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NoMoreStudying

NoMoreStudying

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NoMoreStudying's Latest Activity

  1. NoMoreStudying

    Considering FT agency, a few questions...

    I'm in the Baltimore metro area, if that matters. I met with an agency here that has a good reputation from it's nurses and hospitals. She said I would have no problem scheduling three 12's per week. I do 11a-11p ER and most people don't like that shift. But the idea of being canceled worries me. I figured out what I need to make in a year and then divided by 50 weeks, to account for 2 weeks per year of issues. My goal being to set aside money in case of illness, cancellations, etc. Should I expect cancellations in the summer and holiday times? Are we talking the entire summer or just partial? Do I try to arrange a contract prior to those times? I don't want to stay at my current position, but I'm considering transferring to the float pool PRN just in case.
  2. NoMoreStudying

    Davita Acute job

    I've read all of the Davita posts, but they seem to be all related to chronic. How do people feel about Davita with acute positions? I'm an ER RN, interviewing with them for an Acute position.
  3. NoMoreStudying

    What was your first day as a nurse like?

    My first day with patients... I was just trying to get everything done in time. You can't focus on being more proactive, seeing the big picture, etc. You are completely task focused; "get it done and done right." It's been a year and I go through varying degrees of comfort. Like plateaus or summits. I try to give myself a goal each week. One week I focus on printing my monitor strips. Next I focus on better skin assessments. I&O's. And so on. It's usually task oriented, but it helps me to think of the whole picture. For example when my pt came back from the cath lab this week, I felt spot on with my care and my documentation actually reflected it. I really felt like I addressed all of the possible problems and what I did for them.
  4. NoMoreStudying

    Accused of being racist - how to handle?

    wait, are you talking about the boat comment? many initial vietnamese refugees came here on long unsanitary boat rides, rationing what little food was provided. my family is one of them, by choice of course. so when i have regular people complain that i don't understand how hard it is, it always makes me chuckle that they think i was born into a nice middle class lifestyle. i wasn't talking about slavery. which, yes, would be quite offensive.
  5. NoMoreStudying

    Accused of being racist - how to handle?

    exactly why is it extremely offensive? i think it's important to dwell in fact rather than topics so emotional. particularly when there are more important topics at hand. it also lets people know that you have the same real goals as them, not side items. the majority of the time, people will see you actually care about what happens to their loved one. an "i'm sorry you feel that way" never hurts either, sugar rather than vinegar. in some ways, yes i'm being a bit lighthearted in my comments. on the other hand, i've grown up biracial in this country and with two poor families, so i can see both sides. on other topics posted, i think there have been documented studies that minorities or disadvantaged (it's so easy to lump the two unnecessarily) tend to be distrusting of the medical community. there is a history of unequal treatment or poor explanations and involvement in care. it's almost expected and it's part of the image and practice change to make medicine more holistic.
  6. NoMoreStudying

    Accused of being racist - how to handle?

    It used to bother me. It happens a lot in triage, for one. i always bring it back to fact in one short sentence, so we both know it's the end of that discussion. Nothing further needed and no more will be entertained. Works when anyone decides we're "not fair." B/c really, there's no arguing with people so we might as well discuss what's really appropriate. I've had to tell a few people that I won't be discussing anything besides their care from that point forward. "My priority is to assist your child at this moment." "I need to see the most acute patient first." "I was tied up with a complex patient but I will help you shortly." "I'm sorry, that person got a chair in the hall b/c they aren't vomiting like you. You would prefer a bed, correct?" "No, it's not b/c you're black. It's because you're drunk, sedated from your own drugs and so lethargic from that concussion that you don't need any more pain medication. You need a CT scan." I also really enjoy getting called racist or told that I don't give good care to minorities or the poor. B/c a) I'm Asian and b) I grew up dirt poor with intermittent housing and basic needs. It always makes me smile to myself. "You don't know what it's like to have nothing!" I'm sorry, did you come here secured in the bottom of a boat, too? Although, I'm always sympathetic unless people are ridiculous. Even then I can get by with some coffee in me.
  7. NoMoreStudying

    Fibromyalgia

    I always think of that commercial "Depression hurts." I know when I feel depressed, I'm very achy, don't sleep well, all over pains. And then it clears with the depression. I always see fibromyalgia as being similar but more chronic or poorly managed. Twice I had hugely swollen joints with it and all of the autoimmune studies were negative. A male friend of mine was severely depressed, no mental health history and not ackowledging it. He was in chronic pain, too, which he did acknowledge. No relief from pain meds. Finally he saw his doc and antidepressants resolved everything. If he were a woman, though, he would have been a perfect candidate for the dx. After, he kept saying "I can't believe depression can cause so much pain!" Of course, he still chooses to focus on the pains as the problem more than the depression, probably b/c of the stigma.
  8. NoMoreStudying

