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iluvivt

iluvivt

Infusion specialtist
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Content by iluvivt

  1. iluvivt

    My back kills!!

    I have tried so many brands and the best for me are Klogs brand and I like the clog style with no back (slip in) A few years my last pair were just trashed so I stupidly bought a pair of Nurse Mates..big mistake....my feet were killing me 3 hours into my shift.I could not get a new pair of Klogs fast enough.
  2. iluvivt

    Med error

    Well, how much muscle tissue did the patient have? If it was a fair amount I would not worry If it was a 90 year made up of skin and bones then I may worry. Either way, please keep this in perspective as while it was an error it was not a horrendous one as the medication still went into muscle tissue.
  3. iluvivt

    Curiosity Killed the Cat and Got 50 Hospital Employees Fired

    I am too concerned about my goals and keeping my life on track that I could care less about any patient, celebrity or not, that I am not directly taking care of. I have a position that I am asked for consults all the time or in other words my opinions on the best evidenced practice and/or policy so I need to go into charts that I may not ever touch the patient.I protect myself by documenting why I am in the chart.
  4. iluvivt

    Robot tells man he'll be dead in hours

    It was a human being speaking with them and I would have been grateful to speak with any specialist via telemedicine who was helping us.I am certain Kaiser also had their staff helping this man and the family at this difficult time.It does not have to be only one way to provide the care needed.
  5. iluvivt

    Robot tells man he'll be dead in hours

    This is far from deplorable! First of all it is not a robot telling a patient and their family that the end of life is near, it is a doctor using a modern tool.People hear bad news over the phone and internet all over the world.Instead of being grateful to the hospital and the specialist using this technology someone is looking to criticize the medical community.How about this: We do not invest in the technology and bring a specialist to the beside faster or bring one to you that you may not ever have bc access to. I am so sick of hypersensitive people that think everything must be done their way so their sensitive little feelings are nurtured.They should be grateful their good and kind family member was taken care of in the last few days of their life and offered some dignity and hopefully a peaceful passing. We just lost our dad and it was long and hard but our family was filled with gratitude that we were blessed with four caregivers that were so gentle,devoted and kind to our dad.We made sure they knew it too.
  6. iluvivt

    Lost job over HIPAA violation

    I think its absolutely awful of them to fire you for this. They could have just given you a verbal or written warning because really what harm came to the patient.You know what is going to happen to you now..... A Big Nothing. You will not lose your license over this either as Nursing Boards have much bigger fish to fry. Learn from it and move one and please stop stressing because it's not necessary.
  7. iluvivt

    Platelet Administration

    If this Y type set up has a standard blood filter (can't be a micro aggregate filter) it can be done this way, '
  8. iluvivt

    Platelet Administration

    I need to know is there a standard IV filter on the set that the platelets run through before they are pulled into the syringe? If no they are not following INS guidelines.
  9. iluvivt

    Any facilities actually using an AccuVein? Any thoughts?

    I have been on an IV team almost me entire career so I am a pro at vascular access and Ultraound use so I have no use for them.However,if a tool will help a nurse start a good IV I am all for it.The problem our team as seen is nurses using superficial veins that last one antibiotic dose or a very short time and then we are called to find a better site or they find veins,many not good,and still can't get it because they have poor skills.So we are not big fans.
  10. iluvivt

    Should I feel guilty?

    Guilt is an emotion felt when you have done something wrong or immoral .When you inform your employer you are not available for an extra shift or shift change on short notice you have done nothing wrong. They are simply just trying to staff for that particular day.This is a never ending process in hospital settings as census fluctutates, nurses call in ill and there are limitations in how many positions there are on any given unit.Do it when you can and want to and kindly decline when you are unable to do so.There is benefit for you though because this allows you to pick up shifts when you need extra income.This has helped me throughout my entire long career to stash away a lot of cash for my emergency fund and to pay for unexpected events.
  11. iluvivt

