gettingupthere

Aren't your CNAs and LPNs working under the license of the DON? Or am I mistaken?

OMG! That was a long time ago! $1.50 in 1968!

Congrats!!!!!!!!!!!!

OMG! This is ME! I am ALWAYS ready to help my pts and coworkers, WHILE I'm at work! Once I get home, I don't want to talk on the phone evn. I check in with my kids, quickly find out if everyone's OK, make dinner and either go knit and watch TV or iron, do laundry, when I do laundry I get "lost" and just don't think at all! My husband gets annoyed with me, I just don't feel like talking. I DO help take care of my mother in law though. She is a nervous nellie and is always asking " can I take a tylenol"? But she's a grand lady and loves me. I was on vacation one time, this man fell and had a seizure, I thought" oh crap", when a young nurse went running up to help him. I said " great", cops and paramedics came and I walked away!

Non of those were wet to dry! wet to dry is not done 3 times a day. The reason for wet to dry is to debride a wound. If it's done 3 times a day, there isn't enough time to allow the gauze to dry. That being said, this is cruel! Think of it, it's meant to debride. The dressing is left in place until it drys out, then the nurse comes along and pulls this dry dressing out, supposedly debriding as it comes out, causing bleeding and further tissue damage! Would ANYONE want this done to them????? If the dressings are too wet, then there is maceration! This treatment is archaic!(sp) sorry for such a miserable response, but that type of dressing makes my knees weak!!!!

I graduated in 1968. I started working in a LTF for $3.50 hr. Whem I got married in 1969, I moved to New Mexico and started working in a small hospital making $1.50 hr! I make $34.00 hr now at a LTF, the same one I started at back in 1968!

Ahhh, now THAT DID happen to me many years ago! The cath wouln't deflate, my supervisor said to "cut the cath and pull it out" Guess what? I wouldn't come out!!!! Had to send her to a urologist! Bad thing to do! Never did that again!

I have been inserting foleys for 40 yrs! I have never pre-tested a foley bulb! Never was taught this practice in school! BUT, yesterday I was placing a foley in a pt with a new graduate assisting me. She asked me if I was going to pre-test the bulb? I looked at her, and told her "no, I've never heard of that" She too tells me it's a practice being taught. I have NEVER had a problem ( and hope I never do". When did this come into practice? Have I been living under a rock?

Thanks CMARM! As a matter of fact, I did have a KCI rep come in, she really had no more suggestions than what we were already doing. BUT, I really never thought of the condom cath! DUH! As it turns out, we had wound rounds today and the doc I usually go to for advise in these matters suggested that we D/C the wound vac ( as I thought she would) and suggested that we try using a calcium alginate to pack it lightly and cover it with a dry dressing. I am going to apply the condom cath tomorrow though! Otherwise we'll be changing this dressing several times a day! Thanks so much for your input! I really do appreciate it! Debbie

I have a client who arrived at my facilty with a stage 4 wound to his ishium. After a few weeks of the wet to dry dressings he arrived from the hospital with, we decided to try the wound vac. It has healing well up until a point. We are now having more trouble than ever keeping it from sidding off of the wound and interupting the treatment. We have had and OOB schedule of only 2 hrs a day to keep him off the area. He had previosly been on a hoyar lift. Now though, he is stronger and able to get out of bed with 2 assist. Still is on the same OOB schedule of 2 hrs. However, NOW the vac is slipping off the wound on a much more frequent basis, and due to the site, it ias impossible to reenforce it. The sponge at this point is already out of the wound and pulled up. Also, I have noticed that there is no longer grainage in the cannister. Let me try to explain what we have been doing to apply the vac. The area is irrigated with N/S. Dryed. Skin prep is applied around the wound and up the entire area where the bridge will sit. Because of the moistness of the area ( the client is also incont) I have been putting a small piece of duoderm near the peri area ( the very thin duoderm), and a bit of stomahesive to help it stick.then use the white sponge and cut it to put into the tunnel. I then cut a piece of the plastic tegaderm and put ot over this and cut a hole over the area where the white foam is. I then cut the black sponge and make a bridge to either his hip or thigh. This worked in the past, now, no longer. The wound is about 3x2.8cm and has a 2.3cm tunnel. Previosly was a bit wider and 6 cm tunnel. So now I'm asking for any expert opinions. Is it time to remove the vac? If so, what now? The Doc I have is really not that experienced with wounds and takes my advise or those of us who work with wounds. BTW, th wound is clean with nice healthy tissue, not really any maceration, and he has little or no pain. Again, there has been no drainage in the cannister for a couple of weeks. I'd appreciate ANY suggestions. Would really love to give this man the opportunity to be up and out for longer periods of time and take advantage of PT! Thanks!

Only every three days????? I never heard of calcium alginate dressings being changed so infrequently! Ca alginate is for draining wounds, so why would this be ordered q3days? That's neglectful! If this pt is on hospice, they are at the end of life. The body is breaking down, a wound could " take off" in no time. Poor nutrition, poor hydration. poor thing, does she have adequate pain control? I think ca alginate is not a poor choice, just needs to be changed more frequently!

I work in Long Term, I understand the need for Agency Nurses and the need for nurses to work for agencies. I don't feel positive about them at all! I find MANY medication errors, I see how some do treatments ( if they actually do them). They don't do any of the routine things, like PPDs!They spend alot of time out smoking!They don't take direction from regular nurses on the units. I have even seen them on their cell phones WHILE they are giving meds ( thus the med errors!). There have been some who come in from one job and work a double shift at the facility!They use poor judgement and are too tired to do the job properly! Frankly, they frighten me!

In our facility nurses are not allowed to remove staples!

If you have patients on Med A, you need to be very specific in your documentation. For instance, should this resident have a hip fx, then you need to document on pain level, meds given and effectiveness. How they transfer, do any self cares, self feed, coninence, how they toilet, how much assistance is needed. Identify the reason that they are in the facility and document anything pertinent to their stay. Good luck! It will come easier as time goes by.