llgRN

My question is really specific to NSO. I've always carried MP. Anyone have problems with them, their website, etc?

Has anyone had problems with NSO. I've used it for yrs but never have had to USE it...still don't...just wondering

It was for the same amount of hours, right?!!! So the only thing needing fixing is the main schedule. That is unless you get shift differential for the 11P-7A, ...they may actually owe you money!!! Bottom line...email everyone and tell them sorry you mistakeningly did it and want to set the record straight...dont get all worried about this...you did not hurt or kill a pt!!! Ive done it several times in my career....besides, they were the ones who did not do it correctly in the first place. Dear...... When I checked my pay stub, i realized I was short two shifts. I mistakening told (ward cleck) that I worked blah and blah and she corrected it. When i got home and thought about it, I realized I actually worked blah and blah. Those were the two days that (preceptors name) was off. I was called in by (ward clerck) and worked with (whomever). Please let me know if there is anything else I need to do to correct this error. Thanks for understanding. I will watch this closer in the future. Regards and have a great day! Nurse0612 Send the email to your director, the ward clerk, payroll and your preceptor. That's it. FORGET ABOUT IT!!! lol

oh...one more thing...the nurse who gives the shot should be observing and recording expected effects and adverse reactions to the shots they give...that is pretty standard.

I think there is CUDOS for the doc and nursing staff to train the CNAs to do the AIMS. There is something to be said in training personal caregivers to be able to watch for these symptoms. Im not sure they should be the one who performs the test and records the AIMS in the medical record, that sounds like they are being "lazy butts"!!!

I've been wearing clogs of some kind, ever since my Mom brought them home from Sweden/Norway when I was a little girl....I have worn Crocs for at least 3 years. Love them for sure. I wear them with support socks. Work in Gero Psych now....so...we don't get too much spillage....ANYWAY....thought I would pass on that after cleaning them with antibiotic soap and or alchohol foam/wipes....I take Armor All spray and spiff them up...you can get Armor All pull-up wipes too...They look nice and shiny again.

Hey, have been following this thread. Now decided to "add" to the discussion. I work geripsych. There are so many "theories" that we learn in Nursing School, and then we have to actually apply the stuff practically in our daily work. We are trained to gear our work/teaching at the developement level/educational level of our patients. An AD pt is developmentally not in the same level as a pt without it. Our dementia pts run the full range of developmental/educational levels. Many people back 50-80 years ago were not able to finish even the 8th grade before having to go out and work. We also can not forget that they ARE adults with adult experiences, some of which they still remeber parts of. I think back to when my dad was growing up in MN. My dad only went to the 8th grade. The family lived in a "cold water flat" with a shared bathroom and no shower/bathtub. My Grandma had to get out washtubs and fill with water heated on the wood burning stove to bath the kids and they only did this on Saturday night, so as to be clean for Mass on Sunday. There were 9 kids in the family, and only 5 beds, in 3 bedrooms. My Grandfather was not a steady worker, and there was not always enough food to go around. On the other hand, my Mom's family was very well educated. My Mom's dad had a college degree in Math and worked at Honeywell. He even had a job throughout the Depression. They lived on a farm and had plenty of food. My Mom had 4 siblings, each had their own bed. Why am I bringing this up? I always try to remember that we can not just take a theory and make it work with our pts. I can imagine if my Dad was alive and had dementia and we were trying to make him bath because that is the right thing to do. Gotta keep the pt clean, and it is what we were taught to do in school. We would have a HUGE fight on our hands. His family only washed up daily and took one bath a week. He would be the one hoarding food in his room because he'd eaten "enough" and would be remembering to save back something for later just in case, and not to waste it. He might also be that naughty guy crawling into bed with another resident, because he never had the luxury of having his own bed, and is confused. We have to use our theories and experience to formulate the care of our pts. For example...that old guy crawling into bed with another pt may not be an old "horn dog". It is a lot more therapuetic for a staff memeber to say "Oh, Mr Green, I am so glad to see you. Lets go down this way and get something to eat before you go to bed" than saying something like "What are you doing in here. I have told you over and over again that this is not your room and you have your own bed. It is not okay for you to keep bothering this patient. Now get out of here" I hope you can follow where I am going with this. One more thing.....we need to remember the developmental stages when dealing with "young" nurses. This is not a slam to anyone. We just have to keep in mind not to alienate the "youngsters". They have lots of enthusiastic ideas and we can learn from them too. BUT....could they not just learn to repect their elders!! :sofahider OK sorry I could not resist that!! :)

I am assuming that you want to save $$, or you would have an RN position. I work at a geriatric/psychiatric unit in a hospital. We always have an RN and an LVN on the unit, then fill in with CNA or MHA as needed. The LVN is mainly concerned with medication administration and treatments, wound care, etc. Below are links to the Texas State Board of Nursing...we have LVN's so I am assuming you are in TX, if not look up that state's information. Below are some links to info for TX. http://www.bne.state.tx.us/npatc.htm ftp://www.bne.state.tx.us/LVN-guide.pdf http://www.bne.state.tx.us/vnpract-qa.htm

