florry

:) :) Yes, A bone marrow needle is aprox. that big. I just discovererd that you were asking about a bone marrow spesificly...I have had that much biopsy myselves, and wanted to tell that it depends where on the body y have to take that biopsy..When I took severeals biopsies in my breast, they used different zises, from a little needle supervised by ultrasound, to the needle zice that was as a bone marrow look a like! The most part of the breast is fat, and they couldnt understand that it was so mutch hurting!!! I also had to take mammographi with that needle in my breast, and fainted severel times, because of hurting, and of course of my tention...Well it wasnt bone marrow, but I will never never tell a patient that biopsy doesnt hurt....:stone

:kiss THANKS AGANIN! THAT WAS MAKING ME MY DAY VERY GOOD! YKINOUR ATTITUDE SHOW ME THAT YOU ARE THINKING AND ACTING IN A NICELY ETICAL WAY! Thinking about my own behaviour against people, and my way to wellcome them espescially in healtcare, when we use to talk about it here. Its NOT EASY TO COME TO LITTLE NORWAY(WE USUALLY THINK WE ARE THE BEST IN EVERYTHING, ESPESSIALLY IN HEALTCARE....) AND TRYING TO LEARN, SPEAK, WRIGHT OUR LANGUAGE, IF YOU ARE FROM ANOTHER CULTUR/MINORITY.....I am white female, but if you also have another color of your skin...its harder for them, unless we pretend to say "we have no rascism problems!!" I wish i learn more, and sure I do, by listening to other people/nurses around the world!!!!:kiss and

:wink2: :wink2: Its all right!! I apology my bad English! I tell my self: If you dont ask, you dont learn..So my intention was to learn! Yes, I speak norwegian, and are from Norway, and have a terrible English. I dont mean to offend anybody!!!!:wink2:

:wink2: Thank you again! If I do understand the issue in the way the terms or description for IM AND SC is used. I understand us are using the term VENTROGLUTEAL OR DORSOGLUTEAL if giving IM. And of course iron an B12 require deep IM injection. I understand the Z-track method, too, that we also use described in an other way, beause the language. Though I DO HAVE MANY DICTIONARIES RELATED TO HOSPITAL ENGLISH, - I STILL CANT FIND THE WORD VENRTO- AND DORSOGLUTEAL. I AM NOT SURE I UNDERSTAND THAT THAT IS IN MUSCULUS GLUTEALIS, BOTH OF THEM, OR IF ITS EITHER THE M. QUADIPPLEX OR THIGH? Would anybody try to give me an answer in that? Sorry that my language is that bad, but you dont learn, if you dont ask. I certainly know and educate norwegian studenst in that par of nursing, but we use norwegian as a language...:wink2: I REALLY DO APRESSIATE YOUR MANY ANSWERS, THANK YOU FOR TAKING TAME FOR DOING THAT:wink2: I am only interested in learning the Terms!!

:wink2: Thank you, this was wery well illustrated as told! We use some of the same tecknic, but not the "Z" as a term. I am supprised that you in US seem to have that kind of a system, shortenings when doing nursing! Though I have also seen fex. other illnesses as MRSA that sorry to say, is out of control. Certainly we can learn or eacc other, and I appressiate that you took your time to answering me about that issue!! Thank you, again!

? in your country or us, would you telling me what a z-track is! i cant find the word translated, and i apressiate if you can explain it! thank you very much!:)

:wink2: :wink2: :wink2: SORRY; WHAS THAT A SUPPRISE? WOULD YOU IF SO TELL ME WHY? HAVE I MISUNDERSTOD?:wink2:

:wink2: yes!!! Apology my badEnglish, I hope Y do! What beeing from Norway a supprise!

