KatWright

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Need more info. You are giving .96 what? mg, mL. What is the strength of the vial? 2cc: whether you draw it up into a syringe or waste 1 cc of a 3 cc syringe is still 2cc's.

Like SCgirl22, I too have many coworkers who are from the Philippines. They are superb nurses and I am proud to call them my peer. When my daughter was looking at colleges, I had HER do the math. She could go to a big name college (she had the grades and was accepted, but we had no money, no grants, no scholarships). She could attend the community college and transfer to the university and we could afford it WITHOUT loans or she could go to the big name college and be in $ 80,000 debt. She chose NO debt and is grateful. She has friends who have so much debt that there is no light at the end of the tunnel. You are around 20 years old and in 3 years you will be 23 with or without an education. You are being offered a HUGE gift of education from your parents. Take it with gratitude.

Are you a nurse already? Do you want to be involved with Labor & Delivery? Post Partum? High Risk perinatal? Have you asked yoursely "Why OB" What size hospital are you working in, or will work in? Small? you will probably do a little of everythin. Big? You will probably work on ONE type of unit and never see the others.

I have been a nurse forever and know that it is my passion. The beauty of this profession is that we can change our minds and our speciality whenever we want. I started in orthopedics, learned everything that I could and was good. Next I was a hospital float. At the time, my kids were young, involved in activities and I was newly single. I did not want to be involved in "office politics". Floating was the answer. I worked on every unit and was able to write my own schedule to match that of my children. Eventually the hospital got rid of the float pool and I had to choose a unit. I chose Oncology and fell in love. THIS is what I was born to do. Sounds corny, huh? But it is what it is. Eventually I went back to school and completed the RN to MSN with a focus in Oncology (Clinical Nurse Specialist tract) I guess what I am saying is that it may take a while for you to find your passion. As you decide onwhich way to go, investigate each one. If you decide to be a PA, remember you will always be tied to a physician. NPs can hang out their own shingle, be their own boss and make more money. Love what ever you do. Know that you may "fall in love" many times over the years.

I'll add Right Rate

We have a new doctor, Dr Huh And I am (ashamed, proud, surprised to admit.........your pick) that we have been rather, shall we say, bad. (Similar to who's on first) "Have you seen Dr Huh?" "Huh?", "Yeah, Huh" "Who, Huh?" "Uh, Huh" Now, I will have you know that we do know when to stop.......... When he comes around the corner!!!!!!! OOPS, We got caught. But he just thought that we wanted to ask a question!! Whew!!!!!!

On Mother's day, the page operator was heard by EVERYONE saying: "Would Dr. A..ab..abem..I idon't know how to say that f*%&^$# name" :eek: You could hear giggling all up and down the halls. Never did find out if she's still working !!:roll :roll :roll :roll Kat

I live alone......kids are grown and on their own .........the ex is an ex for many reasons.........anyhow, one morning I had a weird dream (?) a few months ago. I pushed snooze for the third time (usually I only push it once) and I swear that some one yelled......."Get your A$$ out of bed" I jumped up and was in the bathroom before it dawned on me that no one else was there !!!!!!!!!! :eek: :chair: But even though it puzzeled me, I still hit snooze:) Kat

Good question!! Actually it can be from both. Chemotherapy will kill off the "bad" cancer cells but while it is at it, will kill off some of the good cells resulting in neutropenia. On the other hand, people with blood dyscrasias such as acute leukemia, have veins full of immature cells that can't fight anything. Thats why you may hear of someone finding out that they have Leukemia because of a tooth abcess or other infection. Or they have bruises because they have so few platelets (the little sticky things in the blood that help with clotting and until the body is able to produce them, do not live long----only a few days) What a great field....I love oncology........ Good luck to you !! Kat

Frann, how big is your hospital? Our hospital is always full so the acu would be too. How long can they hold a patient in this unit? Do they have a specific length of time? Who staffs it? Critical care or med-surg nurses? Thanks, Kat

Lucky you Night Owl...........I woke up last Wednesday with Bells Palsy following the GI flu. It looks like I'm winking at everyone;)

