NurseBean

I can't seem to get a definitive answer on this one but it seems like a pretty easy question... hopefully you all can help me! how long does it take for a peripheral IV stick (a missed one) to heal up so that it can be attempted again? Or what about a site that ran it's 72hr course and was dc'ed, how long before that site can be re-used? Thanks!

We get tons of "Dizziness and Giddiness" It sounds so cute and happy but they are usually demented old guys who are determined to fall out of bed at all costs!

I would be curious too. We have tons of pts (mostly DM, h/o MRSA) coming in all the time with bad veins to begin with.. having a peripheral line started in ER ( with NUMEROUS attempts) then having Vanco ordered q8-12hrs... The floor nurses get so annoyed with the docs- Hmmm, see if you can guess how often we have to poke them for new peripheral lines after each vanco dose..? try every day! it always seems like if we could just get a PICC right off the bat, we'd all be so much better off! plus you spare the poor pt of lab draws every morning too. Do the docs even understand any of this?

I agree with the immersion idea. I also went to Costa Rica for a month and stayed with a family. It was an AMAZING experience and I would highly recommend it. It really is the best way to learn a language. The program I did was called Adventure Education Centers.

What's worse is when doc order pain meds every 30 min or every hr and the pt needs it that often... you have to assess (How would you rate/describe, etc your pain, grrrr) then reassess (with IV meds) in 5-15 mins!! And you are doing this every half hr to hour! how the heck are you supposed to do anything for your other patients!? But I doubt the docs have any clue about what out documentation reqs are so they don't get it. Otherwise if they were decent human beings they would just order a PCA!!

First off, I agree with everything JANFRN said in the first post. I am a BSN and can personally vouch for the notion of being being able to write a perfect ADA research paper but feeling like I had no idea what I was doing when I got my first job... Most of the nurses I work with are ADNs from a local community college and I feel like they have had such a better clinical education that I did. There are so many times when I think back and curse my 4-yr program seeing that these girls got through it in 2 years and seem to be much better prepared for the real world, not just writing papers! And by the way, there is no differential for having a BSN over an ADN. The only reason to get your BSN is if you want to continue on for some other advanced degree.

We were told that prefilled flushes are good for 1hr after opening by our pharm. Do you think that there is something wrong with what I am doing in this instance? Pt has a saline lock in place with no fluids running and needs an IVP med, ie, 1mg morphine... I would open a new prefilled 10ml flush, unlock the slide clamp on the t- connector tubing, flush with a few mls to ensure patency of the site, give the med, then flush with the remaining amt of saline. Of course, wiping the claves with alcohol each time.

I often find myself using the FLACC scale (for infants) when assessing pain in elderly pts with dementia when they are unable to rate/describe their pain or understand the FACES scale of 1-10 we usually use. The problem is that the FLACC scale isn't really appropriate either. Does anyone know of a pain scale similar to the infant scale that is more geared to the elderly? I can't help but think that someone out there must have come up with one since we have to assess pain on pts such as these all the time! Thanks for any input.

Is there a specific age that is recommended before giving children eggs? We had a sick 13month old in that had terrible diarrhea and vomiting. Couldn't keep down a drop. He was still breastfeeding but the mother admitted that she gave him some eggs for the first time at home before he got sick. Could it have been an allergy? Any other thoughts?

I remember being SO scared of this during my first clinicals in school. And patients are always watching closely and freaking out if there is the tiniest of bubbles when giving IVP meds. I think it comes from something out of the movies. Can't you just see the bad guy sneaking in and injecting a sleeping pt with air and then the monitor goes flatline? Anyway, I was told in school that the entire IV tubing would have to be filled with air for you to really worry. So now I am confused though- which is the better position to trap the air in the R atria if something should happen, left lateral with head of bed up or tendelenburg or something else? Anyone know for sure?

I sympathize with you. Floating can really stink. I am also a new grad and I am working as a full-time float right now and I am getting bounced around all over the hospital. Sometimes an hour here and an hour there. It's crazy, sometimes I will leave work having changed depts 4 times in a shift. Shifts like that I feel like I must have messed up somewhere, either done something wrong, forgot to do something, done something and forgot to chart it.. then I get home and can't sleep b/c my mind is racing. The shifts where I show up, get my assignment, figure out my meds, etc and then have 12 whole hours to get everything done are so much better. And b/c I was hired as a float- I don't get any differential for doing it! Other nurses who float get an extra $2/hr to float. And am I the only new grad that is really tired of hearing the sarcastic phrase "welcome to nursing" when you question staffing, the MARS are incorrect, the hospital changes policies and doesn't tell everyone, etc...?? I can't help but think that if these seasoned nurses think nursing is really that bad and that's the way it's always been, then why have they been putting up with it for so long? let's do something about it instead b/c I don't know if I can for another 30 yrs or so...

Caroladybelle- I couldn't agree with you more! We are obligated to say to every pt "is there anythig else I can get you, because I HAVE THE TIME" as we are rushing out the door b/c we are paged, the MD is on the phone, we hear a bed alarm going off, or a call light that no one else is answering, etc. etc. (you get the point!). How sincere does that sound as you are running out the door with your eyes bulging out of your head!? Believe me, I would absolutely LOVE to provide the kind of care where I actually meant that b/c I really do care, (isn't that what we became nurses for?) but when I have to many pts that are not stable, and have too much going on for one RN to deal with, it puts me in a position where I don't have the time to be that kind-hearted, I have all the time in the world nurse that I wish I could be. Then I go home feeling like crap. Is it just me or does every (esp med-surg) nurse feel like this?

Those PG reports are such nonsense. I think that this whole customer service, the customer is always right notion of hospital nursing has gotten out of hand. It's one thing to empower pts to speak up for themselves with regard to their care (which I think is a good thing) but it's gotten ridiculous. Some pts act like we are waiters who are their to cater to their every whim, and then get annoyed when we "bother them" with our assessments or IV medications while they are trying to nap! I've had pts literally complain because the compression booties were unpleasant and uncomfortable. I wonder how comfortable he would have been with a DVT. On another note, We actually got a few good comments on the "yummy snacks" we served in the ER. No joke! That was what the patients remembered about their visit to the ER. One even wrote, "thanks for the pudding!" I had to laugh and think, oh, sure, that's what we are here for- all your snacking needs.

I had issues the other night trying to get blood out of a tiny twin preemies' heels to do q2hr blood sugar checks. I could barely get a drop and I felt terrible squeezing their little legs. I am not an OB nurse, but was floated there so I am not an expert on this and was wondering if you guys had any input. I warmed their heels first and it helped some. I didn't use alcohol because I was told it would alter the result. And I didn't wipe away the first drop because I was afraid I couldn't get another. Any thoughts?