LEVODEVO

I'm tall and big,years ago,the siderails in the old ICU beds were metal and even in the down position they would end up level with the "JEWELRY DEPT.".during codes,chest compressions were easier for me,due to height and size,but sure enuf,more than a few times 'JAMES AND THE TWINS" got zapped due to some overeager resident or fellow code nurse defribilating the patient and often yelling "clear" as they push both buttons.Add lack of protective gowns,liberal amounts of saline and a wet floor..It's a miracle I have 5 kids!...payback was sublime...we'd call it the DOC DISCO,sometimes 2 or 3 at once would get whacked while intubating a patient at the head of the bed and again some knucklehead would light them up...heck I remember nitropaste popping on a patients chest,that got everyone's attention.....the worst incident for me was while in nursing school in the 80's...I had to teach colostomy care to this young man..and I barely knew it myself..surgical floor,no A/C.. June,90 degrees out...I gingerly Popped off the device and blew lunch all over the kid..this was a 4 bed ward and 2 of the other patients starting tossing after my cue..Sister Marybreadtruck... didn't think it was professional...ya think?

Holly,(what an appropriate name right now)thanks for the thread,really enjoyable.Although compare to now,our equipment and therapies appeared antiquated,I felt the patients and families were different as well,we got more respect,but so did everyone,most folks still feared God,the cops and their parents.A lot of folks have lost God,the cops fear us and our parents are not as respected and revered as in the past.Other than ER and really bad drunks,I never heard the swearing I hear now,the entitlement that families and patients think they deserve and most administrations push.Yes it's good to question decisions,but some days are a fight every single hour with some bozo family member whose entire medical encyclopedia came from JERRY SPRINGER.Those still of the WWII era still practice manners and respect.I don;t remember the dead lingering as long as they do now,I;ve had patients with mold found in their wounds they are so far gone,but some distant cousin or hurt and dysfunctional son just can;t make the decision to let paw go...so at $10,000 a day his respirator puffs,his rectal tube drains,and we put drops in his eyes because he no nonger blinks.Years ago,the doc called the code,went out to the family and said he was gone,we did everything we could,etc...now we have bedside vigils,some hospitals allow families present for codes and washing off stool and dressing changes..but I can't go in the backroom of WALMART,but these 'customers" can walk all over us.I used to like the short visits in the ICU when the patients were real sick..I could think better and faster..now it's like i have 2 or 3 patients..the one in bed and the 3 dingos staring at the monitor all day.When patients are awake and doing well,I'm all for it,but demented,vented and dependent..some folks just get in the way.Pedi,totally different story,and I stay away from anyone under 100 pounds.Even the drug addicts and prostitutes 20 years ago,knew we were the good guys and treated us pretty good.I don't see that now.Hopefully when generation X have brats of their own,and they're getting there,they'll start to see the error of thier selfish ways and bring the kids up different.With the fantastic money nurses make now,I feel why there is a shortage is this new generation just don't know how to work hard or selflessly..but then again I see some new kids coming in,the nine earrings,the tat across the lumbar area,plugged into the IPOD during break,and they are the brightest,most assertive and compassionate bunch I have seen in some time.SO there is hope.We can always be glad for change,years ago,teachers nurses and stewardesses(who usually had to be RN'S)had to retire once they got married.

