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flygirls2

flygirls2 BSN

ER/Forensics/Disaster
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flygirls2 has 13 years experience as a BSN and specializes in ER/Forensics/Disaster.

SuperNurse

flygirls2's Latest Activity

  1. flygirls2

    DMAT Disaster Teams

    Hi! Hoping someone can help me out. I have invested my career and education into working with disasters. I have been scouring USAJOBS and am on search notification lists --- for more than one year. I have not yet even seen a position posted. I'm not sure if I'm doing something wrong or if NDMS/FEMA really only opens positions this infrequently? Anyone know anything about this? I am so eager to get started in disasters, but can't seem to find a job :(. Thanks all! Laura
  2. Ok-- I hope you all can help me with this! I am a PCU/ED nurse and my hospital very recently built and opened a psych transition/holding unit beside our ED. I was eager for a change and got one of the positions. First of all, I'm loving the job. Psych appeals to me so much more than I realized-- at least at this acute level. I love excitement, and thrive on adrenaline-- yet my stress levels have significantly decreased as I don't have the responsibility of keeping people alive each shift(to as high a degree). I am seriously concerned about our safety on this unit. There is a mix of psych and medical backgrounds among our nurses as we are a sect of the ED and have tele/medical components at times. The nurses who have a background in psych are actually fearful of the layout of this unit as well- which concerns me- as they would know.. I'm dedicated to the success of the unit, and am taking precautions as much as I can. I accept that violence is a part of nursing, regardless of specialty. My hospital has an inpatient psych/detox unit, but they do not accept patients with a high risk of violence. So this 'transition' unit has been built to contain patients either holding for our state mental hospital or patients who are not appropriate for our inpatient unit. We can take anything- from children(no age limit) to psychotic violent ex-cons. I'm hoping some of you can tell me about the layout of your acute psych unit? Particularly if you work at a state institution or accept violent patients? We have two RN's working at all times, and our unit has 5 beds. We are situated in an enclosed hallway with locked doors. No windows- no access. Our nursing station has one door- which 'does' lock, but we're told we are not to lock it except in emergency- as it would be better for us to run into the hallway than to hide in the nursing station. The door and the 'plexiglass(?)' windows around the nursing station could all be broken by a patient who wants access. So here are my concerns-- please tell me if this is standard practice for a psych unit holding potentially violent patients. I hope to make suggestions to the powers that be to improve the safety of this unit for our staff(and patients). 1- Nursing station should have an alternative exit and/or we should be able to close and lock the door. We have one doorway- that must remain open at all times. Patients frequently walk up to our door to speak to us- effectively blocking us into a corner. It's very intimidating to have a large psychotic patient in the doorway- when you have no exit. Nurses know not to allow this to happen in patient rooms-- to always maintain the control and never let yourself get blocked in. On top of that, our med machine is located in the nursing station-- motivation for a patient to want to join us in there. 2- Only two staff.. I know two of us could easily get overtaken. There has to be one of us available to call for help at all times. We have portable walkie talkies as our means to call for help-- which I've learned can be difficult to fumble with when there's a patient behaving violently and you're alone with one other person. If both of us are changing a bed together, we could be overtaken and locked in a room. Obviously- we need to be proactive in thinking about these things. But-- the fact that I have one person to depend on is scary.. In one violent situation- my co-worker froze for a few seconds. I guess we have to all learn to really trust each other. 3- Our unit is one long hallway. Three rooms must be walked by before reaching the nursing station. We've already had a patient jump out of a room and pin a staff member against a wall in that long stretch. 4- According to state law- we are not able to lock anyone in their room. We have temporary lock buttons at the nursing station as well as outside each room. We have successfully been able to use these when patients have become violent inside of their rooms, but when they kick the door- it bows out(different problem altogether). But say strong young man becomes violent in a hallway, schizophrenic granny comes walking out into the hallway and then 8 year old child patient joins us. We have no control. Is it standard practice to not be able to lock someone who is known to be violent and allow them out when they ring a callbell as needed? Also- the potential for a patient to open the room to another patient(possibly a child) and assault them? The other patients really have no safety parameters in place. 5- I'd like to be carrying some kind of panic button? I'm sure I have more concerns.. But I'm just hoping you can enlighten me to what is the standard practice- particularly on a unit that does hold violent patients. This may all be the 'usual', and I'm over-reacting as a new psych nurse. Any safety tips you can give me from your experience? I just really feel like I'm working in a jail with equivalent dangers- but no protection or weapons.
  3. flygirls2

    Good Hours for Single Mom?

    What I meant by pick her up and drop her off---- I was thinking if I did something like the home health where I make my own schedule-- maybe I could intentionally not schedule visits when it is time to pick my daughter up so I could do that and drop her off at either a friends or grandmas(still better than the entire night) and then return to work for the last visit.
  4. flygirls2

    Good Hours for Single Mom?

