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repost: new ICU job, pregnancy, and swine flu
I just heard they are going to recommend women who are pregnant, no matter what term they are in, get vaccinated. Good luck with your decision. It is hard to know where you can work today and have the lowest risk of getting Swine Flu, perhaps working as a telephone nurse or Ask a Nurse. You could always try doing precerts for an insurance company. Good luck deciding what to do and on getting pregnant.
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Physical Assessments: Do Any Nurses Do Them
Diane, I just spent 4 days in a tertiary care hospital that granted had many sicker patients on the floor than me but not once was I examined by a nurse. Not sure what my chart said other than I did read what the doctors wrote who said I was comfortable. Curious to see what the admission form said on it since I know they have quite a detailed form to fill in and there is no way it could have been completed accurately. If I didn't work at the hospital I would complain. As I mentioned in another forum it was a horrible stay. I was admitted for pain and one time it took 2 hours to get pain meds another time 3 hours. I was crying and wanted to scream. When my mother complained they said they were busy and I should ask for the pain medicine before I needed it. You can't ask for pain meds before they are due and you should have to anticipate you are going to be in pain so you ask for them ahead of time.
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Pelvic Pain
Thanks for the responses. However, I am confused since I remember there being certain repsonses and I can't find them. The link says there are 10 posts but I only see 5 whenI moved from page 1 to page 2. Anyway, the reason I haven't been posting is that I ended up in the emergency room and being admitted on Wednesday and got out on Friday. They admitted me for the pain and did anothe CT which didn't really show anything other than a bunch of fecal matter which bought me lactulose, miralax, a suppository, and senokot/stool softner. Surprisingly they didn't send me home with orders to take lactulose or miralax (I know Miralax is now over the counter). I kept insisting I wanted to be seen by Gastro but was told I wasn't sick enough (hmm, you admitted me to the hospital but I can't be seen by any service other than Medicine because I am not sick enough?) I finally contacted GI myself and they sent one of my doctor's colleagues since he was on vacation. Nobody outside of Medicine and the nurses had heard of such a thing. I work at the hospital and none of the doctors in my department had heard of any such thing. I was getting to the point where I was going to call in a favor but since I am new to the hospital I hate to have to do so. I saw a great gastroenterologist who said based on my history, my family history (the intern said I didn't tell him my family history but then he didn't ask and being on high doses of narctoics I wasn't thinking straight) he wanted to do a colonoscopy and happen to have an opening this Tuesday. The intern also said I didn't mention I was having fecal leakage but that is why he did the rectal. I have never had such incompetent care from an intern and nurses (sorry I hate to have to write this on here since I have had some GREAT nurses, I know there are always a handful of bad ones). The intern I saw was very smug about the fact that he was the first one to do a rectal on me. The nurses were asked to get a stool sample but by the time I was able to produce one I was leaving in the next hour so they said they was no reason to test it. Doesn't make sense to me. It also took them several times forever to get me my pain medicine, the first time 3 hours after I asked, the second time 2 hours after I asked. It wasn't because I wasn't due for it or the orders weren't written it was because they had to get it from the pharmacy, it took them an hour to respond to my reqest, and the nurse's excuse "we are very busy and whe had six patients". I tried very hard not to ask for things I could get on my own. I finally got to the point where I had to have my sister come stay with me and my mother came down. Oh, and the nurse told my roomate that she was not feeling well herself (the nurse and that she had the flu). When I went to be discharged the nurse had just literally discharged my neighbor, turned to me and said walk down to the nurses station and I will discharge you. To tired to argue, I did. The intern handed me written directions for my colonoscopy and discharge instructions. I questioned what he had written because it didn't make sense to me to have to drink 3 bottles of mag citrate at once, he said yes that was what they wanted. I showed it to my mother who also quesitoned it and we called and that wasn't what they wanted. Also he had written I was supposed to drink mag citrate today and it turns out it is tomorrow. I swear if I am readmitted I refuse to allow this particular team to care for me. I will be keeping copies of the notes I was given since they were so bad. My roommate also had terrible care. They decided she should have a colonoscopy and decided this in the afternoon but waited until 8pm to have her start the prep and cut it in half due to her medical condition. Well, surprise surpise she wasn't cleaned out enough and they refused to change her procedure time because it would mess with their schedule. She has to come back in a week and redo the prep. It made me so mad since it was the doctors and nurses fault that they didn't give her the right prep nor start it on time. Okay, I have vented enough. Hopefully this colonoscopy I am having is worth it and they will come up with something. The doctor, the first one out of many thought he could feel an indentation and seemed to think maybe I have a hernia but I know that won't show on the colonoscopy. Oh and my boss stopped by to say I don't have enough time in extended illness or vacation which didn't make me feel any better. I am concerned about losing my job. She is a new manager and I need to call either my old manager to find out the deal about being sick or call HR. I mentioned it to one of the doctors in my department and he said don't worry you aren't going to lose you job your too valuable but I don't think he has any say in it. I work for 9 doctors and the doctor that came by is one I am friendly with but don't work under. I did contact one of my doctors for help and unfortunately he now knows more about my care then I wanted him to but I was desperate and will hopefully keep what he knows under doctor/patient privledge but I am not sure it applies. I think I would contact him again because I was so desperate.
