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brownbook

brownbook

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  1. Study: Dietary Supplements Do Nothing for Health By Serena Gordon (HealthDay Reporter) Here's the link to the entire article. I've been hearing, from bona fied medical scientific research, since at least 2005, that multivitamins and supplements are not needed unless you're a vegan or pregnant, or diagnosed by a medical doctor as deficient. Which is very rare. If you are basically healthy adult you do not need them. Being tired, not adjusting to night shift or day shift, is no reason to take them. Sure see your primary physician if you're constantly tired. But unless a specific diagnosis is made multivitamins and supplements won't help! In fact they give many people the false impression that scrimping on a DAILY variety of fruits, vegetables and unprocessed foods, because they are soooo busy, work night shift, don't have time for healthy eating, is okay! Just my vent. I'm tired of reading on All nurses recommendations for vitamins and supplements.
  2. brownbook

    Admissions and Post-ops

    I think it's crazy and I'm not a new nurse. I'd speak up. Stop everything you're doing, patient asessments, passing meds, etc. Find the charge nurse and tell her you cannot take the new admit because you just got a fresh post op, you're hanging blood, etc. If this continues start applying for a new job.
  3. brownbook

    Pulling to other units

    I'm very flexible and love to float to other units, but I do hate what you describe. If it happens frequently, 3-4 times a month, if several, (many), staff are told to change units in the middle of their shift, maybe you can all meet with the director of Nursing and calmly explain how difficult and unsafe this is. Bring facts about how often this happens. Offer solutions. Maybe a permanent float position can be posted where the float nurse is expected to change from unit to unit as staffing and census changes. I think I've read about such position here in Allnurses. It'd be a nice incentive if this position came with a higher salary.
  4. brownbook

    Tips for same day surgery

    Same day surgery...."we" don't even have our own Nursing Specialties section . I know this has been answered by me many times....but I am not good at finding old posts either. Maybe look under OR..or PACU...or Ambulatory Care/Clinic...but none of those are only for same day surgery. Some same day surgeries can be connected to acute care hospitals, or they can be independent stand alone clinics. There are differences in working either one. A patient for same day surgery has to be, is, very healthy. They are assessed and cleared by their primary care physician, they are assessed by the surgeon, they may, or always, receive a pre-op phone call from the anesthesiologist and the pre-op nurse to review their health, medications, etc. The nurse mainly checks the paper work, takes vitals, wittiness the consent, puts in an IV. It is not the time or place for a head to toe assessment, not even listen to lungs, heart, etc., UNLESS, they present with c/o chest pain or trouble breathing, are asthmatic, etc. (then they may be sent to the ER?) The OR is run like an assembly line. Ideally the patients are moved in and out by the clock. The surgeon loses money, wastes their time, if they are ready for the patient and the pre-op staff does not have the patient ready. Plus making the following case start late! Even in PACU, a fresh out of OR sedated patient is moved quickly. These days anesthesia is so "light" and short acting, patients are wheeled out of OR sitting up joking with the anesthesiologist and nurse. I've worked out patient surgery clinics where I've been"threatened" with an incident report if a stable patient was kept over 2 hours. So of course you assess them, but a quick one, then start their snacks, start their pain pills, go over post op instructions with their ride home, and out the door.
  5. brownbook

    Travel Nursing

    This times 20.....you may be lucky to walk into a nursing unit and get 1 hour of orientation. Then a full patient load and you're on your own. The hospital uses very expensive travel nurses because it's running short staffed. Which may indicate a problem within the entire hospital.
  6. brownbook

    I have been on night shift for 30 years and...

    ????? Who, what, or why made you go to day shift? This will stay between you and me only, I promise . It seems awful if you were content with nights. I loved nights, did it 17 years. I was more tired of every other weekend than I was of working night shift. Got a Monday to Friday job.
  7. brownbook

    Question about blood pressure medications

    Great to learn new stuff in my old age. Never heard of isolate hypotension. Irregardless this discussion seems very academic. If the patient was in CCU, Swan Ganz, artline, etc. his isolate hypotension would be closely monitored and treated. What unit are you working on? What is the rest of the patient's medical history? Why is he in the hospital? How long has he been taking carvedilol and hydralazine? Was this a one time blood pressure reading or was it repeated with similar results. What has his blood pressure trend been since his admit? How is the patient looking and feeling? All that, to me, is what critical thinking means. But I was never clear on the concept of critical thinking .
  8. brownbook

    CNAs starting IVs

    This! Whoever started the IV......a RN is responsible for assessing the site.
  9. brownbook

    CNAs starting IVs

    The whole issue is as clear as mud. I worked in a free standing ambulatory surgery clinic in California. We had a tech who had been a veterinary tech. She was one of our go to staff when we had a difficulty starting an IV. I was very happy to pass off hard sticks to her. One day I come to work and am told she can't start IV's anymore? As other's have posted it is a skill. Many tasks are being delegated to CNA'S, MA'S, Tech's, etc. It would be nice to have a consistent policy that cleares up some of the confusion.
  10. brownbook

    Question about blood pressure medications

    I'm not sure what "isolated" diastolic hypotension means? You can't give, or hold, a blood pressure medication based on one blood pressure reading (if that's what it means)? Retake the blood pressure.
  11. brownbook

    Single mother working 12 hours night shift

    I had help so I've not dealt with your exact situation If you're working 3 twelve hour shifts out of a week including every other weekend, it seems the issue of getting child to school won't happen that often. How old is the child? Who will be staying at night? What are you worried about on the few occasions someone else will be sending child off to school?
  12. brownbook

    RNs giving patient lab results.

