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woody62 RN

icu, er, transplant, case management, ps
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woody62 has 27 years experience as a RN and specializes in icu, er, transplant, case management, ps.

grandmother, disabled

woody62's Latest Activity

  1. I do not know. When I reactivated my license, here in Florida, in 1996, they asked for a diagnose, medications and when I had been last hospitalized. My psychiatrist wrote a letter stating he felt I was stable and saw no reason to restrict my license. My license was given to me. Woody:twocents:
  2. woody62

    who should sign DNR for teenager?

    There is no simple answer to the question. Even if the minor is emancipated, most physicians and hospital administrators would not accept a request. At the very minimum, two or more psych evaluations. And if parents appear, it would be a hard row and a court battle. Woody:twocents:
  3. woody62

    INSULIN NCLEX question

    I would choose the answer which had the 5PM included in it. I very rarely take regular insulin. And I generally take it on a sliding scale because of my use of steroids to help control my asthma. And most Type 2's who do, take the combination, which has another set of peak times. The peak time for them is two to six hours or one to four hours. When I have suffered a hypoglycemic episode, it has generally been twelve to sixteen hours after I have taken my evening dose of NPH. Two of the past three times, I woke up about 2AM, went to the bathroom, voided, got up and passed out. I later came to, crawled out to near my bed, went out again, woke and found my roommate kneeling over me. She called 911. Both times I got up to void and collapsed after voiding. By the time the paramedics tested my blood sugar, they stated it was in the twenties. I blame my low blood sugar on not taking in enough carbohydrates at dinner and not eating a snack. I also now check my blood sugar, in the middle of the night, if I get up to go to the bathroom. Better to be safe then sorry:yeah:. Woody:twocents:
  4. woody62

    INSULIN NCLEX question

    Many of us insulin dependent Type 2's, nurse and non-nurse, are well educated in the symptoms of hypoglycemia. We know when we start to experience the early symptoms, enough to check our blood sugar. And if it has only dropped a little, to continue to monitor it. And to take corrective action. When we run into problems is either when we are in-patients and have nurses who believe they know more then us. Or when the hypoglycemia occurs when we are a sleep. I have suffered three episodes, in the past six weeks. All occurred when I was asleep at night, either between 2AM to 6AM. And from eight to twelve hours after taking my NPH. I received expert help from the Fire Department paramedics summoned by my roommate. My PCP and endocrinologist's have lowered the dose of my NPH. And I am monitoring my blood sugars closely. The person I depend the most on for current knowledge is a certified diabetic nurse educator. She has the most current and up to date information. And my own body and knowledge. If you want to teach a new insulin dependent Type 2, please involve a certified diabetic educator. Woody:twocents:
  5. woody62

    INSULIN NCLEX question

    I am sorry but I believe none of these answers are correct. I take NPH and ocassionally regular insulin with it. I have to watch for a hypoglycemic attack at the time at which my NPH begins to peak, six to ten hours. And if I have to take regular insulin, two to four hours after injecting. And from experience, when I have suffered a hypoglycemic attack, it has been generally six to eight hours after injecting the NPH. If one suffers from not taking in enough carbohydrates to match their insulin dose, it usually happens at the peak times of the insulin. Woody:twocents:
  6. woody62

    advanced directives and power or attorney, please answer my question

    When I first started in nursing, we had an ethics committee to decide when to take a patient off a ventilator and DNR him. Unfortunately, it seemed the committee took more time then the patient did to decide to die. I have informed my daughter her failure to follow my wishes will result in a life long haunting of her, after I die. She is well aware of my wishes and has promised to follow them. We have had many open discussions on the process of dying. And the terror of a relation attempting to make-up for old mistakes, by keeping a love one alive. Woody:twocents:
  7. woody62

