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  1. kids

    "The Good Ol' Days!"

    Not only were pumps uncommon (and reserved for a few drugs) but you also had to know what BRAND of IV tubing you were working with because each brand had it's own drip rate. I loved it when I could get my hands on microdrip tubing because they were standardized and easier to calculate (at 60gtt/ml). We didn't just chart in blue/green/red, meds were written in the MAR by shift color and it was a med error to transcribe it in the wrong shift color. Bic still makes their push button 3 color pen, they were great because you didn't have to carry multiple pens. Foleys drained to a glass bottles that sat on the floor, night shift swapped them. I remember rigging up a crude but effective wound vac using a Gomco, a new product called Tegaderm and rolls of Kerlex. Dang but I should have patented that.
  2. kids

    Coffee Addiction

    I drink 3-4 12 cup pots of coffee a day. Some caffinated, some not, I really don't care either way. I drink it because I love the taste and feel of hot coffee. ETA... I go weeks at a time drinking nothing but decalf without headaches or anything. Drinking caffinated doesn't perk me up, give me jitters, etc. It's like I'm immune to it, lol.
  3. kids

    Salary for home healthcare nursing

    Indeed. The majority of PSA's cases are medicaid and it significantly impacts what they pay. I worked for them in a border town, nurses on the north side of the river (in one state) made $5 less an hour than nurses on the south side of the river (in another state). Their payscales are determined at corporate and have very little room for negotiation, about the only time you can get extra money out of them is if you exclusively work private insurance cases. I was with PSA for several years, working my way up the food chain into management. I learned a lot, I believed in their mission and I left on very good terms, they still give me glowing recommendations when I use them for a reference. They couldn't pay me enough to go back to work for them.
  4. kids

    Step away from the old nurse!

    To me, there is nothing respectful or loving about someone, other than my children, calling me mom or mama. If anything I find it highly disrespectful to their own mothers that they would diminish her title in such a way. My children's friends learned very quickly that I would not tolerate their calling me mom and I learned almost as quickly that the kids who would do so were more often than not being manipulative. The same has proven true of coworkers.
  5. kids

    Lots of young people on disability?

    No, there is no shame in recieving benefits for a legitimate disability. But when you get lumped with the "skeezes" it makes you feel like you should be ashamed. I've got well over 6 months in the ER and I don't feel the same. I'm also wheelchair bound due to a spinal cord injury and also experience several comorbidities. I'm able to work for likely the same reason your husband is...I have the education and experience that makes my employer want to go above and beyond to accomidate my needs. I don't work because I take pride in earning a living, I do it because after working as a RN for more than 20 years disability pays a piddly $1200 a month. Your husband and I are the exception to the rule. To hold either of us up as some sort of model of what a disabled person can do and declaring the "vast majority are just lazy, have a sense of entitlement, and are just taking advantage of the system" does a serious diservice to disabled people who can't.
  6. kids

    Nurses aren't maids!

    In a former "life" I was the clinical coordinator for a branch of a "nation wide pediatric agency" that shall remain nameless. If the child is medicaid their service plan very likely includes doing the child's laundry, washing their dishes, preparing the meals, cleaning the child space and equipment, etc as part of the nurse's duties in the home as time permits. If it is included in the service plan it is the agency's contract with the state and you have to provide the service. I've also seen private insurance contracts that also list those tasks, again, as time permits. Medicaid (and many private insurance) know that very often the 'nursing care' being provided over night consists primarily of monitoring the child and intervening as needed. Check the child's care plan and 485, what does it say about meeting the child's environmental needs? Private duty Peds nursing isn't just about the patient, it's about providing support to the family too.
  7. kids

    overreacting or not, that is the question!?!