hELLO DUTCHGIRLRN...love the women's health history trip,or is it herstory?Lysol,wow..I don't like it diluted and on the floor,nevr mind anywhere else..the old ads are great,I dabble in antiques and collectibles and have come across many old mags and pamphlets directed towards women and their predetermined role in society. one little book I sold ave tips on how to pleae your man(1947),hair all done up before he comes home,dinner ready and his favorite cocktail chilled,June Cleaver to the max.....being the oldest of 3,I was always selected to go get milk or bread at the local market,I WAS ABOUT 8-10..we didn;t worry about strangers in those days,although we were warned..anyway..occassionally ahd to pick up that big lavender box with the flowers on it...i was,never knew what the hell it was..always the same time the bathroom smelled funny for a week...we guys in the neighborhood would later put our heads together and come up with all kinds theories as to what was happening to our moms...none of them close...I remember CATHY RIGBY,the tiny olympic gymnast jumping up and down on a trampoline on TV,as one of the first Tampon ads by a celeb...pretty controversial at the time...duh,, I never got the jumping thing,til later..(won;t fall out)..she made a lot of money with that add,did some broadway later as Peter Pan,married a Doctor(real treat)..being a history nut and justa aplain nut as well..I remember reading how the women folk were allowed to live aboard some of the British warships,many having lied they were married to the men..and there "personal" laundry was hung on the shipps rigging to dry...stains and all.. went to Catholic nursing school after a long hitch in the Navy...femimine hygiene wasn't covered...in that great detail..there was 4 guys in my class....let me tell ya,the beach whistle hi the fan when got on the floors for clinical and had to wash up menstruating women(terrible term I know)...the Navy taught me not to panic...but we all lost it...we all found friends among the female students we could take aside and make sure we were doing everything alright...the older nurse thread is great,sorry to get off tangent here...even with all the computers and new monitors and cameras,etc,we still as nurses are in there talking,touching and holding the patients...the docs from what I see are getting farther and father away from them...rolling rounds with a portabel c.o.w. (COMPUTER ON WHEELS),rarely entering the patients rooms..asking the nurse what their lungs sound like(I tell them go find out for your self,I did),NP'S are doing so much more of the work..too many new ones now though..so lacking the expertise we would get from the docs..at my place the RN/NP relationship is a tad strained,they have more initials after their name I make $20,000-30,000 more than they do....I tell the new nurses to take every advantage to eyeball yor pateint regularly...if you don;t see the problem you can't it...all the monitors in the world aren;t going to see that left foot getting cold and light blue unless it's uncovered and touched...the reddened coccyx..abd distension hides well under 3 blankets..I ask he cna's to keep the patients trays in the room after eating so I'll really know what they're intake is,,although I help feed my patients almost all the time..great time for small talk,anything new hurting them..howz the pain meds working,even get em to cough up some old meidcal history that can help..80% of my pateints are vented and medicated..so I don;t always have the chance..thnigs are looking up...no more opening he belly to check for a bleed...no more rotating bp cuffs...ice water lavages are gone..leeches are back...pain med and sedatives can be fine tuned much better,,veryfew IM injections...respiratory infections are still rampant but not quite as fatal...head injuries are not the DOA's they used to be,and AAA'S are off the vent in a week,versus down to the morgue in a shift...Radical necks can now go back out in public instead of hiding due to terrible scarriing and the use of voice boxes..CABG patients can be home in less than 2 weeks,back to grilled cheese sandwhiches and marlboro's......I love the evolution of nursing,I started in the 80's,still regale in my grandmother's stories of the 40's...well enuf rambling...gotta get cooking for Xmas EVE..still home recovering from back surgey..back to the ICU soon,my wife the RN is working OT today..and she can;t cook anyway....God bless...

the beers....years ago the our med fridge didn;t lock...talking 20 plus years ago..and part of the narc count was the 2 buds...at the time there was far more men in medical school than women,(I think just the opposite today),anyway,the good ole boys were always eyeing those 2 beers...the more they talked of football at their old alma mater,the more we watched them..it was our butt(the nurses,of course)if they were missing...and the few times they were we always caught the culprits...it was then their jog to go out and get them replaced,more than once some guys wife or girlfriend would come walking sheepishly into the ICU and and hand over 2 beers to the charge nurse. the bile thing does sound wicked gross,and yes they drank it,and they were MADE to drink it,something you couldn't get away with now...my A and P is getting away from me more and more as the years go on,but I do remember these patients on Gomco suction,and they were losing tons of bile a day...a problem at the time...today we'd slow down or stop the suction...there may have been an ileus,the need to as little abd distention as possible...now I'd love to know why...I had an uncle that was on IWO JIMA as a Navy corpsman....to keep the numerous wounded from going into shock they would give them cold cofee enemas..called MURHY'S DRIP...I guess it worked really well....he later workded at MASS. GENERAL in Boston,after the war and saw it used there as well,like a lot of trauma medicine a carry over from the war...my first den mother from cub scouts was one of the first to use silvadene for burn patients,she took care of people from the COCONUT GROVE fire in Boston during WWII....My uncle would also talk about how they would try and capture tape worms by making you swallow a string with some "bait" on it..then slowly pull the string out and the worm....

I never quite understood the bile thing...it had just stopped when I got into nursing,I've had older patients tell me about from time to time...ahhhhh..the keys..they always had backups....and as wrong as it was to throw the damn things in the woods..I was younger then and doing back to back 12's with a one hour trip each way...so exhausted at the end of a shift,I just couldn;t go back...I did drive back a few times to deliver the keys...that's when i found out they had "sets' of new ones all set to go...told this by one of the veteran nurses...in honesty(no pun)probably the only dishonest thing I did in nursing,went to an excellant Catholic nursing school, and to this day those Nuns are still sitting on my shoulder...the hospital soon went to a numbered lock system after 2 men in stolen lab coats picked the med room ock in borad daylight and cleaned the whole thing out...