    Seasoned Nurses - This one is for you

    I love all the new technologies in IV Therapy.The use of Tip Confirmation Sytems to verify tip PICC placement lessens treatment delays and saves nursing time and money.Also the use of Ultrasound to get that PICC well above the ACF in the Basilic or Brachial vein.The use of Ultrasound to start a PIV is a different matter.While still good, it's not as easy as many portray it to be and they have a much greater propensity to infiltrate than the standard method to start an IV.Do I use it.....yes...but only if I have toif other options do not exist.It does buy some time though to get IV therapies started while you work on central line access.It's also annoying that nurses fail to lrearn how to start an IV by palpation or visualization and want to go straight to technology.They pick these superficial veins with a vein light that last a few hours or fail multiple times with the US and fail to see or palpate the good veins right in front of them.I see this every day.Technology is only as good as the hands it is in .
  12. iluvivt

    "Yesterday, December 7, 1941..."

    Thank you....A day that will live in infamy.Many Amercans have as their grave the USS Arizona and many lost their lives during that sneak attack that forced us into WWII.
  13. iluvivt

    HIPAA violation and future employment opportunities

    I would not resign.HIPAA violations are reported to the Department of Health and Human Services' Office for Civil Rights (OCR) .Your facilities compliance officer will determine if if it is a reportable breach .Many minor errors made in good faith are often not even reported.Also what matters is if the breach caused harm.Its not like 50,000 medical records got into public hands or insurance fraud was committed.Serious violations may result in disciplanary action from employer or BRN.Willful violations,such as theft of PHI for personal gain or use can result in criminal penalites.So you will not lose your license,you may lose your job,you will probably hear nothing from the OCR or your BRN because they are too busy for such small incidents.Not saying its not bad ,but it effects only one person and seems little harm was done.
  14. Ports actually have the lowest infection rate of all CVADs.They, of course, are still subject to infection especially if the patient is immunocompromied. If it is a single lumen port and medications are incompatible then it is very common to have both a port and a PIV.
  15. iluvivt

    First time in my life that I feel like a failure

    When is life ever always smooth sailing ahead....NEVER! Failing one class by one point does not make you a failure.What makes you a failure is giving up on something you want to do because it got a bit tough.So take some time to get it into perspective then get back up and go after what you want!
  16. iluvivt

    Accused of not giving dilaudid

    If you have not had a patient/and/or family complain you have not been a nurse long enough.You will have to provide nursing care to all types and you can not control the angry,bitter,manipulative,ignorant and just plain crazy patients and and their families.All you can do is control your response to them and that includes to not let them rattle you. I would never lessen my hours over a nutty patient because it's their problem,not mine.It's just part of the job and while it's annoying as hell to deal with it , anyone who has dealt with patients understands!
  17. iluvivt

    PICC Nurse in 2 months?

    Yes I will get a list of things you should review.Many will include central line guidelines and current recommendations for thrombosis and other complications.Often they are not all in one place and you have to hunt a liitle bit to get the information.I have been placing PICCs since 1989 and this has been my experience when I am looking for current information.
  18. iluvivt

    PICC Nurse in 2 months?

    Start the training and then you will see all that is involved...but you need to go for it.Research shows it takes anywhere from 20 to 50 PICC insertions to feel comfortable and be competent.Learning anything new starts with the first step and might I add a strong commitment to the process.If you start let me suggest some good resources for you.While learning the technical skills is one thing knowing what to do about complications and other problems is another.Will their be an experienced PICC nurse to turn to for support...you need to find out.
  19. iluvivt

    Forgot to restart my patients fluids

    It is a medication error.It is an ordered IVF at a prescribed rate and was not reinitiated after the IVP medication. You should have looked at your IV set up and added a T extension type tubing or dual lumen extension set at the hub of the IV catheter.If its not set up that way you can prime your add on tubing with a normal saline prefill and add it on and redress the site as needed.You can also give it push at the closest Y site if compatible and if not you can also put the fluids on hold or pause ....give an adequate amt of Saline Flush...then your agent (the prescribied medication ) and another normal saline flush.You also want to solve the problem for the next nurse so you lessen the disconnections.Much better to lessen disconnections and keep a closed system.
  20. iluvivt

