LiverpoolJane

LiverpoolJane has 21 years experience and specializes in Dialysis, Nephrology & Cosmetic Surgery.

LiverpoolJane's Latest Activity

1. 

   Transcript for ENB courses?

   LiverpoolJane replied to misswoosie's topic in International

   I trained at a hospital shool of nursing starting in the early 1900s pre project 2000. I did get my transcripts from the university that has replaced my old system of training but it did take about a year and several attempts before getting a proper breakdown. I would also advise using CGFNS from the start as initially I just asked the BON to evaluate my transcripts but they wanted more info. Although I resent the cost of CGFNS it did get the job done and is accepted in most states.
2. 

   Non-Medical Prescribing

   LiverpoolJane replied to LiverpoolJane's topic in International

   Thanks all for the replies. I have heard from other NMPs how scary it is when you first start to prescribe. I'm looking forward to getting started and hope I can just start with the drugs included in the formulary created for my course. I picked drugs I've been familiar with for many years - anaemia management, phosphate binders etc, working in a speciality (renal) you become very familiar with a small group of drugs.
3. 

   Non-Medical Prescribing

   LiverpoolJane posted a topic in International

   I have recently completed my NMP, got my official results about 2 -3 weeks ago now. I was just wondering about a number of things: How long does it take for NMC to record this How did those who are NMPs start prescribing eg, limited formulary at first and then expanding on this. Is your formulary "logged" in a formal way with the Trust or a more informal, local way, with your supervisor etc . I was in discussion with a nurse who is an NMP a few days ago on the issue of transcribing. From my course I understand that I would be ok to do the TTO for a pt from the in-patient script, or to write up current meds on admission. She seems to think this is not the case, but she does work in out-patients so in a different area than myself. I'm sure this will all become clear when I contact the NMP lead locally but just wanted some thoughts from current NMPs on here. Many thanks. Jane
4. 

   Blood transfusions??? just say no...

   LiverpoolJane replied to macgirl's topic in Nursing

   why are people failing to read what has been written by jws in this thread but continue to rant about jws abandoning their patients and abdicating care?? it has been said that the objection is to actually spiking the bag and connecting the blood to the patient. it has been stated that they will do the paper-work and the clinical observations before, during and after the transfusion. in 20 yrs of nursing i've never been greeted with hostility from co-workers if i have asked them if they mind doing the connecting up if i do the observations & paper-work etc. i've helped my fellow nurses with their patients on numerous occasion, for instance if a patient had a really malodorous wounds and one particular nurse couldn't face it. i've stepped in on other occasions because perhaps a nurse is getting a rough ride from a particular patient or their family and it was geeting too much for them. i didn't accuse them of dereliction of duty or suggest they should not work in this particular area because of some situation easily dealt with by another nurse. we should be able to support each other and i'd be surprised if anyone has been greatly inconvenienced by a jw co-worker. be reasonable, some of you are blowing this out of all proportion.
5. 

   Slowing down LEGAL immigration process in the US

   LiverpoolJane replied to demigod's topic in International

   I can understand people getting angry if local junior nurse jobs were being given to overseas nurses while local nurses were being over-looked. I'd be surprised if this was the case. As a UK nurse who was seeking immigration to the US the job I applied for was for someone who had experince in acute and chronic renal replacement therapies and plasma exchange. There is an on-call rota so you would be expected to work autonamously on the acute med/surg wards and ITU. Surely if there was surplus of such qualified and experienced nurses locally then there would be no need to look to other contries to fill these gaps? If there are local unemployed nurses who could step into that role they would've snapped them up, so when I see statements re, overseas nurses taking local jobs when there are local nurse unemployed I am a little sceptical. I can appreciate that there will be newly qualified nurses struggling as the same situation applies in the UK at the moment, but they cannot fill the specialist vacancies that exist. As an ex ward manager there have been times when we've recruited overseas but this has been a last resort we only recruited experienced nurses. At this time as far as I can tell there is no active recruitment by the US for overseas nurses, as any glance in the job section of nursing magazines will confirm. Also agencies have gone under or stopped sponsorship to the US. There will be a trickle of nurses coming through and I'm sure this will slow further.
6. 

   post op and renal failure

   LiverpoolJane replied to isthatso?'s topic in Nursing

   The biggest causes of acute kidney injury (AKI) in the surgical setting are hypovolaemia and sepsis. Some surgical procedures are higher risk - there is about a 20 - 30% incidence of AKI following cardio-pulmonary by-pass surgery. Patients with and underlying chronic kidney disease (CKD) are more prone to also develop an AKI. Management is fluid and elctrolyte balance and acid-base balance as you often find they have a metabolic acidosis too. Some drugs are causes of decreased kidney function - some antibiotics, NSAIDs and contrast following radiological procedures are the main culprits. Also another reason is urine retention - so bladder examination / USS to eliminate this.
7. 

   Blood transfusions??? just say no...

