nowplayingEDRN

Tait, The 50 lb weight restriction shouldn't have been an issue as 99.9% of all job descriptions I have ever seen say that the nurse has to be able to lift 50 lbs with assistance! I'd give my eye teeth for a 50lb weight restriction as it would make it easier to find a job. I am not suppose dto be lifting over 10 lbs on a regular basis and only up to 20 on occasion...that lift restriction screams damaged goods and makes finding work difficult at best.

Never heard of that! interesting... Tom, I won't knock your copper and magnets. I know people that have swore by them too. My theory is, "What ever works for you"....I went for some rolfing sessions(once a week for 10 weeks) when I sustained my first back injury in 2004 and it worked wonders along with diet modifications and some specific vitamins and supplements. Unfortunately rolding(a form of deep tissue massage) is not cheap or I would give it another whirl. Slowing making the transition back into the diet modifications to see if they will help this time around with a different type of injury.

I'm beyond flexeril and naproxen....I miss those days!

I would love some tips on how to get into the CM field. I have 15 yrs experience in step-down, ICU/CCU, ER, Amb-surg and PACU. I am enrolled in a CM certificate program. I had a vocational counselor take a look at my resume and tell me that people are afraid to hire me because they think I will get bored and leave! I need to reinvent my nursing career due to a back injury and and that seems to be the most logical move for me at this time. I sure could use any pointers anyone has. Seems like any CM jobs here in NY all want someone with a BSN and experience. I went to 1 interview but they didn't tell me that I would be working as an intake nurse as well as CM for their home care angency. I have sent my applications in to other places but I never get a response or I hear, "Your resume and skills are impressive but we are pursuing other candidates that better suit our needs..." Thanks, Christie

I have not found any other school that offers this particular certificate. I am currently enrolled in the course. You have a max of 1 yr to complete the course but you can complete it sooner, if able. With your BSN you should find it relativel;y easy to get into the CM field. I am taking the course as I am not in a position to go for my BSN yet and need to reinvent my career due to a back injury. As an ADN nurse, I am going to be challenged as here in NY it seems that in order to get a CM position you need, not only the BSN, but experience too! Rare is it to find someone willing to train. Good luck.

You are fotunate that topicals, like icyhot, and OTC POs still work for you. My injury happened in February 2006. I had a previous, similar injury in 2004 but I recovered nicely, not this time. And the injury was different in all ways. Ah, well!! C'est la vive!

I have Facet Arthropathy with DDD and ? herniated discs. I go to the chiropractor twice a month, sometimes more, primarily medicate at bedtime with Percocet, Valium and Zanaflex. Tried 2 rounds of PT(the 2nd round was in a nice, toasty pool) with no improvement. I have had multiple trigger point injections, 3 facet joint blocks and 1 median branch nerve block in my lumbar spine. I am now looking at the possibility of radiofrequency therapy. I have been told that I should never return to bedside nursing because of my severely limited ability to stand or walk for a lengthy period of time as well sit(that just about interfers with everything in life, huh?) and was sent to a state vocational program for people with disabilities to attain help in reinventing my nursing career. It has been a bitter pill to swallow and I can not honestly say that I have completely accepted this.

I would strongly sugest that if anyone is planning on applying for SSI/SSD that they get themselves a lawyer as well. They usually take no fee if you do not get awarded SSI and if you do get the SSI, they take between 10-15% as their fee and it is well worth it in my opinion. Also, having a doctor with with you have a good rapport, that keeps excellent records and is willing to assist you in attaining SSI is also a plus. The urged my hubby to apply for it immediately in 2000 but he had hope he would get better but he didn't, he applied for SSI on 2006 and was awarded a retroactive award to 2004. The judge asked why he did not apply sooner and when we told him, he shook his head and said amazing! Each state has different programs for Medicare drug programs.supplimental insurance, for the best assistance, your local office for the aging can assist you in choosing the plan that best fits your needs. I wish you the very best of luck in this venture. Be advised that if during the hearing for SSI/SSD, the judge rules that you can do some sort of work, you could be sent for career retraining(that's how it works in NYS).

:balloons: Hooz.. Thanks for taking the time to read my post. I am blessed that I do not have that sort of pain in any of my extremities, nor do I have any symptoms of RSD. I have intermitten pain down the back of my leg(from the sciatic) and intermitten pain running down the outside of my left leg into my foot. My toes pretty much stay numb as well as the bottom of my foot which is why they keep looking for herniations but they can't find any! I am a medical mystery!! Hehehe!:monkeydance: No, surgery is a last resort treatment for facet arthropathy, which I have decided is a fancy name of pack pain that they can pigeon hole under any other diagnosis!! And so I pop my percocet with valium and zanaflex(for the spasms) and plug along! It's horrible to feel betrayed by the very profession you devoted your self to and gave 100% to. It's like the minute they know you are hurt, they don't want to be bothered with you. It's my back, not my brain that's hurt!:angryfire I just hope and pray that the end result of some of this retraining is a job that will allow me to pay my bills and have health assurance!

Hooz...I don't know what state you are in but in NY state they have a program called VESID(Vocational and Educational Services for Individuals with Disabilities) they help you try to find something that you can do so that you can return to work and be more productive. When trying to stop a stretcher with a fresh post op patient from smashing into the wall and some equipment in the hall (my transport attendant decided that they did not need to help anymore at this point and walked away! yes, they still have their job and I am sidelined from the work I love) I developed Facet Arthropathy at L4-5. While i realize that this is not as serious as herniations and the like, I do have hronic back pain and it interferes with my ADLs, standing, sitting and laying. i can not lift more that 10lbs on a regular basis and ocassionally I can only lift up to 20lbs, so of course I can no longer go back to working in the recovery room. In NYS the max worker's comp pay out is $400 bucks, of oc urse I am down to 300 a week and now they want to cut it even more. I don't know how I am supposed to survive on even less when my poor hubby is on disability and has to take most of him money to pay for his medications! Of course comp pays for my medication. I had 3 facet joint blocks, which helped a little, I did PT is 2 6 week increments 3xweekly but that didn't do much for me at all except fire up my sciatic nerve from the intake exam! My next step is a median branch nerve block at the L4-5 level (I am currently awaiting authorization, something I won't get till I go to court at the end of this month.). I have trouble walking for longer than 5-10 m inutes and standing becomes aproblem usually after 5. It makes doing things around the house interesting and I don't dare take the jug of milk out of the fridge with 1 hand. In addition, non work related I have severe herniations at C5-6 and C6-7 but being out of work for as long as I have, I have no benefits to get that fixed...but I ramble..... Back to VESID....they are helping me get a certification in case management, not exactly what I want but it will give me a pay scale close to what I am used to and I will have access to health benefits and it will be easier to keep the physical restrictions my doctor has set for me. They do also send people on for BSNs or MSNs as well as other continuing ed courses things that have good marketability to get you back into the work force. To the young lady that started this thread....I take it that when you suffered all those herniations that you were not a surgical candidate? I realize that surgery is not the end all and be all of pain management and I know that most folks that go through back surgery still have pain but is it an option? Acupuncture is just a pain management tool and does not solve the whole picture. Maybe you should try to find the best neurosurgeon or orthopod specializing in spine surgery in your area for a consult. You may have to go as far as 2 hours from your home, if you are able to travel that far. I worked in an orthopaedic specialty hospital in NYC when I sustained this back injury (ironic, isn't?). My heart goes out to each and every one of you that have had such injuries. And I look forward to discussing this further with you all. ~C

Definitely ask for orientation to the basics and do a rotarion in general surgery so that you get a grasp for all the different instruments. I hope that you make out well. As for 37/hr for a FT slot for a BSN, I believe that is the basic starting salary in the NYC area but it is also dependant on how many years of experience you have and how many years of experience the facility is going to give you credit for. I hope that this information helps you.

Jnette is a wonderful friend and a kind, compassionate and dedicated nurse. Her advice given over the years, taken from her experiences in life have always been appropo, delivered with love and kindness and have always brought a ray of hope into the world. Although I have been on hiatus from allnurses, my thoughts have always been with this lovely lady with the propeller beanie!:roll

I do work for Medical Staffing Network and they try very hard to get you in for at least one day of orientation so that you have some familiarity with the facility that you will be working in. I have found those orientations to cover primarily the most important things you will be seeing in the area you are assigned to. For the 13 week assignments, you should be getting a regular hospital orientation except that you will not spend very long with a preceptor (usually just a couple of days) as the idea is that an agency nurse is supposed to be flexible enough to rapidly adapt to any scenario and be ready to fly by the seat of your pants so to speak. Not always the worlds most comfy situation, to be sure! Like Triage said, shop around. Agency nursing offers a variety and flexibility that you will not get in a FT position. It could be a fabulous step in your career.

I work for MSN(Medical Staffing Network) doing per diem work. I did a 13 week assignment with them, which is how I landed my first FT PACU job. When I did the 13 week assignment, I was paid weekly, opting to take and use the bank card to access my pay. They always were concerned about how I was making out or if I was running into any problems and if there was an emergency that I required same day pay, they were excellent about taking care of it for me. As far as per diem goes, that has been a different ball of wax than a 13 week assignment. I found that they did not look into a facility when they were notified of bad situations or poor treatment of agency nurses. They tend to treat the per diem nurse more like you are on call and I found that the facility that I was doing the most per diem for did a lot of last minute cancelations. Over all not a horrible experience. I would imagine that each regional office operates differently. But over all, I would have to give MSN a favorable report.

I would say it is all what a person's personal goal is, their finances and what they wish to achieve in the end.

Any place that I have worked PACU, the PACU RNs start the PCA or at least set it up and send it to the floor with the patient. That way all the floor nurse has to do is turn the PCA on, make sure it is programed properly and start the paper work. Epidurals are also started in the PACU but that is because we have to verify that neurovascular status has returned to the limbs before the epidural can be started.

At the trauma center the liver transplants go to TICU and sometimes the CABG patients will go straight to CTICU. Any other vented patient comes to PACU and is monitored for a short time. At the trauma center, sometimes the vent patients are held in PACU because of lack of ICU/CCU beds. At my previous facility the vent patients came to PACU and usually stayed for about one[1] hour, primarily because the SCU nurses were too spoiled (I know it isn't nice but in this instance it was true) and the fellow didn't want to be bothered. However, if the patient had not come out of the OR before PACU closed (they did not run a 24/7 PACU. Closing was at 12 midnite, so anything from 1130 on was pushing the envelope) they went to SCU to be recovered, vented or not. Of course it was always a fight to get the patient there. On rare ocassion, a vented patient went straight to SCU but that was if the patient was having tremendous problems intraop. I do, however, agree that if a nurse is going to be recoving a patient, no matter where they are going, the staff on that floor should have some sort of PACU training. If staff are having to recover fresh post-op patients and they are not comfortable, they should be contacting their nurse manager, the nursing supervisor and if they are unionized, file an unsafe staffing report to protect themselves and then request training from Staff Developement. There is no replacement for proper training and education to maintain safe patient care and nursing practice.

I have never seen pre-op warming. Depending on the Anesthesiologist they may use and upper or lower body Bair hugger which helps with the confounded low temps that I see come out of OR and into the PACU (as Nursonegreat stated, takes forever to warm them up) I also have found, although I did not do a QI on it, that the temp is directly related to blood loss too. Maybe it should become a standard of practice to do pre-op warming. Krusty, thanks for the info.

1. Does your PACU allow visitors? At my old facility, it was 1 person at the bedside for 15 minutes unless it was a child(up to age 18) and then we allowed 1 parent at the bedside at a time. At the trauma center, they do not allow visitors in until the patient is fully awake and then it is 2 people for 5 minutes unless it is children or an older child that had been going through multiple surgeries, i.e. a young person with severe burns 2. If so, under what circumstances? i.e. peds cases only, special needs, ect. See number one[1] 3. Is the visit just for a quick minute or is it unlimited to stand in there and see everything? Again, see number one[1] LOL:chuckle 4. How many people can be in there per patient at a time? Refer to number one[1] 5. How do you handle privacy issues, giving report when a visitor is in the room, etc. or when patients go bad or code in front of visitors, etc. I have had to chase family back to the bedside of their loved one and on rare ocassion, had to ask them to leave. If there is an emergency of some sort, while the nurse whom was responsible for the patient pulled the curtain, the charge nurse would shoo the rest of the visitors out, except in the case of a child. The, we pulled the curtain around the bed as an extra barrier. Report was limited to being given at the desk at my old facility, family having been sent to the floor that the patient was going to, armed with the room and bed number. At the trauma center, there are 2 phones in addition to the ones at the desk that they use. I do not like that set up because if you are stuck using one of the extra phones there is no measure of privacy in giving report. Sometimes you just have to improvise and be as cautious as possible, being mindful of HIPPA. I hope that this is helpful information for you.

I think it is all a matter of preference of the Anesthesiologist writing your post op orders. When I worked down town in NYC, they usually started with Zofran and then used compazine IM, choosing to use Vistaril when the patient had a high level of anxiety. If the Zofran and Compazine did not work then depending on the doctor that responded to the call that the patient still had hyperemesis, they may prescribe reglan or droperidol. I have been finding that they are shying away from the droperidol due to the black box warning that accompanies it. Now at the trauma center I do some per diem work in they use Zofran and Kytril primarily and very rarely Vistaril or Compazine. I have also one a rare ocassion seen them use reglan. It also depends on the hospital formulary as well.

Frank blood is bright red in color and usually indicative that the doctor may need to take the patient back into the OR and find the bleeder and tie it off as opposed to serosanginous or dark, occult blood.

If you are thinking about a BSN following your ADN, do it now. It is much easier to go for the BSN immediately than to wait for a bit before pursuing it. And as stated, there are many jobs out there that are BSN prefered, especially if you plan on pursuing a management position.

Was doing a search on nursing links on the web...thought I would click and see what this was, which was WONDERFUL!!!!!

I don't even know what authorities to actually report this situation to. I do know that I went back to this same facility one more time and was sent to a completely different unit. Unfortunately, these people made things so distasteful that I finished my shift and then spoke with the agency on the next business day and told them that I was not getting paid enough to take the abuse that was being dished out. My hearts and prayers still go out to the patient, if he is still on this earth. Haunted, may your future prediction come true for me, I could use one of those vacations.:Melody:

I have not been agency all that long (almost a year) and after my first agency assignment, took a FT spot with a hospital bit have continued to take per diem shifts doing different things for the Agency. 2 weeks before christmas, I did a per diem shift at a hospital for what was supposed to be ICU but turned out to be Step-down. Here is my dilema: I was assigned a pt of the Jewish faith that was in the end stages of life. The family had made the pt. a DNR but when the BP started to plummet the Rabbi came in and made the decision that the Levophed drip should be put back on the pt to maintain the BP (this is not my dilema). In report I was told that the pt was unresponsive, total care, PEG tube, T&P q2h, had a decubitus on the coccyx and a supposed "skin break down" on the scalp that could not be found, a trach and needed frequent suctioning, constipated and was recieving massive amounts of stool softeners, laxatives and enemas to try and get him to have a BM. It was rather challenging trying to perform the necessary tasks for this patient while working around the family and Rabbi but I did so with little disruption to the time schedule for meds. I was told that the patient had been bathed on nights and so that was something that did not need to be done. I was struck by the poor condition that this patient seemed to be in. he was so frail lying there in the bed. But what struck me most was that it seemed like this pt was NOT unresponsive at all. Yes, he was contracted and yes he had involuntary movements but it seemed like when I would go to pass meds through the PEG he would stiffen up, preventing the meds from sliding easily through the PEG until I told him what I was doing, at which point it seemed to me that my pt would visibly relax and the meds slipped down and allowed me to flush the tube and straighten his bedding and clothing back out. This reaction from the pt puzzled and troubled my 6th sense a bit. This however was reconfirmed when toward the end of my shift I needed to help with a partial bed bath because of well.....he was getting massive amounts of stool softeners and laxitives! So when we were done with the linen change and partial bed bath (washing hands when done removing gloves of course! ) I decided to do trach care as his trach tie looked to be a sorry mess.....well this was the start of a nightmare for me (having been a floor nurse when staffing numbers on nights were of dangerous levels!) I have been short staffed before and worked in places where staffing numbers are not where they should be but I was appaled at how absitively filthy this trach tie was! It was evident that it had been left on the pt from the begining of time as it had embedded its self into the very edematous, swollen skin of this pt's neck, which started to bleed a bit when it was removed. I cleansed the area with NS and put telfa pads down when I noticed it was bleeding before applying the clean trach holder then performed some serious trach care and applied a new dressing to the trach. Now being on a mission, i went to change the dressing on the supposed breakdown that no one could find on the scalp. Well, you can't find something when one does not take off a cap that a pt is wearing can you???? Needless to say, through all these dressing changes, I noticed a tear running from the corner of the pt's eye! Now, I realize that this was the first time I was in this facility but this was just the frosting on a less than warm and fuzzy welcome. The whole experience at this place was nightmare-ish and when I called the Agency on Monday to let them know how things went, I made it abundantly clear that it was a less than positive experience for me and I was not sure I would be willing to go back. Here is my dilema.....the condition of this pt was deplorable and I was debating whether or not I should drop the dime and make a report on this pt to the proper authorities. What would you do??