Didn;t think I was this old....mast trousers,hockey helmets for adult siezure patients,pre-op "nipples to knees' shave for everyone,putting out occasional fires from patients on O2 smoking in bed...making sure all the bedpans were off the patients trays before the Father gave morning communion...always having 2 Budweisers in the med room fridge for the pateints with bad DT'S ,worked wonders..caught many a resident getting into the beers and making them go out and buy new ones before narc count....remember throwing the narc keys in the woods(twice)on the way home,too tired to drive back the 26 miles back...flippin ortho patients every 6 hours no matter what...feeding patents their own bile back,would mix it in coca cola....using a magic marker and tape measure to kep trakc of abdominal distention...catscans that last 30 minutes...had more than a few codes in the scanner..the old glass bottle chest tube setups breaking when they got pushed under the bed and the bed got lowered...no air conditioning on the surgical floors,just the ICU's and that was because it kept the equipment cool...ostomy care at 4pm in July was a real treat..foot tents to keep the covers off the toes....I remember how we would 'whisper" and "check out" a patient with tatoos..especially female patients, in my ICU now,I think I'm the only nurse without a tattoo and I'm a guy and a Navy vet...

We just won a new contract..and our wages and bennies have been fling all over the hopsital,media,mailings to fellow employees etc...I've been hearing lots of "nursebashing" although not to my face..6'2 300lbs..years ago...I would have talked to them in a very unprofessional manner....maturity is nto a bad thing...when I "overhear" these malicious whinings....I DO get in their face and politley tell them "if you thinks it's so great and our lives and jobs are so wonderful,then become one of us,there is a shortage of over 100,000 RN'S nationwide..percentage wise the Navy Seals graduate more people than most nursing schools...(kind of a stretch,but let them go google it)...then I tell them to call me this Christmas,you know the number..I'll be right here..

....drinking from a glass problem......she can never get enuf fluids...and to think they used to call her "IV" in nursing school because she was always scratching underneath her.....

Hi,just had my 3rd OR procedure where propofol was used for a pre-op prep,all peripheral,who the heck's gonna place a central line for one of the most popular pre-op meds used today?....had a bunch of dental work done...oral surgery....propofol....worked great...and certainly no central line from the dentist..I use it like candy in my ICU and we're spoiled with dentral lines,but if the central lines get crowded and they do...propofol will be one of my top pickes to change over to periperal due to it's safety....hope this helps....hey Docs choice,who knows what he heard or saw and now is scared of propofol....my guess it was something piggybacked into propofol that he didn;t knwo about that did some damage...just a guess...

hEY KID,i'M ON DAY 6 AFTER L2-3 DISCECTOMY...MICRO SURGERY...R leg felt like the hip was bad,knee,and half of foot numb...hip ached all nite and day...neurosurgeon do the work...excellant reputation does them like muffles at meineke....so a week tomorrow and just coming off the darvon.about 3-5 a day...stayed overnite,,left late 2nd day.....my right leg had becoem so weak from the muslces not being used well,that i have to build them up...the numbness of the surgery wore off on day 4,and yup started to feel a twinge of tht hip pain coming back(mri/xray of hip ok)incision on my back is still raised quite a bit,but only one pillow behind me in chair instead of 2...i see the doc in 2 weeks.he told me on my discharge day that when i go back to work is up to me...just gave me strict instructions for these first 2 weeks...i hope i see more improvement...the thigh muscles dont ache like before...not allowed to pick up anythig over 10 lbs...grabbing a half gallon of milk and u swear your spine is going to bow out of your back...if this all sounds confusing it is..i was warned it may not make things better...he'sa good honest doc and not a nut...so hopefully when i see him at the 2 week mark he as a plan...12-16 hour shifts with a killer spine and shooting pains down the leg make for a miserable life...i'll be using up all my bennie time on this one...good news,i can stand up from a chair now with out having 3 of the kids pull me up or grab every cushion on the couch to get up..i can just stand...rolling over in bed was awful...bmuch better,getting out of bed was brutal now much better...funny guy, i was not to touch the dsg,don't chgange it,just let if ofll off which it did,i have a terrible plantar faciitis to my left foot...which disappeared after surgery....i almost cried with joy...but again that masking post op numbness subsided and that's back....i'd reallyy be pissed if this was for nothing or there is more to do.............i'm 80lbs overweight,and that is where i now must direct my attention....actually looking at gastric bypass...6'2 300 lbs...was once raw muscle...i can;t hold it up like i used to...my jaw aches at the end lf the day from clenching my teeth in pain....the hospital and nurses were great....intubated,naked face down....thank God I got the propofol first...no replacement disc...found a fragment in the disc space as well....was wounded years ago in the Navy..you never know...i have 4 weeks pay to cover the whole thing,if i'm out over that i can go to my short term disability..which takes long time to come..I hope things change....good luck.....i'm new at this and wanting too much too fast...

