keludtke

I work at a family practice clinic and have been there for maybe 1.5 years now. I used to work in the hospital on the med-surg floor for almost 4 years. In the hospital setting, pretty much all our meds were delivered IV. Usually, we only gave IM injections when a patient was extremely agitated. Since I have been in the clinic, I have given plenty of IM injections. I swear that you could only give up to 1 ml in the deltoid muscle. I could be totally wrong, but that is what I remember being told. I had a situation today. I had a patient who doctor ordered Toradol 60 mg and Solumedrol 40 mg IM. She gets both of these at another doctor's office (Rheumatolgy) at times. She has chronic pain. The nurse there gives both of these meds in the deltoid. I told the patient I wasn't comfortable doing that. I found through our computer system SoluMedrol should not be given in the deltoid because of risk of subcutaneous atrophy. What about Toradol? I think 60 mg/2 ml is too much in the deltoid because it is 2 mls plus being the type of med that it is. I give plenty of immunizations and B12 in the deltoid. I talked with the patient and gave them both without difficulty in the ventrogluteal. I am now doubting myself because I can't find anywhere in my saved notes from school, the hospital, or my clinic nursing skill book on how much you can give in the deltoid. Anybody got any advice on this matter?

I graduated from nursing school with my BSN in Dec 06. I got a job on a med-surg floor in my hometown. Before I graduated I did a rotation in Public Health and I loved it. I was told to at least get a year experience on med-surg. Well, now it has been 2 1/2 years! (Time flies!) I don't mind hospital nursing, but I know my heart is in public health. I have tried twice to get a job as a County Public Health Nurse. I have gotten interviews and have been rejected. The first time I heard they hired someone who already had public health experience. I need some advice. What do i need to do to get into public health? All advice is welcome! Thank you

Can anyone explain how HIT comes about? I understand it is caused by use of heparin and causes a reduction in platelets. I can't wrap my head around how this happens in the body and then it leads to irreversible platelet clumping? Please explain.

They wanted to go to an all white uniform at our hospital also with no collaboration from the nurses at all. However, we all got together and wrote letters and emails to our Nursing Director (I work at a small community hospital) listing reasons why we don't want to go to all white. They listened! They formed a nursing uniform committee and all white is now officially out of the question. Now I am just waiting to buy new uniforms. Rumor has it, it will be blue pants and a white top.

I give phenergan IV all the time, very slowly, over 10 minutes, and mixed with at least 10 ml of NS, with good flushes before and after. Our hospital policy states we CANNOT give phenergan in hand or wrist veins due to the fact it can cause necrosis. So now a lot of the docs are ordering Zofran instead.

Hi! I was wondering if anyone could answer two questions for me. I am a fairly new nurse who works nights. I asked the nurse i was working with, but she wasn't quite sure. 1) I had a patient who had a Rt hip fracture. They did a pinning. Since it was not a total hip arthroplasty, she doesn't have to follow the same guidelines (once she is healed) as a THA, for example, never cross her legs or bend over 90 degrees. 2) What is it about anesthesia that makes most of my patients have nausea and vomiting when they come back to the floor? Thanks! I really enjoy this site for the tips and knowledge I receive.