? ? All right; now I understand the language: The dorsogluteal aeria is the same place (upper, quadrant,so far away from the sciatic nerve y can come) we use to give IM, but not allways, it depends on time u have to prepeare for that, the medicament, size of the body, the diagnosis of the pt and many other things. What you should know, is that its easier to set and easier to get IM in the thigh. As an example of that: To get antibiotics in your thigh, hurts EXTREMELY! Therefore we often use LIDOCAIN/NOVOCAIN before we are giving antibiotics. Mostly you'r md order iv if not per os, if you need antibiotics. But I have seen so many times that MD order IM for antibiotics, that I think its nearly unethical....Do not harm the pt. I have got dorsogluteal IM medication given by a MD, and unfortunately he hit some tread of the sciatic nerve. It hurts alot, i got numbed, and was told to lay down and dont move. I dont ever blame him, because the same doc has given me the same medication that many times, and in a perfect way; he unfortunally hit some of the sciatic "branches". Nobody is similar. And if you can imagine a tree with branches, he was that unlucky to hit a small branch or section. Its a risk, yes, and you have to learn it. The end of the story was good. I could feel again, I can walk, and after a day I was totally fine. Bevare of the risk to touch the periost, too. That is extremely hurting, but as a nurse you can easily know when you hit periost. The needle stops. If you search the net or your literature its esyier to learn and point, and after training you'll gett your own method. Suddently you can "feel" that "I do it correctly and in my own way." Use the little needle ( in size )you have to. Note that B12 and iron is very difficult to give. The substance is that tough, and never push the skin if the medication is heparin-likly. (Heparin is usually given sc, too) This is what I have learned and also teach my student to do. If you have a medical-doll, practice many times before you give IM. You have to learn all methods. Its one place you can set IM: in the delta mucle, too. I have done that only a fewtimes, just to vaccinate.

Thank Y for asking...I have also been an instructor for nurses, but maybe I am stupid, or maybe its the language-problem; Would you mind telling me were on the body Y and the students are practicing,- in another language than latin? So I can learn from y! We describe IM EITHER GIVEN IN THE SEAT: UPPER, OUTERMOST QUADRANT, its very complicated to translate the word in a disent way without using words that can offend people (feks. pt). The part of the body is near the hip. Or you can prefer to give IM in the thigh; If you look at the thigh, imagine 6 equal parts, then use the part in the middel, and outermost. Sorry I have plenty of books, trying to translate those words, but that was not easy. I wish I could wrote or give y a map, that show y how I used to do when I was an instructor, and what I now do as a RN. Since its IM, I often prefer the thigh method, because it hurts to move, if Y have a hip problem, or if its emergency. But I know from experience myself that given the IM by my seat, it often doesnt hurt that much. It depence of coruse the amount of fluid that is given. Narcotics for cronic pain patiens are often given true PCA, but if they need more painkillers, they often need IM or IV push. Narcotics in emergency cases often require IV. I am trying to say that it depends on the medication, the pt (fex very thin), the diagnosis, so Your students have to learn that even this is one way we teach you, in practice you'll learn that its many different ways to give IM, because the "case" is that different. Since I have migraine, I often get imitrex, in the mucle, I can confirm that the thigh shoot hurt much more than other places. If y can try to tell your student that if the patients are relaxing the best they can, it wouldnt hurt that much, even you have to use the thigh. I often choose the needle size, despite its IM, but fex if y have a tiny little old lady, I am very carefull with regullary IM size of the needle.:wink2: :wink2:

Hello! This was an interesting pathway: MRSA has to do with a cultural issue. And as I understand; the MRSA as a problem, is larger than in Europe too. (as well in Canada.) When some of you mayby are thinking that I dont believe you can anything about MRSA, I apology; if I have offended you. It seemed to me that you've a lot of knowledge and experience with this issue. The lack of superior-system in your healt-¨care programe, though, could have done much more with their knowledge to get money to fight against infections that seems to be THAT BIG in Us compared to europe. Sorry to say, but the statistics show that. Dont think that I attack anyone here personally, even they dont change at home. The attitude and act I have some problems with, are those that steel scrubs, those that use scrub on the E (I defend them if the Hospital dont has the changing facilities..) And ; finally; I apollogy my bad English, mayby I have misunderstand a sentence or a word. I wish I could speek exellent, and probably you wish that, too:clown: The discussion itself has turned into many ways, someone care about the color, some care about infection(s), and many other issues. I am of course very interested in infection-control. I believe y when you describe your knowledge you've got. I MISUNDERSTOD THE PERSON WHO WAS WRITING ABOUT MRSA IN FEX GROSERY-STORE, AND THAT MRSA IS EVERYWHERE. IT IS. I WAS THAT HOOCKED UP IN THIS SINGLE DISCUSSION AND HOSPITAL, AND MENT THAT WHE WERE ONLY TALKING ABOUT MRSA IN THE HOSPITAL...PERIOD. sorry, I understand the huge problem in your country. That situation is far away from the MRSA statistics in our country. Therefor I was VERY INTERESTED IN HOW YOU DO YOUR MRSA SCREENING IN US!! WHEN SOME OF Y ALSO DESCRIBE THAT SOME HOSPITAL WAS SKIPPING THE CONTROL, BECAUSE OF THE COSTS...THAT MAKES ME REALLY SCARED:chair: Well, what can we; you and I (not personally ment) learn from this? The Statistics can tell about the difference all over the world related to MRSA, routines against infection, health-care system, generelly speeking; the routine of wearing a scrub/working-habits/uniform and also a cap. I have certainly forgotten something?Can sombody help me?

