BJLynn

I'm an LPN currently. Hoping to go back to get my BSN eventually before I'm to old and frail to use it. At my facility the only time we make a delination between RN and LPN is when an outside staff member starts to get a little huffy and asks for a "real nurse". We just kind of roll our eyes and hand over the phone to one of the RNs who proceed to inform the caller that the NURSE they just spoke to is more than capable of talking to them. We all work as a team where I work. We pool resources, knowledge, and skills. Therefore it really doesn't matter if the individual nurse is an LPN or RN. Besides, at my facility, there is very very little difference between the job of an RN and LPN. In fact, when I answer the phone, or call to a Dr's office, I just identify myself as a "nurse". sorry for the rambling..............off to find more coffee................stupid second shift combined with daughter who thinks 6:30am is a good time to get up..................thank goodness she's cute...................

I disconnected a catheter to irrigate and confirm placement because there was blood in the bag and very little urine. A blood clot was clogging the tube. It was about 4 foot long. Bloodiest cath change I've ever done. Then there is the various tunneling decubs, broken bones, dislocated joints, and one of my favorites, the lady with her scalp split open to the bone.

We change anything associated with the tube feed once every 24 hours. Third shift usually does it when they do the 3am meds. For those on the bottles (big plastic containers for Fibersource HN), we change the tubing when we change out the bottle(which is generally q 20 to 28 hours).

I found a really cool chart that has onset, peak, duration, administration in relation to meals, and other information. I don't have anything directly related to this thread (my first instinct was that that guy would have his insulin processes slowed down...), but wanted to share this chart. I have it tacked inside my MAR at work. http://www.musc.edu/pharmacyservices/DI/InsulinComparisonChart1.pdf

I had a lady pull out her G-tube three times within 36 hours. Thankfully I wasn't working that day. Too much paperwork lol. 48 hours later she pulls it out a fourth time.

I've had that reaction too. I exlpained it to my GP like this: Dr: You have listed down Compazine as having an allergy to. What was your reaction? Me: Picture a squirrel on crack........ Dr: Oh my, I don't think we will give that one to you ever again.

1425 to 1445 Arrive in nursing office and get report. Check for any new orders. See if any residents are out on doctors visits. Check the neuro, seizure, atb, and outstanding specimen board. 1445 (Hopefully) go to my assigned floor and quickly scan the medroom to make sure supplies are there for medpass. 1500 Feed my one bolus G-tube feeder. 1510 Go back to medroom, get 40+ cups of water poured, get my applesauce poured up, and make sure I have all needed reinforcers such as candy or ciggarettes. (some residents get these if they answer questions about their meds or if they just plain take them) 1530 (if nothing has happened) open door and do med pass for 40+ people. Run med programs for those that are on them. 1615 My four diabetics start coming up. Do accuchecks, give insulin when nessecary, call for orders if needed. By this time my helper has arrived, and he/she goes and takes care of my two residents that need catheterized. 1645 Hopefully medpass is over. I run to the fax room and fax the pharmacy before they close for any meds that I may need delivered that night. If medpass is not over, ask for backup if avaliable, or shut door temporarily and resume medpass when I return. 1700 Go over MAR to double check no ATB got missed in the controlled chaos that is medpass. Get any treatments done that can be done. 1800 Do second bolus feeding on bolus guy. 1815 Take break.....maybe 1845 Get one of my pump feeders her meds and hook her up. Do accucheck on second pump feeder. 1900 Get ready for second medpass. 1930 Do second medpass. Smaller than the first one. 2000 Do accuchecks and insulin. 2015 Hook up second pump feeder. 2030-2230 Do treatments, charting and any other things that need to be done. 2100 Do third bolus feeding on bolus guy 2245 Give report to oncoming shift, count narcs. 2300 If everything has gone according to plan, clock out. This schedule subject to any injuries, illnesses, in house doctor's clinics, new orders, unccoperative blood sugars, residents having difficulties with emotional outbursts or physical aggression, fist fights, injuries to the nurse, stubbed toes, pyscotic breaks in medline, etc..... The last time I was able to follow this schedule as written.............I really can't remember. There is usually two or three of the above incidences to help spice up my day.

An oldie, but goodie: I got a urine speciemin cup and put some tea in it. I walked out of a resident's room, held it up to the light, unscrewed the cap, and proceded to drink a bit. Then said, "Hmm, a bit sugary" The people around me about fainted.

