NurseRotten

Lately two new songs have been reminding me of nursing: Jordan Sparks' No Air - Tell me how I'm supposed to breathe with no air, no air, no air.... and Leona Lewis' Keep Bleeding You cut me open and I Keep bleeding Keep, keep bleeding love I keep bleeding I keep, keep bleeding love Keep bleeding Keep, keep bleeding love You cut me open For the patient with the highest INR I have ever seen personally, it was 38. No surprise her hemoglobin was 4.2

Van Morrison - How Long Has This Been Going On

If you are seeking a Nurse Internship consider some of the hospitals in the Texas Medical Center in Houston. A number of the hospitals have magnet designation, so you can trust that they are dedicated to nursing. I would also try to interview with Methodist, St. Luke's, and Memorial Hermann before making a final decision. Each of the mentioned hospitals have fantastic internship programs. Don't be so quick to look down on Ben Taub either. The Harris County Hospital District offers excellent learning opportunities for new nurses and have excellent benefits packages.

For the AMA patients, and those who have had unfortunate complications that made their hospitalization lengthy. Daughtry "Home" I'm staring out into the night, Trying to hide the pain. I'm going to the place where love And feeling good don't ever cost a thing. And the pain you feel's a different kind of pain. Well I'm going home, Back to the place where I belong, And where your love has always been enough for me. I'm not running from. No, I think you got me all wrong. I don't regret this life I chose for me. But these places and these faces are getting old, So I'm going home. Well I'm going home. It reminds me of my brother. He was hospitalized for 3 months after a near-fatal motorcycle accident two years ago. It reminds me of his attitute at the time.

My Med/Surg Unit 40 beds Ratio 6:1, free charge on days Telemetry We are the catch-all for the whole hospital. Whatever doesn't fit somewhere else gets dumped on us. Bariatrics, ortho-spine surg, COPD, CHF, Pneumonia, AIDS, Sickle-cell, lap choles, drug and etoh detox, post-cath obs, post Pacemakers, uncontrolled diabetes, wounds, hypertensive emergencies, GI bleeds, gyn surgery, you name it, I have cared for it. And, all our nurses float everywhere, including ICU (which I disagree with). Average length of stay is 4.3 days. Most of ours are ambulatory because the high number of drug detoxers and bariatric pts. Which really sucks because then they can walk up to the nurses station to b!tch instead of just staying on the call light. I almost prefer more total care pts because they complain less. Nothing is worse than a drug detoxer that is so sick they are constantly vomiting up their anti-psychotic meds!!!!!!!!!!

Night Fever by the BeeGees. Or another one that reminds me of Viagra Jump, by VanHalen "I get up... and nothing gets me down."

That's probably because the Texas BNE was established to protect public health, not the nurses. The orginization's mission is to make sure that each person with a license to practice nursing is competent and safe.

I live 26 miles south of downtown Houston and 23 miles North of Houston. Although I live in a the 'burbs, I experience a nice mix of family oriented fun. But there is also plenty of singles nightlife. The Clear Lake area hosts a number of nightclubs and hundreds of restaurants. I am close enough to Galveston that I can go and enjoy the water, and I am just a twenty-five minute car ride from Houston's greatest shopping area, the Galleria. The midtown area (inside Beltway 8 on the West side) is great for singles, but it has more of an urban appeal than the suburbs. Katy is great, but the traffic is a nightmare. Forget the I-10 corridor! Galveston has alot of beach life, but the native population can be a challenge. The crime is high, the housing is poor (especially apartment living), and the only hospital on the island is UTMB which specializes in indigent and correctional care. I completed my student rotations on Galveston Island, and I found that commuting over the causeway bridge to be a nightmare during Spring Break and the long (8 month) summer tourist season. The island hosts Kappa Beach Party each year which paralyzes the police force and forces the closure of businesses due to excessive drunkeness and lude behavior. In addition, Mardi Gras is celebrated for several weeks on the island, Dicken on the Stand during December, Lone Star Motorcycle Rally, and a host of other "attractions" add to the problem of increase travel time to work. Additionally, the hospital census jumps during any of the festivities. I love to play in Galveston, but I would not want to live there. As a matter of fact, three UTMB docs live on my street just 23 miles North on I-45. I large number of the professional staff of UTMB live off the island and commute due to the shortage of housing on the island. For example, many homes built prior to the 1900 hurricane still stand in all their splendor, with Section 8 housing (Govt projects) just next door. Google the Clear Lake Area Chamber of Commerce for a better overview of the Clear Lake area. The Woodlands is a beautiful community nestled in tall pine trees. And it is home of the Cynthia Woods-Mitchell Pavilion where all the big concerts are held. The city has great shopping at the Woodlands Mall, and Memorial Hermann-The Woodlands Hospital and Methodist Hospital Woodlands. If you decide to live in Houston and commute to the Texas Medical Center (a few city blocks lined with 7 or 8 large highly-acclaimed teaching Hospitals), the drive would take about 1 hr during rush-hour (which may or may not be a problem depending on your shift). Oh yea, rush hour in Houston starts around 3:30 pm. Another idea, if you want a small town appeal in the heart of the city, try looking at West University. It is located just blocks from the Texas Medical Center and Rice University. Historic homes are a staple, and you are close enough to everything that matters. A few blocks from West U is the Village which is a cluster of restaurants, boutiques, and night venues like the Gingerman Bar and the Baker Street Pub. Plus, with Rice nearby, there are plenty of young singles.