    H.R. 5924 Emergency Nursing Supply relief act

    In an attempt to answer the OP's questions. We have been allowing facilities to import foreign nurses to shore up the almost continuous shortage of nurses. We began losing young people entering nursing programs in the 1970's when more and more fields were finally opened to women. Our best and brights left and went into those fields. In the 1980's we opened up independent nursing practice, allowing those who wished to then engage in independent practice. At the same time, there has been a reduction in funds usually given to nursing, both in terms of grants and research. Also the salaries of nurse educators does not match that of an independent nurse practitioner. Thus fewer are entering the education field. As a result, our educators are now generally in their fifties. And most of the educators I know not only teach but engage in another nursing practice to generate income. We are losing educators, while we are building up waiting list for programs. This is a very real incident. Unless more money is put into developing nurse educators and expanding programs we will have to continue to import nurses. We will be taking nurses away from their own people. And we will be down grading the income of our own nurses. Woody:twocents:
  8. woody62

    advanced directives and power or attorney, please answer my question

    I have a Living Will and a Health Care Proxy. My daughter is named as my proxy. She and I have had numerous talks about what I want done if I am no longer able to voice my choice. I have also discussed this with my PCP, who is aware of my feelings and directives and has agreed to them. One point, if the health care proxy is not a relative, there is a chance that that person will be ignored. Family members are given a louder voice then a non-relative health care proxy. Woody:twocents:
  9. woody62

    Cussed out by a family member

    No, I am a sixty-three year old grandmother, not a grandfather. If anyone thought I meant for someone to take an upset individual off into a secluded room, you have miss understood what I was attempting to say. But neither would I have this discussion in front of the patient, other patients or visitors. I am sorry but every time I read about a problem patient or family member, too many of the nurses seem all to ready to jump on the 'call the cops bandwagon.' Very few seem willing to do what I was taught was part of my responsibility as a nurse-use communication. I realize I am among the few who believe that it is better to attempt to communicate with an individual then to call the police. Perhaps my upbringing shaped me, I have lived in two vastly different foreign countries, in their neighborhoods, in their schools. And have traveled extensively overseas. And my initial nursing experiences, in NYC, exposed me to many different beliefs, cultures and manners. I do not apologize for taking what may be considered the high road, it is what I was taught, by my parents and my nurse educators. Woody:twocents:
  10. woody62

    Cussed out by a family member

    I would take a different route from what many have suggested here. It is not pleasant to be berated by a family member, especially in front of others. But this gives you an opportunity to use all those excellent communication skills you learn in your program. I would calmly ask the person to step into another room with me. And once there, I would have validated the person's anger but also asked what they were so upset about. And asked what we could do to change the situation or help the resident. It could be something as simple as the person having a bad day or being overly concerned about a patient. Or it could be the result of another person treating the parent or visitor rudely. The visitor stuck his finger in your face. He/she did not physically assault you or threat you. Calling the police is going a little out of bounds for me. It has been my experience, when a visitor is angry, he/she is not angry at me specifically but at another nurse or the physician or worried about their parent and feel very impotent. As long as a person does not physically assault me, I am willing to listen and even be blasted. And then attempt to resolve the situation. If the individual refuses to discuss the matter, I would warn him/her that such behavior would not be tolerated the next time. And would result in the removal of the individual from the grounds. Woody:twocents:
  11. woody62

    Nurse fired for calling police

    nursesteve2004, if I had been an employee and received the lecture you state all employees did, I would have been looking for another job. No one is forced to stay with an employer that they feel puts them and others in jeopardy. If anyone stays with an employer who forbids contact with an outside agency, who does not provide a safe place of employment, then one is getting just what they have bargained for, a job with strings. Strings that they have agreed to by not seeking out other employment and remaining. I am sorry but I have worked in states where I was represented by a union and in right to work states. Both states and all of my employers had to provide a safe work environment. Failure to do so could have prompted investigations by state and federal agencies, which I would have been willing to pursue. I have been assaulted twice in my twenty-five years of working. I have worked in a variety of settings, including a psych unit that was an admissions unit. I was more afraid of some of the staff then I was of the patients. I found that if someone reacts in a negative manner, they will get a negative response. If, as a patient, I am approached in a negative manner, most likely I will respond in a negative manner, even if I am in a good mood. If I am not, that negative manner will just add to mine. And nurses wonder why patients and their families react the way they do. They remember all the negative treatment that they have received. And if one is approached in a manner of confrontation, to supposed negative behavior, what can one expect their response to be? My mother had a saying "You can catch more flies with honey then you can with vinegar." Woody:twocents:
  12. woody62

