nursenatalie ADN, RN

nursenatalie is a ADN, RN and specializes in Surgical.

nursenatalie's Latest Activity

1. 

   Has your hospital closed the floor for low census?

   nursenatalie posted a topic in Nursing

   Our hospital closed our surgical floor to admissions on Thursday. The rationale was that they anticipated a decreased census because of the holiday. We joined our Orthopedics wing on Friday afternoon bringing 10 patients with us. Crazy thing is that we now have 15 of our patients and surgical patients are all over the hospital including adults with abdominal pain admitted to the pediatric unit. Anything like this ever happen where you work?
2. 

   What do you use? A fanny pack?!

   nursenatalie replied to er1c15's topic in Uniform/Gear

   I wear unisex scrubs with only two pockets. One on the left chest and one on the back. I don't put anything in the back but can fit everything I need in the one pocket; two blue pens and one red, scissors, tubex,mini dry erase and permanent marker, alcohol pads and chapstick. Hemostats and tape clipped to my waist. There are times that I may put more in my pocket and it is a running joke that I have the neverending pocket, like a clown car.
3. 

   Fem Fem Bypass

   nursenatalie replied to tnbutterfly - Mary's topic in Nursing

   I would insist on speaking to doctor. Don't know about this doctor but we frequently have doctors speak to family members before a procedure and they always call. The doctor is the one to speak to you about risks etc. but we do this procedure often. Did your dad have a fem-pop bypass? Or ileofemoral?
4. 

   Need help with IV technique

   nursenatalie replied to Firemedic7's topic in Emergency

   I can't imagine that being color blind should affect your ability to start IV's. I think you are looking with your eyes for a vein and that may be the problem. Feel with your hand and finger. The veins you see, unless the person has ropes aren't always the best veins. Make sure your technique is good and practice, it is the only way to get better. See if you can go to day surgery and start IV's.
5. 

   Heparin in an emergency-to draw PTT or not?

   nursenatalie replied to Shell5's topic in Med-Surg

   Please, aspirin is an anti-platelet drug and doesnt significantly increase ptt. Like I said, if the patient is having clinical symptoms that require heparin then best to begin heparin and adjust dose for efficacy. Worrying about a baseline ptt on a pt. who has not been on heparin therapy in an emergency situation instead of beginning treatment would infuriate some.
6. 

   Duties as a Med-Surg Nurse

   nursenatalie replied to whitneyLOL's topic in Med-Surg

   Pretty broad question. My duties depend on the day, my patient load and change every day.
7. 

   Can a suppository be given via a colostomy?

   nursenatalie replied to floatRN's topic in Med-Surg

   yes, if the surgeon orders it. Had an order from the medical doc to give suppository via new colostomy and called the surgeon to make sure it was ok and he said no. If the surgeon himself ordered suppository or enema via colostomy then ok.
8. 

   Heparin in an emergency-to draw PTT or not?

   nursenatalie replied to Shell5's topic in Med-Surg

   Our surgeons wouldnt give a rip what the ptt started out they would only want to change rate based on 6 hour ptt. Too late to get a baseline if you've already pushed the bolus. Some docs would be ticked that you took the time to draw a lab for baseline that wasnt ordered when the clinical picture must obviously show this pt is not anti-coagulated enough or else it wouldn't be an emergency to get the heparin going.
9. 

   Fentanyl patch & witnessing

   nursenatalie replied to gtmoore's topic in Nursing

   We have to witness waste with another nurse. Form comes with patch, we must cut patch in two and put in sharps container.
10. 

    Lap chole

    nursenatalie replied to cndrn's topic in Med-Surg

    Funny how things are different, we allow pts to drive after 24 hours. I was back at work in three...would be funny to be able to work but not able to drive yourself there.
11. 

    Sleeping pill at THIS time????

    nursenatalie replied to mediatix8's topic in Nursing

    As a general rule with only a few exceptions, I would not give a sleeping pill past 2 am. I work on a surgical floor and the day time is reserved for walking and therapy so pts need to be as awake as possible for that. Ambien and other sleep meds are given with the intent to make the pt sleep and this is the only reason they are given. Although they may also make the pt go crazy, disrobe, pull out their IV and run down the hallway naked, that is another story. Other meds are given for nausea, itching or pain and have the side effect of sleepiness. There are few exceptions but generally no reason to give a med to make a pt sleep while the sun is shining.
12. 

    Lap chole

    nursenatalie replied to cndrn's topic in Med-Surg

    We rarely have any stay overnight. Usually when pain and nausea are controlled and they can pee they go home. Average 2 hours. I had a lap chole last summer and left after 45 minutes, I met criteria and didnt want to stay a minute longer.
13. 

    Lantus part II, oh how I want to scream!

    nursenatalie replied to evans_c1's topic in Nursing

    I personally agree with your charge nurse. If the patient is not eating then you are probably giving them sliding scale as well as the lantus, right? I would prefer to manage them on an as needed basis than give a long acting drug that could bottom them out. Face it Lantus lowers blood sugar, did it need to be much lower? Scary thing to know their blood sugar could bottom at 2 am and you may think they are sleeping peacefully while they slip into a diabetic coma. You wont convince me this patient needed lantus. Ultimately clarify order now that pt is npo but dont care who ordered it, the md is not going to be the one monitoring the pt through the night...I would not give it with that blood sugar.
14. 

    PACU RN's- what is your visitor policy?

    nursenatalie replied to RN34TX's topic in PACU

    We allow no visitors in PACU. There are no walls between beds, only curtains, and the report between anesthesia and nurse is verbal so I think it would be difficult to maintain patient privacy(you tell the md to lower his voice.) Patients dont need visitation at this time they need to be monitored. Peds are the exception, and only exception to this rule. If a patient is stable enough for visitors then they should be going to the floor. Family gets to talk to surgeon while pt in PACU, and gets update from nurse after 30 minutes so they get their reassurance.
15. 

    What is ur average 2 week take home pay?

    nursenatalie replied to chioma829's topic in Nursing

    Here goes... 1.Type of nurse? Surgical Nurse 2. How many hours u work per week? 36 one week, 48 the next. 3. How many years of nursing? three 4. What Shift: Day, Evening, nights, or weekend only? nights 5. City and State Western North Carolina 6. Average 2 week gross pay $1900 after insurance, tax, retirement and foundation contribution
16. 

    Heart Sounds anyone?

    nursenatalie replied to ltrnkoczy's topic in Med-Surg

    yes, definately make sure the earpeices are facing forward. I am embarrassed to say this but it is the truth: I was out of nursing school roughly six months before I realized I had earpeices turned the wrong way! I was very embarrassed, it wasnt that I didnt hear things before but wow I could sure hear them afterward! I usually tell this story to any new grad I am orienting. It makes them a little less timid about asking me questions. I am sure they think if I spent six months with my stethoscope turned the wrong way I am not going to laugh at them!