In rounds an MD asked me for ideas on how our hospital can implement a process for notifying Medicare patients of thier right to appeal their upcoming discharge. We are struggling to get physicians on-board to provide us with notification of the anticipated discharge (48 hrs prior) and how we can insure that all the Medicare patients are notified. What have you tried that made the process easy? Are the case managers responsible for the notifications or is the responsibility placed on the staff nurses?

Stone Temple Pilots' Creep "Take time with a wounded hand cause it likes to heal... I'm half the man I used to be."

http://www.medscape.com/viewarticle/520714 This article is titled "What Do Nurses Really Do?" It was written by Suzanne Gordon. You have to register to use the site, but it is a fabulous read. This article helped to formulate my own opinion about nursing advocacy.

My husband is a funeral director. I think that the series Six Feet Under did an awesome job of portraying life in a funeral home. And what about ER??? Although sensationalized, ER does a pretty good job. Anyway, I am a nurse. I care about nursing. I want to be seen as more than just a handmaiden to the physician. Nurses use evidence-based practice to intervene everyday and save patient's lives. I think nursing should be shown for what it really is. So if you are sick of hearing about it, why did you read the thread?

I am not inferring anything. I was just describing the situation. People were asking if nurses were portrayed in the Sopranos, so I was just jogging the memory from some scenes that I remember. And about the ICU nurse comment, Um, unless you have a fresh trauma and have a 1:1 because the patient is that critical, the nurse will not always be in the room. And, that's what the glass doors are for, so you can sit and chart but still have an eye on both your patients. I actually think that the medical scenes in the Sopranos were more realistic than some scenes than I have seen on other shows.

About the ending, supposedly, three endings were created for the series so that even the production crew would not know how the series would end. I estimate that the three alternate endings will all be available when the final series is released on DVD in a few months. It's all about marketing. Or perhaps the ambiguous ending was to leave room to create the full-length movie that critics speculated about. But when I think about other series endings, I think the mystery was a nice way to cut it off. I think back about the ending of Seinfeld. It was so silly, and a huge disappointment. I am glad that the Sopranos didn't end that cheesy. And, if Tony was wacked - we would all be thinking, what happened to Carmella, AJ, Mead, the wedding, etc, etc, etc. Six Feet Under's season finale showed about 20 minutes of vinettes about where all the characters ended up. That was interesting.

Earlier this season, Junior was at the high-priced psych facility. He and the young Asian man that he befriended pulled off a scam to avoid the psych meds. They showed a nurse doing her med rounds with the orderly and the Asian kid creating a diversion so that Junior could avoid taking his meds. When Johnny Sack was dying of cancer in the institutional care facility, he was not attended to by nurses but by other inmates. One inmate was a former physician who was shown making beds and doing other CNA type duties. The nurses in the ICU when Tony was shot by Junior a few seasons back were portrayed well. They provided patient education, and I vaguely recall them getting ready to change his wound vac. I specifically remember Meadow questioning the doc during that season about her father's sepsis. She asked, "What's he on?" And the doc replied, "Zosyn." I guess that's somewhat believable.

iPod!

