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sister--*

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  1. sister--*

    gift ideas for christmas to co-workers

    One yr. I made hot chocolate mix, filled plastic sandwhich bags about 1/2 full beginning in a bottom corner, placed a few marshmellows on top, twisted the bags closed, and then tied them off with curling ribbon. I included instructions to mix with one cup hot water and stir. They looked like little ice-cream cones. Really cute. Another yr. I purchased little smudge pots from a craft store (20 for $1)....a size just perfect to slip into uniform pockets.... and filled each one with with my favorite hand lotion/cream. I decorated the little lids with stickers that I purchased at the Dollar Store. I placed these all in a wicker basket to which I attached a Christmas card and an invitation to take one. One yr. I found myself with co-workers that liked to laugh. I took Dollar Store maxi pads and made little "Pad About" gag slippers. Four pads per pair. I decorated the slippers by hot glueing little sequins and minature baubles onto them. The decorations came from a Dollar Store garland that I had purchased and cut apart. Let me tell ya, these were a hit!! Another year I found little Holiday/Winter sun catchers at the Dollar Store 4/$1. Well, I bought a box. Those went over well, too. I've baked fruit breads in miniture bread pans and given those away. You can bake a lot of these for a little bit of $$. Last year I received a small Holiday bag of the Epsom fragrant salts mentioned above. I used it to soak my feet before giving myself a pedicure. It was so nice!
  2. sister--*

    Nursing shortage: A myth?

    With business running the show Nurses are working in the "factory" model. Each Nurse is assigned a production number each day. Profit knows no acuity. What business ignores is that we're not working with "widgets" (get 'em done and put 'em on the shelf and there they stay), but, with real human beings with ongoing needs. Unfortunately it's only at the bedside that these "widgets"/production numbers become real human beings. Consequently, Nurses are expected to do more and more with less and less as management cranks-up the production line. It's no wonder that so many leave the profession.
  3. I got it for adminstering scheduled oral meds at the scheduled time to an acute care pt. while she had family in her room. The family complained that this interfered with their visit. We were very short-staffed and I had a pt. go down on his way from the bathroom to his bed; unconcious. As I raced to his side I passed the code button and activated it. It turns out he had only fainted and came around within several minutes. After, I was reprimanded for using the code button.
  4. sister--*

    IVPB administration and potential problems

    Okay, I'm interested in the test's answer to this question. Perhaps just a bit of Devil's Advocate, too: I may not be looking at the correct resource, but, I'm not finding a Cetriazone. I see Ceftriaxone (Rocephin) listed. Maybe a need to clarify the medication?
  5. sister--*

    the accutane smell

    My son was on accutane yrs. ago and I do not recall an odor. What I do recall is that while on the drug my son required frequent liver panel draws since this drug was reportedly very hard on that organ. I've taken care of people with liver diseases and several of them had a sickly sweet fetid odor. I was told that this odor stemmed from severe liver dysfunctions/disease/involvement.
  6. sister--*

    How to answer? LONG

    After questioning staffing concerns several times at a high level I was given a poor review. The first in all my practice. Consequently, I resigned that position realizing that I had become a target. Of course, they began to build a file. Included was: 1) One incident. Pt. pain control. Pt. refuses pain meds on my shift with c/o of following nurse having to medicate pt. for pain. 2) One incident. Administering ordered medications while pt. family visiting. Family felt this violated their visiting time. 3) One incident. Not immediately alerting charge nurse to pt. condition change. Charge nuse alerted when she returned to floor from E.R. Pt. already stabilized. 4) One incident. Using code alarm to gain additional assistance to pt. room after pt. faints on the way to B.R. 5) One incident. Encouraging diabetic pt. to allow ordered lab draw for blood sugar resulting in insulin administration per physician orders. Pt. was teary and I asked the Dr. to discuss this with her. He did. She allowed it. I was told that pt. said I was too convincing and was never to care for her or her family members again. 6) Many incidents. Time management. Not taking a 30 minute lunch break. To rectify these situations I was to: 1) meet several times a week with my charge nurses for their input and direction. 2) Take the first two admits on every shift I worked. Failing to do these things with satisfaction of all having input could result in termination. Now, on paperwork for new positions there's a question: "Within the last 5 yrs. have you resigned or retired from a position after being notified you would be disciplined or discharged, or after questions about your clinical competence was raised?" Honestly, how do I reply? Answering "yes" I must explain in a very little space. This is what I came up with: "I resigned a position due to receiving a poor review. This review occured after discussing floor staffing issues several times with the charge nurse, the ADON, and the DON. I am available to discuss this situation if requested." How would you answer and reply to this question?
  7. sister--*

    What do you think about cell phone use?

    When our new telemetry units and IV pumps came in the cell phone ban was lifted.
  8. sister--*

    Potential new law to be passed...to help nursing shortage

    My state allows it and my experience is that it's frightening. While setting-up (and administering) G-tube meds for a resident on a wing other than my own, I asked the med aide that was in charge of running this cart where the residents metaclopramide was kept on this particular unit. She ran to get a new bottle. Holy Cow! She handed me the magnesium! I thought I'd die when I pointed out to her that this was not what I asked for. "Huh? This isn't the right stuff?" This gal had NO IDEA that Magnesium and Metaclopramide were not the same thing. Another time I was working a med cart when I asked the med aide where this resident's atarax was. She walked over and grabbed the atenolol card and handed it to me. WHAT? How many times had that happened before!? IMHO there wouldn't be a nursing shortage if facilities would hire enough nurses. People arn't factory widgets...get 'em done and they stay done. People are in fact dynamic with ever changing needs....just like we were created.
  9. sister--*

    Need recommendation!