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Wearing Gloves When Taking Vital Signs?
I was wondering what is considered the norm in different people's ERs when taking vital signs about whether nurses/techs wear gloves. Whenever I have been to the ER the person who does my vitals on admission never wears gloves but several times when the techs have come in to take my vitals (no body fluids expsoure possible) they have put on gloves. As you would expect, at the doctors office they don't wear gloves either for taking vitals. When I have asked why they need to wear gloves to take my BP the responses I have received are "I don't know why you are here, so it is a standard measure" and "You don't know what I might have" (meaning the tech)-if I have to worry about catching something from the tech, she shouldn't be working. I understand the role of PPE and am all for it but I also was taught that a basic exam you don't need gloves that it is good for the patient to have human touch without a gloves barrier.
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Pelvic Pain
- Pelvic Pain
10 months of fecal staining and not one rectal. It is more embarassing than anything else but I also know it is not normal and I am concerned. Yesterday I decided to wear beige pants because I hadn't been having issues in a while. You guessed it, I found I had gone through my pants. I went around the rest of the day with a sweater wrapped around my waist wondering how many people had seen the stain but not said anything. I have seen many doctors at a top hospital, nobody thinks I need one and when I had my annual pelvic that doctor didn't do one. At least I know if can't be uterine or ovarian cancer. I just feel very lost and frustrated. My life was on hold for ten years when I had all this pain and finally it got better and I have felt like I have really been living.- Pelvic Pain
They say the pain is possibly due to an ovarian remanent which showed up on CT/MRI. Also, most are just passing it off as chronic pelvic pain which is just a diagnosis when they don't know what else it could be. I thihk someone thought possibly IC or IBS but I have been checked for all of those in the past. Several years ago I had a colonoscopy in fact I have had two which came back negative, cystoscopies/urodynamics, barium swallow, upper GI all of this when they were first trying to diagnose the problem when they said it wasn't GYN but then I had a hysterectomy and was pain free for several years. I never wanted to see another doctor for the rest of my life. I sat arguing with the doctor about the fact that I have never had sex because she was like everyones definition is different. I think I finally convinced her. They tested me a few months back for STDs because they didn't believe me, oh well just don't make me pay for a pregnancy test. If you still think I could be pregnant after having had a comlplete hysterctomy then you get to pay for that test. Sorry probably TMI.- Pelvic Pain
5 differrent healthcare providers-2 gyns, 1 ER PA, and my doc today and his colleague (I was scheduled to see her since I was told he didn't have time for me but she went and got him) haven't felt I needed a pelvic. I guess I am just tired of the buck being passed and feel weird asking for a pelvic and a rectal.- Pelvic Pain
First off I want to say I am not looking for medical advice more advice on how to deal with doctors. I have been having pelvic pain off and on for the last 4 months after being pretty much pain free for 4 years since a hysterectomy. I am on oxycontin which hasn't done anything this last week so I was told to go home and take some morphine to try and break the cycle (don't worry I am a secretary not a nurse and I have given up driving). My frustration is that my new gyn sees no need to exam me (trust me I don't really want an exam but I would like to know what is causing the pain. Does it make sense that my new gyn who I have seen twice in the last 3 weeks, my internist who I saw today, and the ED a week ago don't see any need for a pelvic? The reasoning I get is that I don't have any female organs and they don't want to cause more pain which I am grateful for. They did do a urinalysis which was negative. I had a CT and MRI in May that were negative. I have seen a gastroneterologist and urologist who say it is not their department but my new gyn wants me to be seen again. I can't schedule an appt (not be seen but schedule an appt) for two weeks at the hospital's gastro clinic Another embarassing symptom besides the pain is that I am occassionally having fecal incontinence. Very embarassing. My doctors say it isn't normal for a 33 year old (never thought it was) but nobody has done a rectal on me. How do you ask for that? The fecal incontinence is not due to the hysterectomy since the problem didn't start until 3-4 years afterwards. I don't want to be back on narcotics and I need a doctor who will take charge of overseeing the various doctors I do see which is what I told my PCP when I started seeing him. I feel like I am being bounced between specialities because everyone says it is not their department which is what I went through 10 years ago before finally being diagnosed with chronic pelvic pain and finally having a hysterectomy. I really enjoy Allnurses especially reading the humor section. Okay I just needed to vent. I am trying not to let my family know since they say I need to be more forceful with the doctors and they get upset with me for missing work.- Question for any CRA's
I don't know where you live but I know of several programs online and locally in MA that have clinical training programs that offer CEU hours. The one I am enrolling in is at BC but since I am not yet a nurse it won't count as credits or CEUs. You might also try checking out info on the ACRP.org website for people in clinical research.- Stool sample for Micro class?????
