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Serlait

Serlait

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Serlait's Latest Activity

  1. Serlait

    Does the bad pop up for Pearson Vue mean you fail?

    Groan.....my goodness....why not take yourselves and AN just a little too seriously...If this poor nervous kid wants to ask a simple question, let her ask. If you don't want to read it....then don't. No need to be snarky and flame someone for deigning to post an NCLEX question in the precious General Discussion. Get a life and some feelings....you don't have to be a nurse to be considerate of others....just a decent human being.
  2. Serlait

    Pacemaker interrogation

    All the staff in our Cardiac Device Clinic are RN-BSN nurses. We do not work for a cardiac device manufacturer and do not work for a hospital. We work with a team of cardiologists/EP doctors. And the actual interrogation can NOT be taught in minutes. Where did you get that idea? The thought that interrogation could be taught in minutes is uninformed and dangerous. Are you aware that when you use a programmer you have control of a patient's heart? There are dependent patients who MUST be paced and the potential exists in the programmer to cause pacing to be at voltages that are less than necessary to capture the heart. I have heard of patients passing out on the floor because an uneducated person attempted to interrogate their device and caused prolonged pauses in therapy causing syncope. Further, each manufacturer's programmer has it's own format and different devices can have different platform appearance within the programmer. All the nurses in our clinic have been trained to use the programmer from each manufacturer. The cardiac device representatives in our area are highly educated....some with PhD's and are nurses, engineers or other professionals who have received extensive education in cardiac device technology. Some are licensed, others are not, all are educated professionals. Believe me, cardiac devices are extremely sophisticated pieces of medical machinery that are FAR beyond the failure to sense and failure to capture that we were all taught in nursing school.
  3. Serlait

    Pacemaker interrogation

    Just about to complete my first year as a Cardiac Device Nurse. I am an RN-BSN with ICU experience. Had to have strong understanding of cardiac rhythms.....rest of training has been on the job. Our clinic interrogates and troubleshoots pacers, ICDs, CRT devices.
  4. Serlait

    All in my head?

    WOW! You're doing a lot of sticks for an alternative medicine clinic. Can't help wondering what the heck all your patients are having infused. Especially those coming in weekly. Is the fact that it is an alternative medicine clinic precluding patients receiving PICC lines to avoid such frequent sticks? Don't get me wrong, I think there is definitely a place for alternative medicine, but I'd be more worried about what I'm infusing so frequently than my ability to stick someone.
  5. Gee...I didn't realize that being a nurse released me from assisting another human being when I'm off duty.
  6. Serlait

    Different Piggyback Antibiotics, Same IV Tubing??

    Regardless of her credentials, Ms. Hadaway stated on her website, Lynn Hadaway Associates Inc. Lynn Hadaway Associates, Inc.: Studies on Backpriming "Unfortunately, this is an area of clinical practice that has received no attention and no research." (First line of author's response). Until there is evidence based on research, I'll follow my hospital's policies so I have a paycheck to take to the bank.
  7. Serlait

    Different Piggyback Antibiotics, Same IV Tubing??

    "Yes the 2004 article still applies as no new studies to prove there is a better way." But the 2004 article was not supported by evidence based research. Again, there has been no research to support either practice. How can one claim "best practices" with a dearth of research to support such a claim. I find it interesting that if someone is unwilling to switch to another practice, especially when there is absolutely no evidence to support the change, they are accused of being unwilling to "change their habits". Very simply, if you want me to change my "habits" then show me the evidence that supports that change. Please don't site an eight year old article that does not include the most recent recommendations of agencies cited in the article. Both the CDC and INS revised their recommendations in 2011. If I were not willing to change my "habits" in the face of research, THEN I would be deserving of your censure, until then or until I have the evidence to argue for a change, I will follow the protocols of my hospital. I can't imagine trying to defend myself if there were some sort of problem or compatibility issue by saying that I based my practice on an article written in 2004 that was not current.
  8. Serlait

    Different Piggyback Antibiotics, Same IV Tubing??