Exellent acting/handling!Y're using y knowlege and judgemeent!

The hospital area is a huge place for any deciases, and we in Norway send them home as soon as possible, be/c the risk of transmission infections... Yes, I can absolutely see your health-care-problems in US, despite: The Descussion HERE IS about HEALTH CARE PROF. wearing scrubs in public, will confirm my ideeas that that has to do with many things: fex. the stupid idea, using hospital scrubs in publics, as I have said. and I am thinking thinking globally: How can WE TOGETHER FIGHT MRSA AS HEALTh PROFF! ITS METHODS FOR SCREENING WHEN WORKING IN A HOSPITAL, YES. WE ARE USUALLY WORKING WITH PUBLIC PEOPLE (THATS the reason they'r COOMMING FOR ,A DECIASE). WE ARE DICUSSION WHAT WE AS A HEALTH CARE PROFESSIONAL CAN DO, AND WHAT ATTITUDE WE HAVE! I AM TOTALLY AVERE OF MRSA-PROBLEM IN US-COMMOM PUBLIC, PEOPLE THAT DONT CARE, PEOPLE THAT DONT KNOW, CANT AFFORT ETC. TO GET TREATMENT. Also many, too many are undiagnosed! Everybody can contain the MRSA, beeing healthy, seeming so, without knowing, and transfer it to other innosent people! THEREFOR: IN A HOSPITALSETTING: Y'VE TO BE ABSOLUTELY LOJAL TO THE SYSTEM WE ARE WORKING UNDER! I CAN ABBSOLUTELY SEE THE US PROBLEM; 200 000 MILL.( OR MOREO?)ITS IMPOSSIBLE OUTSIDE THE HOSPITAL, AS YOU SAID, TO 100 % OUTSIDE THE HOSPITAL TO GET RID OF MRSA. I AGREE WITH THAT, AND GIVE Y MY SUPPORT HOW WHE CAN HANDELING THAT PROPLEM!!!!! YOU HAVE A MELTING POT WITH PEOPLE FROM ALL OVER THE WORLD,- WITCH IS A HUGE PROPLEM TO YOUR COUNTRY, COMPERED TO MY COUNTRY, WITH 4.5 MILL. Unified mostly). I hope Y understand me, but we are now dicussion health-care professonells, and my intention was not to bring in MRSA discussion for common people. As I have read thrue the sides here, I am humble, and has gotten a picture of your health-care system. I must say that I'm very lucky living under this conditions. and are sorry to hear about your health - care system witch couldd be "healtthyer". If you are comming to norway, staying for 3 mnds, get sick, every tests, hospitalcare in total is free....!!!

