TeresaB930

I am 45 years old, and just finished an ADN program in March of this year. I have been working in a Skilled nursing facility for nearly 3 years. (I started as a nurse tech right out of first quarter) It's no med-surge, but every day I work, I learn something new, and my confidence builds. They've also been awesome working with my school schedule, which is why I've stuck around. I'm in the BSN program now, full time credits and continuing to work full time.....the point being, every day I'm putting my hands on patients, and get to continue my education. So what if you spend 2 years on a foundation. I've done well in school as well, but NOTHING replaces hands on experience. ICU will be there in 2 years. My two cents work....good luck! Teresa

Always.

I'm a "newer nurse" too. I was taught to put it back in as well. When you pull the residuals out, you're pulling digestive enzymes and flora out too, and that should go back into the patient. My med surge book (Smeltzer, 2008) also states "aspirated fluid should be readministered." Teresa

I've never heard of Jevity causing sediment in the R/C. If she has had an R/C for more than 10 years, I'm sure she is chronic UTI's. Try flushing the cath daily or BID with 60 cc normal salline. A flush kit is cheaper than a weekly cath if you take into account the increase risk of infection every time it's changed. Teresa

Check with an audiologists office. I had an ear infection 1st quarter of the nursing program, couldn't get signed off on BP's. I was finally referred to an ENT, he scooped wax out and prescribed Anti-biotics. I stopped at the audiologist desk in the same building as the ENT. I was so frustrated of unable to hear the beats, I inquired, and they told me they could order amplifiers for stethescopes. Good luck! Teresa

Baking soda is inexpensive and odorless too.

Really, I think if you are going into nursing for the right reasons......namely a passion....a passion that will drive you, all else will fall into place. Sciences were my worst subjects behind math, but I made it through. And trust me, Nursing is heavy in sciences and math! I think they were my worst subjects pre nursing due to lack of understanding. Now, I get it and it all fits together. Best of luck

P-Population I-Intervention C-Comparison O-Outcome LOL! I just walked this walk! I just finished my evidence based paper review! WHEW!! Like nothing I've ever done before! Anyway, I had the same frustration that you're feeling. I know that the teacher don't want you to look at studies and develop a PICO, but that's what I ended up doing. My area of interest is wound care. I went to the CINHAL database and entered wound care in, and chiseled away at what came back. I ended up with something like "In patients requiring wound care, does tap water as compared to normal saline reduce the incidence of infection and decrease the cost of dressing changes?" I have a great professor, and was able to throw the PICO's at her and get her feedback. I would suggest that. Best of luck! This was one of the toughest papers I've ever written, because it's a whole new language! Teresa

Benner's Caring Theory. Teresa

Remember A & P? I'm considering going on for my Masters, and my adviser this week said she has critcal care nurse fail an advanced A & P class that's required. She says 20 hours a week minimum of studying just for that class. That's not to scare you, I just happened to speak to my adviser this week, and that was what she told me. Have you thought about talking to an adviser? Good luck! Teresa

Wow, not where I work! In our SNF. If our residents choose to go out to smoke, they sign an informed consent, and no way do our employees take them out.

I'm not going along with the flow of responses here. If your administrator saw you giving her a cigarette, what do you think the response would be? It isn't your responsibility to provide cigarettes to her....period. So lose the guilt. If she wants to smoke bad enough, she will ask family or friends to bring them in for her. Once you've set your foot down firmly, she will stop asking you.....and hopefully she doesn't take the O2 tank out with her!!

I wanted to get input from nurses in Washington state on the Death with dignity initiative on the ballot next month. How do you Washington nurses feel about this? Teresa

My daughter receives botox for dystonia. She has only received it from neurologist and physical medicine doctor. Frankly, I'm not sure I would trust her in the hands of anyone with less credentials. To hit the exact muscle, and inject the right amount of botox, I'm certain requires tons of training. My two cents worth.

I agree with you hottiemom......I'm the wound care nurse at our facility. Wash the wound and peri wound, then dry it well. Apply a barrier like No Sting. It provides a barrier peri the wound, providing better adhesion for the Tegasorb or whatever you're putting on, but it sounds like there is some increased moisture in this area. The No Sting, by providing a barrier of adhesion, also provides a barrier to the skin so moisture doesn't sit on the skin. No Sting comes in little packets like a 1"x1" sponge. Good luck!

RN2B....You are certainly entitled to your opinion. I have 3 children and all have been immunized with the MMR vaccine. Guess what? My children don't have autism. The evidence is not clear that this vaccine causes autism. This mom would rather keep them from having any one of these three horrible diseases, then speculate if the vaccine will cause more harm than good......IMHO. Teresa

I have a scrub top with several permanent marker "dots" from when the top came off my marker! AND......it has a hole in one of the pockets from my bandage scissors! I'm thinking starting price......$250.00 Buy it now.......$1500.00 Free Shipping!

Let me see.....this patient is on hospice, then not expected to live more than 6 months. I anticipate she will pass before the meds will expire. Teresa

Congratulations on your accomplishments so far! I found that the 5th and 6th quarters of the Nursing program were the most challenging. I think you need to ask yourself these questions. How have you done in the classes you've taken so far? Do you have sufficient time to study? What kind of support do you have? Do you have children and a husband who are going to compete for your time? Certainly I won't recommend you work or not. You have to make that decision for your financial well being. However, I will say that working in LTC while I was in the program provided priceless experience that I was able to take to clinicals with me. Best of luck to you! Teresa

I was taught if you don't listen to lungs posteriorly, you haven't listened to the lungs. I was fortunate enough to spend 2 weeks with an awesome respiratory therapist. She taught me this.....when a patient is laying supine, ask them to take their right arm and cross it over across their chest. This gains you access to the right lung and visa versa for the left.

An LPN friend of mine works for a physiatrist.

Congrats! The time you spend in class is minimal, especially in your pre-reqs....The time you need to dedicate to studying may be your challenge. For me, a single mom with 3 children, studying away from the house with study groups was most effective for me. The further I got into pre-reqs, then into the program, the longer the study sessions away from my children. But....it's all temporary! And its all worth it! I just graduated in March took the NCLEX in April and just got back from taking my children on a long overdue, well deserved vacation to Disneyland and Las Vegas! I am so happy you have a supportive husband. Best of luck to you!

The link didn't work for me, so here's my input. BP meds-Lisinopril Metoprolol Vasotec Hydrochlorathiazide Diuretics-Lasix Bumex Spironalactalone Pain Meds-Vicodin Morphine Oxycontin Methadone Lots of Sinemet, Neurontin, Potassium, Mag Ox, Anti-depressants and Insulins. These are many of the most common meds I give just off the top of my head. I'm sure I'll think of many more after I post this! Congrats on your new position! Teresa

Can somebody please help me to understand why RNs are paid so poorly in LTC? I love my job in a LTC/SNF. I started 2 1/2 years ago as a Nurse Tech, worked through school to LPN, and finished school in March, passed my boards and received a whopping $1.25/ hr raise from LPN2 to RN. What gives? I finally have developed confidence and defined myself as a very good nurse (I feel) but I'm frustrated that pay is so poor, at least compared to the hospitals. There is very little incentive to stay. Please understand, it's not all about the money, but it's a little about the money! I haven't left to the hospital that will pay me $5.00 more an hour because I love my job and I love this population. Any feedback would be appreciated! Thanks! Teresa

I would highly suggest you buy the newer versions. It will save you the frustration of trying to find a table, grid etc the teacher references in class. Also, I kept all my nursing books. I have referenced them on numerous occasions. You may want to purchase your own to build that library. Good luck and congratulations!