Good luck but I think that you are doomed. I have not called in sick for a year and was just waylayed by a bug that had my HAIR hurting !!!!!!! I felt yuckky for 3 days !!!!!!!! And I didn't even feel guilty. Kat

PLUMRN, How big is your hospital? How many ADT nurses do you have? Does the ADT murse work on your unit ONLY? Is the unit charged for her time? (How?) How much time is alotted per patient? How experienced is she? Do you think they will expand this? I really think that this is a great idea, especially if the nurse is well rounded and a true self starter (a fast worker who is not shall we say .....lazy) I can invision several nurses on this "team", Critical care nurses, Peds, OB, med surg & tele. and possibly working 16 hours a day, maybe even 7 days a week. Our hospital has 750 beds and we are expanding another 150 to 200 beds and as you well know, it takes and hour to admit someone, obtain and initiate the orders, which is a bit of a pain because rarely does an admission come at a "good" time. I'm not sure how many patients we admit in a 24 hour period, but we are ALWAYS full with several people waiting in the ER or at home until a bed is available. I'm going to do a lit search on this so if you can think of any articles written about this topic, please let me know. Thank-you Kat

I would imagine that this would be a very busy job, because the turn around time should be under one hour.Therefore the person (or people) would have to be self starers and not ones that would take a 30 minute break between patients. And depending on the size of the hospital more than one would be necessary. What I have read (all current since 1998) said that for the larger hospitals, there would need to be coverage 24/7 !!! I can understand using a Clin Spec but I also think that an experienced nurse would be appropriate too. (I was a hosptial float in a >500 bed hospital for 12 years and I LOVED it. I did ICU, ER, NICU, Med-surg, L&D recovery room, peds, neuro, recovery room. ) I think that anyone that can successfully float anywhere could do this job. Thanks for your input. Kat

I read an article about nurses that go to the ER or to a newly admitted patients room to admit them, initiates treatment (ex. start IV, Abx, wound care...what ever) and then turns the patient over to the floor (or ICU) nurse. This does not include (elective) post ops because this is already done. Is anyone familiar with this? Thanks Kat

One of the posts reminded me of 2 patients that I took care of YEARS ago. Thei first was a 50ish y o man scheduled for a CABG the next day, and he wanted to be sure that all of his affairs were in order. I asked him if he was having premonitions and he said no not really. I let him and his wife know that if he wanted to put it off for a few days it would be OK. He was not critical. So his lawyer came in and he signed his will and DPOA, I was one of the witnesses. The day after surgery, I asked one of the PAs (that work with the cardiac surgeons) and he told me that the pt died on the table !!! I told him of my conversation with the patient. The PA said that they tell all of their patients to have everything on order and that this man kept putting it off. The other one was a man that was to have an amputation (below the knee --diabetes) In the afternoon. But in the morning, he was saying that I should pack up his stuff because he was not coming back....I asked what he meant...he said that he was going to die during surgery, but that he was OK with that....Very calm....very strange...It made me uncomfortable, so I called the doctor and told him. He came to see the patient and said that what the patient was saying made him uncomfortable and cancelled the surgery!! The patient had a major stroke at dinner time and died !!! :eek: I had forgotten about these things, isn't there a song that says thanks for the memories ? ;)

Love these spooky stories:eek: I work in a hospital that has grown alot over the last 20 + years. The Oncology unit used to be on the 4th floor and quite often before someone died, they would tell "the kids" to go play somewhere else. They ALL described the kids the same, a boy and a girl about 6 or 7 years old, both blonde and they were playing at the foot of the bed. Well, the Oncology unit moved to the 9th floor about 10 years ago and the kids moved too !!! I don't know it it is true, but the rumor is that 2 kids died in a house fire YEARS ago, well before the hospital was there :confused: Whats strange is that is only happens in 2 rooms (the same rooms when Onc was on the 4th floor !!!) :eek: I have only experienced it once and I told the family that I thought they needed to call the family from out of town if they wanted to see her. But because the lady was still doing OK (eating and getting up with a little help) they didn't believe me. You guessed it she died the next night about an hour after yelling at the kids again :D hmmmmmmm