I believe one of the major reason to aspirate is to ensure you are not into a major/minor vessle,thus making the injection an IV push injection...IVP insulin can be serious...the belly,back or the arms,flank are pretty safe for this reason,plus the insulin needle/syringe itself is basically too short to get into a vessel...I volunteered for a Meningitis scare years ago and gave hundreds in Im injections,all deltoid..and we all aspirated...my A and P is getting farther behind me,but some of us got pretty good back flow when we aspirated,so we tossed that needle and went to the other arm,and i if all was ok,aspirated again,and injected..

Hi,I'm an RN with ADHD,even have the initials ADHD,next to my name after RN, on a custum name badge I have...anyway..already forgot most of you questions,so I'll just give youa bunch of info and u can pick it out I make $49.86 an hour...will ratify new union contract this coming tuesday...after 3 years I will make $55.02 per hour I work 36 hours a week...OT'S we short during the summer,starting to pick up big time.. I work 7a-7p,every 3rd weekend..my eve and weekend and diffs average out to about 3 bucks an hour....we take turns doing charge/resource nurse and that is 3 bucks an hour..do this about 2-3 times a month I am a staff RN...we have no travelers/agency in my ICU..there are few in the hospital...probably due to the strong union/high wages..our OR nurses are almost all agency/travelers...we had a bunch that were all of the same age group and retired all at once...our acuity is incredible and I guess ti has been tough to get local RN's to train for OR... I have been at my hospital 20 years this February... my wife the witch carries the health insurance...she is also an RN. if I were to carry it,right now i'D BE PAYING 15% to the hospital's 85%...our next contract has changed that to 20%/80% it's the same for full or part timers..something the hospital tried to change...they wanted newcomers to pay more..way more...we stuck to our guns,most of the newcomers are out kids and we want to encourage good RN's to come here..we won I live in Pascoag,Rhode Island,but work in Worcester,Mass...26 miles away..Rhode Island is in the dark ages with wages and are paying the price(pun intended).agencies from Rhode Island call out ICU all the time with day shifts...$10,000 sign bonuses and 58$ an hour...when Woonsocket R.I. opened up their new cardiac unit..they found they had docs up the whazzooo.but no experienced RN's..and crap pay...I have my $18,000 sign on bonus letter taped to the outside of my locker...it makes me feel good at the end of a long day... Rambling as usual...I'm 51 been a nurse for about 25 years I've worked in nothing but ICU,right out of nursing school...Trauma 18 years...now combo of SICU/TRANSPLANT/CARDIOTHORACIC/VASCULAR..the airheads that run the hospital just built 3 beautiful new ICU's too bad no one to work in them..TRAUMA ICU...is wicked busy...I used to be stationed on a HELO CARRIER.. I think I see more landings here,then I did on that ship...so the RN's in Trauma are beyond burnt and will take advantage of these new icu's and finally escape...it's never the patients...but about 98% of trauma is associated with dysfunctional families,and the support at my place sucks..and the nurses can;t do it anymore... I don;t do nites..but diff is 5.00..eve 3.50...weekends...3.00...charge...3.00...preceptor...1.00 so we all refuse..i think it went up with new contract.. Boston about 25 miles away is about 10-15% more in pay..and their acuity gets spread around,,,we're in central mass and we get all of new england and new york and the islands..even canada/border..not to mention the folks from the caribean who fly into the country for the first time and have their free surgery the next day...Boston is one of the most expensive places to live in the world,never mind the country..so we do ok that's it rambling man is signing off.....

HI,there are new federal guidleines out on glycemic control...they are designed for the general patient population and not diagnosis specific...we know the potassium is important with cardiac patients and insulin eats K+ so keep an eye on that....

I work in Mass.,the feds have been getting pretty strict on giving K+,and our hospital has been quite good at following the rules...the max I have ever been able to give peripherally is a mix of 40meq of k+ in a liter of D51/2 ns or some derivative of saline..at a max rate of 60mls per hour and it must be on a pump. I work in an icu and central lines are the norm...20meqs in 50mls of ns at 100mls an hour...know what their k+ was before stating it,check the labs,don;t take someone's word....seen a lot of staff and pt's burned over this...peripheral potassium infiltrates can be horrible..i've seen plastic surgery involved,and of course lawyers...slow and dilute,i take it the pt can;t take po...kinda late for your reply but just got back in,hope it worked out..

These quotes and one liners are killing me..recovering from back surgery...just 4 days ago..the darvon bottle is getting lighter...but the laughing at all these nutty one liners is great..what a bunch!!!