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pawashrn's Latest Activity

  1. pawashrn

    LVADS in the community

    ghilbert. point well taken. But a renal nurse and a CV nurse are two different skills and knowledge. As, in the comment before yours. If the Dialysis Nurse makes the pt. intravasculary dry then their actions are directly responsible for the pt's. pre-arrest condition. I am just saying that, once you have an LVAD and need dialysis a hospital setting with readily available knowledgeable support is the best setting for this pt. Not in a dialysis unit where the only support is another Dialysis RN and the local EMS. Taking roadtrips and traveling is the responsibility of the patient and is not involving another person's livelyhood in this decision. The dialysis RN is doing a job, period. Their life is going home and taking care of their families. It is not a calling, nursing is job, that only a few people can do and do well. It is no different than the master carpenter. Just because we may save a life or partake in the healing of another person. We should not place our egos on such a pedestal that we feel that we are better than the average person. A garbage man's job decreases mass infection among the populace by removing waste from our immediate enviroment, therefore, allowing all of us live a healthier life. Enjoy and nice hearing from you.
  2. pawashrn

    can ICU nurse handle 2 pts on the levophed same time

    2 pts. and each of them is on Levo, is a great assignment for me. H--- I have had 2(vented pts. on levo.dopa, epi, blood sugar checks every hour. Alot to do about nothing, some people will always create a nightmare out of any assignment. You give them 2 pt.s on NS and they're screaming
  3. pawashrn

    Nurse to Nurse Communication

    personally. am I being cold. I treat any pt. I receive as if they just came thorough the ER and no knows anything about them. Does it really change your nursing care to know they had dialysis 20 days ago. no, you are assisting in the care at this present time. It is up to the physician to know the previous care given in order to plan the future care.
  4. pawashrn

    LVADS in the community

    you do what you accept to do. My opinion only. They belong in a dialysis center within a hospital setting. An arrest is an arrest and the poor Renal RN taking care of the pt. is accepting the responsibility. Family member/caregiver or not the RN is ultimately going to be accountable. We all know that some family members are ready to sue in a heart beat. Even if that heart beat is only 10% EF and is knocking on gates.
  5. pawashrn

    Dobutamine Advice

    dobutamine is great for unloading a pt. with CHF. pts. do come to the hospital for Dobutamine therapy every couple days or so to help increase the contractility of the heart and therefore improve systemic functioning of the circular system and thereby decreasing or preventing CHF emergencies
  6. pawashrn

    Open Heart Recovery Training

    I have been doing open heart surgery recovery nursing for 14 of my 16 years of nursing and have never read a book on how to care for them. Truly, just get in there. Use your basic knowledge, because every pt. responds differently. I have had pts. that don't do anything the text book says. Best advice is really know your drugs they are your best friends and adding, weaning, titrating of drugs what makes for a nice night for you and the pt.
  7. pawashrn

    why be nice?

    smile,explain the care, fluff the pillow, massage the toes and when you get in your car scream like we all do. Hospitals are not focusing on the nurse who gives excellent care. They want the nurse that doesn't know a thing about medicine, but leaves the family smiling. Remember perception
  8. pawashrn

    Working in a weight-loss clinic?

    I agree with your first responder
  9. pawashrn

    Old RN in a new country!

    People are people in every country. When we're are sick we're miserable. Be yourself. You have been Nursing for 25 years. I am sure you have seen it all. Relax enjoy Tacoma.
  10. pawashrn

    Unsafe Nurse - what can be done?

    Just because she is working, don't assume nothing is being done. document your findings and release them to your manager. Example if you find lopressor in the sharps and it was to be given at 9pm. go back and retrieve the vital signs and see if there was a change. If it was lasix look at the output. You must be a diligent sleuth if you plan on taking this on. This is an administrative problem, not a personal agenda. Proving that she didn't give the pills is hard. She can say I dropped them and had to throw them away. Pick your situations carefully. Accusations can come back and place you in jeopardy.
  11. pawashrn

    New to nursing

    Promote your skills. As an automotive person, your skill should be talking with people and helping them see complicated problems in a simple understandable way. The body is much like a car. engine(heart), exhaust(lungs) driver(brains) electrical system(nerves) fluids (circulatory). You know more than you are giving yourself credit for. You'll do fine. You already know what triggers what and yes. Fuel(Nutrtion) Good luck
  12. pawashrn

    Best Stethoscope for Nursing Students

    Use your eyes and your senses to assess your pt. then grab a stethoscope. As a student you should hone your skills in observation. Such as, a person with no lung disease requiring high O2 and sat's are low 90's, problem. A person with lung disease requiring high O2 and sat's are low 90's, probably were they are naturally. Know your pt. history: retainer/smoker/ARDS. A stethoscope cheap or expensive is not going to help if you don't first know what you are looking for. I have been nursing for 15 years and the stethoscope I use is a cheap Littman I won at a the hospital fair during Nurses Week. I change the ear plugs once a year.
  13. pawashrn

    colostomy with rectal tube.

    What I am thinking is that the colostomy may be high in the colon and the physician is going to re-anastomos later and is letting the excrement be released and is relaxing the lower portion of the colon. Does this pt. have c-diff or colitis?
  14. pawashrn

    Should CVVHD be 1:1

    1:1 ratio for vents. There must be a line forming to the left to work in that unit. If you email me, I'll be honored to send you my resume. Show me where the Moca is kept.
  15. pawashrn

    Dealing w/ difficult/drug seeking pts...

    Most drug addicts and alcoholics are base line manipulators. Kindly and firmly, let them know the schedule of medications and treatments and if they buck you. Notify the physician and let them get so pestered by this patient that they discharge them from the hospital and usually won't re-admit. remember manipulators are only children who have never been told "no" and we are starting to see alot of these people in our society as a whole.
  16. pawashrn

    Graduate Nurse, can't find a job

    You didn't say what state you are in. If you can apply at a University medical center. They take on alot of people with little to no experience. State where you would like to work, but accept anything down the pike. But stay close to you dream. If you like surgicals, try to get a job where surgeons frequently send there patients and get to know them. They have alot of influence, behind the scenes when it comes to hiring RN's in a more critical setting.This first promotion I received was from a surgeon that walked the V.P. up to me and said here is our new manager. That was my interview. Good luck