    That's the problem. Only have one living grandparent in the area, no other family. The grandparent that is here is getting dementia- and was watching her at night, but cannot any longer-- she recently caused my daughter to get a severe burn from scalding liquids, among other things.
  5. flygirls2

    Good Hours for Single Mom?

    Hi! I've been working as charge nurse on a stepdown unit for 3 years on 12 hour nights. I'm suddenly in a very bad position with childcare for my 6 year old child. I have to find a new job, but the problem with days is that my daughter's school does not have an after-school care service. Anyone know of any jobs where I might be able to pick her up and drop her off at grandmas and return to work? Or work from home? Anything flexible for me? I was thinking maybe intermittent type home health jobs where I 'think' I can arrange my own visits? Thank you so much!! I'm in big trouble right now..
  6. flygirls2

    Home Health for Single Moms??

    Hi, I'm in a bad situation currently working 12 hour nights with poor childcare for my 6 year old child. I have to find a solution. The problem with working days is that her school does not have a before or after school program, meaning I have to be there to drop her off at 8 and pick her up at 3. No job offers those kinds of hours. I'm wondering if the 'intermittent' type home health nursing jobs would be a good match for me? Would it be possible to arrange my schedule so that I could always be there to pick her up on time, and then go see another patient after if necessary? Any suggestions? I'm in a really bad spot right now.. Thanks.
  7. flygirls2

    Delayed lung sounds?

    Mets to the lungs. Thank you for the awesome answer! I asked my co-workers, and no one knew.. So I was beginning to think I had imagined it. Very interesting post, thanks.
  8. flygirls2

    Delayed lung sounds?

    Hi all! I work in Oncology and have an 'out of curiousity' question.. I was auscultating a man's lungs the other day, one lung sounded normal... but the other seemed to have a delay between the time that I saw his chest rise and actually heard the lung sound begin. Hope this makes sense? I could see that he'd begun a breath visually, but it took a portion of a second to actually hear it through my stethoscope.. Then I would be able to hear it it last a fraction of a second after the chest had ceased movement. Just trying to figure out what in the world this is for curiousity sake. I looked online, and saw mentions of delayed lung sounds, but couldn't find an answer. Thanks!!
  9. I just graduated nursing school, so bear with me if this is off the wall---but I was just thinking that another consideration might be that it has been misplaced within the body, in which case you wouldn't want to use it.
  10. I was just thinking about this subject today actually.. I am in the ADN program at MGCCC-JD campus. We started the first semester with 52 students. Only 21 passed level 1. We are now coming up on the end of 2nd semester and we'll be lucky if we have 15 start into level 3. This is far higher than a 50% loss! The students in 4th semester(4 semester program) are down to EIGHT!! They also started with 50-52. It seems ridiculous to me!! Is my school really hard or is it normal to have 4/5 of your class fail?
  11. flygirls2

    For Those With Small Kids...

    I have a 15 month old and she will start a in a daycare on the military base I live on in a couple weeks when I start clinicals(whew, long sentence).. My CC doesn't offer childcare, which is fine. The only problem I am having is finding childcare should Elizabeth get sick. I am only allowed to miss one day of clinicals or I get dropped from the program. My daycare is open 6am to 5pm which should cover almost all of my clinicals fine. In the case that I do have a night clinical, there are 'supposedly' two daycares in town that operate 24 hours. My husband is going to be deployed so I have no family here to watch her. Also, I took every class that was available online--online. They cost more, but I saved out big time on daycare. Good luck!
  12. flygirls2

    What do you plan to do once you graduate?

    Oooh, now that's something I really don't think I would like. I love little babies, but NICU would be too hard on me. I can handle loss in L&D, but I couldn't care for a baby for weeks or months only to have them pass. That field would be too hard for me. Sounds really neat! I'm going to keep that in mind, I'd love to do something like that.
  13. flygirls2

    Ob Hesi

    What is HESI? This will be my first semester of clinicals, is it some sort of standardized test?
  14. flygirls2

    What do you plan to do once you graduate?

    locolorenzo22---What is Doctors without Borders? Sounds like it might be fun. I went to Kenya and Costa Rica while in high school on mission trips.
  15. flygirls2

    What do you plan to do once you graduate?

    ^Ahh really?? That's so crazy! I used to be a student pilot as well! I worked at an FBO and ADORE aviation. I hope to get my license eventually too. I ran out of money, LOL--that's expensive school.
  16. I have wanted to work in L&D ever since I had my daughter. But I'm only starting my first semester of clinicals, so only time will tell what I actually enjoy working in.. I have some interest in surgery too.