rachelgp

Hi all, I'm negotiating an agreement for a federal contract that will involve traveling to multiple states (this is as a NP). The recruiter states since it is a federal contract, "Any state license is accepted," but I can't find any info on the legalities of this. Google has not been helpful! Does anyone have any definitive info on this? TIA, Rachel

Those were my exact concerns. Thanks for confirming that I'm not being unreasonable. My background is in ER and Occupational Nursing, and I've always had a Dr. that can give me orders or had standing orders signed off by a Dr. When I explained this to my "supervisor," she just gave me a blank look and then started telling me the people that held my job previously did it (as if that's going to make me any more likely do something I believe is wrong). She's not a nurse, and I'm not sure she'll ever truly understand why I object to doing this...wish me luck!!! And thanks again for backing me up!!!

Hi, I'm new to CM nursing, and this may be a stupid question, but I'm hoping some of you can help clear this up for me. I work as a w/c Nurse Case Manager, and my Claims Adjuster (who sees herself as my supervisor) wants me to give out wrist splints when any office workers c/o anything that could remotely be suspicious of carpal tunnel (as an alternative to physician treatment). I'm not comfortable with this. Yes, I know these can be bought without a prescription, but I would assume if I'm providing them, I'm going to be responsible for f/u and any complications from these people wearing them incorrectly. And it's not like I'm working in a clinic with standing orders or anything. I'm just concerned about the ramifications of this. Am I over-reacting here? Thanks in advance for your help.

I once dreamed that I fell while going down the steps into my laundry room at home. My dream was very vivid (and a little graphic). I remember hearing and feeling my humerus snap and the only thing I could think was, "At least I hurt myself bad enough that I can call in to work!" When I woke up, I was so disappointed that my arm wasn't broken, I actually started crying. Then got ready and went to work...yes, I know I needed a new job. I have one now and am so much happier!

I was working in the ER and had a guy in his late 60's who had dislocated his hip. We had medicated him with Valium and he was in less pain, but a little "tipsy." Before leaving the room, I attached the call bell to his rail and told him how to use it. Then I asked, "Do you know how to call me if you need me?" He gave me a drunk little smile and said, "Angel....!" I had to laugh a little at that one, but I did manage to remind him of my actual name and demonstrate the call bell to him again! How cute!

I've also seen orders for continuous Albuterol nebs to lower K+. Used Kayexolate, the insulin/dextrose/calcium chloride combo, and continuous albuterol nebs on a pt. with a K+ of 8.2. Seemed to work!

Anybody have an experience with pregnancies when the patient has a large fibroid? I just found out that I am pregnant, and at first it was thought that I had a molar, but it was confirmed on US that there is a healthy baby (9 weeks) along with a fibroid the size of a nerf football! I have been referred to a high-risk OB, but haven't seen her yet. Does anybody have any experience with this sort of thing? I am wondering just how stressed out I need to be! Thanks!

Well, I am personally happy to see that so many of you are outraged at this. I was (and still am) a Paramedic while I was going through nursing school. I can't count the number of times I was called an "ambulance driver" or talked down to...I tried to tell myself that it was just because these people had not been educated as to the scope of practice that Paramedics practice. But, it was still frustrating. I remember one day, an RN thought she needed to describe to me what "gross hematuria" was. HAHA! I was an ER tech while I was finishing nursing school, and at the same time was working as a Paramedic. I would hear all these derogatory remarks made by nursing staff, and, strangely enough, other nurses rarely stood up for us. In fact, I can remember several times when ER docs would step into a conversation to defend EMS. I confess, I still have a little bit of a chip on my shoulder about all this, even though I have been an ER RN for almost 2 years now! You can bet, I'm one RN who will step up and say something when I feel EMS is being mistreated or disrespected! So, thanks to all those who realize that we aren't just "ambulance drivers!"

Amen to all! Patients seem to think that since we're nurses, we "owe" them something. Not sure why, but that's really how I perceive it. We've actually had patients break into a code and state "I've been waiting 2 hours, when are you going to see me?" This for complaint of cough/cold and other non-emergent complaints. Can they not see us doing chest compressions? HELLO...?!

I have to agree with all ya'll. PBDS stinks. I had to take it about 2 weeks after I graduated, and didn't really know what it was all about at the time. I completely agree that it's insulting. Even as a new grad, I found it offensive. Plus, I do not feel that it actually measures competency or knowledge. The way the questions are asked can be misleading, too. I actually passed it, but hated every minute of it. I have been considering getting into traveling, and I do not plan to take it again. Do you think they would make someone take it again who has already passed it? Would they make you take it again at each new facility?

I am an ER nurse, and my husband and I are considering a move to the Branson/Springfield area and I've been thinking about doing travel nursing at least for a while after we get there to get a feel of the different hospitals before I sign on permanently somewhere. Anybody have any warnings/recommendations about traveling companies/hospitals, anything? Any help is greatly appreciated. Rachel

OK, here's me: Born and raised in South Texas, graduated as a Paramedic in 2001, and as a nurse in Feb. 07. Working in the ER now, but starting to peek around and see what else is out there. I'm interested in PACU, OR, and flight nursing. I guess that's about it!

I hate when patients walk through the ER door asking, "when do you serve dinner around here?" They drove by a ton of restaurants on the way here, but of course, they want something for free.

I work in the ER and we use a sheet that has blanks for diagnosis, admitting dr, recent vitals, diet, pending labs, wounds, pending procedures, and room to write a little extra if needed. We actually send it by the tube system, and then call to make sure they received it and see if they have any questions. There's a spot to check off that the unit was called for final discussion. Hope this helps! Rachel

How about FMPS--"Fluff My Pillow Syndrome" for all those wackos who ring the call bell every 30 seconds for bull&%$#!