august07

Does anyone else call them Rally Packs (not sure why we call them this?)

One reason other women may not be supportive is jealousy. Not so much jealous that you are getting a "break" but jealous because they never had children, or are infertile, or were unable to breastfeed. In other words, don't take it personally, it may have nothing to do with you.

I learned "Roast Beef Sure Gets Lots of Gravy" Red Blue Sst Green Lavender Gray

Depends on the situation. If it's a small mistake that's not a big deal, I wouldn't get the patient all worked up over it. Giving a pt way too much insulin is something I would tell them. I would also tell them if their PICC line was put in the wrong spot, how else would you explain that to the family-"Oh, we always put these in twice!"?? I have been told not to tell a pt. about mistakes made by the doctor. I had a doctor once make a mistake concerning a surgery, but I never told the pt since I felt it was the MD's responsibility to explain it.

Thrown to the dogs. I got about a 10 minute "charge nurse for dummies" pep talk. I've asked for formal training, but they say "just call the nurse supervisor if you have problems." This was after being a nurse for only 5 or 6 months. Basically, they will throw you into it when they're desperate, when all the seasoned nurses are off, especially around the holidays. At night, charge nurses on my floor have 5 pts. No extra pay.

You'd have to work for about 20 years as a nurse to be able to pay for med school. Most people that go to med school cannot afford it, they just get loans and pay if off 10 years later when they're making the big bucks. I think you should decide if you want the nursing route or the med school route and then go for it. During med school, you live,eat,and breathe studying and classes. You barely have time for friends and family, let alone another job. Nursing is not an easy career choice either,by the way. Just try to think about which lifestyle and which sort of career you would prefer.

I work on med-surg and can only push Vasotec. Anything else and the patient has to be on a tele floor.

You always want to draw from 2 different sites because of the risk of contamination. Coag negative staph and diptheroids are common skin contaminents that can sometimes cause false positives. When the lab calls and says there are 1 out of 4 bottles that are positive, that may be an indicator of contamination, whereas 3/4, it's probably a true infection. Also, the sooner you get a call, the more likely it's a true infection. When blood cultures are received in the lab, they are incubated in a machine that flags them as positive when it detects gases that are emitted by the bacteria. Only then is the blood plated out on a dish and worked up. Blood cultures are incubated this way for 5 days, then get thrown out, unless the doctor is looking for some specific bacteria that takes longer to grow. Also, if you ever have only a tiny amount of blood that can be drawn, always put it in the aerobic bottle (the blue one) because that's where most positives come from.

TURP stands for transurethral resection of the prostate. Correct me if I'm wrong but I think they don't remove the entire prostate, just part of it so it's not really a prostatectomy.--------------------------------------------------------------------------------and here's the foreigner asking: What the heck is a "toomey?"Toomey's are those big plastic syringes that hold 70ml of fluid. We use them not only for catheter irrigation, but also PEG tube feedings and NG tube irrigations. You must call them by another name.

We turn all fluids off for 2 minutes before drawing blood from a PICC. Flush with saline, waste 3ml, then collect sample. If you forget to turn off the TPN and draw blood, usually the potassium is the valus that's way off, not the H&H.

How much can a pt.'s hg level rise after two units of PRBC? I had a pt. go from 9 to 13, can that be? Usually it seems to go up only by about 2. Has anyone seen big jumps like this after a transfusion?

Thing I hate about white uniforms is seeing everybody's underwear! I don't need to know if you are a granny-pants, bikini, thong, whatever type of underwearer. And then there are people that wear colored underwear under white scrubs.

What do you do when you get new orders right before you are planning to leave? Do you leave it for the oncoming nurse or stay an extra 15-30 minutes and do them yourself? I feel like I shouldn't have to stay late, but on the other hand, I can see where it would be really annoying to walk into a bunch of new orders.

My old job banned the internet and I thought it was so going to be so terrible, but after about a month, I had totally forgotten about it. You get used to it. I would think if you are complaining about not being able to use the internet, you've probably got a pretty nice job!

Hi I recently had a pt. getting vancomycin through peripheral IV's. She was a very hard stick but someone managed to get one in her hand, and they weren't going to be able get a PICC for her for a few days. So, I hesitantly gave her the vanc through her hand IV and to my horror, it extravasated and her hand was swollen three times it's normal size. I took out the IV and elevated it, but now I'm wondering-what are the chances that this pt. is going to lose her hand or suffer major damage? Does this happen often? I'm so worried.

Yes, C.diff is present in very small amounts in everyone's intestines, the problem is when it overtakes the "good bacteria" like when people are on on abx, especially long term abx and when people are immunocompromised. It's all about keeping a balance. The lactobacillus is the "good bacteria." This same thing happens when people get yeast infections when on abx because the abx kills off the good bacteria and the yeast take over. I don't think C.diff is found in other areas of the body unless for instance, you perforated your intestines. Some people have chronic problems with C.diff because they don't have enough lactobacillus,they are on long term abx, etc. Most people are just treated with Flagyl and/or Vanc.Staph is present on our skin, like Staph aureus and Staph epidermis. The problem is when these bacteria get in places they're not supposed to be, like your blood stream. You have bacteria naturally on your skin, in your throat, intestines, lady parts,etc. It's all about keeping those bacteria where they should be and in the right proportions. When I use gowns,gloves, etc. is it more for the sake of other patients than it is for me. I probably won't get sick from touching an isolation pt. but I sure can pass it to the next 3 patients pretty easily.

Not all antibiotics are compatible with IV fluids containing KCL. I recently had one that wasn't (can't remember, but it may have been Zithromax.) I just call the pharmacy anytime I'm not sure.

You only isolate for bacterial meningitis. Most people with viral meningitis are not even admitted. Why is pt. getting antibiotics? They are only effective against bacterial infections, not viruses.

Thanks for all your answers. Maybe to some of you it is "common sense" and basic skills, but in my first year of nursing school one of my instructors specifically told us that if a pt.vomited, you could take the pills out, rinse them off, and re-administer. That is why I asked, because it didn't sound right to me, I just wanted to hear what others thought. I know it sounds like a pretty dumb question, but I had to ask.

When are you taking boards? I have been studying for about a month now and am taking them in one week. I have felt the same way though, missing alot of questions, not remembering certain things. But there are so many questions that could possibly be on boards that it's impossible to know everything. Try to focus on weak areas and if you can at least narrow it down to two answers, you're in good shape. I have found that the longer I study, the more things have been coming back to me and am actually surprised at how much I do know. Good luck, keep studying and tell yourself that you WILL pass.

So when you give a patient their meds and they throwup right after, do you fish out the meds and give them again or just chart that they vomited after giving the meds? Or get pharmacy to send new ones up? I have heard different things. If they are important meds like BP I would think you would have to give them again. Also, I am fine with stool, blood, urine, etc. but sometimes seeing emesis just makes me feel like I'm about to add to it. Any tips for this?

From reading an earlier post about anxiety from working on a medical floor and people responding by recommending that the person "take care of their anxiety," what ways do you handle it without resorting to taking meds? Or are meds necessary? I have had some anxiety attacks, but I figured every nurse must have them.