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Toquay's Latest Activity

  1. Toquay

    Port in the arm instead of the chest

    Sounds like a passport was implanted which looks like a mediport only much smaller. The passport can indeed migrate or flip over so its very important to feel and determine that the port/septum side is up. You must still use a huber or noncoreing needle to access the silicone septum which is only about as big as your smallest fingers nail bed. The size of the patient or the amount of tissue one has to feel through can make this port a little more tricky to access. You should still feel the back of the port through the septum when accessing before trying to use it. Once accessed follow your hospital port policy for maintaining it. Hope this helps. Toq
  2. Toquay

    Some OB questions

    I am a nurse but not in OB so wanted to ask the experts. Is it common for OB to change the due date in the last few weeks pregnancy? Daughter had been going to fetal maternal medicine for entire pregnancy until a week ago and has been told she is due Nov 19th and at her OB appt the other day (OB she has never seen before) was told her due date is the 26th. OB stated only US that counts was the 6 wk one as it is most accurate (daughter was getting an US twice a month through preg) and that all other US are off by 2 weeks. This OB insisted my daughter heavily consider epidural since it was first baby and started throwing out possibility of c-section, I asked about epidurals slowing labor and was told "not the way they do it" as they only do it at a certain point in labor. I told her I was under the impression that anesthesia called the shots and most times it was at their convenience or when they were on the unit to which she did agree that was partially right. Daughter lost her mucous plug 1 week ago (I saw evidence of this) had some contractions but nothing that lasted or became regular. She saw OB (not the one above) the next day and was confirmed to be 2cm dilated but no mention of effacement. The OB above refused to do vag exam after moving my daughters due date back a week states baby has 2 more days to be at 37 wks and this would be risky for baby. She did do a speculum check and stated cervix was closed up and not 2cm anymore, explaining that the cervix opens and closes at the end of pregnancy. I know the baby will come when it is good and ready and not before. However, my questions are is it common to discount all US except the first one? Is it usual for cervix to close after losing mucous plug and being at 2cm with manual exam? Can the speculum exam be as accurate in determining the cervix was closed (exam was super fast maybe 3 secs)? Finally any thoughts on the epidural (I know its a personal choice) and laboring times? Women have given birth for thousands of years it is not an unnatural act it seems like instilling fear in expectant moms is common. Thanks for any feedback, I know every pregnancy can be different. Toq
  3. Toquay

    Fl. educated nurses

    Edison Community College ADN 1992 Review for NCLEX by hospital internship (once a week x 6 weeks) Passed 1st attempt
  4. Toquay

    New grad RNs: Do you hate nursing already?

    Another solution that may work for you is going to part-time, since your spouse makes enough to support this change. This was to option I went with a few yrs ago and its worked out great. I love nursing and using my skills to help and educate people but was getting burnt out doing full time for 15 yrs (ER night shift). I would find myself counting down the hours I had left to get ready for work and feeling emotionally drained before I even got to work. I found myself snapping at things that were beyond my control and dwelling on it for hours. I felt isolated in my feelings and stopped doing things for myself because I was so mentally drained. Now that I work part-time (3 twelve hrs shifts a pay period), I am able to go to work feeling refreshed and new every other week-end. I find I am more helpful to my co-workers and to my patients because I am now taking care of me. I only wish every nurse were able to to work these type hours and still make ends meet. I do help out co-workers and cover shifts for them to help out now and then and admin likes this as I am never in overtime. Its a shame to lose good nurses totally and this may be something to think about. Toq
  5. My husband laughed at this idea... but what if we had a National lottery once a week whereas the winner would be exempt from future government taxes. One ticket per person at the cost of $1. US population 307,025,703 as of July 28th. Seeing a FL billboard bragging about 22 billion lottery dollars to the school system since its inception made me get to thinking. How many here would spend $1 a week at even the slightest chance to never pay taxes again. The governemnt would only lose 52 people a year that should be paying taxes. Toq Ok so I am a dreamer and like thinking of off the wall stuff but am curious how many think something like this could work?
  6. Toquay

    Health Care: The Ticking Time Bomb

    No where did I post that people with poor life choices would not get care. I again for the record stated that if one can afford 5-6 dollars a day for smokes why could they not put same amount into their healthcare. Why, Lamazeteacher, are you so opposed to people taking some ownership for their own care? Toq
  7. Toquay

    Health Care: The Ticking Time Bomb

    If you read my post I never said there were not people that did deserve or need help/ assistance. I merely stated that there are people that do work the system and hurt the others that truly need help. I have also read many posts here by people that needed help at different times in their lives and government programs helped them to get back on their feet. I do feel if someone has the money to buy an unhealthy lifestyle (which is their right) they should not be entitled to take money away from people with true hardships. Toq
  8. Toquay

    Health Care: The Ticking Time Bomb

    People have the right to smoke, drink, eat diets that will kill them and engage in risky behavior of all sorts. The issue is not about rights because if you work to support the above "choices" then why not work to support paying for your healthcare as well. If you can pay 5-6 dollars (many smoke more) a day for smoking (or whatever vice) then why not put 5-6 dollars a day towards health insurance. Then people truly needy of government help could get it. The problem is too many feel they are entitled to free care. Toq
  9. Toquay

    Grammy awards given in triage!

