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boggle ASN, RN

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boggle is a ASN, RN and specializes in Med-Surg.


boggle's Latest Activity

  1. boggle

    To Swab or Not to Swab......

    "The way we've always done it..." is a dangerous basis for nursing practice. I think we nurses have been bedside researchers and scientists for decades, but now we finally have easy access to studies that support what we do....and we can cite it too. I commend you posters who are seeking out the answers from manufacturers and infection control studies. Please share your results with us!
  2. Also, does anyone know how to post the image of the dvcipm.org pain rating tool here. I didn't know how to attach it to my above post. thanks.
  3. delphine22, I agree that verbal description can be helpful with the pain number rating system. I've heard so many patients say they just don't know what number to say. Where did you get you verbal descriptions? Are they a particular standard? ive been working with some returning veterans who are using a multi image and verbal description scale. It's from the the Defense and Veterans Center for Integrative Pain Management (dvcipm.org. The pain rating scale listed under the Clinical Resources tab, as well as others.) This is getting favorable reviews by my hospital, and is beefing considered as an additional pain assessment tool.
  4. boggle

    Question on Washcloth and bathing

    I'm glad to hear you thinking about infection control here as well as keeping nasty smells out of the resident's hamper. I think I hear you identifying 2 main concerns here (in addition to coworkers doing their own thing)........the condition/ cleanliness of the hamper, and the concern that the washcloths will be contaminted for further use along with any laundry it touches in the hamper? Does your facility have any written policy on handling laundry? There is likely a policy, just not know or being followed by the caregivers. The infection control nurse needs to hear your questions and concerns, ang take action to educate the caregivers and enforce the policy (before the facility gets cited by inspectors). Facilities I've known line the hampers with a plastic bag. Laundry is removed from the room in the bag, and a new bag is placed in the hamper. The facility's linen and washcloths were put in separate hampers. Facility's linen got the heavy duty bleach/ disinfectant treatment in the laundry. That kills everything.....the linens are safe to use again. The resident's own clothing was washed as regular clothing would be, but also had the hot water and hot dryers. Clothing soiled with feces would be put in its own plastic bag and washed separately in the laundry dept. Best wishes to you.
  5. boggle

    Bullies at the work place.. vent

    Whoa! I hope you are working in a facility that is emphasizing a culture of safety. (I thought that was part of the national reform of healthcare and safety?)Please ask your supervisor or nurse educator to talk to this person, Soon, about errors, that med errors are usually part of a multi-system problem, not just her error. This is not a blame thing anymore, or at least it's not supposed to be. Nobody "writes some one up". They report "safety or medication occurrence" where the system didn't work. (I've written a few occurrance reports about my own errors myself. It doesn't feel good) There are usually many, many factors that lead up to a missed dose or med error. If you don't identify these factors, MARs never get improved, med delivery never gets improved, data supporting importance for more nurses per shift gets missed,...you get it. Apparently the nurse you work with doesn't though. Good luck
  6. boggle

    Not sure what to do. Licensed RN working as tech.

    The above post by FMFCorpsman, and many others offer great advice. I've also found myself working with old coworkers or techs, but now with them as my supervisor!!! People grow. You will too. I did want to offer advice to you to keep up your observation and assessment skills while working as a tech. Remind yourself to pay attention to the findings that go along with the patient's diagnoses. No you can't pull out your stethoscope, but you can still observe color, ease of breathing, VS, changes in ment action, LOC, etc. Keep practicing your analysis skills. Pay attention to what you hear the nurses say about the patient that helps you fit the puzzle pieces together. Most of what you do in nursing is analyzing data, planning interventions, intervening, analyzing again, and on and on....At least you can keep practicing a bit of those skills and keep learning while you persue other job opportunities. It may even give you a more positive feeling about getting through your days in the job you don't care for. Sorry for all the trouble you are going through. Keep on learning, and keep positive.
  7. boggle

    Name Badges Worn Backwards

    OK, just a bit if a rant here, ...guess I've had my fill of disrespect for the role and importance of the nurse lately. I feel wearing our full names and credentials are part of being a professional. I totally understand the exceptions in some mental health and a few other speciality units. but otherwise, it's, "I'm Jane Smith, the RN who will be with you this shift.". Yes, I often interact with patients by my first name if they wish. In school, our instructors often referred to us as "nurse Smith", to emphasize the professional title. Yes it's a bit clumsy, doesn't have the same flow as "doctor", but it did distinguish us from the rest of the crowd in scrubs. It has been a long road for nurses to get respect as a profession, and professional names are part of it. We don't call the physicians by their first names, "hey Bob, have you see these labs...."And don't get me started on folks who wear name tags backwards but never clarify their role, leaving ( or leading) the patient to believe they were the nurse when they really were a Medical Assistant or tech. If your badge flips, Fix IT, Pin It!!! Ok, rant over, but profession standing tall!
  8. boggle

    2 glove technique? HUHH?

