jenac

Perfect! Thanks!!

I know I've seen them-the ones that show comparision sizes? Anyone know a site where I could find it? Google has WAY too many, and none of what I want. Help! Thanks.

Thank you both for your comments- I'm glad to know you face no such problems! As I said- I am ernestly looking into this option. It's nice to know all the effort wont be lost.

I'd like to expand on this alittle...I've heard rumors that EC grads are having a difficult time finding jobs afterwards. Can anyone clarify this? I have been an LPN for two years now- with lots of experience (My nose always seems to be in the right place:-) I have thought tons about EC and have gotten the info-but would like some input into the world beyond. I believe the OP would be interested in this info also. Thanks all!

This has been a long running battle with meds for us. He started with the Ritalin in the 1st grade, tried the Adderal, herbs/ interventions and Concerta, -now the Strattera (8th grade). Of all-I felt the Concerta did the best, but after several years, he was all of 80 lbs. soaking wet, which upset him alot. We've switched to the Strattera manily due to the non-stimulant effect. It is formulated to build to a therapeutic level to supposidly maintain throughtout a 24 hr. period- but I haven't seen that yet. After two months- he has gained atleast 25 lbs, but it definatley doesnt seem to be working so well. He is still VERY impulsive and forgetful. His moods do seem to be happier-but than he has always had extreme emotions- Really happy/ Really mad at the drop of a hat. He's stuggling in school, has gone from B's to failing certain classes. At this point- I'm not overly thrilled with the Strattera. I do realize that the dosing may need adjusted (he's still on a low dose for his weight)-and maybe a higher dose would work. He does complain about not sleeping well at night (we first gave it at night, have since switched to morning) and now the mydriasis. To be honest- I'd rather he have the Concerta, atleast it seemed to help him. I do plan on calling the Dr. on Monday- we need to do something. Thank you for all your replys. I appreciate it.

Anyone with experience with Strattera...my 13 year old is displaying constant dilation of both pupils. Aside from the fact that this drug really seems to have no effect on his impulsitivity and hyperactivity- how concerned should I be with this particular AR? Any long term affects from this? I am planning on calling his Dr today but any input would be appreciated. Thanks!

My whole life- I was taught to stand up for myself. To do my best, always. Did I take criticism to heart? Yep-still do. But I will stand up when I feel others are wrong. In nursing school- I personally had a horrible time with my Med-Surg instructor. She was the first to claim it was a personality comflict, even going so far as refusing to act as a reference for me professionally due to her "personal feelings" about me, yet I passed anyway. Did I rock the boat? Nope-and I'm an LPN today because I kept my mouth shut and took her abuse. Witnessed abuse. Virtually every day- I had one student or another, even staff nurses during clinicals comment on how hard this particular instuctor was on me. I once took care of a former student's husband-to which he told me I was doing great and not to let her chase me away. Would I have ever stood up to her? No way-not if I wanted to make it through. I watched her antagonize and bait so many others. I watched her turn a blind eye on blatant mistakes from her "favorite". This particluar woman had the power to make or break me. I went home almost every day in tears- but I kept my mouth shut. Would I do the same if I met her on the street today? Definately not. Does that mean I will take the same abuse now? Not for a second. But-the experience has taught me how to deal with rude, obnoxious physicians. And it has made me a better nurse for it.

Try this page for more information: http://www.cinetwork.com/otero/vre.html Tons of reults on Google. Hope you find what your looking for.

As for the competency question- this man is obviously depressed. The fact that he is stating he would choice death over care makes that a bit obvious. The question than becomes one of if he was not so depressed-would he make the same decision to refuse care? Follow me here? A severly depressed person may quit eating- but, were they not so depressed, they wouldn't. His refusal to me shows that he is not thinking of his own best interested-let alone that of his mother. APS should most certainly be involved. His decison is posing a very real imminent threat to himself. I had a women once who kept falling at home-repeatedly. Broken hip, broken ankle-etc. The last time-she laid for three days before getting help. APS came in and forced her to stay in the hospital pending legal proceeds. She was court ordered into our facility for a month-to get rehab. before she was deemed apporpiate to be home alone. Even than-APS had the right to go back to court after that 30 days to extend it. She posed a threat to herself by repeatedly making decisons that were not in her best interests. I've also taken care of a gentleman who refused care to the point that the Dr. himself called the local sheriff-who called EMS. APS came in and forced this man's family to pursue guardinship, or they would have. These people-while seemingly competent-were unable to make decisions regarding their own care. They were a threat to themselves. APS is there for cases just like this. Get this man help. He may not be happy about it- but the alternative is to sit by and let him kill himself. Does he have a right to do so? Certainly. But are you sure that is turely his wish- or his depression talking?

