lsyorke

I lost my husband in August of this year. Thank God for Hospice and their caring and compassion. While I didn't need the services that they offered, beyond meds, their presence was so important. Someone else to talk to, someone who understood how being the "nurse" made the whole situation so hard. The hospice nurses recognized what our needs were and let us call the shots when it came to their involvement. I will be forever grateful. I'm thankful to Nursing Spectrum for publishing Bill's story. http://news.nurse.com/article/20110124/ALL01/101240026/-1/frontpage

Tamiflu is a Class C drug for pregnancy: From rxlist.com: Pregnancy Category C There are insufficient human data upon which to base an evaluation of risk of TAMIFLU to the pregnant woman or developing fetus. Studies for effects on embryo-fetal development were conducted in rats (50, 250, and 1500 mg/kg/day) and rabbits (50, 150, and 500 mg/kg/day) by the oral route. Relative exposures at these doses were, respectively, 2, 13, and 100 times human exposure in the rat and 4, 8, and 50 times human exposure in the rabbit. Pharmacokinetic studies indicated that fetal exposure was seen in both species. In the rat study, minimal maternal toxicity was reported in the 1500 mg/kg/day group. In the rabbit study, slight and marked maternal toxicities were observed, respectively, in the 150 and 500 mg/kg/day groups. There was a dose*dependent increase in the incidence rates of a variety of minor skeletal abnormalities and variants in the exposed offspring in these studies. However, the individual incidence rate of each skeletal abnormality or variant remained within the background rates of occurrence in the species studied.

Find a good review course specifically for the Nclex. Don't give up!

MMR and the other "mandatory" vaccines are mandatory for all. H1N1 is a brand new, minimally tested vaccine with unknown risks. The flu vaccine is "best guess". They are not comparable.

I think that his argument is what most people think. We see "defensive medicine" all the time, which absolutely raises costs, but then we also see the negligent doctor. Until there is a true effort to remove the negligent physician, the public is at risk, and the only recourse is the lawsuit. We also see the "group treatment", where every consultant is called in from one group of doctors and every test ordered in each specialty, regardless of admitting diagnosis. Talk about raising the cost! Specialization is a great thing, but not every diagnosis needs 5 specialists to all say the same thing. There is no easy answer, but the patient being the only one being asked to accept concessions isn't the answer.

While there is no excuse for any doctor to berate a nurse, I would not have called the attending. The family wanted to talk to the surgeon, so I would have provided them the phone number of the surgeon. If a doctor is in on consult, especially a surgeon, then you address surgical questions towards that surgeon. The attending is not the one to answer surgical questions, and the "out of respect" thinking just doesn't make sense to me. I don't run every aspect of a patients care past the attending, unless the consultant is in conflict with what the attending has ordered, which was not the case here, since it was information seeking only. The attending called in the surgeon(and other consultants) for their expertise in that area, so surgical questions should have been addressed to him. I'm sorry he was rude.

We are starting to see more and more docs doing house calls. It's a good thing!

WCEI is the group giving the course for WCC, but the test is given by the NAWC®. So completion of the course and passing the NAWC test gives you the WCC certification.

You can also be specifically Wound Care certified through WCEI http://www.wcei.net/

Good luck finding a preceptor. We're going to contact WCEI and see how we can help in our area.

Have you taken the course yet? I believe that has to be done prior to the clinical. We were discussing this at work this week since we have 2 nurses(one being myself) who would qualify to be a preceptor. We're not sure if it's feasible in the fast paced center that we work at.

Acetic acid is available premade from the pharmacy. I would not be mixing my own. It's a .25% solution. While it's use is a bit controversial, we've had great results in wounds that are colonized with pseudomonas. Found it...made by Baxter http://www.ecomm.baxter.com/ecatalog/browseCatalog.do?lid=10001&hid=10001&cid=10016&key=4c9308615c2d041e33ebac65d14b5b&pid=459140

TACE appears to be a very specific application for a very specific chemo. http://www.medterms.com/script/main/art.asp?articlekey=20525 As for other medications, there simply is no need to use an artery and the risks and dangers are massive.

Thanks...yup, as a wound care certified nurse, working in a wound care center for years now, I think I have it down! LOL! Here's a good article on wet to dry dressings. One thing that was beat into us in our certification was "a dry cell is a dead cell"! http://www.medscape.com/viewarticle/470257_2 Sadly, we still see this all the time despite the new evidence to the contrary. Nursing schools are the worst for keeping up with new procedures. Here's some interesting reading on "sterile vs clean" also. http://www.wocn.org/pdfs/WOCN_Library/Position_Statements/clvst.pdf http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2539027 In the case of the question asked, the "best" answer is sterile dressings, since the others are absolutely wrong.

Wow.there's just so much wrong with this question that I don't know where to start. What kind of debriding are they talking about.... Sharp Debride- doctors only. Wet to dry debriding...TOTALLY wrong and shouldn't be used ever. What does the wound bed look like? If there's fibrin, slough or eschar it needs to be sharp debrided or no granulation will occur. Debriding promotes granulation tissue, it's doesn't inhibit it. Sterile dressings for a chronic wound...nope, no sterile dressing required for a wound that isn't sterile, clean is just fine. Wet to dry will not prevent/stop infection. In fact it can create trauma in the wound bed, damaging granulation tissue making infection a greater possibility. You allow a wound to granulate if it's a clean wound bed. Keep it moist(not with saline) with a gel like Hydrogel, or Silvasorb gel(if you need the antibacterial properties of silver)