not seem to realize that something may be wrong, but she is really starting to become "scary." (btw, I requested advice about an aunt and radiation treatment side effects in another thread. This is not the same aunt.) She is becoming increasingly paranoid-to the point where she is certain her step-father is either a.) going to kill her, my sister and I or b.) hire someone to kill her, my sister and I. She strongly advises my husband and I to leave our current home now because we are in danger. She will not come to visit us because she feels that someone will follow her here, and she can't risk putting us in more danger. In the past she has told my dad that he was in danger because my grandfather was angry and was going to kill him (not a chance). After her first husband died, she packed her bags and went to the river to wait for him to pick her up. I could give all sorts of stories, but the point is that I am afraid that she will either inadvertently hurt herself or someone else in trying to protect them. I don't know what to do, so I figured you people here have had experience with these matters and can direct me in the right path. She's such a kind, caring, selfless person whom I love very much. I don't want to see her like this, but don't know how to even start helping her. So, if you have any advice, please let me know-either here or PM. Thank you so very much!

Is there any way to convince her to go? Like I said-she blames it on the radiation and doesn't seem to see it as a big deal. We've expressed our concerns, but that doesn't seem to get us anywhere...

My aunt had Non-Hodgkins Lymphoma about 10-12 years ago. She underwent radiation therapy and has had no recurrence of the disease. The issue is her memory. She is very young, seemingly healthy and active. She does not remember things such as how she and her husband met. She does not remember ever knowing that my parents lived in the same small town as her-and they did for a long time. She doesn't remember recent significant conversations, so sometimes her short term memory is deficient as well. She blames it on the radiation therapy, however the treatment wasn't used on her head. Is this possible? Is it possible there's something else going on here? My entire family is rather concerned and I don't know what to tell them-heck, I can't even find info on the internet even linking these things together. Wouldn't you think this would have resolved by now even if it were related to the radiation? Thanks for your help! ps. She does not drink, smoke, use drugs. Also denies hx of substance abuse.

I think people have abused the whole "breathing difficulties/allergic reaction" issue. It's been used as an excuse for everything from not wanting to finish dinner before dessert to situations such as that lovely lady refusing the tech, or chasing nurses down the hall. It's sad, and it's frusterating. Some people just don't believe that you can't breathe, or that you have a migraine, or are having some other sort of reaction. Then you go to the ER. And they still don't believe you. Anyway, the point is that I understand why people are suspicious. Unfortunately I think that not acting is far worse than giving into behavior that may just be to get attention. You never know. I hope you get what I'm trying to say...it's finals time and my brain is fried. Oh yeah, I just wanted to comment on the wearing perfume because I want to, don't want to smell patients, and so on. We are in a service profession, which means (if I have it right) we do what we're told, when we're told. We don't do things for ourselves. Seems a little cold and negative, but I think we're supposed to be people pleasers. "greatest good for the greatest number" Please feel free to agree/disagree...I'm new here and would like opinions from those who have been around awhile. :) (BTW, I do have asthma, and it is affected by scents, dust, pollen, certain meds and so on. Just wanted to let you know that I'm not really taking sides-just sharing thoughts and experiences)

So, are there issues in your workplace related to amphetamine use? I use ritalin for narcolepsy, and I'm afraid that I may be black listed from certain healthcare facilities if they find out. Any thoughts?

I know this is an old thread, but I thought I would revive it... My question is slightly different-and please be honest-how do you feel about working with nurses (or other health professionals) with narcolepsy? If you have narcolepsy, how do you cope? Thanks for your replies!

For those who have this 'sixth sense', does anyone else in your family have the same sort of ability? I do believe there is at least some genetic component to this...my grandma has always told me about her grandma-who told her exactly when she would die (and of course she was right), but before she died, she also told my grandma when my grandma's mother would die. Again, she was right (down to the day). Now my grandma swears she sees her grandma when something has happened to one of her kids. She always knows before anyone tells her anything. When my grandpa died, I was the only one with him. I knew I had to get back to him right then and there (I had gone to get some dinner)-I had the honor of spending the last few hours of his life with him, and was with him when he took his last breath. I have never had a patient die on my shift, but I don't think I've ever been surprised to hear that they died recently.

At the hospital in which I work, I have never witnessed a doctor being called by a first name (although just being called 'Dr.' seems to be appropriate), and I don't think I've ever heard a nurse called 'nurse so-and-so', it's always been a first name or an appropriate nickname. Definitely an interesting thread! Just out of curiousity-how many of you use your last names at work when introducing yourself to patients/families/etc? Do you have your last names on your name badges? If you do, how do you feel about it?