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Content by ShandyLynnRN

  1. ShandyLynnRN

    throw in the towel with MDS

    I received training through the AANAC (American Association of Nurse Assessment Coordinators), where you can actually become certified. I've been doing MDS's now for 8 months, and am still learning, finding things I did wrong, and have those days where I feel overwhelmed. But I still like it. Try going to http://www.aanac.org. The class they offer, as well as classes offered by CMS are great resources. You can try this link, but I'm not sure if you have to be a member to access it. I'd highly recommend becoming a member though. It has great resources. http://www.aanac.org/education/default.asp
  2. ShandyLynnRN

    Nurses who smoke

    i'm a nurse who smokes. is it healthy for me? nope. i'm also overweight. is it healthy for me? nope. however, i'm not perfect, and i don't expect anyone to think i am. if i need to do smoking cessation education for a patient, i do it. i wish them luck, and believe it or not, they are usually more receptive to me than to my nonsmoking collegues because i can empathize with them. like has already been said, it's not positive for anyone to smoke. too bad we're not all as great as those nurses who are smokers who can refrain from smoking at work. more power to them if they can, but if i could do that then i'd quit completely. but just because some nurses smoke doesn't mean they are less competent or compassionate. i'm not even going to go into the argument that smokers get more breaks.
  3. ShandyLynnRN

    8 year old on psych meds???

    Well, I just got through talking with a very good friend of mine. Her eight year old daughter, with no previous psych history at all, was just put on klonopin and prozac after a TWO DAY hospital stay. Here is a little background: She has always had allergies and asthma, and frequent ear infections, etc..... Other than that, healthy, happy, go with the flow kid. She was with her grandparents in the car after a visit with her dad and step mom (whom she sees maybe 4-5 times a year at most), and had taken some tylenol for a headache. While riding in the car, her grandparents said she started having some type of seizure like activity. Said she was awake but unresponsive.... lasted almost and hour, and then she didn't remember anything about it. They took her to an emergency room, and the doc said she had a severe sinus infection/impaction, and bilateral ear infections. The doc said she was probably having a panic attack related to the pain. As they were leaving, I guess she collapsed into one of the seizure type things again, so she was admitted. CT of the head, EEG, bloodwork, etc.... showed nothing, except the infections previously mentioned. No fevers. After 2 days in the hospital, and several more "episodes" they deduced that first, she was allergic to tylenol and codeine since the " episodes" were worse and lasted longer if she had taken those, and that she was having panic attacks brought on by pain and stress. I guess she has been having some trouble at school with kids teasing her for being "brown". She is biracial, and lives in a mostly white town. (although there are many other races, just not as prevalent). She has gotten this teasing all her life, but is taking it more personally now. She really doesn't talk to her mom much about it either. They put her on bactrim, a decongestant, klonopin, and prozac!!! I just don't see how they could do that without a further psych eval, when she was WELL. Her mom said she didn't think a psych doc even saw her daughter.... just a ped. Since I dont "do" kids much, I really had no idea what to tell her, except that it didn't sound right to me, and that I thought she needed to get a second opinion from not only a local pediatrician, but also a psych doc, ASAP! My friend, the girls mother, was just recently diagnosed as bipolar, so I guess it could very well be that her daughter is having some psych issues, but it just seems that it would be hard to dx a child from a 2 day hospital stay, no psych doc, and when she is so ill! Today she was in so much pain from the sinus thing that she didn't want to be touched. My friend said that she was "spazzing out" telling everyone not to touch her or her dolly, and being combative, etc. Anyone have any thoughts???
  4. ShandyLynnRN

    Meconium deliveries

    We have about 10-20 deliveries a month. On the rare occasion that we have mec, if it's thin and no fetal stress indicated on the strip, then we just call RT to come down "just in case" but the doc delee's on the perineum. If it's thick, or fetal stress is indicated, then we usually try to get the ped to come in, in addition to RT. We don't have a nicu.
  5. ShandyLynnRN

