LuvMyGamecocks

I came across this thread as I'm researching what all you fine nurses have to say about the hospice profession. I'm thinking of making a change from LTC to home hospice.... Actually, the reason I'm a nurse is b/c of the way a nurse in ICU treated US as a family as she furiously attempted to save my grandfather's life. She focused on our pain knowing inside that her attempts would prove futile. We sat with him in peace after staff was told to just stop...no 15 IV lines/tubes, no CRRT, no blood from the episode w/DIC. We were given comfortable chairs, tissues and quiet. I recently admitted a inpatient hospice resident to our LTC unit...young doctor w/ brain Ca. The family came the night before admission to decorate his room w/ memorabilia from college and golf and family....Soooo many visitors brought beautiful signature posters to go w/ the decorations. We even got our house doc to give us an order to let him have beer on Fridays. :) One Friday, the family paid to hold his bed on the unit so they could take him for a weekend trip. He passed away on his favorite spot on the coast of the Carolinas, with his family surrounding him. I've learned of many deaths in LTC, but that one will likely stick with me for a while.

I, too, agree that they have their own stressors. But, having 5 months in LTC (doing nothing but Admissions/Discharges on a TCU and LTC unit) versus a year and a half on a telemetry PCU floor in a cardiac hospital, I understand the "LTC Super Hero" reference. Our RNs have 28 pts...but we have me to do Admissions/Discharges, a wound care nurse doing all treatments, an MD inhouse 5 days/week and a NP inhouse on weekends. I'm told we're lucky!

I have this and engraved it myself w/ a Dremel. Had to sand it down a little, but it was effective. Still in my possession after 2 years!

Hi! I, too, have a +TB reading that could probably be interpreted either way - as an induration OR simply a reaction to the PPD solution. It doesn't show up in the first step, but always shows up in the 2nd step for me. It's not a big deal, really. The last person to read a skin test for me recommended that I don't have any more skin tests b/c she thought it was an allergic-type reaction, rather than induration (which it had been called, previously). I just go to straight to CXR. Just be upfront about it - you'd be surprised at the lack of concern from potential employers (as long as your cxr is clear, of course ).

Just wondering if any of you will admit to ever burning a bridge with an employer? Did you feel bad, but really believe you were doing the right thing? Thanks for your honesty!!

A little more info...sorry for not including it before. Pt came in with c/o near-syncope, was hypotensive...received 1/2NS at 125 ml/hr until her lungs started to fill up, then it was stopped (only got about 400cc). Liver enzymes, WBCs - everything was WNL. The only thing out of whack was BUN and Creatinine. Calcium was even normal (which we don't usually see...it's usually ALWAYS a little low). Temp wasn't elevated, and BP was 110s/60s and not fluctuating. Did I miss anything? Thanks for your responses!! Keep them coming!!

Pt is fine..spent some time on a unit, but is back on my PCU/Telemetry floor for a couple of days.

I need some help understanding the physiology of this... Pt has widely varying blood sugars over 24 hour period. 300+ to 30s and 40s in late afternoon and early morning...no Lantus to speak of, and sliding scale coverage ordered ac&hs...eating well at meals. Electrolytes WNL (K 4.2), but BUN/Cr are elevated - initially 38/3.9, then it rose to 42/4.7 within 24 hrs...not a dialysis pt (yet). I understand why out-of-whack K+ can mess with blood sugar, but I don't understand a physiological reason for a pt to have such widely fluctuating blood sugars. Pt ended up getting four amps of D50 in a five hour period...BS was up to 250-300, then crashed again. We couldn't give pt any fluids b/c of all the fluid in lungs. Pt's body ending having enough of that...before the fourth amp, pt became responsive only to sternal rub, Code White was called, pt went to a unit. Can anyone shed some light? Any piece of the puzzle missing?

A reprimand? Really?

I'm trying not to develop a complex here... I'm a new grad (May), working on a tele unitwith 95% cardiac pts...tons of CP r/o MI, a-fib, pre-CABG, PPD/ICD placement kinds-of-pts. The cath lab asks for 2 INT's, at least 20G...CV surgeons want an 18G. The same month I started, the facility started stocking a new IV catheter - Nexiva. It's virtually bloodless (which it great), but it has a tendency to blow the veins. It has it's own kind of technique for insertion. Enough nurses complained about the tendency to blow a vein, so they are now giving us back the Jelcos. We have the choice of using either, but I like the cleanliness of the Nexiva catheter. MY problem is that I can't hit a vein with EITHER to save my life. I've attempted probably 30-35 sticks and hit 2. 2!!!!! 1 Jelco, 1 Nexiva. I'm off of orientation, but this is starting to really SUCK!!! I hate that I have to ask my co-workers (who are REALLY great about the whole thing) to try. Does anyone else use these? Can you give me any tips? Has anyone else taken a while to find a groove? Thanks!!!

My facility uses the Synergy Model set forth by AACN. Assignments are made using this model. Good luck! http://www.aacn.org/WD/Certifications/Content/synmodel.pcms?pid=1&&menu=

Yep. I work on a telemetry floor, but a buddy of mine works in the ER. He personally saw 4 cases Friday who wrote something similar to "Anxiety/chest pain/depression because MJ died.":

I had a + PPD, -CXR, and was referred to the health department. I haven't been yet, but they'll provide treatment at no cost. I'm NOT required to take meds to start at my new job (my first RN job).

I'm VERY lucky. The Dean of Nursing hand carries our endorsements to our State Board's office (which is about an hour away from campus)...as a matter of fact, they were in the office the day of our pinning ceremony (5/12/09). I had permission to test, tested on 5/26/09, passed, and results were on the BON website on 6/1/09. I would also be more than upset! Maybe after letting some time pass (to ease the sting), you could write a letter to someone explaining your experience. If you know this to be a common occurrence, maybe you could explain the impact on others. I don't know that it would work (and it certainly wouldn't change your situation), but writing a letter and knowing that someone "heard" your frustration might help to give you some closure about the whole thing. It must be VERY frustrating. Hang in there!

Transparent tape...not paper, not anything else...seems to pull out less hair. And Sharpie pens....they're my most favorite pen ever! The ink is dark like a regular Sharpie, but it doesn't bleed through the paper. Now all they need is a RED Sharpie pen.