    I do think you're over reacting a little but you're feeling pretty crappy so it's hard to put it in perspective. That you work there really isn't relevant, it doesn't enhance your credibility or entitle you to special treatment. Part of the routine orders in a lot of ERs, people lie, it's a simple, quick test that covers them from liability. I'd take that as the doc thinking out loud, allergies to morphine and hydrocodone pretty much eliminates 2 of the opiate "families" due to cross sensitivity. Would be nice if he'd asked what you have taken in the past without problems. Sounds like the follow up instructions were included in the dc instructions. Ideally, yes, the doc should have been the one to tell you but they got busy. Would you have been happier to wait, possibly several hours for him to have time to come tell you the exact same thing the nurse did? The nurse indicated that it was no big deal, perhaps that information came from the radiologist. If they had filled up in the time you were there, most likely his thoughts were on dealing with an ER full of people who hadn't yet been seen or treated. My experience is that it's just not that unusual for nurses to include the fact a test was abnormal and needs to be followed up on as part of the discharge. I'm sorry that you didn't get any answers, I hope it does turn out to be nothing. I also hope you don't wind up having to pay for the second CT scan, from an insurance perspective the second scan should have been done as a (most likely pre-authorized) out patient procedure. I sincerely hope you're feeling better soon.
  8. kids

    Demanding resident-vent

    Sounds like the lady has chronic pain that isn't being adequately managed.
  9. kids


    If the obituary is published then the fact the person is dead is public knowledge rather than protected information. I don't think it's a HIPAA violation but it also isn't terribly smart.
  10. kids

    rounding up grades

    It's not just nursing programs with elevated grading. My kid got her AA in accounting at a community college, classes had to be passed with a 74% or better, now that she moved on to a 4 year school she has to have a 76% or better for the class to count.
  11. kids

    reamed out for using soft wrist restraints

    Why not seek treatment for the 'pulling' behavior rather than restraining? The pulling (at the O2 and PEG tube) were very likely pain/anxiety. In a situation like you discribe I'd prefer to try and treat the underlying causes before resorting to a physical restraint.
  12. I don't see how a family members presence or absence in the waiting room would have any impact on care during a presumably minor outpatient surgery. For that matter I don't see where they would have any impact (from the waiting room) on care during a major or inpatient surgery. On the floor, during an inpatient stay is another thing all together. Family presence then can definitely impact patient care, both for the good and bad. Of course I'm the wife who tried to convince my husband to drop me off and go to work while I had a 12+ hour spine surgery (he didn't go for it). I did appreciate all the time he spent camping out at the hospital for the following week, he was the only person who could move and reposition me comfortably.
  13. kids

    Nurse suicide follows infant tragedy

    I am sorry for the losses suffered by families on both sides of this tragedy but I just can't get on board with the idea that the hospital threw the nurse under the bus. For whatever reason she made a mistake that resulted in a death. Accidents and mistakes happen but they still have consequences and you're still responsible for the outcome. If you kill a patient you don't get to keep your job. Harsh? Yes but it's a natural consequence whether you've been on the job for 27 years or 27 days. Causing the death of a patient is a career breaker even if the BoN eventually clears you to practice. To the hospital's insurance company and to the insurance company of any future employers it doesn't matter if it was a one time mistake in a long unblemished career the nurse is now uninsurable. I also don't feel it's an admission of anything that the hospital changed it's policy after the error. It's basic risk management, policies are written or re-written any time there is a need for it, good or bad. I can't begin to imagine the grief and guilt this nurse felt but choosing to deal with it by ending her own life is exactly that, her choice. The hospital, the BoN and the people who didn't hire her are not to blame for her suicide, she chose to end her life, she chose to inflict additional grief on her family. Do nurses honestly think a nurse who causes the death of a patient should get to keep their job? If a nurse caused your caused the death of your loved one you want them to keep their job? Would you want a nurse who had cause the death of a patient to care for your loved one? As a nurse, would you want to share patient care with a nurse who had caused the death of a patient? My answer to all 4 questions is no.
  14. kids

    GUM! Can you chew it on shift?