Now that the Sopranos series has come to an end, what do you think about the portrayal of nurses in the series. The series showed nurses in the ICU when Tony was shot, in the psych settings where AJ was treated for depression and Junior was treated with Alzheimer's Disease and dementia, and tonight the series featured a brief hospital scene with a patient intubated in the ICU recovering from a gunshot wound (no nurse was shown). What are your thoughts?

The original poster of this thread asked how we can change the perception of med/surg nursing. My experience in nursing school was that ICU was "the bomb." I knew right away that ICU nursing was not for me. I distinctly remember a nursing instructor saying to me, "Darling, you are one of the brightest students I have ever had, why do you want to waste your mind by not going into the ICU?" (I'm still bitter!) About 4 months after graduation, I read an article about managing geriatric patinets in a med/surg environment. It stated that due to the pre-existing co-morbidities frequent in geriatrics, managing those patients is as complex as managing an ICU patient. I forwarded the article to her. hehe But, looking back now - I think that the way that Med/Surg nurses can influence change is through advanced education and teaching. All my nursing instructors belonged to some sort of nursing specialty (ICU, ER, OB, etc.). It is human nature for us to think that what we do is most important. I think that students get a biased presentation. So volunteer to precept, obtain more education, and go and teach, teach, teach. Also, if you can write, write! I submitted an article to a nursing magazine and found it published just a few months later. Many nursing magazines take reader submissions. If you love what you do it will shine through in your writing. Start your own grassroots campaign to promote med/surg nursing.

When I was in nursing school I worked as a CNA at a nursing home. In order to pay my daycare I had to work 32 hours a week. Granted, this can be tough while going to school fulltime, I managed to work two 16-hour shifts each weekend. After doing that, 12 hrs as an RN on telemetry was a breeze. For my feet, I took the advice of my marathon running friends and bought running shoes that are 1/2 size larger than normal. As I walk all night, the feet tend to swell. Having the extra room prevents some of the discomfort. In addition, I strive to remain healthy in other aspects of life. Eating a healthy diet, regularly exercising, getting plenty of relaxation on my day off, maintaining a good family/work balance, and (after several years, finally) learning how to detect the burnout blues and promptly schedule myself a break. Finding a job you love also helps. If you can stay excited about what you do, there is less tendency to notice the aches and pains. (I'm always more tired when I float!) Also, as you gain experience (after at least 12 months as a nurse) you will learn how to become more efficient. So if you are starting down the hall to help a CNA with a bath, you know to grab the meds for that patient, the wound care dressing supplies (because you checked when you were in the room doing the initial assessment), the tube-feeding, etc... depending on the type of nursing unit you choose. Not only does your body gain stamina, but experience makes you more efficient so that you actually have to move less.

Wow! Up to 18 patients with only one nurse. Gotta love socialized medicine. Remember that, US nurses, when you vote.

Smith and Nephew has a 4-layer product called Profore. But I think it is costly.

Fair warning: You might still feel like a waiter if you work Med\Surg. Patients who call you to the room for one thing will, no doubt, think of something else for you to bring as soon as you get back. It will feel like the water pitchers are never full. Instead of dessert, you will serve narcotics. You will meet an assortment of personalities. You cannot make the patients who cannot afford the bill wash dishes. And, unfortunately, the tips are always lousy!!! I worked as a staffing coordinator and recruiter for a temporary staffing company prior to joining nursing.

I need a primer in gastic banding. Do you have any tips for care that is specific to bariatrics?

Dilantin IV can also cause Steven-Johnson Syndrome.

Giving Phenergan in a IVPB 50 cc bag is alot faster than looking for a vein and starting a new IV when the site goes bad. Side note: Our formulary requires that orders for Zofran be changed to 4 mg IV Q12 hrs X24 hours. Then, Zofran falls off the MAR and cannot be pulled from the Pyxis. The hospital changed the protocol due to price. This means you can only give Zofran X 2 doses before it is automatically discontinued. That is acceptable for post-op nausea and vomiting, but not too practical for other causes.