one2one

I just watched a commercial on tv for a topical antibiotic ointment where the little girl says her cut got infected and her mom had to take her to the emergency room! For a cut on her finger? Are they kidding me? I just can't believe they would encourage people to tie up the emergency room for such a thing!

There is a book written by Nicholas Boothman called "How to Make People Like You in 90 Seconds or Less". He offers great tips on building rapport with people in literally only 90 seconds. It's very simple and well worth the effort.

Several years ago I was working on a stepdown unit where another RN was assigned to a pt in her mid 40's with MS. The pt choked on her lunch tray and the nurse did nothing to intervene because the pt had a DNR order. The pt died just because she choked on a piece of food and the RN thought that she couldn't suction her because of the DNR order. ( I was off of the floor with my pt in the radiology dept at the time) I only found out about what happened later in the day.

The physician's order sheets we use at our hospital have a space at the top for the physician to write in the pt's code status. One of the physician's recently wrote in "A.N.D." in this space. When asked what it meant, he said "Allow natural death". This is not an approved abbreviation at our facility. When asked exactly what he meant by that, he went into a 15 minute speech. In the end, the conclusion I came to was that the pt was to be a DNR. Have any of you seen this abbreviation used before? I'm not sure what the legal consequences would have been if the pt had coded and we followed the order and did nothing. I would like to hear your thoughts on this.

Promote health, ease pain, allow death with dignity

Well, I want to add that the cost of living in MO is lower than a lot of other places (esp CA). Besides that, money isn't everything. The wages quoted in the hospital websites are, of course, negotiable. For my money, MO is still the best place to be!!

I absolutely agree with give Tylenol and other PRN meds based on the asessment- if they need something-give it regardless of what other nurses might say. I've worked PRN in a longterm care facility for many of my nursing years. I've also found that if you have pt who aren't sleeping at noc may need pain meds. I also discovered that they may not be sleeping well because they are cold. I was surprised how many people would go to sleep just by putting a warm pair of cotton socks on their feet. It works wonders.

I'm thinking of learning Spanish as a second language. Do you think this is a valuable skill in your nursing practice? Would it be worth the time and effort it takes to learn it?

Sounds like a winning idea to me. It would be great experience for you. Some LTC facilities will pay for the CNA class if you work for them. Anything you can learn before you start nursing school will be of great benefit. Some facilites also offer scholarships for nursing school too. Good luck to you whatever you decide.

Is this stuff worse than taking sleeping pills to sleep? I don't need help falling asleep, I just have trouble staying awake sometimes. Any other suggestions on how to adjust?

This is only MY opinion for what it's worth. Starting off in the general ICU of a community hospital is a great place to start because you'll get to see a little bit of everything as opposed to a specialized ICU where you concentrate in only one area. I would try to give it two years if you can. You should get some good basic experiences. Then it might be helpful to take the CCRN exam and get your certification. (It impresses other employers). I don't think your current manager would feel upset with you for moving on after two years.

Have any of you who work nocs every taken Provigil to help with your wake-sleep cycles? Does it work for you? I would like to know your opinions before asking my Dr to prescribe it for me.

If your back pain just started, consider seeing your OB-Gyn. I had terrible back pain and found out I had a bad case of endometriosos growing on the outside of the back of my uterus. It was impossible to see with ultrasound but found it with laprascopic surgery. (I had other sx of endo as well). Once I had the surgery, no more back pain.

Go online and try out the www.wilkes.med.ucla.edu/inex.htm website. You'll hear examples of both heart and lung sounds and the abnormal ones. And it's free!