What kind of facility do you work in? I did this kind of nursing in 1974 !!! and not since then. I do believe that you are right about the nurse practice act. Why do you do it this way. When I am looking at a problem I ask myself these questions: What is the problem? Why is it a problem? Who decided to do it this way? Is it the right decision? Is there another way? Then I list the pro's and con's. That is the hardest part because you have to be brutally honest when doing the pro's and con's. Sometimes I found that I wasn't right, that the old way was OK, but quite often I found that I WAS right. Also, people listen more when you get the emotion out of it and the facts to back you up. Do a literature search (have the library help) Find articles and reaserch studies that show how to do it better, more efficiently, more cost effective. Again, sometimes this may show that you are right or wrong. Would each nurse have fewer patients if this charge nurse took patients and each nurse did their own orders? Also, why are you still using cardexes and hand written MARS, no computer? Maybe it is time for that too. Good luck Kat

If you are giving an IM don't forget to aspirate !!

We really need to work with each other to make sure that everyone gets a break. Bargain...If you cover a smoker, then they should cover you.........go get a coke, take a quick walk away from the unit....and no I don't smoke. Also, if the nurses decides to brown bag it and eat in the lounge, we should cover each other and prevent people from interrupting. I will not interrupt someone at lunch when a family member wants to ask a question. I think that what burns me so much is that they are there for an hour or so and as soon as the nurse sits down, they have a question and cannot wait. So I ask them to leave their number and the nurse can call them or I give them the mumber at the desk and they can call the nurse when they get to their destination. Some times they get angry, but if the staff can't refuel, they can't give proper care. (Yesterday, the family member that got angry said that they had to leave because they were meeting someone for lunch......I just raised an eyebrow and said nothing. They said they would call later) Also, if a patient calls and wants to see their nurse, if I can't answer the question, I'll write it down for the patient and tell them that i will give it to the nurse when he/she gets back. And trust me, our nurses only take a few minutes, but if you get called out for any reason, then that gives everyone permission to ask for other things. Kat

If your patient has experience with shots, ask THEM how they want it. Once in a while I will have a patient ask that I do it slowly but in my practice that is the exception not the rule. Kat

I do the quick dart. But I tell my patients to "take a deep breath, blow it out, take another deep breath, blow it out." I have always had compliments on the technique and they really like having something else to think about.

You know, it's funny that we worry so much about the neutropenic patient that dares to cross our thresh hold !! Yet, we tend to forget that, with MOST of the chemo and it's related neutropenia is done as an outpatient. I would wager that we only see 5% of the oncology patients. Amazing, huh !! Ask your local oncologist. We do alot of BMTs as TOTAL outpatients !!! And our leukemics used to stay for 6 weeks...we're down to 3-4 weeks with a few going home right after chemo is done !! WOW!! One guy is in college and doesn't miss much school....although sometimes he does it online...I'm still trying to get him to do MY homework but he wants top billing !! DO YOU BELIEVE IT!! We teach them how to deal with it. Handwashing, Handwashing, Handwashing !!!! Avoid crowds, if you want to go out to dinner or go to the movies or go shopping, go in the off times. Don't go into heavy crowds. If you must, then wear a mask. No gardening when neutropenic (fertalizer is after all....poop Our patients are successful most of the time. When they are admitted and severly neutropenic we try to place them in a private room or with someone not infected (like a DVT) What an interesting speciality...I love it !! Kat

I know how you feel. I work with people like that but I am finally learning that it is not my problem, it is there and I cannot do anything about their poor care. Think about the patient that says to YOU...where have you been all week, you are great, you spend so much time with me, you have taught me so much...any of those wonderful sentiments that keep you where you are. What I have to do is, when I see them sitting all day, I remind myself that thier A#%#^ will spread, not mine :-)) and then I go spend time with my patients. There is no Eutopia, but we can create it in our own mind. Good luck to you, and when you get frustrated with your coworkers, give yourself to your patients. :)