I agree with Catshow Lady that this is a violation of privacy and an infection hazard/health code violation. We were not allowed to do any body fluid type testing in micro at my community college and had to use fake blood to decide if the sample was A pos, A neg, B pos, B neg, etc. Even in my nursing school we had to use something fake to do occult blood testing. Such a thing as using your own bodily substances was acceptable many years ago but with AIDs, Hepatitis and other communicable diseases known about today most places have rules against this. Even if you wanted to use your own personal body fluids we weren't allowed. I would propose the professor should have you swab something at the salad bar or the bathroom door handle and see what it grows. I know we had to do swabs of places near the lab and it was interesting to see what grew. Also my question at college labs is how is all of this stuff that is grown disposed of? I never saw a biohazard bag in my community college (granted it was a general micro class).- MDs should obtain & have patients sign consent
I temporarily (very short time) worked in Urology as a front desk receptionist and it drove me crazy to give the patients consent forms to sign for procedures. IE patients were being given consent forms to sign without the form being reviewed by a doctor or nurse. It is possible the patient knew why they were coming in for the procedure but many times patients show up for appts just because they got a letter saying they had an appt. I was believed to ask too many questions so I had to let this slide. It is one thing to be told to hand the patient the consent form to read it over and that they will then have it reviewed with them by the doctor and be asked to sign it. It is another to hand it to the patient and say sign here when they are standing at the receptionist desk.- HIV+ Nursing student!
I think it is great you are being allowed to be a nurse and the hospital is willing to work with your "disability". I am still very upset that I had to leave nursing schoold due to problems walking. There are many forms of nursing and not all require working with needles or blood. Are you a nurse or nursing student? If you are a nurse were you HIV+ when you were a nursing student? It amazes me for a field about caring and helping the sick, nursing doesn't help its own people.- Funniest Complaint on Press Ganey Scores
:angryfireI just received a Press Ganey survey in the mail and usually I throw them out but I think this time I am going to complete it. Unfortunately people probably only complete them when they have had a bad visit but I also don't receive one for every doctor's office appointment. My complaints are NOT about the nurses, they were kind and I had actually very little interaction with them. The problem was the doctor's attitude. Yes, he in the end spent quite a bit of time with my mother and I with us coming in for an 8:45 appt and staying until 2pm so I could be sent back and forth for ankle x-rays. However, he was rude, arrogant and didn't answer any of my mother's questions. Yes, I am 32 but she was concerned because we were discussing surgery so I brought her with me. A concern of mine is that I work for the hospital that sent me the survey so I hope they can't tell who responded since I don't want to get in trouble-anyone know if they can track who filled out the form? The form does tell them I was seen by Dr. X on X day and has what appears could be a tracking # at the bottom. I am not really complaining about service (I understand having to wait since he had other patients scheduled through out the morning and hadn't counted on me being such a complicated case) although the last time I saw him he sent me for an MRI/CAT scan (yes both) for my ankle so he knew I wasn't going to have a straight forward problem. Two people who know this doctor say he is great and were shocked at his attitude and said he must have been having a bad day. Yes, it is possible but he was unprofessional, sat slouched in the chair and acted like we were wasting his time. If I am contemplating surgery and you are considering breaking my heel and fusing my ankle you bet I have a lot of questions. So I apologize that this is not a funny comment but I couldn't find any other Press Ganey thread to post under and didn't want to make another thread. Just know that not all Press Ganey surveys' negative comments are about piddly things.- Knowing your Pt's History
I have a relatively new PCP who the first time I went to see him didn't give me time to finish filling out my health history and when we were discussing my health problems failed to noted I have asthma. So the other day one of my doctors prescribed proponarol for anxiety (who knew I had asthma) but said to check with my PCP that it was okay to take with the BP medicine I was on and he said it was fine. Then I was talking with a pharmacologist who almost flipped because I guess you can't take propanarol if you have asthma and I have been having either asthma or anxiety a lot lately (probably anxiety). Luckily I never opened the bottle. I saw my internist today and mentioned to him that I have asthma, I had gone to see him for an inhaler since I had been using albuterol 4 or 5 times a day (I know for a rescue inhaler not good but that is all the ER gave me a script for-its been a while since my asthma flared up and usually it doesn't happen until Spring.) He was like oh, I don't have that noted in your chart, you are right you can't take that. So for the poor patient who probably wouldn't have seen this 3rd physician for a different problem (not asthma related), and assumed the doctor knows best they probably would have taken it. The pharmacy didn't catch it either and I am not sure why since I had just had an inhaler filled at the ssame store that I filled the propanerol. So to all the doctors and NPs out there, please let your patients finish completing their health questionnaire or go through it with them and make sure they haven't missed anything. - Pelvic Pain