:nurse: OK:YOU DONT BELONG IN A SCRUB OR HEALTHCARE JOB IF YOU HAVE MRSA, SORRY!!! GOOD ATTITUDES, NOT ONLY IN OR, BUT IN EVERY SINGLE HOSPITAL, NO MATTER WHAT KIND OF WARDS, UNITS, AND ALSO CLINICS/OR ROOMS WHERE PEOLE ARE TOGETHER, AND NO ONE THERE HAS THE MRSA, BUT MAYBE ONE PERSON HAS WORKED WITH PEOPLE/OR BEING TOGETHER WITH THAT D. IS A THREAT. SORRY TO TELL. DO YOU OR ANYBODY KNOW HOW TO SCREEN FOR MRSA? ITS A PROCEDURE THAT TAKES WEEKS! AND OF COURSE Y CANT HAVE A JOB, THEN, Y HAVE TO BE TREATENED!!! And as an occup. nurse the last years, it was my job to visit the OR and explain proceedures, when taking care of pt. with MRSA in the OR, where everything seemed to be so clean or sterile. The procedure in OR is exstremely important...Well, it seem to me that you know much about it, so tell us the way we are fighting against it!!!!Just for my learning, it is very interesting if y'r hospital do that procedure in a different way. If some employee has MRSA THEY MUST WAIT UNTIL ITS TREATENED, UNLESS THEY CAN WORK. WE ARE DEFENDING OUR PT, RELATIVES AND EMPLOYEES, BY DOING THAT.

I have to tell Y that is absolutely many ways to avoid MRSA!!!!One of them has to be connected to your working habits.There are MENY OTHER, TOO. I AM TALKING AT PREVENTION AND TREATMENT. WHERE DO Y HAVE YOUR RESEARCG SOURSES FROM? In Europe we have a continuating research going on on how to handle MRSA, ISOLATION, HOW TO SANATE, AND HOW TO HEAL SOMBODY WHO HAS GOT MRSA. MANY DIES FROM THAT DESCIES, BUT MANY SURVIVE, TOO!!!! this is actually what I am working with at this moment; screening, preeventing and healing, so together with the Cheif of Infection Medicine, we are saving lives.

I hope Y'r understanding, as a professional nurse, and act like that! This note was not done to offend you, but open your eyes, if your notes waseded irony....Y'e the answer. If Y'r asking me out for dancing tomorrow, .....take a look of our distance.... If Y promice to use y'r privat wardrobe, the person you might ask for a dance, this will give you respect for what you are as a privat person. A professional nurse never dance at the work or out in a scrub. Take care of youreselves and I wish you good luck and a happy new year as a professional, discent nurse.

Yes, its the care of the patients I am concerned of, so its very nice to to hear about somone that really care in this way. Even it is of course many other ways to take care of, do their nursing that also count: knowledge, etichs and of course much more....

I hope this dinner was out on your working place at the cafeteria in the hospital! If not, I think you have a huge lack of understanding hygiene, infection-controll, lack of knowledge and attitude related to your colleges that fight every day against MRSA as an example. I can ensure you that this is not about y and your scrub only, this is a global problem, that can kill people. MRSA, that y probably dont have heard about! Do me a fawer and read about it. I have lost relatives cause of that MRSA, I have lost a friend, because of people who doesnt care abaut the rules, regulations, infection-control system. I am talking about not respecting the policy and Hospital rules and regulations. They want the best for the single pt. And if you are dressing like this, even the scrub was clean, its not meant for using as a dress for eating out, unless this is a cafeteria for the hospital. ¨

:wink2: I can understand the problem for the hospital! We are actually paying or do a deposit for our working habits when we are beginning in a new job. If quitting, y get all back if you leave all of the uniforms back... If people is stealing....I cant believe the etichs...

Well, the answer is based oth etichs: "DON NOT HARM" is on of them. If Y or your manager or anyone of the employees, dont do the best for the pt. related to hygiene, or fex. are some part of transferring infections as MRSA AND ANY OTHER TREATH to the pt because their immunesystem are lower just because they are in a hospital with a decease,- that outside, -the hospitals employees can be (for the singel pt), and because Y AS A HEALTHY PERSON CAN TRANSFER FEX. MRSA TO ANYBODY THERE IF YOU DONT RESPECT THE HYGIENE OR INFECTION CIRCLE!ITS THAT IMPORTANT, THAT IF ANY OF OUR EMPLOYEES HAS BEEN IN COUNTRIES THAT US, ENGLAND, AFRICA, ASIA AND SOME EROPEAN COUNTRIES, AND HAS BEEN WORKED IN A HOSPITAL,(EVEN WITH PAPERS), THEY MUST do A SCREENING AND MEDICAL EXSAMINATION IF THEY ARE STARTING TO WORK AGAIN IN THE HOSPITAL in our country.....This is the chief of infection medicin staff that set the protocol,and has pepole like me, that perform the tests (MRSA, TBC-Mantoux). This is the Health-care authority that made the rules and regulations based on research and infection-control all over the world... So, its IMPORTANT, SCARY, AND HAS TO DO WITH ATTITUDES.:sofahider

:sofahider That MRSA AND TBC AND CL.dIFF IS VERY SCARY, I CAN AGREE WITH YOU!!!!!

