mtwife

I have had similar experiences with the power ports. Overall, I like them but we've had several that are quite stingy with blood return, etc. When I spoke to the rep, he stated that most of the problems are related to how the port is placed initially (perhaps they are a bit different than traditional ports on how they are placed-- different technique). Of course, that doesn't help after the fact! I do recall that I had more trouble with a certain surgeon's power port placement than another's. Hopefully the mfr is inservicing those who place the ports!

What a disservice to the patients. I wonder if they are aware of how unsafe the situation is. One nurse can only do so much. . . I sometimes get overwhelmed with 2 RNs plus a tech mixing chemo in our clinic when we have a busy day. So glad you left. I LOVE oncology and the patients are wonderful and complicated and they deserve excellent care-- meaning safe staff ratios and lots of safety measures like double/triple checking orders, use of IV pumps, etc. Reminded I'm blessed at my job (even when it's frustrating or overwhelming!). Hope that clinic get's its act together for the sake of the patients (and nurses!).

Is your surgery center affiliated with a hospital? If so, contact the IV therapy team (if there is one) or the oncology department to see if they can give you an inservice. Or, see if there is a hickman/port sales rep covering your area to see if they can provide education. Ultimately, it's up to your manager/institution to determine competency and draw up policies on using these devices. Best Wishes!!

I have a yellow gold wedding band w/ diamonds and a solitare engagement ring. Wearing them to work has been fine. . they are a snug fit so don't slide off with glove changes. I clean them regularly. The rings are beautiful! I'm proud to be married and would feel strange without my rings on! I have a coworker with a white gold set, and have noticed that the white gold has become yellowed/discolored d/t the alcohol hand sanitizers (foam/gel) that we are required to use. So, keep that in mind. If you like the look of white gold, consider platinum! God Bless and congrats!

I got tired of the scritping and "customer service initiative" in hospital nursing. Some days it felt like it was more important to make sure the kitchen got the meal order right or that the coffee was hot than make sure the antibiotic was on time or the panic labs reported. All the 'behind the scenes" stuff (like calling docs, coordinating tests, consulting pharmacy, calculating dosages) was secondary to patient-percieved "good care" (we were told to prioritize pillow-fluffing for the patients). How can pt satisfaction be monitored properly if they really don't grasp what we do on their behalf?. Nice tirade, I know. But now I'm in outpatient and it's much better. I know some patients were aware of all the work I did for them, but so many complained b/c they didn't get their diet coke on the meal tray (or the family would complain). And I think it's all a result of patients being customers rather than patients and expecting a hotel atmosphere where nurses become the concierge. :)

Hi! I started off as a new grad (9 years ago!) on an oncology/med surg floor. THE best decision I could have made, in my opinion. We also had a great crew, the oncologists were great, and I learned so much. I couldn't take the hospital's chemo certification test for 1 year, so I was able to get the basics down (they did their best to not give me any chemo patients. If I had one, the charge nurse would hang it and then educate me on the drug and we would both monitor). These days, it seems a lot less chemo is given on the unit (unless acute leuks/sarcomas/lymphomas w/ heavy tumor burden). You'll see lots of complications from disease/oncologic emergencies, etc. Adds a new dimension to basic med surg nursing. And the patients are THE BEST! Onc experience can also open doors to other opportunities: I now work in outpatient infusion and give chemo all day, and my inpatient experience is what landed the job! Love it! It can be emotional and you will see a lot of death, but with a good crew (nurses/aides/etc) and a compassionate heart, you will love it. You will learn so much.

I echo the responses of inquiring with your educator. In many instances, this policy could harm the patient more than protect the patient: i.e: pressors, iv antibiotics, even prn meds would be "held" (unless blood is stopped and line if flushed) if said policy is as strict as it appears (it appears the intent is to ensure no solutions "mixing" w/ blood?) I'm sure multiple central lines in patients needing frequent prbc transfusions is not the ideal solution! Let us know!! :)

I always stop IVF/TPN/Heparin for 5 minutes before drawing labs from PICC lines. Our policy is to waste 5cc's of blood, but I usually waste 10cc's. And, if it's a double lumen, make sure that all fluids are turned off. . I forgot to in the past and wondered why the blood glucose was 500 and the K+ was 6.0! If you're drawing coags, definately make sure heparin is OFF for 5 mins, flush with 20cc's of NS and draw a good waste. Some institutions require peripheral draws for coags, but I never had problems if I followed the stop/flush/waste system. PICCs are wonderful if maintained properly!

Ha Ha, Stepford Nurses. We were asked (required/requested) to wear the script on our badges as a reminder. I became so weary and apathetic to the customer-centric hospital stress that I left and am loving outpatient nursing :). Glad for the hospital experience. . .so thankful for other opportunities!!

I was working, in room 6214 taking care of my dying patient. I watched the coverage with my patients wife. . . he died that day and still think of how she dealt with such sadness and tragedy. Later that morning, I walked to the nurses station in tears and encouraged everyone there (doctors, secretaries, therapists) to pray, pray, pray because our nation was attacked!! Was scheduled to fly to visit Grandma the next day, but flights were cancelled, so my precious little brother drove 5 hours to pick me up and take me to our parents so we could all be together.

James Madison University in Virginia-- good school, prepared me well almost 9 years ago. Go Dukes!

We write the times and date on the MAR as well, and it is the responsibility of the MAR checker to transcribe the orders. Sometimes the pharmacy can add a comment to the med order, but usually there are restrictions on what the pharmacist can add. We've had trouble, too, and the main reason is because the MAR check was too hurried and didn't manually transcribe important info that the computer didn't print out. Sometimes, if it is a mtx level or something like that, the charge nurse will have it on her report sheet and make an effort to follow up on it (although we all know how busy it can get so can't rely on charge nurse to follow up on EVERY level). Something like a level should also be on your work order sheet (something like a Kardex or computer generated list) or in the computer as an uncollected lab with the time, so SOMEONE should have seen it, right?