First you should go to the aacn.org website and read the requirements for taking the exam. If you meet those requirements, go to www.ed4nurses.com and consider buying their review course. That's what I did and I passed the first time I took it. I had scheduled my exam and felt prepared (though still afraid of failing) The day it took it, my grandmother died that morning. My family insisted that I go ahead and take the exam anyway. I was upset and cried all the way through it, but managed to pass it anyway. I say, if this is what you want, don't be afraid to go for it. You'll be glad you did.:wink2:

Whenever I see someone use WNL I always wonder if it means "within normal limits" or "We never looked"

In time, you come to realize that death is as natural a part of life as is birth. Sometimes it comes too soon and sometimes it's prolonged too long. You will come to find your own inner strength. Once you've realized that we are all mortal and we are all going to die, it helps some. There were always be those times when a death makes you feel just devastated. But I hope at some point in your career you'll be able to witness the death of a person who has had time to prepare for it and accepts it. And when they die with their loved ones all around and holding their hand, you can see the beauty of passing away when you're ready for it and know how much you're loved. My own grandmother passed away 32 days ago at the age of 96. I loved her more than I have ever loved anyone but I could accept her passing because it was what she wanted. Sorry this is so long but I want you to see that every death is not a tragedy.

I was sitting in the human resources office one day when a woman wearing sweatpants, tank top and flipflops walked in and asked for an application. The receptionist was very respectful but very direct in telling her that the way she was dressed would never get her an interview and proceded to tell her that she should come back with a "business casual" attire, then she could help her. I was so impressed that the receptionist would take the time to explain this to her and how important it was. Sometimes someone just needs to teach people what they are doing wrong, in order to help them do it right in the future.

Remember , you learn differently after the age of 30 than you did when you were younger. Study what you don't understand first thing in the morning, then your brain works all day to catagorize and store the information. Never study what you don't understand right before you go to bed. Your brain won't be able to process it. Instead, try to go over what you need to memorize right before you go to bed, your brain will keep processing it all night and store it in your memory.

Does your employer address which kinds of shoes you can wear? The hospital where I work just recently banned Crocs because of too many slips and falls with them. I personally cannot wear Berkenstocks. I paid $120 for a pair and could never wear them because I had such terrible back pain that within a few hours I could barely walk. I like Propet shoes myself. Very comfortable and not terribly expensive and the look nice too.

Hello! I've lived in Missouri all of my life and it's a truly great place whereever you decide. You might consider Columbia MO. Right on I-70 between St Louis and KC. Close to the Lake of the Ozarks too, so it's not a far drive to anywhere in the state. It's a moderate sized city with a rural feel. Great Mizzou (University of MO) Go Tigers! University of MO hospital, Boone Hospital Center, and VA. Great Dialysis center with the most friendly (and fun) group of nurses ever. Come for a visit and give it real consideration before you decide. I know you'll love it. And we would love to have you here.

Welcome to the world of nursing! Don't be discouraged. I have to say that most of the time when a preceptor is being as unhelpful as yours, it's because they lack confidence in their own skills and abilities. Sometimes a nurse feels threatened by a new hire. They think "will she be a better nurse than I am" or "will she know that I really don't know what I'm doing?" Often nurses aren't preceptor because they want to be but rather because they have no choice. Not everyone is able to be a teach, but should still be a good role model. My only advice is, just try to understand her perspective and be her friend. Don't criticize her either to her face or to anyone else. You should be able to voice your concerns to HER supervisor if they ask you how things are going. But be sure to only do it in a private setting. Good luck and don't give up!

Wow, what an awful experience for you. I'm wondering what the other nurses who dealt with this family have to say. Surely if they had been in the hospice program for a week, another nurse had also been involved in the situation. Maybe the pt's personal physician could add some insight into the family dynamics and the wife's behavior in the office or hospital setting. Was the pt hospitalized at any time in the weeks prior to beginning the hospice program? Maybe the hospital nurses or social worker could give some input. Sounds like maybe the wife was having severe "caregiver stress". Surely the hospice you worked for has had similiar dealing with other difficult families. Anyone who has been in nursing any length of time runs into difficult family situations.

I have an interview for a job. What are good questions I should ask the nurse manager who will be interviewing me?

Hate to sound like a commercial but really the Ed4nurses.com website offers courses in critcial care essentials and critical care mastery which are done in layman's terms and are easy to understand. Helped me out a lot.