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neuro, med/surg/, cardiac care
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agent66 has 19 years experience and specializes in neuro, med/surg/, cardiac care.

2kids, 3 cats, dog, rabbit , laundry

agent66's Latest Activity

  1. agent66

    What kind of LTC resident will you be?

    Oh likely the one that pulls her foley out fully inflated just for fun, ouchie!! Or watches till after the nurse rounds at night, then takes off out the front door most likely headed for a mall!! tammy 66
  2. agent66

    I think this protocol is awkwardly worded?

    we have started something similar, calculating the creatinine clearance, and holding metformin for 48hours post procedure. it is still doc dependant if they want the hydration orders or not with the bicarb infusions. some just still go for the mucomyst , some want the mucomyst and hydration. why must protocols be so difficult? the docs don't check it , they think is standard, but actually they have to check it off if they want it, oh boy so much confusion. you would think also they could calculate the number themselves on their order sheet and do the orders right away if the number warrants it. but they leave it for nursing to do and call them back later . oh and did i mention often the crcl is not even calculated , but found in the middle of the night, pre procedure? that gets a 7am call to the doc in his car who doesn't even know the patient. great system.
  3. agent66

    What's Your Nursing Christmas Wish?

    I wish that patients that can walk outside to have a smoke, would not ring me for a glass of juice!! tammy 66
  4. agent66

    Is it ok to fax a letter of resignation?

    I would absolutely hand it in to HR in person just to make sure the right people got it. Guess I don't completely trust fax machines, or managers for that matter! Take a copy for yourself as well just in case. Don't want any miscommunications following you to the next job. 66
  5. agent66

    A Flutter irregular, it is A Fib?

    Your ventricular rate will only be regular in A-flutter if your flutter rate is constant , ie 4:1 , 3:1 etc., that is 4 flutter waves to every one ventricular complex.(or 3 or whatever the ratio is) If the f-waves are conducting at different ratios then the qrs cannot be regular. So yes, aflutter can be irregular if the f-waves are conducting at varying ratios to the qrs.
  6. agent66

    Holidays: Here We Go Again

    By contract our schedule has to be out by now. Is my year to work Christmas, but again lucked out, am working christmas eve days and boxing day night, and New years off. Is not so bad, I don't think as not travelling too far out of town for dinner.
  7. agent66

    Sleep Hygiene

    Great thread Zoe, I must be the odd man out. I sleep great, night time, daytime. Have never had to use gravol, benadryl or anything. I can drink coffee all day long and does not bother me to go to sleep. Tea on the other hand makes me travel to bathroom way too many times after dozing off so now avoid it. I have been doing 12 hour nights only for almost 20 years and have no trouble switching back to day mode for my days off . To boot I can sleep after nights , get up at 3ish and go back to bed at 10pm and sleep right through the night! As for background noise does the kids yelling and the dog barking count?? Perhaps it is because I am high energy person while awake that I fall asleep so easily when I do crash, who knows. I sympathize with those of you that do not sleep well, have worked a night or two with those who have only slept an hour or two before coming in for their second nightshift, not pleasant!! Tammy 66
  8. agent66

    Who is responsible for preceptoring?

    I would disagree not for myself personally because I have preceptored and enjoyed it, BUT there are nurses who don't do well in the student/preceptor role. They either don't have the personality for it, and by that I mean the patience it takes to answer alot of questions and show someone a procedure or routine that they have been doing for years with one eye closed. And if we were all honest, we would admit there are people we work with that we wouldn't wish even our least favorite students on. Of course there are also those in our profession who take on students so they have someone else doing their work for a said amount of time, and they can have a break. Yes, that is the truth also. Would I do it again? For sure, because I really like being in the teacher role and feel I have a lot of experience and insight to offer newbies. But it is not for everyone, and shouldn't be forced on someone that is not comfortable or appropriate to take on that role. Tammy 66
  9. agent66

    So what makes you pass out?

    Doing three nights in a row, 12 hour ones of course. Thankfully I am in my bed when I do pass out, but has been close a few times at red lights!
  10. agent66

    What do you think about people calling you "honey"?

    I would really have to agree with Sarasota, I cannot stand being called maam at the grocery store, OMG, am I like 100 years old?? Pretty sure I am only turning 41 this year. When I went down to New York to shop last month, all the girls and I thought it nice that all the waitresses called us "hon" or "honey". They made us feel really welcome, and it was the women our age as well as the younger girls. We gave them a hefty tip just because they made us feel so special. Now "darling" I don't think I would stand from a patient or otherwise, just not an endearment I have ever warmed up to. As for "baby", yikes that reminds me of bad pick up lines from college, no thanks then and no thanks now.
  11. agent66

    How long do you stay over shift to finish work?

    I also work in a telemetry unit, and I work only nightshift. 2hours later than your shift is way too much time. Unless your patient needs transferring to a critical area at the time of shift change etc then you shouldn't have to spend more than 15 minutes past your time to get loose ends tied up. I always chart the nursing notes as I go and sign off meds as I go. If MARS need recopying or charts stocked, I make sure the wardclerk is aware before she takes off at 2200. There is always unexpected events that you cannot plan into your night so your charting always needs to be up to date. This is something I always , always reinforce with the students. Things change quickly, "always expect the unexpected". You need your breaks as well, so plan them into your night. Delegate some tasks to others if they are sitting around and you find yourself overwhelmed, some nurses don't offer, but are willing to help you out if asked. Your time management will improve with experience but consistently getting out more than 15-20 mins past your shift is not good for your well being.
  12. agent66

    IUD retrieval??

    Thanks for all the posts, makes me want to run out and get one!! NOT!!
  13. agent66

    Why Dogs Make the Best Friends

    i work cardiac, I am female, my pets are mixed. 3cats: 2male and 1female 1dog, mix collie/shepard female who I have big issues with who is the queen of the castle , but she does leave my shoes alone !! 1rabbit, think he is a he, the kid at the petstore said so but I haven't checked and don't really care. and i am bad, they all sleep whereever whenever:o:lol2:
  14. agent66


    Were you by chance showing your nervousness around the patient? That could account for the increase in BP. Those pauses aren't too long, but if they were increasing in frequency , I would have called the doc to come assess the strips and probably send her elsewhere for closer monitoring. Was she a sick sinus syndrome patient, or in some kind of block from the Cardizem?? True enough her BP was holding and she was obviously alert enough from what you said in post, but if the pauses were getting longer and more frequent then I would also had her assessed and possibly shipped elsewhere. Not my favorite thing to have to pace a person with the pads at the last minute. Were they considering a permanent pacer or just going to watch her rhythm a few days off the drugs? I would hope she also had a big fat line in somewhere. Always better to go with your gut, you did the right thing for your patient.
  15. agent66

    How Would You Handle This?

    Hip check buddy and his cart out of line, oops sorry i must have tripped (in my usual 4inch shopping boots of course), then give him the "tammy look" which would undoubtedly scare him and his gifts rights out of the mall.
  16. agent66

    Pt post CABG changed in mental status

    I would agree with above poster with the on or off pump OR? We refer to this as "pump head" post op. Look up in the OR notes and see how long the surgery was and if indeed they were on pump. Again a few days in the cardiac SX ICU would do it too, with sleep deprivation etc, as well as just a bad reaction to the anesthetic. Perhaps he threw a few emboli as well during the surgery, what were the risks for that? You can certainly have people who are as you said A and O X 3 but quite inappropriate.