    Calling double gloving a "Technique" is really confusing to all, especially to nursing students. A few years ago, I searched all over for some reference to support double gloving to better protect the caregiver, Infection control sites, NIH, you name it. I couldn't find anything, ...BUT... I think it all comes down to the quality and fit of the gloves you use. If your facility has lousy gloves, shame on them. Raise a fuss ...... OSHA anyone??. You would think it would be far cheaper for a facility for you to use one pair of good quality gloves to get a task done than multiple pairs of ones that rip and shread. Sigh.I can see the point of the convenience of stripping off one dirty glove and having a clean one on underneath when handling messy cleanups though. Wish I had thought of that earlier.
  9. boggle

    Nursing phrases

    If you can, find a recent nursing physical assessment or nursing skills book. Most of them have a list in the back of common nursing phrases and statements with translations from English to Spanish. You could use the same phrases, just translate to your desired language for teaching.
  10. boggle

    RN stealing from my facility

    I agree with the poster who stated police should be involved. Money missing from a purse is a police matter. A bp cuff?...well, I wouldn't call police on that one, but probably would for something of greater value, especially if taken out of my bag or coat or locker. I would definitely write up an incident/occurrence report about any of my or my patient's items that come up missing. Hopefully someone in risk management will pay attention to the growing pile of incident reports. Maybe trends and patterns will be identified. Good luck, Levelee, .....and write your name on everything and keep what you can under lock and key.
  11. boggle

    Medical Books

    Have you been involved in the nursing field during those 20 years? If not, you have a lot of material to cover. So much has changed. To begin, I would suggest you get ahold of the most current skills text and med-surg text you can find, and become familiar with Nursing Diagnosis and Nursing Process (Carpenito or Ackley& Ladwig). Become very familiar with whatever texts your students will be using,too. Good luck.
  12. boggle

    I love nursing.. not sure if nursing loves me

    I think for those of many of us who chose caring professions, we are deep feelers. We hurt and beat on ourselves as deeply as we care and give to others. Our culture? our upbringing? who knows? You must stop ruminating over your errors, (and you/we will make errors), and forgive yourself. Can't let it go?... then take care of yourself, take yoga, pray, see a counselor...whatever it takes to find peace.
  13. boggle

    Student Nurse with ADHD

    I agree that you should work through your schools disability office. Accommodations for extra time and quiet rooms for exams were quite routine at my school. I would hate to see the few barriers your ADHD present keep you from success in nursing. As far as not reading or owning the text, I think that is an really unwise practice. Lectures are supposed to enhance and help you understand the concepts better. The basic material is something you are responsible for reading and knowing before you come to lecture. If you only have the lecture material, you are missing part of the picture. (by the way, the office for disability at my school has readers to help with students who had trouble with comprehension and deciphering the written material). I'm glad you had a second chance after the IV med error. That was an immediate dismissal error in my school. Is the restriction on students giving IV push meds in your nursing student handbook or syllabus? If so, being told only once that you may not give IV meds was plenty. You will be held accountable for all the written policies you have been given both in school and in the workplace. (The office for disabilities may be able to help you with a reader for those too.) I hope this all works out well for you. Good luck!
  14. boggle

    What type of floor is ICUP?

    Oh dear! "ICUP" was a running joke throughout my school years. Are you sure this is an actual unit name? or is someone just teasing you?
  15. boggle

    People you "know "coming to your unit for care

    I have worked in a community hospital where you probably know casually or closely many of the patients. Even if you don't realize that you know them, they probably know you. When possible, I try to not care for people I know personally. I did outright refuse an assignment to care for someone with whom I was in a close business relationship. I felt that just wouldn't be ethical. I do make a point of telling any patient (or family) that I recognize and care for that in the hospital, I'm a nurse, not their neighbor. I respect their privacy as I would any patient's, and I will not acknowledge that I knew or saw them in the hospital. I just smile and nod when I run into them outside of the hospital.
  16. boggle

    High blood pressure

    I know what you mean. Google is not always helpful when it comes to research based/ current medical information. I'm glad to hear you are thinking critically about the health information you read. Some college libraries (especially those with health career students) have access to those restricted medical information sites through their computers, and often let visitors use the computers. (The reference librarians will help you). If you don't have access to a college library, try the National Institute of Health's website. http://www.nih.gov. All nurses has links to reference sites too. Good luck:)