    I don't care how "discrete" you are, if you're chewing gum I still think you look like a cow chewing it's cud. Gum doesn't freshen your breath any more than spraying flowery air freshener after some has a sinky bm make it not stink, it just adds another layer of smell. Yum, minty tuna salad. To a degree the mouth is self cleaning, if your breath gets stinky after a few hours you need to see a dentist. If you have dry mouth due to meds or a health condition get an rx for some lozenges.
  15. kids

    What kind of bag do you use?

    I use this bag from Hopkins and love, love, LOVE it. http://www.hopkinsmedicalproducts.com/product.jsp?path=-1|2756|5673&id=18456 The red tagged end pocket holds a 1qt sharps container (unique to this particular bag). It looks like it would be really heavy but only weighs 3 pounds. Very durible and looks clean and crisp even after a couple of years. Hopkins also stands behind their bags. Through my own fault I broke a zipper, Hopkins replaced it (the bag) at no cost to me.
  16. kids

    A signed contract in exchange for pain medicine?

    Marinol is an FDA approved drug and would provide all of the same "benefits" she gets from injesting mj. http://reference.medscape.com/drug/marinol-thc-dronabinol-342047
  17. kids

    Awkward situation

    Cheating and gossiping are two different things. The OP trash talked the classmate behind her back and got caught, the apology was deserved. OP, accept that your classmate no longer trusts you enough to pursue a friendship. Get over it.
  18. kids

    Colace and Senna BAD drugs???

    As I recall each tab of Senna S is 8.6mg senna & 50mg colace, ask the doc to prescribe the components so you can get both in liquid form. And never heard either is 'bad'.
  19. So why is ok for truck drivers? Because it's for public safety and serves the greater good. False positives are not that common and are usually resolved with retesting. Politically unpopular or not it's illegal except in some specific circumstances. (And is a topic for another thread.)
  20. kids


    You're very close :) SR/XR pain meds are given to provide a somewhat stable dose of medication around the clock. The ramp up over several hours, plateau then ramp down. They are often timed so that the new dose ramping up overlaps the ramp down of the earlier dose. The regular acting med is given for breakthrough pain. You'll probably most commonly see SR (sustained release) XR (extended release) and LA (long acting) meds given for 'chronic' pain. The last few years a lot of the ortho doc in my area have been prescribing lowish dose Oxycontin for their surgical patients with oxycodone for breakthrough. Their patients seem to be more comfortable, mobilize a lot faster and over all get less medication that those on the traditional "oxycodone 5-20 mg Q 4hrs prn pain". Because of the use of generics and similar names you'll always want to read your medication and it's dosing throughly. Generic Oxycontin may be written as oxycodone SR, oxycodone liquids may be written as oxydose or oxystat and generic oxycodone tabs may be written as IR (Immediate Release). There is also MS Contin which is a brand name for sustained release morphine sulfate.
  21. Some things take time to make it through the system. Self report that felony conviction to the FL BoN, then come tell us if you got to keep that license.
  22. Research is showing that many peanut allergic kids may eventually out grown severe reactions and desensitizing treatment is showing a lot of promise. Why does it seem so much more common now? One theory is that the kids are being sensitized in utero. Peanuts and their byproducts are cheap and deeply entrenched in the food supply.
  23. kids


    You've got it :) Can you think of a reason why a patient would be on both medications?
  24. Exactly! And as a person who views most of life in terms of black and white it infuriates me.
  25. I tend to agree with eriksoln. It's a simple solution to a simple problem: If you steal drugs from a patient you lose your license forever. If you have a substance abuse problem and do NOT steal drugs from a patient you get to go to rehab and be monitored with the goal of getting your license back. 'Assistance programs' are a new phenomenon, I think created to keep nurses in the field during a period of critical shortage. Twenty plus years ago if you got caught stealing drugs and were reported to the board your career was over. I also think it is another example of how a large part of society has come to expect that excuses can minimize the consequences. I don't care how crappy your childhood or home life is, how stressful your job is, how much pain your in. A nursing license is a privilege, you steal drugs from a patient you lose that privilege.