As everyone has said- having a supportive partner and family willing to chip in makes all the differnce. As one of the first posters said- some of those horror stories come from people who aren't so lucky in their choices. Some of us saw nursing school as a way to better our lives, in more than one aspect. Is it difficult, yes. But not impossible. You'll do just fine if you work hard enough. Good luck.

I think 1:20/25 with two aides and a float is pretty much the norm around here, on day shift anyway. On midnights it goes up to 1:40/50.

1- Nurses who claim to have done a drsg. change- yet, it's exactely the same one I put one yesterday (or three days ago)and my initials are still on it! 2-The LTC nurse who grips about having her aides hrs. cut due to low census- but whines about doing an admission. (Typically the one who has five/25 open beds and nothing major going on) I will do anything I can to help if you TRUELY don't have the time- write the orders, do the assessment- or even work a 14 hr. day to do the whole darn thing. But, come on. I like to get paid- how about you?

It is horrible (not to mention unproffessional) the way you are being treated. Unfortunitly- I have seen this many times, as a CNA, and as an LPN. Staff complain about lack of help- yet they chase the "newbies" away. You sound like a good person- atleast your trying. There is never a cause for this type of behavior. You don't have to take it. I would resign immediately- and definately let the DON know what's up. Somebody seriously needs to address this issue. Good luck to you.

Ok- my 12 yr. old is having a f/u IVP tommorrow morning following kidney surgery in January. As prep for the IVP- he was suppose to be giving a lax- 10oz. of Mag Citrate, 4 Doucosate tabs (20mg), and a suppository (10mg) . Even on the best of days- wow, that's alot. In his case- he's had frequent loose stools this week- so it's counter-indicated anyway (and therefor held in leu of clear liquids x 24 hrs. pre-test) My question for all you Peds nurses- is this too much for a child?

I have actually dealt with Tapp and Mereck recently for a resident who has no insurence and pays privately for his meds ($500 a MONTH before Pt. assistence programs like the ones you have listed) The only thing I'd like to add is that some of the Companies you have listed (I know Tapp and Mereck) will only send the meds to the Dr., who than has to forward this to the patient. Small thing- but one Dr. had a fit about it. Best to know in advance.

Now Jnette...we know you love to talk! Join us for that, if nothing else!

Zacaries- a Zpak is a Zithromax dose pack. The Prednisone was for the swollen throat, and the pressure due to my ear canals swelling shut. It decreased the inflammation and made it bearable untill the ATB kicked in and did it's thing. Amazing little pills...

Some doors really do hold mysteries. I'm so glad your's turned out so well. Congrads.

Hahaha...exactley! I'm one those nurses that generally tells the DR. what I need. She plays along- but it drives the MA nuts...:) Called her once after a bout with serious sinus/bilat ear infections/swollen throat. "Amoxicillan ineffective- how about a Z-pak and some Prednisone?" No problem. I had horrible right shoulder pain a few years ago. Felt like my shoulder was going to explode every time I took a breathe. No N/V...no GI symptoms. Took me four days and breaking down in tears to finally call the Dr. who gave me a twenty minute lecture on diagnosing myself as she's arranging an ABD Ultrasound to rule out Gallbladder.