    Overcoming for Mario

    yet ANOTHER quote from you Mario--------It seems there are many water walkers who assume never having made a mistake.------------------- *I* have made mistakes. I have been written up for those mistakes. The difference between you and me is that I OWNED UP TO THEM! I have made med errors. And then I filled out an incident report about them. Yes, nurses are people, and we are human. I don't believe that anyone here has said that we are "walking on water" or capable of that. BECAUSE we are human, we also are able to realize our failures and mistakes and take the blame for them. This is where you are still "NOT GETTING IT". It's great that you still pursuing your dreams. If that's what you want then by all means go for it. Noone here is trying to stop you from that. What we are trying to do is to show you where you are still wrong. It's not your instructors fault, OR anyone else's fault. I'm glad that you were failed in school for your mistakes. I know that if *I* had made those mistakes in school, I would have failed as well. I would have deserved to be failed. Those are the rules. Even if no harm came from your mistakes, it could have. One of the things, atleast in my program, and it sounds like it was in your program as well, that were taught to me from the beginning was rules and accountability. That is one if the biggest parts of being a nurse. Nurses are given quite a bit of autonomy, in the presumption by our employers that we learned how to be accountable for our actions in our training.
  6. ShandyLynnRN

    Overcoming for Mario

    ---I ain't denying that I did make errors, but it was harsh to extend punishment.--- See, Mario, that is what I am talking about. You admit that you made a mistake, yet still cannot admit that it was YOUR fault that you failed. I believe that THAT is what everyone here is trying to get you to see. Try repeating after me: I screwed up. *I* failed. It was MY fault. *I* am the only one to blame. My instructors were only doing their jobs in failing me for something that was MY FAULT.
  7. ShandyLynnRN

    Overcoming for Mario

    Mario, you AGAIN, have been given good advice. Work hard, don't give up, but MOST importantly, LEARN FROM YOUR MISTAKES! In order to do that, you HAVE to own up to them. Stop blaming the instructors! Stop saying that you didn't deserve this! Stop saying it wasn't your fault! If you continue to think in this way, then you WILL continue to fail, and continue to blame others instead of looking in the mirror for the cause of that failure. I am in NO way meaning to flame you. I just don't understand how you can start threads like this over and over again and hear people telling you the same things, and still not get it. For the love of my sanity, PLEASE start taking responsibility where it is due.
  8. ShandyLynnRN

    Is a pacifier a chargeable item in your facility?

    They are charged at our facility. Well, atleast we have to take the little charge sticker off the package before we open them. I believe though, that in all reality, it is just a means of tracking supplies in most cases, as most patients are just charged a flat rate. I know that in my state anyway, that medicaid patients (which most of ours are) get charged that way. We don't even get paid for the mom's unless they stay for more than 24 hours.
  9. ShandyLynnRN

    Any recommendation regarding post c-section pain relief

    Toradol, Toradol, Toradol!!! Usually 30 mg IVSP X 1, 6 hours after delivery, then 15 mg IVSP q 4 or 6 hours routinely for 4-5 doses, then q 6 hours prn. I have seen c/s patients that didn't require ANYTHING else post-op for pain. If you do have the duramorph, be sure to ask for narcan to be added to your IV fluids post op for atleast 2 bags. Although I have used narcan and benadryl and other things for the itching in my patients, with very little relief.
  10. ShandyLynnRN

    Difference in Needles

    I wasn't taught to use a filter needle (graduated nursing school in 98) and have never seen a filter needle in the three hospitals that I have worked at. What do filter needles look like? Are they packaged different? Maybe I have been using them all along and just not know it?
  11. ShandyLynnRN

