prn nurse

Lotsa night nurses take tylenol PM or Benadryl 50 mg prior to going to sleep. One of the secrets of tolerating nights. Waking up with a headache, especially if it is occipital, is a symptom of hypertension.

Sears stores want to stop selling medical uniforms, but they have quite a few specialty catalogues , and one of those is their uniforms catalogue. Avida has great uniforms and are verrry nice on returns, sending you a return bag and paying return postage.

Dear Frankie Jane, Isn't this a screwed up world we live in? It wasn't but a few years ago that everyone who had a chole...lap or not, was not approved to return to work for 6-8 weeks. Six weeks was the minimum to return after any kind of abdominal surgery. My next action would be to call the hospital and speak with the CNO - chief nursing officer . Pooey on an HR clerk. I would speak to someone in Nursing.....get names. I swear I'd threaten to sue them....except that doesn't go over well.... does it? Demand they show it to you in writing. Call the HR person and tell her to fax it to you...you can receive faxes at commercial places. It always makes them nervous when they have to show it in writing. I wonder if it has been challenged. You could call the Labor Board to see if it is legal. It certainly doesn't sound ethical. Does your hospital have a chief ethics officer? Call them & discuss it with them. We were just discussing this last week at the hospital where I work. Same deal. You run outa days, you're outa there. Even though they are short of nurses and have a slew of agency nurses working..... go figure !! Although I was told IN ACTUAL PRACTICE, they usually carry the nurse along on ABSENT WITHOUT TIME, ETC....some excuse. In other words , it is on the books , but not really enforced. I think someone has just told the HR to do that...threaten you lightly---pressure you a bit, to get you to come back NOW! I'd do it my way,.. whats' best for me & finally tell them , "you all do what you gotta do." I would not go back to work....until totally healed !!!! That means not giving them a return date. Thats what they will push for. The complications puts the ball in your court and they are looking very non-compliant, unsupportive, unethical here. You can easily get a hernia in the surgical area's from pulling , bending , wrenching, lifting, etc. We see them all the time...surgery-induced hernias= another operation. Do what you gotta do girlfriend , but take care of # 1 first and don't let the bastards grind you down ! And DON'T WORRY ABOUT THIS AFFECTING ANOTHER JOB APP. never !!!

This has been the most interesting and thoughtful thread I have read in a long time. You scholars deserve a big "Thank You!" for representing nurses so well ! You certainly "know your stuff" and express yourselves articulately. It's inspirational. Don, I love that 1904 post. I saw it on the other thread & copied it for a discussion at work. When I was in school, I was encouraged by the Dean Emeritus at the Universitys' School of Nursing to write a history of the Nursing School and the part I remember best is the extreme difficulties she experienced attempting to get the nurses registered. She had to plead before the State Legislature many times, write and visit the governor of the state and state her argument before the schools' Board of Regents' and President. Just as with our Allnurses posters', she saw elevating the standards as her primary objective.

The unit clerk is not qualified to be the tele tech either. Some hospitals want to put inexperienced people in the telemetry monitors' chair and simultaneously charge the patient an outrageous fee for "being on telemetry." Some assume the tele technology interprets the data, but that is not necessarily true. Lots of things happen with rates and rhythms that the computer doesn't pick up. I agree with MollyMo... it may never start. Lots of options get bandied about at the management level that never take place. I hope for your sake it falls through. Its' only based on bottom line..... more profits.

In our NICU, we gave Nimotop via the ng or po. Either way, here is what we did. We placed the big rubbery capsule in a 30 cc plastic med cup of room temp water. let it set about 15-20 minutes and go back....it has basically dissolved. stir it a bit with a tongue blade and then strain it thru a 4x4 into another cup. it is then ready to give to patient with not a drop wasted. One of our docs said when patients are able to swallow and swallow those big capsules that too many pass on thru the body unassimilated.