    The CDC issued new guidelines as to the time a primary set should remain in use in 2011, this is the conflicting information in the cited article. Also it is noted in the 2010 Lynn Hadaway Associates Inc. link r.e. backpriming "Unfortunately, this is an area of clinical practice that has received no attention and no research." (First line of author's response). And further down in the authors response to a post "Of course there are no studies to refer to about this practice. I would recommend that your practice council consult with a pharmacist knowledgeable about IV drug compatibility information just to be sure. I just checked some recent compatibility information on Vancomycin and found conflicting compatibility information when given with ampicillin, several of the cephalosporins, nafcillin, piperacillin, ticarcillin and tigecycline. I would recommend that you assess the common combinations prescribed by physicians in your facility and then assess the compatibility of those combinations." Additionally, per the 2011 CDC guidelines, "No recommendation can be made regarding the frequency for replacing intermittently used administration sets.Unresolved issue " (#2 under Replacement of Administration Sets). Hence, the use of backpriming cannot be claimed to be evidence based, therefore, how can it be best practice? I don't see it as not wanting to change habits, but in following the protocols established. It seems to boil down to using the practice that your hospital or agency establishes as best practices. If your agency says a new secondary for each drug and 24 hour use for each secondary and you wanted to argue the issue, what evidence would you present? What research could be presented? At this point, per Lynn Hadaway, "The absence of studies means that we are left to base practices on general principles of infection prevention." (Paragraph 3, author's response). It would be extremely interesting to look at the rates of blood stream infections in hospitals with varying practices to see if there is a greater incidence of infection when multiple secondaries are used vs limited access for secondaries. Perhaps a good research topic?
  9. Serlait

    Different Piggyback Antibiotics, Same IV Tubing??

    I can't help wondering if the cost of a secondary set is more or less expensive than the saline used to backprime. Further, the sited article is dated (copyright 2004...which at 8 to 9 years old would this source even be an acceptable source in most evidence based research papers?) and no longer complies with CDC recommendations. It looks as if the Infusion Nurses Standards of Practice were also revised in 2011. See new CDC recommendations here.... CDC - Patient Cleansing - 2011 BSI Guidelines - HICPAC
  10. Serlait

    how long did it take for you to get into L&D nursing?

    Interesting. You've been a nurse for just a little more than a year, have zero L&D experience and you're going to be a charge nurse? Wow....THAT doesn't seem safe at all.
  11. Two months in and I'm about done. My company made us all salaried, switched us to a new computer system and now I'm charting for hours on my own time. I LOVE the patients, but REALLY hate the fact that this charting is eating my life.
  12. Serlait

    Best shoes for plus size women

    I tried New Balance as well when I first started school and working 12's as a PCT. My back would KILL me by the end of the shift. That's when I switched to Dansko's which really helped the back, but just didn't work over the long haul. Honestly, there are so many shoes and feet are so different, you may need to just try a few pairs to see what works best for you. Good luck in finding a comfy shoe AND with school! Congrats on getting into school!
  13. Serlait

    Best shoes for plus size women

    I'm not as tall as you are, but am a little overweight. I tried Dansko's and wore them for a long time, then started having really severe heal pain. I switched to Merrell's Jungle Moc and LOVE them. No more pain. I can walk in the morning after getting out of bed with no pain.
  14. Serlait

    need encouragement

    Now that's just sad. You've worked hard for your degree and title. Don't let anyone pay you less than what you're worth. CNA pay....NO WAY!
  15. Congratulations on your acceptance into school! You've got a great start by working part time in a hospital. That's how I got my job. But never forget that school is your priority. I busted my butt during school, graduated with a 4.0 and worked part time (16 hours a week) as a Patient Care Tech on the unit I wanted to work on after graduation. When I was at work I gave it 110%. I did everything I could to provide good patient care and to be supportive of the nurses. The nurses were awesome and allowed me to observe so much of what they did. I was offered a position in February to be filled after I graduated in May. So it's great that you're getting your "foot in the door" now. As unit clerk, you'll learn a LOT about MD orders, procedures, etc. etc. Good for you for being so proactive.
  16. Serlait

    Pearson Vue Trick - Poll once you receive your results

    Worked for me and five others.