:wink2: :wink2: Ok, Y'r hopital manager of the hospital have a huge problem. They need to have som right and regulations, based on etichs in healthcare/houseceping . Its about behaving, its about respect for the pt,colleges and the manager, and of course. She or he cant expect any other ways to coop with that kind of problemes ,if the employee dondt have any other faccilious to change theire working habits. No-way, its about color or not, cotton or polyester imflammable or not, this is an attitude problem, if people use the scrub on the E. The mangager of the hospital cant complain, if the circumstanstes of workinghabits is that bad organized. I'm convinsed that everybody working with patiens ar obligated to an ethical standard. I am defending the pt. rights too "DO NOT HARM", BUT ALSO THE EMPLOYEE'S RIGHT "TO DO NOT HARM". Its a manager problem. Sorry to say that.

To me its very interesting to discover that we use allmost the same procedure at the other side of the world: We have to cover OR scrubs with a new coat, if leaving the area. Also its interesting about what Y'r wrighting about masks! I have also read a study about that, that made the same results! We dont use shoe-covers anymore in OR, we'r changing shoes,- in a special locker zoone. Visitors can borrow visitor shoes. The manager of Hygiene in Nursing and our Cheif of Infection Medicin have come to that conclution that if you have to cover y'r shoes, Y'l probably touch the floor, and THE FLOOR IS THE MOST CONTAMINATED PLACE in the hospital at all.... But; IF Y'R WORKING ON WARDS ON ISOLATION ROOM: F.EX. WITH MRSA AND CL.DIFF.; THEN Y'Ve TO COVER Y'R SHOES (PROBABLY B.CAUSE Y CROSS THAT CONTAMINATED ZONE OFTEN, WITHOUT HAVING SPECIAL SHOES IN THAT KIND OF ROOMS ON WARDS..) I have never read any study about this infection threaths. It has to be a threath because, the floor is the most contaminated place in the hospital, and f.ex. Cl.diff. AND OTHER MICROBES, make toxines that can survive for weeks, if not desinfected. Dust is a growing place for both yellow staph., Mrsa and Cl.diff.... AND sometimes these pt. are in need for surgery procedures in OR.... Sometimes if Y have to bring the pt with your contaminated shoes along to units that require special high level of hygiene, as orthopedic, onchology chemo-units, PICU...NICU...and the md. still using their scrubs all over the hospital... I also have to tell about some of my study-tours, (and mark; this tour was 20years ago), but this was in one of the famous privat hospital - I can tell the name of the country: England; but of course no other name. The floor was covered with carpets in EVERY SINGLE UNITS AND ROOMS, EXCEPT THE ROOM OF THE OPERATING THEATER!!!!! 15 YEARS LATER: I VISITED A PUBLICH UNIVERSITY HOSPITAL IN THE SAME COUNTRY, But a different place of the c. I WERE COOMING DIRECTLY FROM THE AIRPORT, INTO THE HOSPITAL, INTO ICU, OR, AND PICU, AND THIS WAS "THE END OF THE OPERATIONS TODAY, AT 2.PM", SO WITHOUT ANY HANDWASHING, CHANGING OF CLOOTHS, WHITOUT A SPESC. GOWN: I WAS NICELY ASKED IF I WOULD LIKE TO SEE THEIR OPERATING THEATER... AFTER TRAVELLING AROUND THE HUGE HOSPITAL, WE WERE DISCUSSING THE INFECTION RATE IN THE COUNTRY, MY COUNTRY AS WELL AS AT THAT HOSPITAL. THEY HAVE THE SAME LOW RATE OF MRSA, TBC, CL.DIFF, URINE-INFECTION, UPPER AND LOWER RESPIRATORY INFECTIONS AS IN MY OWN COUNTRY. EVEN IF IT SEEMD TO ME THAT THEY USED AN TOTALLY DIFFERENT WAY OF PREVENTION AND HANDLING INFECTIONS. IS THERE AN SINGLE ANSWER TO THIS Q.? PROBABLY NOT!!! ALL THE THING I HAD LEARNED IN MY NURSING EDUCATION WAS DONE IN AN OPPOSITE WAY. WE USED, AND ARE STILL USING LITERATURE FROM US, MOSTLY, BUT SOME OF THEM ARE FROM ENGLAND, TOO. I'M following an interesting debate about "nurses tossing the white uniform..", Its about hygiene, contamination, infection, too. Still very much to learn from other sides of the world. I'M NOT SO SURE ANYMORE THAT OUR WAY TO DO OUR NURSING IS THE RIGHT WAY... (Still, I apology for my English, I wish it was exellent:clown:...sure, Y think that, too...)

