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And one of those jerk-off's used to be an MD? I can only imagine (not that I want to)... what a bunch of lame-o's.

Yes it's the doc's job to make a medical diagnosis, but it's our job to think critically about what's going on with the patient and possible diagnoses so we can better anticipate treatment and plan our care. We spend far more time directly involved with the patients and should put the knowledge aquired therein to best use. Plus, we should do what we can to make patients comfortable and that takes critical thinking and problem-solving. It might be as simple as adjusting the heat when someone's sweating or taking off a woman's bra when she has chest pain, or it could be tricky as is the case with this patient and her diaphoresis...I could get wordier, so I'll leave it at that!

Is that because "accidents can be prevented"?

If she's there as a patient, she's a patient, and should be treated the same as any other. If she were a teacher, would it make a difference? Hopefully this is a wake-up call for that woman to get the help she needs...knowing her colleagues want to help instead of feeling like they're out to get her might be a bonus.

[color=#003399]refer to your acls books on the h's and t's (causes of arrest) [color=#003399]hypoglcemia or [color=#003399]hyperglycemia- low blood glucose from overdose of [color=#003399]oral hypoglycemics such as [color=#003399]sulfonylureas, or overdose of [color=#003399]insulin. rare endocrine disorders can also cause unexpected hypoglycemia. generally, hyperglycemia is itself not fatal, however [color=#003399]dka will cause ph to drop, and [color=#003399]nonketotic hyperosmolar coma leads to a severely hypovolemic state. hypoglycemia is corrected rapidly by intravenous administration of concentrated glucose (typically 25 ml of 50% glucose in adults, but in children 25% glucose is used, and in neonates 10% glucose is used.) however, the patient will often require a continuous intravenous drip until the causative agent is completely metabolized. in dka, the goal is correction of acidosis. in nkh, the goal is adequate fluid resuscitation. (taken from acls blurb online)

Agreed. Trust your gut and commit to an outcome. Having numbers is one thing, but what are you going to DO with them that will benefit your patient (ie: follow protocol). If you're uncomfortable, don't fight that. Easy for me to say, though, right? Suggest speaking with the child's physician, maybe arrange a family conference to discuss issue, and develop a protocol.

I don't think it matters what area you work in, you can never get away from weird...nurses are magnets for it. One time on my LDR clinical I had a lady come in at 6cm, and stoned out of her mind. While getting everything set up (my preceptor was in the room, thankfully), the woman said "Uh-oh, I think I have to s**t or fart or something", and out popped baby's head!! I almost died.

Don't be afraid to ask for extra orientation if you feel you need it; there's no harm in asking, and only you know how comfortable you feel. You'll never learn all you need to know in your orientation, no matter where you work, but remember it will come with time. The hardest part for me was remembering all the residents, especially since they don't wear bracelets. I used to check the tags in their shirts (most are labelled) then realized that Anne might be wearing Millie's shirt, etc. It will come; have confidence in yourself--you made it this far, right? Best of luck to you!

MommyandRN, it must feel so good to make that realization! I have to agree with snowfreeze, ICU seems too task oriented for me. Though I do miss vents and knowing my patients inside out and backwords, there's a lot to be said for interacting with patients and families, seeing them ready to go home, etc. Although there's also something to be said for hourly sedation...

Try posting in the specialties forum. If no luck finding a candidate, why not visit your local peds unit? That might showcase your motivation; when we did interviews in training they had to be face-to-face, so as to help us improve our interpersonal skills (establishing a rapport, body language, etc.). Best of luck to you!

"...silverfish under pendulous breasts..." That is one of the grossest things I've ever read. (shakes limbs to rid herself of heebie-jeebies)

Management hires many uncertified workers ("off the street" is something we hear a lot) with hopes that they can entice them to take their CNA course; this guy had no training, certification or previous relevant experience and management mislead him.

I, too, have a regular flock of "iron filings" at my cart...I used to think I was trapped in some weird parallel universe like a combo of "One Flew Over the Cuckoo's Nest" and "Shaun of the Dead"...now I just chuckle, smile, and try to get around!

We had an underpriveliged woman in LDR for her 9th (that's right) delivery, stated she "hardly gained any weight this time". Low and behold when she pushed babe's head out she defecated (not uncommon) and umpteen million tapeworms shot out of her with such force and odour the LDR nurse ran out of the room to vomit. Ew.

I hear you!! I have several scars from aggressive residents...I learned to wear long-sleeved t's under my uniforms!! On this topic, we just hired a young lad who quit the same day. He was told by our supervisor his duties would include keeping patients company, playing cards, giving them food and drink. He couldn't believe he had to be in the bathroom with another person let alone provide personal care! People are crazy if they think nursing assistants have low stress!!