    Forgot to restart my patients fluids

    It is a medication error.It is an ordered IVF at a prescribed rate and was not reinitiated after the IVP medication. You should have looked at your IV set up and added a T extension type tubing or dual lumen extension set at the hub of the IV catheter.If its not set up that way you can prime your add on tubing with a normal saline prefill and add it on and redress the site as needed.You can also give it push at the closest Y site if compatible and if not you can also put the fluids on hold or pause ....give an adequate amt of Saline Flush...then your agent (the prescribied medication ) and another normal saline flush.Ypu also want to solve the problem for the next nurse so you lessen the disconnections.Much better to lessen disconnections and keep a closed system.
  21. iluvivt

    Sexual harrassment or just an old creep?

    He is enjoying your company and companionship and be may be looking for more and for sure more of the same. You are going to have to take him aside and tell him as not only will it solve your problem it is a kind thing to do.Here is what I would say, I value our work FRIENDSHIP but it can't interfere with my abilty to get my work done so going forward I need you to call and see if I am available for a break as opposed to coming to the department and I may or may not be depending upon the workload.You need to stress the word friendship as you are declaring that is all you want and you are also asking him to stop coming to the department looking for you.Notice, that you are not assuming or even asking if he as a sexual interest in you because that may not be the case.He must honor your request or he can't even be a work friend.
  22. iluvivt

    Pressure sensitive IVpumps

    The nurse is the infiltration detector.You already have the solution and that is more frequent and accurate assesment.As Muno already,stated an infusion pumps have downstream occlusion sensor circuitry that detects elevated pressure between the pump and the patient. When the pump reaches the preset limit for the occlusion pressure ...it will alarm..The nurse can then go in and assess and figure out why there is resistance between the pump and the patient.This does NOT indicate that infiltration or extravasation is occuring because infiltration/extravasation pressures are much lower than the pumps downstream occlusion alarm limit settings and will not trigger the occlusion alarm .If you think setting the pump to the maximal downstream occlusion alarm will help by making it more senstive and thus with a lower value...Think Again.....what happens then is the patient and nurse are driven nuts with nuisance alarms and it still will not detect an infiltration.The alarm will tell you if there is resistance...that could be caused by a variery of things such as a pinched cannula....pinched IV tubing....IV tubing that has become pinched in the pump....(sometimes these are upstream occlusions)...even a pinched slide clamp ..Your premise that the pump is not doing its job is incorrect. Pumps do not detect infiltrations and the feature you are referring to is only to detect resistance as I explained.If you were told this...it is incorrect and I can refer you to more information if needed.I have had many a nurse think this and I politely correct them and tell them they are the infiltation detectives.
  23. iluvivt

    IM lorazepam help

    The fact remains....they had a seizure related to bc alcohol withdrawal Evidence is strongly in favor of the use of benzodiazepines to treat alcohol withdrawal states. They unequivocally reduce the risk of severe alcohol withdrawals like seizures .so it make sense to give it. I bet the order does not say if the patient becones responsive do not give the Lorazepam. The goal is to treat the patient and the underlying reason for the seizure remains...so give the dose.Doesn't that make sense?
  24. iluvivt

    Central Line Placement and Masks

    Maximal Barrier Precautions Defined Best practice is use of maximal barrier precautions which means strict compliance with hand hygiene and wearing a cap, mask, sterile gown, and sterile gloves and covering with a large head to toe sterile drape. The cap should cover all hair and the mask should cover the nose and mouth tightly. There should be an empowered observer that monitors the entire procedure to make certain there is no breach in practice and no one enters without a mask and cap on and and maybe even a gown depending on how close they get. The empowered observed also monitors for a break in sterile procedure/technique such as when a sterile glove inadvertently touches a non-sterile item when being applied. The empowered observer has the responsibility to stop the procedure until the breach is corrected and should be filling out the CLIP form (If in US). Are you not doing this?
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