hello forcemaster! i am wondering, when you are writing and giving us excellent standard procedures in england, - from "nursing standard", that there must be very difficult policy around the world about this issue. when you are decsribing your routine, witch is excatly the same in norway. maybe there are european, asian, us and so on has their owne policy whereever they belong to, despite what nursing reasearch is telling us... i understand that money is one factor that can inhibit contamination. i understand that the whole discussion is difficult. i understand that infection diceases are more and more an escalating problem. isnt this an agenda for who? where we all in healthcare can focus on infection, contamination, the huge travelling around the world and what can be the best for the world relating to this "scrub/shoos-discussion". maybe there are other and better method to solve this problem...and i am only obligated to follow our policy in europa, scandinavia, based on reasearch roules and regulations. despite "er" is a entertaining tv-series, the first thing that was totally different from my hospital world, - and they had real md and rn to always give them advice: the scrubs, lab coats and so on, were used outside the hospital. of course this was made to entertain us, but only once i saw an episode about washing the hands... except or-scrubbing. once i saw an episode about the color and nurse scrubs that was discussed. only once i saw an episode about toxic/non-toxcic -area. i love this "er", and of course its not real. but its related to "the real er and hospital". the script, the episodes was exelent! and mayby focus was etical, human being/relations oriented, more than "infection-oriented". and remember; the first written material was done in the -70's. infection medicin wasnt on that agenda in the same way then as now. my issue is that if you dont work in healthcare, you dont see all that "small, mayby nedy things".....as changing habits many times during a day, codes for not cross the lines. proceedures about washing your hands mm. the way they handle contaminated gloves, masks whatever, and the way to act in a "triangle", as i have learned to always do my nursing, was never the agenda, i am a little bit supprised that people - nurses all over the world seamed to have so different policy!!! i am talking principle, not about the single nurse practise, (sorry, that my english is not that good, but i understand..) all related to scrubs, gloves, masks, germ, policy, wasnt real. maybe i have done "wrong nursing" during to contamination - even i have been working as a nurse - only for about 20 years(also educator for 9 years....)mrsa, cl diff. tub resistent bacteria, e-coli, sthaph., resistent infection, virus intreatable; are tretening the whole world now and that must be of interest for who...how can we together fight against that global issue? is the same policy when handling contamination a start? from florry, still wanting to learn more.

Thanks nurse Karen! Now Im hoping nurses round the world understand that might be some problems or difficulties when we ordinary RN's are trying to understand your system, certificatients, abbreviatiens, dresscodes at work (color/scrubs or not scrubs), rules and regulations not in one state,but in the US, UK, Canada all together.... MAYBE ITS A LITTLE BIT DIFFICULT TO DEFINE WHAT NURSING REALLY IS... I THINK THE PT DOESNT CARE ABOUT ALL THIS STUFF. THEY WANT A CERTAIN LEVEL OF PROFESSIONALISM, POLITENESS, DIGNITY AND A HUMAN BEEING WHO SEEMS TO LISTEN, DO SOMETHING, AND CARE. May I ask if someone can answer me what NURSING IS:) :) ? ISNT IT ABOUT 1) COMMUNICATION and 2) COVER FOR SOME NEEDS RELATED TO NURSING...?