    The intractable nausea and vomiting that is observed putting their finger down their throat to make themselves heave. The hyperventilating anxiety attack put in a stretcher complaining they are going to passout and being told to "Go ahead". I personally like the fake seizures that need to sign papers for registration and the seizing stops long enough to sign their name and then resumes. Toq It's all job security and if you don't laugh once in a while the absurdity will kill you.
  10. Toquay

    Which should be seen first?

    Could go either way depending on the age of the pt, VS, and history. If both are equally critical my ER would make room for both, if any delay (room being cleaned, pt being moved) I would get the EKG, start the line get the labs and put O2 on the pt. I can even get an updraft ordered for the SOB if their symptoms indicate the need for one. Toq
  11. Hospitals are businesses and are about their bottom line and making money. I think Nurses and other hospital staff will see their own benefits take a hit. Meaning the hospital will decrease the percent they pay for employee benefits. You may see fees for the once free in house services or programs (employee assistance, smoking cessation, weight management, etc) and pay more for your own personal/ family coverage and have higher deductibles. Probably get the speech how we all have to pull together meaning the end of yr evaluations will continue to have lower than cost of living increases to off set their loss. The funny thing is the person in management that comes up with this will probably get a pay raise and promotion as well as a new committee to work under them. Toq
  12. Toquay

    ONLY 6 week orientation for New Grad?

    I went to ER from ICU and was given 2 weeks orientation (6 night shifts with preceptor). Thank god I had a few years adult ICU experience that had given a critical care course (3 weeks). However, I had no experience with OB/gyn, peds, basic ortho, and many other ER type presentations. If I had been offered back my ICU position back, then I would have ran from the ER as fast as I could. Ideally IMO, all new nurses should have a critical care course and 4-6 months preceptorship to develop a good foundation. Things move fast in the ER and while feeling inadequate as a new nurse is common, the hospital and senoir staff should provide an atmosphere that will allow new nurses to become strong team members. Its sad to see promising nurses get discouraged with the "fly by the seat of my pants" orientation. Toq
  13. Toquay

    ICU v. ER

    I am sure you have all heard the "If you build it, he will come" well the ER is of the philosophy... If you come, we will see you. It would be nice to close the doors when the ER is full or when staff has reached its limit but there are no limits in the ER. You work as hard and as safely as you can, let people know when you are stretched to the max and hope to see a light at the end of the tunnel. We used to be able to divert ambulances when we were at breaking point but even that is now a "no no" per the hospital system policy that I work for. We are in the business of healthcare 24/7 and as such we see, treat, and admit based on each pt needs... not to pick on the nurses. I still stand by the fact that every department is different and can vary from hospital to hospital. Every department will have its good days/nights and also bad days/nights, its simply the nature of the beast. The best way to get a feel of the work atmosphere is to talk with the people that actually work in that department or shadow someone. Toq For GilaRN: ER patients are not categorized quite as "simply" as you may think, and some patients can be very complicated and time consuming while we find out what is going on. They do not come to us with diagnosis and orders to follow, we often have to scramble to have all that so "simple" information to pass on.
  14. Toquay

    ICU v. ER

    Every floor has its demands and as mentioned shadowing at the hospital you are at is the best way to get a "feel for the flow". Some departments are managed better than other and some are staffed better than others which has a HUGE impact on job staisfaction. Some units have nurses that help each other and some don't. As far as the ER turning problem pts over to the floor because they can't solve said problem ... never seen it happen. I have yet to see a patient that was known as unstable sent to a regular floor, this type pt is usually upgraded to an ICU bed so the patient can have optimal care provided. The house supervisor can reassign pts if they are told of impending problems. Do patients go bad on the floor? Of course, but I have yet in my 17 yrs of nursing seen anyone knowingly dump or pass off an unstable pt. Toq
  15. Toquay

    Jury rejects rectal exam lawsuit.

    TiredMD just perked up LOL. Toq
  16. Toquay

    Jury rejects rectal exam lawsuit.

    Eventually we will sue ourselves right out of healthcare providers, they are guilty if they are not thorough and apparently guilty (according to some) if they are. I truly have never seen a doctor ever do a rectal just for the fun of it. Toq