Pinch............ sometimes...depends on how thin the patient is, the medication and whether or not the right size needle was stocked in the drawer for the job. Mapping always. I map and palpate the area prior to selecting my site. If the patient has received lotsa prior injections, (and there are some lousy shot-givers out there)... then frequently, I would be injecting into sterile abcesses (previously given injections that the medication did not absorb or disperse)... or into scar tissue.....if I didn't palpate first. So, I always palpate to make sure the site I have selected is best for the injection. About 1/3 of the time, I choose another site. Have you seen patients whose hips are all lumpy and bruised.?? Poor injectionists. Don't be afraid to use a long needle. My favorite for IM's is 22 gg and 1 1/2 " long. Inject slowly as the previous poster said. I usually massage it in. (pain and nausea meds, not heparin and insulin,, of course) As far as the pinching....my hands are small, and I find I can give a better , more controlled , non-painful injection if I do not pinch. Pinching with one hand leaves me with the syringe and plunger to deal with with only one hand...I guess I never did it enough to "Perfect" my technique. But I definitely do when the patient is thin ...

I worked a couple of years on PP. New grads can work there very well. At my hospital, L&D is separate, & nursery is separate. All three are under the same nurse manager, but the staff is not interchangeable from one area to another. Each area is considered its' own specialty. To work in a facilility like this, it has to be a large hospital &/or a hospital where a lot of babies are born.....say, 150-200 a month minimum. The PP nurses at my hospital have been there anywhere from 10 to 30 years. They came and loved it. It helps to go to your medical bookstore and buy some books on breastfeeding and postpartum care. All teaching of breastfeeding and most infant care teaching is done by PP nurses. A large part of their responsibilities is in the teaching. New moms receive several hours of teaching. On PP, GYN patients are usually there too. So , you may have women having gyn surgeries on your unit.....any problems associated with hysterectomies, lady partsl, rectal prolapses, "pelvic relaxation" type surgeries, female urinary tract surgeries, and of course C-sections. So, you will have a lot of post-ops, and those are interesting. Admissions for scheduled C-sections are challenges, fetal monitoring and interpreting the monitoring....you will take classes and become certified in that..... Mom's with pregnancy induced hypertension and in crisis are huge responsibilities....and a challenge. IV magnesium administration and monitoring for siezures, etc. is a challenge. So, to sum up, it is much more challenging than it seems at first glance. Go for it. The best thing about nursing is you can always switch if it isn't for you. Initially, go for what appeals to you. You may still be there in 2032 !

The way I understand what you wrote is: The order is: Tylenol #3 0600-1200-1800-2400 -- a scheduled med Tylenol Plain Q6 hours PRN You gave a PRN Tylenol at 0300. Am I correct so far? If so, the answer is yes. The scheduled 0600 Tylenol #3 should be given. I would guess this is for pain control. And the Plain Tylenol is for minor breakthrough discomfort? The next time you could give a PRN Tylenol in this scenario is at 0900. And then, yes, you would give the 1200 scheduled dose of Tylenol #3. You usually have another nurse to consult with until you are comfortable and gain more experience and confidence.. Also, in the hospital, there is usually a pharmacist to ask his opinion. And lastly, you can always call & ask the doctor...... (I wouldn't do it in the middle of the night). The doc likes to see his scheduled meds given as he ordered them. If there is doubt, hold on the PRN and give the scheduled. As far as Tylenol is concerned, it is a handy thing to know the maximum mg. a person should take a day, so you don't exceed it. Tylenol is liver toxic. Many docs with toddlers and young children say they won't even have it in their house....if I didn't get the scenario correct, repost it, and I will re-reply. :) Hang in there.............

We do not submit the certificates of ceu's earned to anyone. I just keep mine at home in a file labeled "Nursing Stuff". The State Board of Nurse Examiners can request to see my continuing education certificates at any time. (To ascertain if I am in compliance). If they notify me that they want to see my ceu certificates, then I would make copies for my files and forward the certificates to them. That is the only time we have to submit them to the state board....if they request to see them. And they do request a certain number each year. The secret to compliance and staying out of trouble with the board and protecting your license is to be sure you have completed your required # of ceu's BEFORE your liscense expires. (That is why one year i was hustling and faxing , etc.) Even if you are one day late...and complete the ceu's one day after your liscense expires and you have checked off on your liscense that "Yes", you have done your Ceu's, your butt is up the creek if the state board nabs you in their audit. And, your employers sometimes wants your ceu's in your employee file. This company, netce, also keeps a record of your courses. But ultimately, it is up to each individual nurse to know what her state requires, and to have the courses completed the day BEFORE his/her license expires. And keep records in the event you are selected for an audit.