    Unprofessional Nurse

    I am sixty-three years old. I have no savings, no retirement, no property, about $30,000 in medical debts that I have been slowly paying off, no credit cards. I live on a fixed income, which after paying all my expenses for the month, generally leaves me with $150 to $200 to spend any way I wish. I treat myself to a dinner out twice a month, go to a movie every two to three months, buy books I enjoy reading. I have a forty-one year old married daughter, whom I do not expect to pay for my future care or any of my debts once I am dead. Since I no longer own any real property, the hospitals I still owe will be out of luck. Children of irresponsible adult parents, who are adults, can no longer be held responsible for their parent's debt, unless they sign an agreement to accept the responsibility. Those that do own property are subject to their state's laws regarding seizure of such property to pay state debts. Here in Florida, a spouse may obtain medicaid and remain in the home until their death. The property is then sold and money applied to what the state has paid out. Rarely is there anything left over. For those who have irresponsible parents, that parent is responsible for their own bills. If you do not want to be held responsible, do not sign any agreements that hold you responsible. A bit of an aside. I had a retirement fund, owned a condo, had bills, which I was paying, had a savings account. A bad accident wiped out my savings, the government took half of my retirement when I cashed it in, in an attempt to save my condo, the bank took my condo. I have not been able to return to work and I have not been able to save anything. I am dependent on Social Security. I don't think I have been irresponsible. Perhaps I could have planned a little better but hindsight is always better then foresight. Woody:twocents:
  13. woody62

    Working with a cast?

    A few questions, please. How do you wash your hands between patients? How do you wash your hands prior to giving a treatment. How do you remove dressings and apply fresh ones? How to you pass an NG tube or a foley? I agree with the other poster. Ask your employer to put you some where you do not have direct patient contact. Another question. Don't you have short term disability insurance through your employer? If so, you can go out on it. If not, consider purchasing it, in the future. Woody:twocents:
  14. woody62

    75 mcg Fentanyl patch a day early on lethargic patient?

    Back in the mid1990's I was on a fentanyl patch. I suffered no lethargy, so I think hers may be due to something else. Second, one gets a measured dose. Putting on a new patch does not give a patient a boost of medication. I would have removed the old one, cleaned the area and applied a new patch. Woody:twocents:
  15. woody62

    Withholding Pain Meds???

    I wonder what the DON would do if surgeons said their patients were to received pain medication regardless of HER rule? I can understand it not being given then a patient being asked to sign for consent immediately or shortly after receiving it. I have gotten MS, in the ER, then signed consent for treatment and some procedures. And my state of mind was never questioned. My daughter did throw a deputy out of my ER room, following pain medication for major trauma, while waiting for me to go to the OR. Considering I never could remember him being there, any response I had made would most likely been thrown out of court, or so my attorney told me. I question the legal footing this DON is on. People receive pain medication and sign consents all the time. If a person is too confused by medication, they are generally too confused to respond correctly or sign permission for anything. Woody:twocents:
  16. woody62

    Bi Polar and nursing

    What do youmean you could keep up with your paramedic classmates? I was an undiagnosed bipolar during my nursing program and it was a struggle for me. I was diagnosed in 1976 and went on medication with very good effect. I came off medication during the 1980's without any impact. In the 1990's I was back on medication and suffering from the swings that accompany bipolar. My physician is talking about taking me off my lithium. I am not sure. Once one is stable on medication, there shouldn't be any problems, except you may miss the highs. And you shouldn't have any problems with which ever program you decide on. Good luck Woody:twocents: