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Almost RN Grad

TechnoDanceNurse's Latest Activity

  1. TechnoDanceNurse

    Difference between neurological nursing and psych nursing

    Neuro - you are doing heavy medical stuff, like IV, central lines, NG tubes other kinds of crazy tubes (like EVD drains)... you are doing lots of vitals and neuro checks - often on confused patients who will pull out their catheters and try to climb out of bed, play with their feces, etc. Lots of total cares - you will likely be doing feeding, bed baths, turning, brief changes, transfers, etc. Psych - mostly oral meds, with an occasional feces-player-type. Mostly verbal/visual assessments. Mostly independent with ADLs.
  2. TechnoDanceNurse

    What is Neuroscience Nursing?

    This article sounds like an administrator or manager's voice - not a "nurse in the trenches" voice. I think it would be useful if this article mentioned the unique day-to-day stress and challenges of working in Neuro, like the confused patients who are pulling out catheters and other lines, and patients who are aggressive, throwing feces, or otherwise require 1:1 and how that pulls CNAs from the floor, thereby putting more work on other staff. Articles like this are nice, but I need nurses on the floor to tell me how it is. I'm grateful for the Allnurses forum!
  3. TechnoDanceNurse

    Not happy in neuromedsurg

    What did you not like about OR?
  4. TechnoDanceNurse

    UTI vs Cystitis

    Urinary Tract Infection (UTI) is general term used to describe an infection anywhere along the pathway in which urine is created, stored, or travels - this can include the kidneys (pyelonephritis), bladder (cystitis), or urethra (urethritis). In this way, a UTI doesn't necessarily "cause" anything. It's more of a term to describe/classify, like illuminati88 said.
  5. TechnoDanceNurse

    Insulin Strategies in SNF

    Hello! I just started working at a SNF (26-32 person patient load with a mix of LTC and post-acute rehab cases) and I routinely have about 7 or 8 diabetics who I obtain CBGs for and administer insulin to. I was wondering about strategies for efficient and safe practice with this task. Everyone seems to get s/s Novolog before meals, and several people get Lantus, sometimes HS, sometimes BID. Question 1: How long before a meal is served is a CBG reading good for? Can I get a CBG reading and then administer the insulin 30 minutes later? Question 2: If I have to give two injections, one with Lantus, and separate one with Novolog, how far away from each other do the injections have to be? Can I use the same arm? Your experience is invaluable, and EBP sources are even better :) Gracias!
  6. After working my first nursing job in an inpatient drug rehab for 2.5 years, I was hired by large SNF company, with 29 facilities in the region. I'm currently in orientation which is scheduled to last 1-3 months. The patient load is about 25/nurse. At the facility I'm training at, there is an LTC side and an Acute side, but I will be transferring to an all-acute facility after I complete my training. There is an electronic record system that seems efficient and easy to use. I haven't noticed a shortage of supplies (but this is my first week). We have med-aids pass a lot (but not all) meds when census is high, and when it gets low, then the nurse takes over that duty. Compared to the specialty psych environment I came from, this is much harder work. Compared to my clinical experience at the hospital during nursing school, this is still slightly harder because of the high patient load. I find it intimidating to have to be responsible for 25 people, but I suppose it's better than some other places, plus it looks like we have decent support (DNS, RCMs, CMAs, etc.) The nurses do a lot of hands-on work (especially wound and skin care). The RNs also work very closely with the CNAs to feed, transfer, and maintain hygiene. Everybody changes diapers, including the RNs. There's much more dementia at a SNF, and that's a big difference between it and a hospital. Working with patients who have only basic communication skills, and sometimes no verbal communication at all is something that boggles my mind. But to summarize, and address your question once more, I think SNF nursing is harder than hospital nursing. The benefit is that if I can succeed in this environment, then I think I will be well-prepared for hospital work. No problem!
  7. TechnoDanceNurse

    Heparin Drip Compatibilty

    That's why someone would use two different pumps - so they could administer two different drugs into one line at different rates. Even so, I too would try to avoid mixing anything with a drip. It's extra-safe nursing practice, and we could all use more of that.
  8. TechnoDanceNurse

    Incident Reports

    I found this in my nursing text: "The nurse should never note in the patient's medical record that an incident report has been completed and filed. This may alter the protection from discovery normally provided the document in some states. The jury also will be made aware that an incident report has been filed because they have access to nurses' notes submitted in evidence during the trial." (Cherry, Barbara. Contemporary Nursing: Issues, Treands and Management, 4th Edition. Mosby, 102007. p. 171). It seems unethical to me that there is an active effort to "protect the discovery" of an incident report. I suspect that the words "incident report" upsets juries, and that's why there's an active effort to omit them from the chart. I figure if I do my job competently, then that's the best protection I have - not cunningly worded bureaucratic paperwork. I'm sure lawyers and business managers see it otherwise. That's why I'm glad to be a working person, and not behind a desk. They can keep the money and power, I prefer dealing with truth and reality. There's something spiritually gratifying about it - honest and pure.
  9. TechnoDanceNurse

    Heparin Drip Compatibilty

    I was just reading an article about common med errors, and heparin/insulin errors were mentioned here: http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/psn/transcript.cfm?show=65#8 What puzzles me is the idea that Heparin is added to TPN regularly. I have heard of Insulin being added to TPN, but never Heparin. Is adding Heparin to TPN a common practice, and if so, why? The only thing I found about it in my nursing textbooks is this: "Unlabeled uses: Hydrocortisone 15 mg and heparin 1,500 units as additives to TPN to reduce thrombophlebitis in peripheral lines. A 5-mg transdermal patch of NTG is applied to the catheter insertion site and changed daily." (Gahart, Betty L.. 2010 Intravenous Medications: A Handbook for Nurses and Health Professionals, 26th Edition. Mosby, 072009. p. 694). Curiously, I found that quote in a pediatric section about Hydrocortisone. Still, I wonder about why Heparin and TPN might be mixed?
  10. TechnoDanceNurse

    Heparin Compatibility

    Heparin and Metoclopramide (Reglan) are compatible according to this website: http://www.globalrph.com/metoclopramide_dilution.htm plus I double checked it with my IV meds book (Gahart, 2010). No offense, but this question seems like one that you should be able to answer for yourself. It's the sort of information that is a minimum for competency as a nurse. But don't be discouraged by my opinion. I'm much happier that you reveal that you need help, because nurses who are afraid to ask questions may be more likely to make a critical error and potentially hurt someone. With that said, please consider talking to your charge nurse or unit educator about ways to build up your competency. It's better that you take time to learn the basic nursing competencies rather than lose your license after you hurt someone. Good luck.
  11. Hello, I'm a second year student in a ADN program and we are once again studying the Corbin and Strauss Trajectory Model of illness. I was just wondering if anyone uses this model in a practical way and how? Thanks!
  12. TechnoDanceNurse

    Verbal Abuse?!?!?

    Being harangued by a coworker is a complicated problem, being berated by a patient is commonplace in the ER. 75% of the volunteer shifts I do in the ER involve at least one homeless person or otherwise screaming at staff and having to be restrained. I'm wondering why many Americans are more concerned about violent videogames or Janet Jackson's super bowl nipple, rather than violent criminals who spend little or no time in jail? More importantly, how can we change people's attitudes so that they will punish criminals appropriately? I know of a man who confessed to sexually assaulting two minors over a period of years, and he never went to jail. I wonder how American's priorities over innappropriate behaivior could be corrected? Cheers, Andy

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