   LiverpoolJane replied to macgirl's topic in Nursing

   Macgirl - I have been nursing for over 20 yrs and am a JW. The first thing you need to establish is if you are willing to administer blood to another person despite your stance on receiving blood products yourself. For some JW's after examining the scriptures they have a clear conscience about hanging blood for others who have consented to receive it. If you still decide that this goes against your conscience then you need to consider how you're going to plan your career. There are areas where blood transfusions are less likely and others where it is not appropriate and patients are transfered to an acute facility to have their blood transfusion. In 20 years of nursing I have found that colleagues have been very supportive despite some of the hostile responses I have seen on this forum. As one poster stated he/she will see a BT maybe once every 3 - 4 months so hardly a huge issue in certain areas of nursing. I have been careful not to mention my own stance on if I am willing to administer blood to others or not as I don't want to influence your decision either way. PM me if you want to discuss further.
8. 

   Jehovah's Witness nurses in the critical care unit?

   LiverpoolJane replied to asdf88's topic in Critical

   I just wanted to clarify the issue of blood transfusions and JWs. The decision whether to administer blood or not is a personal one, not one that is laid down by the organisation, so some JW's will and some won't. There are examples in the bible were "Gods people" when in captivity had to serve unclean meat to the king and others although they wouldn't eat these things themselves. Some JWs will use this as an example to help them reason that they would be ok with hanging blood products, even though they wouldn't have one themselves. There are similar issues when it comes to whether an individual will consider organ transplantation or not, I know JWs who say it would go against their conscience other I know have had organ transplants. OP, whether you are prepared to hang blood / blood products is a matter for your consideration and not just because it is the opinion of someone else.
9. 

   Nurse practitioner

   LiverpoolJane replied to Sailrmar9's topic in International

   and this site may be useful http://www.nursepractitioner.org.uk/
10. 

    Nurse practitioner

    LiverpoolJane replied to Sailrmar9's topic in International

    There are advanced practice nurses in the Uk but they are not regulated / registered like they are in the US. The NMC is supposed to be working on this but it is a long time coming. In the meantime have a look at the following link from the Royal College of Nursing and it will hopefully answer your questions. http://www.rcn.org.uk/__data/assets/pdf_file/0003/146478/003207.pdf
11. 

    cathlock heparin

    LiverpoolJane replied to armynurse,rn's topic in Urology

    Weekly only if it's not in use. We have a few patients who hold between plasma exchanges and weekly has been adaquate.
12. 

    Acute Dialysis Medications to Know

    LiverpoolJane replied to sfoltz1's topic in Urology

    I think the main ones are antihypertensives, ACEi, ARB, BB, CCB etc, also any diuretics the patient may still be taking.
13. 

    breach of contract

    LiverpoolJane replied to anamica's topic in International

    I'd be interested in the outcome of this. I signed a contract in 2007 and so have been caught in the retrogression trap also. Another nurse I know signed with the same agency around the same time as me. He mentioned his wife was keen to relocate in Australia and when I asked him about the $10,000 fine he said our Attorney had told him that with the time that has passed it would be difficult to pursue someone for this. Your situation is different though as you are now resident in the US - unless the agency doesn't know this?? I would e-mail your Attorney and see the response.
14. 

    Liverpool Women's Hospital

    LiverpoolJane replied to Celia M's topic in International

    Getting info can be a problem and I would suggest that you come to an arrangement with just one person and speak to them only. Ideally the ward doctor or the ward manager / sister, that way they know what has been said before. In the past I have agreed to be the contact for families who live a distance, as the junior staff felt a bit twitchy about it anyway. I would ask to speak to the ward manager and ask him / her if you could set up an arrangement with an individual and ask him / her which one it would be. Then arrange a best time to call back next time. I hope they are reasonable about this, it can be uncomfortable for staff after being brought up on not giving info to families the way we used to many years ago, and especially over the phone. If that doesn't work I would suggest you enlist the support of PALS, customer care or speak to the "matron of the day" I see they have according to their site.
15. 

    If I do Midwifery course?

    LiverpoolJane replied to haveyourbowelsmoved's topic in International

    Good - I would if I was in your position, get as many skills and as much experience under your belt as you can. I'm having a second wind as a student and am disappointed it's coming to an end, it is over far too soon for my liking.
16. 

    Liverpool Women's Hospital

    LiverpoolJane replied to Celia M's topic in International

    Hi Celia, the days of the telephone trolley and communal TV in each room have been replaced with individulal phone & TV at each bed space. That comes with a considerable charge unfortunatley. I think it something like £3-£5 per day for the TV and calls at an extortionate amount. Be grateful the nurses allow your MIL to come to the phone as it is usually discouraged. Hope you MIL makes a fast recovery and is well enough to be transfered. Since posting my first response I started thinking of many people who have been treated in Liverpool Womens and can only remember of hearing very good experiences. I'm sure there are the other stories but on the whole it seems to have a good reputation. Jane