Never argue with a delusional pt or try to "fix" the delusion...you can not win. To that person it is reality. You can only offer reality based things from your end, to build trust, approach them slowly, encourage them to voice their own feelings/needs, reminisce. You do not have to agree with them to talk to them one-on-one. Just say things like...oh that is interesting, tell me more about that. Once you have trust being built....they are more apt to take a chance and start taking their meds. Also don't try to talk them out of some sort of rituals that they feel they must do. You will spend too much of your valuable time for no avail. Find out something they are interested in doing (look at their activity assessment) maybe offer to play a game of cards, or dominos etc. They will start to trust you. Never let your guard down though...you have to be self aware at all times. Also, if they are having any type of hallucinations, do not tell them they are wrong/argue. You can say I do beleive that you are seeing/hearing (ect) that, but I am not seeing that...tell me more about that...do you recognze the voice....does the voice tell you to do something...ect. You may just find out some valuable information for your treatment plan that way. For instance someone who is not eating may have "voices" telling them that the food is poison. Oh...by the way...if they do not take their meds...just crush them and put them in their oatmeal or afternoon snack....OK just kidding!!!

We have a family friend that is now age 26. He grew up with my daughters, and is best friends with my oldest daughter's hubby. We first met their family at church when the "kiddos" were in the church nursery. Little Mike would ONLY eat peanut butter sandwhiches.....no jelly, only white bread and it had to be Jiffy peanut butter. He did from time to time include MacDonald's french fries, but I think that was only so he would have something to eat when the moms met for playtime lunches at McD's playland....he grew quite well with few colds etc during childhood....OK i think he did get in a few assorted veggies over the years, but not many....ANYWAY....somewhere along the he did start to eat spaghetti with tomato sauce. Big Mike is now engaged to be married.......the cake will have peanut butter frosting...hee hee...and, he is starting school to be of all things...a Chef!!! ....so....free advise....set the limits you can...and don't sweat the other stuff. The main thing is to try to keep control in areas that matter.........you really can't have your kiddos ruling the house.

Greetings!!! Take things one at a time. Try to arrange a visit with a pediatric nurse...maybe you could follow one for a few hours on their unit. Also, there are lots of volunteer jobs a most hospitals...maybe you could present yourself to the Candy Striper Director and let her know you are interested in peds and see if you can be assigned there. Also...let your mom know this...I am a Psych RN...do charge work...anyway the Social Workers and Therapists on most Psych units have their Master's degree...I think I make more $$ than they do...and there is about a 6 to 1 ratio of RN's to therapists where I work...so that translates to more job security with Nursing!! Anyway...don't get your Mom too upset...use some "theraputic communication" (that is what Nurses call how they talk to patients) with your Mom. Tell her that you are really Thankfull for her suggestions and that you will for sure keep them in mind while you are checking out all of your options....she may actually have some contacts with hospital staff since she worked in a doctors office and could help you with networking and getting hospital visits set up. One more thing....know that any post high school education that you do will require LOTS of studying and LOTS of tests....no matter which field you go into. Most people over time get "use" to taking tests and having litle time for anything else but classes and studying while in school...but it is very rewarding in the long run!! God Bless and Good Luck!!! PS...Glad you like Barnes and Noble....spent LOTS of time there with my books and study groups going over lectures and preparing for tests!!! ( Maybe I should have bought B and N stock!!)

Ok...well the rationale about taking apical is because you are actually listening to the heart...can tell if there are any "funky" things going on....and it is actually the heart you are listening to.....not just feeling for a pulse "ei: blood flowing at a "far away" place".....anyway lots of people on dig have heart arrythmias that will not be "picked up" by just feeling for a pulse....its nice if they are on tele because one can "not see the p-waves" or see the PAC's or PVC's...A-Fib.......but on the units where I have worked....most situations are of the chronic type...not acute...so no tele........AND so apical is the best thing then...and gotta listen for at least a minute...can "miss" stuff if you don't...

Ok good....now i will let you know about the situation.....I work geripsych and skilled....so most of our pt's are on a morning regime along with a whole load of other meds.....our orders are usually to hold if apical pulse is my general bent on this is that it is a chronic thing for him (them)...we are not really treating them for acute cardiac arrythmias......(of course we do our assessments and report things not wnl).....so it is my thinking that one should not keep checking the pt's pulse and then give it when it gets over a point....and just follow the orders of checking the apical pulse (check lastest dig level of course and all) and hold if pulse is

I do those things too for sure.....wondering about the timing...dose...getting docs to order dig levels.....do you have p&p for holding.....do you call doc if you hold....how long do you hold it?...for a day?.....until next dose due?...do you check pulse later in the day and give it then if apical pulse is >60......

Doing clinicals in Chicago area..... middle aged man with FB (pear) in rectum...required surgery and antibiotic therapy.......oh yeah forget to tell you that his "friend" tried to "cut" the pear out with a paring knife.....