Well, if nothing else- we've all found that we're definately not alone. We have our own little support group right here! No matter what each of is is going through or dealing with- I hope all of you who are just getting into dealing with an ADHD dx realize that life can be normal. My son was dx with ADHD in the first grade. He is now in the seventh. He was VERY impulsive-when he got older, he explained it as having an itch and scratching (you never think about that-just do it). Like hitting, running around the house,yelling out for no reason other than to make noise, etc..Without the meds-he can't sit still for two seconds, always moving/fidgiting/wiggling/tapping his fingers or toes. He can't follow two part directions like, "Go upstairs and get a sweater"-he goes upstairs, but forgets what he was suppose to get, or gets distracted and into something else. At school-he would bring home papers for homework-but forget the book he needed. He is quick to get mad-is almost always rude with a reply when you tell him/ask him something. Every emotion is to the extreme-anger, sadness. He would bring home schoolwork and we couldn't read a single word he wrote because his handwritting was so bad. When we first started the meds- it was an AM thing only. You could literally take papers he had done in the morning and compare them to ones he had done in the PM-and it literally looked like two different kids had done them- the handwritting was different (legible/illegiable, the answers were more thought out/ short and off topic). Back when this all first came up, I was very lucky to have great resources. I worked with a Specail ED Speech therapist who was a wealth of knowledge. She told me exactly what to say to the school to get them do intervine. The evaluation is called a Multifactored evaulation. The school Pshycologist looks at all aspects of the childs day-talks with each teacher and observes every aspect of how well they interact with others, how well are they processing the information they are given, etc... It showed if his problems were actually causing a learning disability (multiple tests including IQ and several that showed how he learned such as if he was a visual learning, his reasoning skills, his processing ability, etc.) From that, we (the School and I) sat down and made an 504 plan (IEP plan if a learning disability is found) to address ways that we could help manage his problem areas. In my son's case- he scored very highly on everything- but showed a very high distraction level (no shock to me). So we sit him close to the teacher, near the front of the class away from doors or windows. That way he has less of a chance of distraction between what the teacher is saying and when he is hearing it. He had a "homework" buddy- that was actually just the kid sitting next to him in any particular class that would make sure he wrote down the homework assignments. He will never be graded on his handwritting (had one teacher that refused to grade his work because she couldn't read it easily- it was a LONG year) Little accomidations that we can do to help make it easier for him to learn. It has made quite a difference. He has alot more confidence now. The 504 plan is modified each year- and I am VERY involved in his schooling. I am his advocate, as the school will only do as much as they are forced to do. As for the meds- they helped to bring out the real child that we all knew was in there. He says that they help him to slow down and do things right. He once told me that it's the world that moves to slow- he's just fine. Everything to him was too slow- and he couldn't force himself to slow down enough to keep up. Like a train of thoughts in his head that he just couldn't grab onto. The meds help him to be able to focus on one thing-verses twelve. He can sit still, fight his impuses and accomplish each task completely now. He is happier-as he's not getting yelled at all the time, and he's less likely to blow up at you when he gets mad. He can control himself physically, mentally and emotionally. Dealing with him off his meds is exhausting-no matter what type of discipline you favor. He's a normal kid now-in his own mind-and from all outward appearences. He is so much happier. He has lots of friends-and goes to thier houses now without fear of how their parents will react to him if he does something wrong. As this has been something we've dealt with for years now-his friends all know about it, see the difference in him-and accept it. To them- it's just how he is. But he HAS friends-which is the point I want to make. He can go to their houses and spend the night (I always talk to the parents and have them give his meds in the AM) As he's gotten older- he has adjusted. We all have. The only bad thing is that I am constantly struggling with the crutch of his meds. If he, for whatever reason, doesn't get it that morning- he will undoubtably at some point in the day say, "It's because I didn't get my pill today.", usually as he's getting introuble for something. I would love to think that one day he won't need it anymore-but I find it very hard to see that ever happening. He just can't seem to control himself, by himself. It just doesn't seem to be possible. Even now- after all these years- he reverts right back to same type of things any time he doesn't get his meds. But- I'm hopeful. Well worry about that down the road. I'm just so glad to have my son standing in the sunshine verses the darkness all the time. Good luck to all of you who are going through this. Have faith.

Wow- what a situation to witness! Were this pt. my sister/mother/friend- I would have a fit!!! I definately think you did the right thing here. Any bystander would find this situation abusive- including the pt. herself. What about someone who just "happens" to walk by and witness something? Or someone who overhears the situation or the staff talking about it? Forget the rest of the ER staff. It takes only one person to report suspected abuse for the sh** to hit the fan for everyone present that day. Here's the thing- if YOU felt uncomfortable with it- it was probably wrong. Period. Good for you for doing the right thing.

Thank you for the clarification.

I choose LTC because you really get to know each one of your residents. You get to make the difference in their day-get to become almost family, sometimes all they have. Some of the people you meet are just amazing-all kinds who have lived amazing lives and can share so many things.They truely appreciate every second you can give to them-every little thing you can do for them. As the last poster stated- We get to hold their hands, laugh with them, cry with them-and be with them when they leave this world. Hopefully we also get to make a difference for the time in between.

Per the OBN- CEUs are required except on the first renewal after inital licensure by exam. So..this being my first renewal (Licensed initally in 9/02) I don't need any?! Really? Shucks...and here I've been hitting every free site I could come up with. Can anyone clarify?

For some of us- this bill seriousily screws us! I am the Admissions Director of an LTC. That means plenty of late nights and weekends.Let's see how willing I am to work 10-12 hrs a day plus weekends now..... The only part of this position that makes it worth it is the money- including the overtime. Take that away and it's just a REALLY fast-paced, stressful job that's not worth it! Thanks alot Mr. Bush......