Fgr8Out

Never been enraged by a patient expecting to be medicated as prescribed by the physician... it's their pain, not mine... and I have no right to judge. Give them their medication and go read up on pain management.

You took the words right out of my mouth! Excellent response! Lori RN, CMSRN

Thank you, badkids. I was wondering who everyone performed their clinicals with during nursing school as well...nad I'm leaning towards the idea that they trained with nurses who were equally sour. But the postings do prove a point; not everyone has the right aptitude to nurture our nursing students. I won't allow my CNA students to come near such nurses, as my CNA students are future RNs and don't need such negativity so early in their education. I've seen the tides change at our facility, however, as fewer CNAs and Nurses refuse to accept a student. We understand the value of these opportunities to educate one another, and are proud to share our expertise. Raspberries to those of you pickle suckers... life is too sweet.

Your last paragraph is quite a generalization about Med-Surg nurse opinions. Perhaps this is a true statement where you work, but it is certainly not a true picture of all Med-Surg nurses. I think some of this opinion about new graduates going directly into a critical care module stems from the perception that they lack clinical experience. I believe, however, that clinical experience can be gained in every setting from the onset. If a new graduate truly believes that the critical care setting is where their heart's desire lies, then that is what they should pursue.

As the premier leader in Adult Care/Med-Surg nursing, the Academy of Medical-Surgical Nurses (AMSN) offers Med-Surg Certification to ADN, Diploma and BSN nurses; those passing the exam earn their "Certification Medical-Surgical Registered Nurse" (CMSRN). It is recognized throughout nursing. Med-Surg IS, as you point out, a nursing specialty. While the client population may have a broader base, the focus is on adult health care and education. All nursing has a med-surg facet, and med-surg nurses are able to fulfill a wide variety of roles throughout nursing. As a member now of our hospital Float Pool, I find it easy to work on any floor. This is not to say that a nurse, is a nurse, is a nurse. It also does not mean that every Med-Surg nurse has the capacity to float throughout a hospital system with ease; I simply have found this to be a venue for preventing overload from working the same scene over and over. When it comes right down to it, Med-Surg nursing provides not only specialty expertise in the clinical setting, it also is the base from where all nursing originates. The other arguments in this spool about staffing and patient load issues are not exclusive to the Med-Surg realm. Nursing has been perenially short for quite some time. And just because the nurse/patient ratio in the critical care units is higher, does not mean their work is any easier or any less demanding. As our overall hospitalized patient population become sicker, those in the ICU/CIC are increasingly more complex as well. To anyone interested in certification in Med-Surg nursing, you can go to the ASMN website, at http://www.medsurgnurse.org. Our annual convention is this September in New Orleans, and there are 5 days of many great speakers and presentations planned, along with the opportunity to network with other nurses, and just plain have a good time.

That's a very unusual rate, to be sure. The Community College where I teach CNAs is somewhere in the neighborhood of $500, I believe. There is a big difference in what is taught from course to course too, as evidenced by how some of these candidates perform at State Board testing. Believe me, I can tell who had the quickie 2 week course, and who had a well rounded class that lasted 9 weeks. Additionally, in our state, graduate CNAs can have their entire tuition costs reimbursed if they work up to 6 months at an extended care (ie nursing home) facility, prorated if they don't start right away after graduation. It's the law.

I believe it's used as an adjuvant, as previously stated by others.

So long as she's not oversedated, her physician should look at increasing her pain medication and provide something IV for dressing changes and/or a shorter acting analgesic possibly every 4 hours as needed. For wounds of that magnitude, the medications ordered are definitely inadequate, judging by the patient's response.

Ativan should always be refrigerated (according to manufacturers instructions) to maintain stability. Additionally, ativan should always be diluted with an equal volume of compatible solution prior to IV adminstration, due to it's viscosity and potential for irritation at the insertion site. Proper technique includes drawing up only the amount for use and then diluting it. Drawing the entire vial, diluting and then administering only the amount you need is inappropriate, as you can never be certain if the amount you inject is thoroughly mixed or not. It should not be diluted for IM administration, and should be injected into deep muscle tissue.

I whistle! :rotfl: Patient's generally love it, sounds cheery and I come across as happy in my work. And I've yet to hear ANYONE complain about it... not even the "complainers". My faves? Whistle While You Work, It's A Small World Afterall, If I Only Had A Brain.. :roll :roll :roll

We treat many of our traumatic crush injuries preemptively for rhabdo, according to a protocol designed by one of our trauma surgeons. I've seen cases from MVA's, from vascular occlusions following grafts, and due to prolonged immobility with/without anoxia, as many of you have reported. My most recent rhabdo patient was this past week... drug OD, unconscious for at least 12 hours... ck>10,000, bun/creatinine out the roof. Anoxic brain is going to be his ongoing issue... a shame, nice looking young man with a great future ahead of him... past tense, of course :stone

:balloons: Kudos, Tweety!!!! :balloons:

perfect... thanks Fins :)

Originally posted by ADNRN I'm out of this string. ~*~*~*~* ::fingers crossed::

~*~*~*~* :: passing 3rd a cup of camomile tea :: There, there... you just had a very bad dream... all is right in the world. Give me your errand list and get some sleep.