    The Circumcision Discussion

    I have had numerous patients ask me the same questions. I tell them this: It is more common for boys in *my* area to be circ'd. Certain cultures around here do it less often, mostly hispanic. It is purely a personal choice. There are pro's and con's to both. I don't care what anyone says, I have seen little (or big) old men with foreskin infected, or a caregiver forget to pull it back down after cleaning and it became swollen, or (I think this is the term, cant remember) phimosis, where the opening becomes too small to retract it properly thus increasing the risk for infection, etc... There is also the body image thing to be addressed. I always tell them to consider whether dad or brothers are circ'd. Not that it is a BIG deal, but there would be questions like "why does mine look different than daddy's", or "the boys in the locker room were teasing me" (my ex-husband told me that that was never an issue when he or his friends, circ'd, were in there with someone un-circ'd. Then there is the fact that IF there is a mistake, the boy will be scarred for life. I have also seen many circ's, and although I had my son circ'd, as a nurse now I'm not sure that I would have another boy of mine circ'd if I had to make that decision. Also, about the medication. The doc's I work with use lidocaine for all circ's. The last hospital I worked at, there were two that didn't use anesthetic. They said their reasoning was that the procedure takes 5 minutes or less, and the only time there is pain is the small cut, which is usually only about 30 seconds or so. The lidocaine burns, and hurts the baby anyway, and the burning lasts for 30 seconds to a minute.
  12. ShandyLynnRN

    Has anyone noticed the # of guests we have on the bb?

    mmm hmmm. THat about sums it up. Thanks Jenny
  13. ShandyLynnRN

    VBAC question...PLEASE HELP!!

    If she does decide on VBAC, she needs to check with the hospital she will be delivering at to see if they have an OR crew round the clock, or if one will have to be called in if there is an emergency.
  14. ShandyLynnRN

    poor spelling -- it matters

    You've gotta be kidding me.
  15. ShandyLynnRN

    Everyone Please Read

    um, I think many of the people that participated in "that thread" have since apologized and said that they were wrong. So why does it still seem to come up, as if we are NOT "getting it?"
  16. ShandyLynnRN

    Girl gives birth in chatroom,talking to me!

    That is indeed an interesting story! It makes me wonder though, if they were just pulling your leg???
  17. ShandyLynnRN

    Nursing is pathetic...

    My thoughts are that this thread needs to be closed/deleted. There are entirely too many posts here for anyone to read through.
  18. ShandyLynnRN

    Strange things that you saw when you were a student

    When I had my son, I had a male LPN student examine me, from epis to peri care, to breast exam... The next semester I started nursing school and guess who was there in my RN class??? Talk about embarrassing!!!
  19. ShandyLynnRN

    What is Caring to You?

  20. ShandyLynnRN

    ..and now for something completely different

  21. ShandyLynnRN

    Darn stupid doctors!!!! geeesh!

    Pulling on the cord can actually cause the cord to separate from the placenta, causing hemorrhage, OR cause the placenta to come out NOT intact, with retained placenta products left in the uterus leading to hemorrhage and possible need for D&C. One weird thing I have seen, actually happened TWICE in one week. The doc was not pulling on the cord at all, but as the baby delivered, the cord was SO short that it literally broke!! The doc had to hurry and clamp the cord! the second was a cord that was so small and friable that it TORE as the doc was trying to put the hemostats on... he had to tie the thing because every time he tried to clamp it it tore more.
  22. ShandyLynnRN

    Seeking OB/GYN opinion...

    Good luck! I'd like to hear what you find out
  23. ShandyLynnRN

    Hypothetical Question re: prn meds

    Oh yeah, I was gonna add that too. Then you wouldn't have to worry about the whole timing thing.
  24. ShandyLynnRN

    Hypothetical Question re: prn meds

    That's what I do. Then, if I find that the second dose helps, I will give the full 2 mg when it is due again. If the patient is hurting before the four hours is up, then I might give the next dose 30 min early since we have 30 min before and after meds before it is an error. ---OR----I might give 1 mg, and then TWO hours later give the other 1 mg, and get them on a 2 hour schedule if that works better for them, and they are still only getting 2 mg every four hours.
  25. ShandyLynnRN

    What is Caring to You?

    Caring is everything mentioned above. The first thing that I thought of when I saw the question, was that caring is to not judge patients by their seemingly non-existent pain, when they say they hurt. Caring is not judging patients by their family members. Caring is giving EVERY patient the SAME treatment, even if they aggravate us from time to time.