    All great ideas! Please, please, please follow through! In addition, be sure to pay particular attention to the facility up-keep and cleanliness as well. Odor? Check-out the soap dispensers..do they work? What does the linen look like? Does the toilet leak? Is the trash overflowing? Are the walls chipped and marked? Is the paint old and dirty? Are the walls clean? How about the floors? Is there enough room for your parents and their things...w/c, walker, cane, TV, chair...in a resident room. Look at the water pitchers. Are they clean? Is the water cool? Don't be afraid to snoop, ask questions, come unannounced at anytime. Do you see friendly, family type interactions between residents and staff? Are residents and staff clean and neat? What are the staffing ratios? (not just on paper, but, on actual timeclock) Is the atmosphere rushed and chaotic or do you observe unhurried, pleasant conversation between residents and staff? Anyone smiling?...believe it or not this may be an indicator of the facility tone. Observe the care flow during an evening's treatment and med pass. Are there enough staff members to attend to everyone properly (in your own determination) during this time? Check out the food...important as well! Is it adaquate? Is it nutritious? Is it enough? What's that food served on? Paper plates 24/7? Old plastic glasses that look like a garage sale find? How are meals served? Family style, buffet, or dipped-up by the kitchen staff with a tiny icecream scoop? What's on the menu for the month? Who serves....Nursing or kitchen/dining staff? Inquire about snacks. Make it a point to visit ALL the units in the Nursing Home, not just the one your parents would be assigned to. Do your own assessment on each one. So many facilities will put the "pretty", well maintained units in the areas that get the most public traffic. YOU WANT TO SEE THEM ALL! Look, listen, learn, and research. Trust your "gut" instincts. There ARE good Nursing Homes out there. It's up to you to find one. Rest assured there are some really nasty ones out there, too. Good luck to you as you search. ABOUT COSTS: you'll have to be wise to catch all the costs. When I was looking for my Mom a few yrs. ago I found the costs to vary a few thousand dollars a month. What I actually discovered is how they list these costs. Some will be all inclusive of services and supplies. Others will give a base rate and then an ancillary list of costs should more be needed such as: use of a w/c (yep, if it's only for a sit outside once a month), a box of kleenex, a bottle of lotion, resident bathing, laundry, a trip to the Dr.'s office....etc. Again, good luck to you!
  10. sister--*

    Tncc

    I, too, found it stressful. However, I also discovered that I really enjoyed it. TNCC allowed me to get my assessment and prioritizing skills down pat while multi-tasking in an emergency situation. I think you'll find it quite interesting and helpful.
  11. sister--*

    Please Reply. I Need Your Input

    Worked with a picc line and discovered there is no policy and procedure book for the facility. This frightens me. I was wondering why there was no I.V. sight/line care listed on the mar. Now I know.
  12. sister--*

    Please Reply. I Need Your Input

    Hmmmm, legally responsible for 97 residents here. 1 RN, 1 LPN, 3 aides at night provided all show-up. Sat. is was me and two aides. Too many issues. Run, Sister, run!
  13. sister--*

    Please Reply. I Need Your Input

    Wanting to change from Acute Care med/surg to LTC/Rehab, I recently took a job in a LTC/Rehab facility as an RN, 12 hr. night shifts. Ratio on my wing is 25-30 pts. from alert and oriented to alzheimers/dementia. Fairly safe and independent residents to total care. I've found that Med-passes and treatments are all mine on this unit for the full 12 hrs. I'm there. Have been promised a Medication Aide but rarely have one. Staffing on my wing (25-30 residents) consists of Myself, one and rarely two aides to assist people to bed from 6 p.m. until either 8 p.m. or 10 p.m. One aide after that until 6 a.m. In addition, Trachs, G-tubes, IVs are my total responsibility facility wide....about 100 residents. Also, this facility is computerized and I've been promised, but, have had no training on that. Very frustrating and time-consuming not knowing what I'm doing with that computer. I was given three days of orientation and requested and received two additional days. I asked for more, but, didn't receive it. Is this usual staffing for LTC/ Rehab facilities? I'm feeling overwhelmed and that this situation is quite unsafe. Please reply.
  14. sister--*

    Will I ever feel normal again?

    I vote for the stress of it all. My kids and I took care of my Mom when she was dying. It was a tremendous roller-coaster of emotion, physical care, family conflict, grieving, estate work, and etc. Going to work after was the only "normal" I'd had for quite some time, yet, I was exhausted. I took those naps and allowed myself the time to occassionally zone out. Gradually, things began to improve. Give yourself time and treat yourself well.Hugs to you. It's been quite an ordeal. Oh yes, EAP....a good idea!
  15. sister--*

    Feel Good Campaigns by Hospitals

    I worked at a facility that did this. It began as a good thing and then turned ugly. Joe got the praise, Jane got the prize. Over time Jim began to feel slighted, and June became moody, yet ALL were very good Nurses! Eventually, the Joes and Janes became targets of the Jims and the Junes. The gloves were on. Teamwork disappeared. Nasty cliques developed and those already there enlarged. Nonsensical complaints and write-ups esculated to the point that Nurses were even approached by management due to "concerns" that they didn't say Good Morning in pleasing ways, they didn't smile enough, they didn't cheerfully volunteer for ALL their shifts new admissions....yada, yada, yada.This campaign created its own monster hostilities. Hostilities that caused some great Nurses to leave while others continue to search for employment elsewhere. They've lost some very good Nurses. Nurses that are hard to replace.
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