Yup, it's a holiday where I work. We do not get a lot of perks, so the holiday thing is nice. Double pay rocks. New Years Day, Christmas Day, Christmas Eve, Thanksgiving, Presidents day, Easter, 4th of July, Labor day, Memorial day. Way back in the stone age when I used to manage a movie theatre, I had a mix of Jewish and Christian employees. My employees always got at least one holiday off during the winter "holiday season". I was very flexible as to which holiday they wanted off d/t family/religious reasons. Worked out well for me. (I did the same in spring too) I had a very loyal crew because of a little flexiblity on my part. We paid slightly over minimum and no holiday differntial.

LOL that reminds me of the other day when I wiped off a patients face before the doc examined her. And I held her hand away from him. She had just done some poopy painting and her aid had not sufficiently cleaned her up. Anyway, he's examining her, I'm holding her hand, and the other two nurses in the room keep looking at me giggling. Doc: I give. What's the joke? Me: Sir, that wasn't chocolate pudding I just wiped off of her face. Nurse #1: She's quite artistic. (Nurse 2 is about to loose it to laughter) Doc: Uhhhuhh......and what do you mean by that? Me: Sir, she just got out of the restroom and apparently decided to do a little painting. I don't think her hand it quite clean and I'm trying to keep her from touching you. Doc: Thank you. An excellent idea. Keep doing that one. I think this exam is done. Doc gets up and does a nice surgical scrub on his hands.

One of my residents came down to the med room so I could flush her G-tube and give her some feeding through it. Me: Ok, time for your tube flush and feeding. Her: You can't do it. Me: Oh? Why not? Her: Tube's not there. At which point I undo her binder to look, and lo and behold, no g-tube. Me: Well, where is it. Her: In the bathroom where it fell out. Me: (not knowing whatelse to say) Well, go get it! She goes down to her room, gets the g-tube and brings it back to me just as nice as can be. I promptly sent her into the ER to have it replaced. At the ER they put a new one in. AND sent the old one back!! LOL

Personally I would have a very hard time doing taking care of a known child molester. Why? At age 8 I was repeatedly molested, and there was a kidnapping attempt. I know what this man did to me. I know how long it has taken me to "get over it". I know just how much his abuse affected me physically and physcologically. Having said that, if it was not possible for me to switch patients or something similar, I would give competent care. I could not guarantee it would be compassionate however.

OP: You did the right thing. You listened to your instincts. Rule #1 of Search and Rescue, Lifegaurding, EMS, or whatever: Never create two victims. A dead or injured rescue person is no use to anybody, especially the original victim. I'm one of those people who will dive in and help (aka: adrenaline junkie), if I'm needed and it is reasonably safe to do so of course. But I will not endanger my life senselessly. Yes, I have put my self in danger for total strangers, but not without extreme thought put into it first. I've perched on a cliff helping to get a trauma victim out of an isolated ravine in the dead of night, but I will NOT stick my hands into the blood of a stranger without protective gear on or do rescue breaths without a barrier. It may not create a 2nd victim right there and then, but it may down the road. (During the whole ravine incident, I was tied off and secured with ropes and other equipment. Some danger to myself, but it was mitigated danger.)

That's what I did after about three weeks of no sleep due to getting up every two hours for breastfeeding. If I had not started co-sleeping, I doubt I would have lasted longer than about four weeks breastfeeding. I breastfed my little girl until she was about 15 months old. When she was 7 mo old she went to her own crib exclusively. When she was about 10 mo old she went to her own room. For my daughter, having her in the same bed/co sleeper actually helped her adjust to our (DH and me) sleep schedule. She never did have the whole nights and days thing mixed up. Right or wrong, I attribute that one to the co-sleeping we did. And she does really well at nights now. It's a highly individual decision. I don't drink, I avoided OTC drugs like the plague when I was breastfeeding, and I followed safe co-sleeping rules. For my family it was right, for someone else's it may not be.

I went into give a resident a depo shot in her room. She was in bed. This particular resident can not move herself in bed due to neuro/muscular condition. I proceed to give her her shot, and I ask her if she needs anything. She needed moved around. So I proceed to move her and arrange all of her pillows for her. Then I tucked her in and said goodnight. The next day, the social services director handed me a card that this resident had painstakenly written out for me (part was written for her) thanking me for my kindness the night before. Made me feel all warm and tingly inside.