    You can't be so black and white! You would not tell a patient their blood glucose level prior to giving insulin? Even for a newly diagnosed diabetic this would be part of patient education. And long time IDDM patient's know their glucose levels and insulin needs way better than you do. You would not tell a patient who's H&H was low, who the doctor had already talked to about the treatment plan...."to get 3 units PRBC then the H&H would be rechecked", what it was? You'd just walk in and hang a 4th unit without any explanation? Or tell the patient you can't tell him what the new H&H was, the doctor has to tell them?
  13. brownbook

    Trump's 'religious conscience'

    "My religiosity....my religion....". I guess because the topic is Trump's religious conscience comment I brought Christianity and Jesus into the conversation. I never claimed it was my religion or my religiosity. I just thought love thy neighbor as thyself was a nice way to get through life. Even an atheist (which I kind of am) or followers of the Flying Spaghetti Monster should be able to live by those words.
  14. brownbook

    Trump's 'religious conscience'

    I love comments that start with, "Us _____ (fill in the blank) believe such and such". A Black comedian joked that when white people asked him, "What do Black people think about _____" (fill in the blank). He'd reply, "I don't know but we're having a meeting tonight and I'll find out". I'm not very religious. How about basing religious conscience on what Jesus purported to say, "Love the Lord with all your heart.... Love your neighbor as yourself....All the Law and the Phrophets hang on these two commandments."
  15. brownbook

    Animal abuse

    This happened long ago so my husband doesn't remember the details...but when he was working Adult Protective Services he was trying to do a health and safety check on an elderly couple. They would not allow anyone into their house. However they had dogs and it was obvious the dogs were not healthy nor being well treated. He contacted the SPCA. The SPCA was able to go into the house to assess the dogs, and my husband went with them and was able to start some interventions with the elderly couple. Just call the SPCA, maybe ask if you can report this anonymously because this is a patient/nurse HIPAA, confidentiality situation, but you believe animals are being abused. See what they say?
  16. brownbook

    Texting a Dr.

    I'm no HIPAA expert. But I know of several situations where patient information was inadvertently given to a different patient. No need to explain, each situation was different. My point is that these things do happen. I was at my PCP for a routine checkup and a patient's information datasheet was handed back to me with my paperwork. It's not great that it happens, but not necessarily the end of a nurse's career. Who's going to bother to report these violations? These are inadvertent mistakes vs a health care worker looking up information on a patient they have no business looking at. Do you plan to turn your best nursing friend in .
  17. brownbook

    Moving to a new unit

    You could try the float pool if your facility has one. I found even ICU became routine and boring after a while. (But that's not why I left). I liked PACU because you only have the patient 1 - 2 hours, it seems like there is more variety. You're hours are usually Mon to Fri, 7 ish to 4 ish, closed holidays and weekends, but you may have to be on call during the off hours.
  18. brownbook

    pre op jitters

    I thought it might be a troll. So often trolls don't respond, but she did. At least it was good for a few chuckles. I've never written penises so many times!
  19. brownbook

    Vitamin infusions

    Gosh darn it....I've been anxiously awaiting the vitamin infusion that will make me beautiful. I even have pictures picked out of beautiful women I want to look like.
  20. brownbook

    pre op jitters

    Okay, I will try again. Yes, I repeat, I think penises are yucky. So get over it! If the exact same situation happens again.... Before entering the patient's room take a deep breath, square your shoulders, give yourself a stern talking to. You can do this! Have a cold washcloth close by. If a male patient starts to get an erection put the cold washcloth on his testicles or base or his penis. Or you can ignore it! By the way, it is okay to put a Foley in a penis when the patient has an erection, but if the catheter does not go in easily step away from the patient, wait a few minutes and place a cold washcloth so the penis is flaccid. If you're just shaving the groin for inguinal surgery you can cover the penis with a small drape and shave one side then the other. Moving the penis out of the way while still keeping it covered.
  21. brownbook

    pre op jitters

    Where did you work prior to pre-op? I don't know, it's old age, or what...but I am not perfectly comfortable with touching penis's of wide awake alert patients. (Honestly I think they are yucky ). It does take a mental kick to myself to get a grip, (ha ha, get a grip), and be professional. I'm quite happy when the CNA says she'll do the pre-op preps. Anyhow don't make a mountain out of a molehill. You are going to be more nervous next time you need to prep a male for hernia surgery. If he and his wife both agreed to her staying let her. Your innocuous comment that you just wanted him to be comfortable seems harmless to me. The wife's reaction seems way over the top!
  22. brownbook

    Vitamin infusions

    I'm "only" an ADN nurse. So maybe it's above my level of education. I'd love to read some independent research on the need or efficacy of IV vitamin infusions. Especially ones for beauty!
  23. brownbook

    Wastefulness in healthcare

    I'm holding a McKesson Sterile Tongue Depressor. It is in it's original paper wrap, undamaged, no stains or tears, on the wrap, yet it expired 2009/09???? Going to McKesson or other hospital suppliers and requesting they repackage their kits, make more items "Sterile unless package damaged or opened".
  24. It's the reason behind the saying to walk a mile in someone's shoes before you judge them. Even small stuff like this. Especially when it comes to parenting and children.
  25. brownbook

    Leaving nursing

    I sincerely hope you are just venting after a very bad day at work. That's perfectly okay. If that's not the case, there's a saying I learned from Allnurses. If one person I meet treats me like crap, that's on them, if everyone I meet treats me like crap, that's on me. Re-read OldDude's post. His reply was similar to mine, but more gently said.
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