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Trauma, Teaching

I prefer dangerous freedom over peaceful slavery.” Thomas Jefferson

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JBudd has 39 years experience as a MSN and specializes in Trauma, Teaching.

Generally all around terrific widowed mom of 3 great kids

"The democracy will cease to exist when you take away from those who are willing to work and give to those who would not."   &&  "I prefer dangerous freedom over peaceful slavery."  Thomas Jefferson

JBudd's Latest Activity

  1. It isn't perfect, but it works. We are told to have our patients out of the ER in 15-30 minutes within receiving a room assignment. There is a place where we can look to see if the floor nurse has checked the EMR review. We are expected to keep charting up to date and ready to go in a few minutes notice. I have had clinical supervisors put in for transport without asking me if the pt is ready! I have had to cancel transport if I am in the middle of something that can't wait. So yes, communication is essential..... but the narrative from the ER chart generally says it all. The floor nurses have called me to clarify stuff, or I have called if there is something acute I think needs to be passed on. Generally if I call, that nurse has reviewed the chart so well that I don't have much to add. And no, I haven't had a lunch break (officially off the clock for 30 minutes) in a long time. Nights are like that. Getting people moving is essential.
  2. Well, for many years my hospital was the only one in town, and is self insured, so there was no anonymity for me or my husband. Many of my nurses were also former students of mine (I taught them health assessment), talk about intimidation, LOL. One time in triage when I went in for CP, the nurse and the tech were arguing (quietly but I still heard them), "no, YOU start her IV", "no, YOU do it". My poor tech's hands were shaking so much, that I started teasing her until she got annoyed and told me to shut up; & whacked it in first stick, LOL. Then a former student got to be my nurse in the back. I don't pay much attention to people trying to impress me, with a badge or with status; they all (well mostly), have to get naked.
  3. JBudd

    Has anyone left nursing job due to COVID19 virus?

    ER here as well. Our masks and face shields are the in clinical supervisors office, but the clin sups will hand them out. We are supposed to keep the face shield and wipe it down, for an indeterminant length of time (not just the shift). I made a bunch of cloth face masks and took them in, ran out in about 10 minutes.... next morning my director said the hospital hadn't come up with a policy about that yet. Didn't stop us wearing them though! One whole section of ER beds has been designated the COVID r/o area; two are negative pressure. It is being well-staffed by inhouse nurses and aides, not the ER (thank God). Anyone coming into the ER with resp complaints is put on droplet precautions automatically, so we gown and glove but have to reuse the gowns and masks (leaving the gown at the door, not room to room). If admitted, the pt goes over to the COVID area. The hospital is doing flex and comp time for the low inhouse census. They are recruiting a "superhero" team to be on call and take the COVID pts; if called in is time and half, plus $10 hour. I'm not signing up as I am high risk; over 60 & post cancer treatment lung damage.
  4. JBudd

    Really America?

    Just got back in the country after a six week hiatus. Went to Wallyworld just to buy some basics to restock the house (my pet/house sitter used most of it, 6 weeks after all 🙂 ). The shelves were totally stripped! no TP, no paper towels, no sanitizer (wasn't looking to buy any but heard complaints). I got a package of paper napkins out of the box the poor guy was trying to stock with. Just then someone was doing returns and put 1 6-pack of PT &1 2-pack on the shelf. I do use cleaning rags but have two pups peeing in the house 😞 The stocker said they had a truck coming that night and if I got there early I might beat the rush. There were about a dozen packs of TP sitting on long lonely shelves, not my usual brand but needs must, LOL, with a couple of cases of towels this morning.
  5. JBudd

    Sign prescription for MD?

    Good Lord! NO! You can take verbal orders, and they are written as verbal or telephone orders with your name and the MD's; but it still has to be cosigned whether electronic or on paper. As said above, signing his name (without yours) is forgery.
  6. JBudd

    Dilute Lasix before giving IV?

    Why bother with the bag? If I'm giving it through a saline lock, I might dilute with a saline flush to make pushing it slowly easier, but only a few mLs. Just don't give faster than 10 mg/minute; risks ototoxicity. You didn't say what dose you are giving? 2 minutes isn't long enough for higher doses. We had a cancer pt who had lost some hearing after getting too much too fast at another hospital.
  7. JBudd

    My Life as a Nurse

    I identify with so much of what you've said, although I was never in NICU itself. 38 years; medsurg, volunteering in Bangladesh and India, more medsurg with an oncology emphasis, the whole AIDs crisis, holding delirious patients' hands and doing imagery to calm them during their night sweats, watching all the new technology coming out ( a resident yelling at me for taking pulse ox readings when they weren't ordered because he didn't want to have to deal with a problem if I found one). Having an AIDs pt cry because I was the first person in weeks to touch him, just a bed bath but it was human contact. Taking ACLS when it was a 2 day, 5 stations to pass, course; and asking why we hadn't been taught any of this when I was in school, only to be told it was a new thing. oops. Moving to ER, learning to pump stomachs and then learning not to. Always new things to learn. Developing really fast reflexes. Getting a masters in education, and finding the wider world of political nursing, research, evidence based everything, nursing theory (not just Watson's caring), and becoming a classroom instructor while still being a trauma nurse. More volunteering, guest lecturing, world traveling. Hospital nursing, camp nursing, first Aid provider for lots of Scout functions, orphanages, classrooms, slums in the third world, CPR on a mountainside, nursing has taken me so many places that I never dreamed of when I got that first letter of acceptance. Thanks for the trip down memory lane!
  8. Follow policy, but if not actually on neutropenics be really careful anyway. During my 2nd bout of chemo (3rd drug), my white count was actually normal so I felt sort of safe going out to a public event. The next day I spiked to 104F, missed my chemo round, and admitted to hospital the next; with massive cellulitis of my affected arm (lymph removal) and Influenza A. My daughter was told I nearly died and came to hospital just in time. We never found out what caused the cellulitis. Chemo patients might look okay, and have good numbers, but are still fragile.
  9. JBudd

    Just graduated from CRNA school

    Just wanted to say congratulations!
  10. The difference between family members giving meds, is they only have one person, one set of medications, to keep track of. Seems like CNAs have much greater potential for error than family, as they have many more than one person to deal with. CNAs are not licensed, they have a certification, but a license requires passing exams (NCLEX), and the state issues a license based on that.
  11. CNAs or MAs? Lots of places use MAs (medication assistants) who have some training in passing meds (not pharmacology), even give vaccinations.
  12. Just turned 60, still doing 12 hour nights in the ER (fortunately, just 2 a week). I briefly tried going back to 8 hour nights when the kids were tweenies, but it didn't work. I had less time with them than with the 12s.
  13. JBudd

    Ridiculous medical mistakes on TV

    NCIS episode with a "bald" cancer pt who had perfect eyebrows & lashes... with mascara no less. Um, I decided to "pretty up" one day with some makeup, and found I had NO eyelashes, not only was I bald but evverry piece of hair everywhere was gone.
  14. JBudd

    Punny nursing names

    So,,,, what did you finally choose? Enquiring minds want to know!
  15. JBudd


    soft enough to use, scratchy enough to scrub it clean!
  16. JBudd

    New Grad

    Yeah, looking back at it, you're right. Don't put it as goals. SMH

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