Help! I need your feedback, thoughts, and advice. The community hospital I am working at is deciding in June that all nurses must wear all white uniforms. Right now, we all have to wear light blue pants, but we can wear whatever color top we prefer. I am angry by this. I personally feel this is an institutionalized, cold, sterile color. Plus, I feel this is "old school". I am 29 yo female and graduated with my bachelor's degree. I am a professional RN regardless of what I wear. My name tag I wear says I am an RN and I have a license to prove it. I know in college I read articles that it is good to wear solid colors because it is more professional than a scrub top with flowers on it. And most of the time, I wear solid blue, which I like. But for some reason, all white reminds me of the nurses in the early 40s-50s in white skirts, white tights, and a cap on their head. I can't explain it in words, but I feel this is a step back for nurses. Many of the nurses I have talked to are angry with this, besides the cost of all new uniforms (oh yeah, they are just providing us with one uniform) and trying to keep white clean. In the email, the hospital states it wants a professional look. Yet, this email was only for the nurses. Of course, it is ok for the doctors to come in with jeans. All the doctors I see (and I work 7p-7a) wear many different types of clothing. Should this not pertain to them and the rest of the hospital staff? What do you feel about this? Has your hospital done this? What should I do? I am thinking of writing a letter of complaint. Do you as nurses feel all white is a cold color? Do you think hospitals should go back to an all white uniform? I think I need evidence based research if I want to write a letter to the hospital administrator of why I feel this should not happen. I like my job and i am not going to quit if we go to all white. Yet, I feel compelled to state my opinion because of how I feel about this matter, but I want to get other opinions on this matter before I precede. Maybe I am the one behind the times?

I am a first year nurse and work night shift. I have had several patients who I had on telemetry be bradycardiac. I get anxious when I am monitoring their telemetry and their heart rate is in the 40s to 50s. So my question is when do you use atropine? What are the symptoms I should be looking for before I use atropine?

Hello. I am a first year nurse working in a community hospital. What is the difference between an antiinfective and an antibioitic? I always look up meds I don't know and I have run across several that I have given that are labeled antiinfectives in my Mosby Drug book. I asked several nurses and no one knows. Can anyone help? It would be greatly appreciated.

Hello. I started this thread awhile ago. Thank you for the support and I am relieved and glad that I am NOT the only one with anxiety! I took your advice and I am seeing a counselor who is helping me with my anxiety. I also saw my regular doctor and I am temporarily on a medication to help me through this. It is getting better. I have fewer anxiety attacks as the days go by. I can sleep now without waking up with butterflies. My off days are fun...no longer are the anxiety attacks hitting me. I still get the butterflies before work, but I have noticed it is not as bad as it once was. I still catch myself thinking about work on my days off, but I mentally tell myself to stop. It is getting better and I am so glad I have this support network. Thanks again! Kristin

Hi everyone! I graduated in December from nursing school and got a job at a small community hospital in January. I am finishing up my orientation and I am starting to freak out. I get butterflies in my stomach and I feel like I can't catch my breath. These feelings I experienced before I went into work and now I experience it on my days off. I can't get rid off the feelings. I am fine once I get going on my shift and I figured it was just nervous energy, but now it is bothering me on my days off. It is starting to affect my life. Does anyone else feel this way? I am going to call a counselor because I can't live like this so now I am starting to wonder if nursing is for me? Did i choose the right career? I get so anxious when I think about: Am i doing everything I should be doing? Do I ask too many questions? Am I stupid for asking all these questions? What should I do? Does anyone else feel this way? Please help.

Help! I graduate in December after a year absence of being deployed overseas for the Army. So I went back to finish school and now am in my last clinical. I am working on a med-surg floor at a very busy hospital. I have strugged all semester. I got my mid-term eval a week ago and she said I need to work on organizing and prioritizing. This is really hard for me, because she hasn't helped me with this. I swear she thrives on chaos. Does anyone have any tips for this? She says I need to improve on my nursing judgement and making decisions on my own. I am feeling really down about this experience. How are you suppose to feel after your last clinical before you graduate? I still feel uncoordinated. My head is always swarming and I am always trying to do everything I am suppose to do and do it right. I ask for her guidance and I feel like I am bugging her with all my questions. It is very frustrating and it makes me cry a lot. Sorry, I need to vent. Any suggestions for how to organize myself? And how to prioritize? Thank you!

I am taking a class called Legal, Ethical, And Social Forces in Nursing for nursing school. I have to write a position paper on an issue that is going on in nursing today. I have to present both sides of the issue. I need help! I feel a little out of the loop on what is going on in the field since I have been overseas for a year serving in the Army. I just returned home Dec 21 and I started school again in January. I don't know what to do the paper on. Anybody have any ideas? It would be GREATLY appreciated!!! Thank you