    Ode to Urbane Scrubs

    I'm 6ft tall and Urbane fits me best. They have tall pants. I like the bootcut and cargo. I do wish the tops had more than one pocket. The length of the top is great also. I've never exposed anything, had trouble bending and lifting, etc. In fact, they're the only ones that move with me and look good. No trying to fit into unisex and having pulling or tugging at the breast, arm, crotch or elsewhere. I order online to get the talls. I have yet to find any other brand that fits well and looks nice. Also, the fabric is softer. Like Dickies, however, I'm between a M and L top. Dickies tall pants are too short. Cherokee is scratchy and the proportions of the pants are off. I found Peaches unreliable in their sizing. In fact, the only problem I've had with Urbane is the sleeves are a little short on the jacket, but that's my world and I roll them up an inch anyway.
  9. It's usually generated by the dx or chief complaint. So I get several boxes to fill in on the computer and it may also prompt things like a neuro, neurovascular, etc assessment, or treatments like elevate HOB. But yes, it's all about teaching you how to think. Most of it is in your head. As tedious as they are, it's worth it. Say you get an abd pain with n/v. Well, you need to remember to assess not just pain and nausea, but bowel sounds and habits, po tolerance, output, hydration status, etc. Taking that extra step. Then maybe even farther. Are they an SBO that's on the verge of septic shock and now we need to be even more diligent, where as pain and nausea are a little lower on the priority list. And the biggest part it teaches you? what are you doing (meds and beyond) and is it helping? B/c you can document all day long but if you aren't showing how they respond to treatment, good and bad, we might as well go home. I always think of it as where they are in the progression of their disease, and what is one step worse or better. Then I have my framework to work with. If it's an elderly person with a UTI, is their mental status clearing, is their urine output adequate and what does it look like, is their BP holding. Right there I can give a pretty good picture and someone can tell how they are progressing. Then I can go into decubs, etc if I need. As much as I hated writing them, you'll be able to tell which people didn't pay any attention to them when you get out and start practicing. They don't show the whole picture.
  10. NoMoreStudying

    Guess this chief complaint

    I remember one more now. Getting report from a new nurse for whom english is second language. Still her english is as good as any college graduate. So she says "the pt, he stood up from the sofa, he passed away. later, he went to the bathroom, he passed away again." I was trying not to laugh, but it was too funny. She looked horrified when I told her the difference.
  11. NoMoreStudying

    Guess this chief complaint

    nope, she truly say "an ammonia." :chuckle
  12. NoMoreStudying

    Guess this chief complaint

    My mother, who has a master's degree, still says people "catch an ammonia." Also, the Taliban is in "Afaghanistan." Like the blankets people crochet, "af-a-ghans." My favorite triage slip was simply, "lage." Luckily, he still had both of them. I just had a young guy tell me he didn't remember the MVC b/c he was unconscious. We explained he called his dad and was walking at the scene. Still, he insisted he was unconscious after the accident. Fine. Later, I ask him if he's remembering anything yet. "No, I'm still unconscious." :roll
  13. NoMoreStudying

    Do you trust automatic "vitals" machines??

    When the machines are being difficult and taking forever, only to yield the dreaded (###), I could certainly do all of my vitals manually a lot quicker. But I've rechecked some manually that originally came up very high or low on the machine and it was pretty close, within 5-10.
  14. NoMoreStudying

    Patient died from 8GMs of Dilantin

    I'm curious what her defense would be. Not to insult, but even an adolescent would think twice about that many vials. I've been confused by the concentration listed on a vial, but you stop and think.
  15. NoMoreStudying

    You experienced ED nurses will get a kick out of this.....

    I'm not experienced but my favorite is the people who come back 1-2 hours later. lo and behold, they still have gastroenteritis! No, they haven't tried any of the meds, but it won't go away! Charge says, so seriously, "That's it! who didn't use their magic wand?!" I also love the people that come to you in triage and say "Fine, I'll go out to the curb and call 911." "Okay, but they'll bring you right back here and now you'll be at the back of the line wasting the 1(2,3,4) hours you've already waited."
  16. NoMoreStudying

    we're pregnant

    mmmm, giant burritos..... I had someone come in n/v after eating Chipotle. I had to block it out b/c I do love the pork.