PaynRN

So 2 doses in. Side effects so far a burning feeling in my abdomen and some diarrhea. I am also a little dizzy.

When I first started my job in Pain Management 11 years ago, I was freaked out that the docs wanted me to just "push it". I of course, wanted to do it slowly like I was taught. I push the meds like the docs want. If I have a very old person whom we have never sedated before I will start slowly to see their reaction. Many of the older folks will get just 2mg and then if we know they can handle more and they remember their treatment, they will get a little more the next time. Several years ago we used to use Versed 2mg/Fentanyl 2cc combo.We mixed it in the same syringe. This was in a Pain Center in the hospital. The doctor switched to just Versed usually 4mg although sometimes 6 mg. Honestly, I am glad we leave off the Fentanyl. IMHO, the Fentanyl was the cause of the incidences of dropped BP's, nausea and low O2 sats. We rarely have any complications with just the plain Versed. I have pushed thousands and thousands of doses of Versed over the years and have had almost no problems with it. The problems come when you add another med to the mix. As for Propofol, check your state nursing board. It is illegal for a nurse in my state to PUSH the drug although I can monitor it as a drip. NO WAY would I ever push that drug. Talk about ramping up the complications/side effects! Honestly, our patient population does just fine on the plain Versed. Most do not remember anything on 4-6 mg, they think they "go to sleep" or are "knocked out" during the whole thing when actually they follow commands, can carry on a conversation, and get themselves up off the table and then next visit have no recollection of it.

Anyone every take the Post Exposure Prophylaxis for a needlestick? I am a nurse in an outpatient pain center. I love my job except the doctor insists upon using un-shielded angiocaths due to cost factor. Yesterday, I got stuck emptying a trash can (someone accidentally threw the needle in the garbage). The stick was on the top of my hand near the knuckle with a 24G angio with blood in the hub of the device. Age of the angio and patient un-dertermined. There is a chance that the needle had been there over a day since that room does not get used that often and to me the blood in the hub did not look "fresh". Of course I am very ****** that this happened. I am very careful with my used angio's and I haven't had a needlestick in more than 15 years. It was at the very end of the day, everyone was leaving and I was left to deal with this mess on my own (finding our P & P, getting copies of everything, and finally going to the local ER) I made it out of the ER 3 hours after the incident. The NP there had given me RX's of the 2 drugs 3TC and AZT. I could not make up my mind about starting the meds in the ER. Of course now after coming home and reading about them I find out that you are supposed to start within 2 hours post exposure which I was not told in the ER. I come home talk to my sister that is also a nurse, call my nurse manager (who is on vacation) and decide that I would try the meds. I go to 2 different pharmacies to get the meds, I pay for 4 days worth of meds out of my own pocket because I didn't have Workers Comp info yet, and take my first dose 7 hours post exposure. So here I sit in the middle of the night because I couldn't sleep. Already I feel funny and weird. I am mulling this over in my head trying to decide if it is going to be worth it. I am definately not a risk taker and am freaked out about the whole thing. So my question is has anyone taken the meds and how were they tolerated? Also, what would YOU do in this situation?

I am an RN in an outpatient Pain Management Clinic. Today, I was working on our office's Infection Control plan that I had just taken over from a departing employee, when I heard our Nurses Aide say to a patient that she just brought back " You are bleeding". A family member pushed a gentleman by my office and I notice he has bare feet with a large 3- 4 inch old open wound on the bottom of his foot. Sure enough, just as my Aide said, he was dripping blood all the way down the hallway to the bathroom. GRREEAATTT. I am shaking my head in disbelief as I follow them down the hallway. The Aide puts on gloves and proceeds to clean him up while I go out into the waiting area to try to see what damage has been done to the carpet and secure the area. I go out and there it was, a 4 foot section of carpet that looked like it came out of a CSI episode. The other patients had moved to the other side of the waiting area thank goodness. I am staring in shock at the mess on the floor that included CLOTS, when a person waiting said " We tried to tell her that it was blood but she insisted that "It's only Ketchup". Evidentally, she believed her family member had stepped on a Ketchup packet while in her car. (Yeah right). She also didn't have any idea where the "bandaid" that she had put on the wound had gone. Seriously, this wound could have taken an entire Kerlix bandage. The best part of the whole incident happened after we cleaned up the mess, she says " Oh yeah, he has some sort of infection in that foot called MRSA" . Nothing like baptism by fire!