Elvish BSN, DNP, RN, NP

Community, OB, Nursery

Member

All Content by Elvish

  1. Elvish

    Ebola in the pregnant patient

    Elvish replied to obrn23's topic in Ob/Gyn

    I went back and reread my mgr's email to be sure I'm not lying to you. The way I read the email is that fever + travel = hazmat and isolation. I'm Nursery/NICU and go to all the deliveries, so I'm not...
  2. Elvish

    Ebola in the pregnant patient

    Elvish replied to obrn23's topic in Ob/Gyn

    The plan at my place is to do a similar screen and if they meet the fever + travel criteria, they go to a designated area of the ICU which has negative pressure rooms and the most air exchange of any...
  3. Elvish

    Ebola in Texas

    Elvish replied to SmilingBluEyes's topic in Disaster Preparation

    Dallas Nurses Cite Sloppy Conditions In Ebola Care This sounds like a story I might be able to believe. Prepared my
  4. Elvish

    Ebola in Texas

    Elvish replied to SmilingBluEyes's topic in Disaster Preparation

    Exactly. I'm not so sure I believe anyone who says a splash-resistant gown, shoe covers, gloves, and a face shield are enough. When CDC and USAMRIID play with level 4 biohazards like Ebola, they wear...
  5. Elvish

    Saw an angry clinical instructor...

    Elvish replied to Bortaz's topic in Patient, Colleague Relations

    Bortaz, I would definitely go above her head. If she is acting this unprofessionally, she needs to be reined in by someone who has some authority over her. I'd find out both the clinical site...
  6. Elvish

    Ebola in Texas

    Elvish replied to SmilingBluEyes's topic in Disaster Preparation

    This Illustration Of Ebola Coverage Shows How Problematic Media Reports Can
  7. Elvish

    Miss Manners for Nurses

    Elvish replied to Emergent's topic in Patient, Colleague Relations

    I've gotten compliments from multiple people on both my kids' manners (my boy is 10, my girl is 3). I don't blame disintegrating manners on young people, I blame it on their parents.....most of the...
  8. Elvish

    Waiting for Labor to start on its own strongly recommended (no surprise here):

    Elvish replied to SmilingBluEyes's topic in Ob/Gyn

    We do several inductions a day, 2-3 AM and 3 PMs are our max. Most of them end in vag deliveries, but we have a hard and fast rule about medical reasons. Our c/s rate is under 12%, one of the top 10...
  9. Elvish

    Ebola in Texas

    Elvish replied to SmilingBluEyes's topic in Disaster Preparation

    Sorry, I found it and couldn't resist. :) Ahem. Back to a serious
  10. Elvish

    "She'll put your butt in a nursing home."

    Elvish replied to nurse42long's topic in General Nursing

    I used to work in community health and parents used to use "nurse will give you a shot" ALL THE TIME. Pizzed me off so much. I'd stop what I was doing, get down on the kid's level, and say, "We never...
  11. Elvish

    Patient satisfaction or patient dissatisfaction

    Elvish replied to Brian's topic in Patient, Colleague Relations

    When I had my daughter 3+ years ago (not the hospital where I work) I got a Press-Ganey. When I got to the question about the patient's perception of whether the doctor/nurse knew what s/he was doing,...
  12. Elvish

    Phenylalanine testing...once or twice?

    Elvish replied to SilleLu's topic in Pediatric

    You got me curious, so I looked up my state's requirements. North Carolina State Laboratory Public Health - Newborn Screening Very interesting to see the variation. It's also interesting to note...
  13. Elvish

    Blood sugar guidelines for neonates

    Elvish replied to RNIBCLC's topic in Ob/Gyn

    I can't speak to your specific situation but sometimes if we get a baby that weighs significantly more than expected (in other words, LGA) we suspect GDM that had a later onset and wasn't picked up at...
  14. Elvish

    Phenylalanine testing...once or twice?

    Elvish replied to SilleLu's topic in Pediatric

    The only time I've seen multiple ones be drawn on well babies is a) problem with the initial sample, such as insufficient blood on the paper; or b) Mom has a known case of PKU/galactosemia etc. I've...
  15. Elvish

    Ebola in Texas

    Elvish replied to SmilingBluEyes's topic in Disaster Preparation

    Exactly. Since the symptoms are sudden-onset, what if it happens in the middle of a flight/grocery store/name your enclosed space? I don't carry enough PPE with me everywhere I go to deal with that....
  16. Elvish

    Phenylalanine testing...once or twice?

    Elvish replied to SilleLu's topic in Pediatric

    Most kids in our place get one screen once they're over 24 hours old (assuming well-baby here). If parents refuse it in hospital or there is a need to redraw, the peds office can do it. Reality is...
  17. Elvish

    Ebola in Texas

    Elvish replied to SmilingBluEyes's topic in Disaster Preparation

    Except that people with HIV aren't going to be vomiting or have diarrhea or bleeding out of orifices. That's the whole point. Sitting next to someone in itself is not the issue; it's that sitting next...
  18. Elvish

    Ebola in Texas

    Elvish replied to SmilingBluEyes's topic in Disaster Preparation

    The fact that it's not spread unless there is direct contact with blood/bodily fluids is the reason I haven't been flipping out so far. Viruses are good at mutating, though, and I don't want to be...
  19. Elvish

    Neopuff and pressures. Looking for basic simple instructions.

    Elvish replied to tinkerbell419's topic in NICU, Neonatal

    When we do neopuff during a resus, we do PIP 20, PEEP 5. STABLE class backs this up. I've become a big fan of neopuff since being baby nurse at deliveries. We still keep an ambu bag around, but...
  20. Elvish

    Ebola in Texas

    Elvish replied to SmilingBluEyes's topic in Disaster Preparation

    Thankfully, it didn't just pop up there. It was someone who had recently been to parts of Africa where it is much more widespread (not that I'm glad it's in Africa either). I read 'The Hot Zone'...
  21. Elvish

    Chloraprep for C-sections

    Elvish replied to Mary C's topic in Ob/Gyn

    Sterile gloves and same application area as klone mentioned. We do it
  22. Elvish

    Blood sugar guidelines for neonates

    Elvish replied to RNIBCLC's topic in Ob/Gyn

    Our standing orders are to check glucose for 4000g regardless of gestation, anyone 45. Our neos like sugars to be >60 after 24 hours, but the reality is we don't check too many sugars at that...
  23. Elvish

    Do you always keep emergency meds on hand for deliveries?

    Elvish replied to perfexion's topic in Ob/Gyn

    Cytotec, yes. Methergine and Hemabate, no. I'm baby nurse at deliveries....I have my little system of blanket setup, but will now incorporate a shoulder roll. Thanks,
  24. Elvish

    Waiting for Labor to start on its own strongly recommended (no surprise here):

    Elvish replied to SmilingBluEyes's topic in Ob/Gyn

    People don't appreciate how much brain growth goes on those last few weeks.....and that immature brain can lead to all sorts of other problems, both immediately and later on. There is a reason...
  25. Elvish

    thermoregulation in the neonate

    Elvish replied to cyndbirn's topic in NICU, Neonatal

    I wouldn't have bathed him at 97.2, personally. I'd have kept him skin to skin or under the warmer. We don't bathe anyone under 6 hours old unless there are extenuating circumstances (example, mom is...