I am doing my continuing education this week. A site I have used the past four years is: http://www.netce.com click on visitor and then nurse and then look at online tests that are available. Last week I went over to the library and printed 3 courses and their tests and brought them home. One I selected from the Alternative medicine category is: Understanding Chinese Medicine. It is 43 pages long and has 50 questions. It is good for 10 c.e. credit hours. It is an interesting course. It should be titled, "Understanding Holistic Medicine". Anyway, you can read the whole thing on the computer there at home without ever registering. Lots of good info at this site. The 50 questions are , of course, right in the article. Nothing tricky...questions are chronological in the article, that is,....the answer to question # 5 is in the article after the answer to question # 4. You don't have to go back and search thru the article for answers. I did the whole thing , test included in 3 hours. I will go back and read it again at my leisure later...instead of just looking for the "answers". This is a good site..they send you a certificate. The courses are accredited. With accreditation #'s. This course is $25. Charge Card. Once I did it by fax when my liscense was expiring the next day! They were very helpful. Anyway, an easy to use site, and an interesting course that I can use for self'improvement, good health and all that. Thought I'd pass it along.

I have always used a pump, even before there was blood tubing. Hb. always increased after a unit of blood despite everyones dire predictions all the RBC' s were going to rupture. I recall 20 years ago using a dial a flow when I couldn't find a pump. And one of my pet peeves is a nurse who is "sure" it is better to let it run in by gravity and it is all in in forty minutes or .......... 5 hours later , the bag is still 1/2 full and they're whining. I've seen my share of pt's in acute congestive heart failure because some lazy nurse was too lazy to go get a pump and her blood has infused in 30 minutes....these are the same one 's who infuse 2 units back to back, asap on 85 year olds....2 units in 3 hours... "but his hb WAS 8 !!!.........

Look around at who is doing the sh*t work of American society. Who is out there building the highways, building the subdivisions, digging the underground pipelines, doing the landscaping, harvesting this summers' vegetables, washing the dishes in your local restaurant, cleaning the skyscrapers at night. It is minorities. And bedside nursing is sh*twork. It is puke, feces, urine, mucus, viruses, bacterial infections, blood, and humanity at its' worst. About a year ago, your administration chose profits over TLC, caring and yes, competence. Minorities will be dominate in five years. And, per usual, your tax dollars are funding those foreign nursing schools. The foreign nurses who come here are not some poor little immigrant who worked her way to the top in her country to immigrate here. In India, the worlds second most populous country, those nurses are of a high class of people. With their caste system, lower class women do not attend the university. And , of course, being a former English colony, they learn English as a second language as small children. In the Philipines, the U.S. has contracted with their schools, with U.S. aid to their nursing schools enabling thousands to become BSN R.N.'s, and to immigrate here annually. Immigration quotas =none for qualified R.N.'s. They want to come here and they too learn English as a second language in elementary school.

I think experienced ICU nurses sometimes resent the new ones who come onto the unit....expecting on the job training. ICU courses are usually offered at community colleges and also EKG interpretation classes. I think if these are available where you live and you do not avail yourself of them and simply expect the ICU nurses to teach you the technical stuff....there is a rejection factor here. Most of the experienced ICU nurses I have known have spent many hours studying and in class and paid for classes.

Sundowner, is there a lot of ongoing stress in other areas of your life? It is the "out of control" part that is frightening. What would you have done if Bertha had escalated? If she had pushed you ...grabbed your arm and said " let loose of my friggin arm, you crazy _itch!!!!!!!!!" What would you have done? If your reply is you would have let loose of Mr. Wheelchair and jumped her, then................No, you are not crazy, yes, you could benefit a lot from discussing your anger with a professional. My bet is there is something going on at home. Who are you really mad at?