MIA-RN

my tattoo artist told me that most ink allergies are to the reds. maybe that has something to do with it?

hi all. I'm an RN looking at a position as MDS coordinator in a 200 bed LTC nursing home. Does anyone have an idea what the average salary is? I live in Upstate/Western NYS. thanks!

These are my thoughts: superficial scar tissue: New and delicate tissue, easily injured and more susceptible to sunburn and damage. It doesn't cause cancer but is way more susceptible to damage/injury and therefore cancer. seborrheic keratoses: I think this is just a form of eczema. numerous facial freckles: Freckles aren't a cancer risk flesh-colored papules: These can be anything. They can be basal cell carcinoma, which means the person already has the cancer and it is not a risk of developing it because they already have it. * I would love to see the rationales from this question.

1. how many years have you been a nurse? a few months short of 3 years. i have been a nurse in the ed for just over a year. 2. what is your educational background and/or specialty certifications do you hold? i have an aas in nursing. 3. what is the most rewarding aspect of your job as an ed nurse? the fact that we do things in the here and now to help an immediate problem. when i send people home, they often feel better than when they got there. i feel like i make a real difference, which i didn't feel when i was a floor nurse. 4. what situations are the most challenging for you as a nurse in this department? the biggest challenge is trying to manage the care of more and more patients without a similar increase in resources. we seem to have more patients who are more acute. also, the people who aren't truly sick take away the time and resources from those that really need it. 5. why did you choose to go into emergency medicine as a nurse? i got very tired of working on the floor, and seeing the same patients day in and day out and not feeling i was making a difference. i like the fast pace and the (relatively) fast turnover. i like seeing a little of everything every day. 6. has there ever been a time when you wish you wern't an ed nurse? no. 7. is there a memorable experiance that stands out as you think back as your experiance as an ed nurse? it's hard to say without violating hippa...when people tell me i really helped them, it stands out to me. (and it is often not related to their actual medical/nursing care) one time i had a patient who came in with mostly anxiety-related symptoms. i took the time to ask her what was going on, and it turns out she was recently diagnosed with cancer, she did not speak much english, and she didn't really even understand her illness or the treatments. i was familiar through my experiences with the type of cancer that she had, as well as with the medication she was taking. i explained the basic mechanisms of her illness, and told her about the medication side effects. she explained that the medicine was very expensive, that she didn't have the funds. i was able to find the name of the drug manufacturer's program for reduced-cost medication, and i was also able to give her information on a local support community for her type of cancer. this young woman came in feeling alone and scared and left with a plan and a new sense of hope. she cried and hugged me when i discharged her, thanking me for giving her hope. this is not the kind of 'blood and guts' experience or even one of the most moderate heroics, but its one that impacted me strongly. what would i tell a new nurse? well, the standard stuff about comfy shoes. but seriously, keep your eyes open and ask questions. always ask if you don't know. trust your instincts; if you find something in your patient that doesn't seem right, bring it the attention of your preceptor, your doctor, or another nurse. your instincts will sharpen the longer you do this job. if you begin to feel overwhelmed, ask for help. teamwork is huge in an ed and most people will help you out. you need to remember to reciprocate as well. grow some armour too--you will see things that will affect you on many levels. it is okay to use therapeutic use of self but if you get too emotionally involved you will burn out. not all outcomes are good and you have to be prepared for that. its okay to cry with your patients.

I avoid this by not pushing meds too often. I never push narcs either. I am always interested in what meds are compatible. I saw an empty IV bag in the garbage that a nurse had labeled 'toradol' and 'zofran'. I wonder if they are really compatible?

I work in the ED and I never try to hold a patient. Shift change doesn't matter in my ED...we get patients as we empty rooms. It's not uncommon to come into a shift in the ED and have a couple 'established' patients and then have a few more that were just placed in beds that the off-going nurse doesn't know anything about. That's just the pace. We call report on the admits as soon as we find we have a room. If I am calling report and realize that its shift change, when I am working 12's I tend to forget about the 8h evening shift, I just apologize and call back in 15 minutes. I understand about getting rooms clean, and I also understand how we get backed up in the ED. Its the process, not the nurses. It's not fun getting a patient when you have just gotten there and have yet to see everyone on your assignment, I remember that from my M/S days, but it's just how the flow goes. I took them as a floor nurse and I send them as an ED nurse...none of the timing has anything to do with nursing.

Thanks! I am going to check the site out now!

oh. my . god. I am so embarrassed--I have this book and forgot about it! Thank you so much!

Hi everyone! I am looking for suggestions/recommendations for a pocket-sized lab reference guide. I am looking for something that lists lab tests, normal values, critical values, and what may cause the labs to be out of the normal ranges. I KNOW these things exist, but I cannot find one! Maybe I am not good at coming up with search terms, but at B&N and Amazon I keep getting textbooks, drug books, or nursing books. I really just want something I can put in my pocket and use to look up lab studies (blood, urine etc.) Any suggestions?

Remember that you just earned your degree in 'textbook nursing'. You are now going into 'real world nursing' and there will be a conflict at some point between what you learned, and what is done. Remember that there is often more than one right way, and learn from the ones who are already there. Ask questions, advocate for your own learning. Ask your NM to let you shadow on a different service--say, wound care or something, in order to help you learn even more. When you walk into a room that first day and say "Hi, I'm *____ and I'm your nurse today," try to believe it. You really are a nurse and you CAN do it.

When I am Charge (which is usually) I take a full assignment, room patients, try to finagle moving patients to the floors, check with triaging issues, help the other nurses, be sure everyone gets their break and cover accordingly, keep a general flow of pts in and out, be a resource for just about everyone. And no extra money for it.

I remember being a very young child in the early 70's and every time I went to the doctor's, the nurse pricked my finger. She would then draw the blood up in a pipette held in her mouth. I remember being scared that she was going to suck out all my blood! They would spin the blood right in the office, to get a white count. They also did throat cultures in the office, and grew them out right there on the agar plates overnight. I remember they would write my phone number on the cover of the plate and call the next morning if it was positive.

I think that even working as a tech, you will be held to the standards of a nurse. Meaning that if you find something wrong with a patient, say vs or bg or something, you have to do something about it, other than report it to the covering nurse. Not being an LPN myself, I am not sure of the scope of practice in that situation,but I know that you are expected to work to the scope of your license. Plus, why work as a tech? Why not work there as an LPN?

Here is another question along these same lines... After drawing up the meds with the filter needle, do you have to change out the needle before injecting the meds into a 50cc bag? I switch out the needle, but nurses that I work with have told me that it's safe not to; the filter mechanism supposedly keeps the glass from being injected out with the meds and into the bag.

Having just sliced my finger a few days ago on an evil ampule of dilauded....I am none too happy that we are using them again. The pharmacy does not have any ampule openers. I am not a happy camper.