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Gampopa

Gampopa

M/S Nurse
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  1. Gampopa

    Our Death-Denying Society (Revisited)

    Recently we admitted an 88 yr old pt. It was his 4th admit in the past couple of months. When the Pts wife was asked about DNR status by the MD she asked him to do everything as long as it wouldn't hurt him. She asked if CPR hurt. The MD, with the admitting Rn in the room, said "not if it's done right"! The Rn just about fell over. When I picked up the Pt I initiated as gently as I could a conversation about CPR and it's effects on 88 yr old ribs. She thought for a moment and said I guess I'll have to talk with the doctor again. I don't know if she had that conversation but I hope she did. If she still wants CPR and full code status that's fine with me (not something I would do for myself or someone I loved) only as long as she's fully and correctly informed about the consequences. I think most of us are in denial of death. When someone is brain dead and on vents, meds etc. we're not prolonging their life. They are already dead. I don't know what to call it. Keeping the organs functioning or something like that but it's not life. They are not going to wake up later because their brain function is gone and will not recover like a liver or kidney may recover after it takes a hit.
  2. Gampopa

    Nursing Salary Survey 2014

    Geographic location: Far Northnern California (Rural) Pay rate: $30 In which area / specialty do you work? Med-Surg What type of license do you have (RN or LPN)? RN What type of degree and/or certification do you have? BSN How many years of experience do you have? 8 yr (4.5 as a school nurse). Are you full-time, part-time, or casual / per diem / PRN status? Per diem 2 12 hr shifts/wk What shift do you work? 6A-6P Do you receive any shift differential? Yes, $1.00/hr. Are you a manager or supervisor? No although I am "lead nurse" when a less senior nurse is also working the shift. (We're such a small hospital we never have more than 2 RNs working a shift.) Also work part time 22 hrs week as a school nurse making $42/hr but am returning to hospital based nursing as I transition out of school nurse position.
  3. Gampopa

    Kinder RU chaos

    What is your kindergarten RU like? How do you organize it? Mine was a chaotic mess this AM with little support from the usually helpful office staff. "Good morning! So do we have check off sheets?" "Nope. Decided we're not going to do that this year" "Oh. How about stations for the families to go through?" "Nope. Doing it differently this year" "Huh. Chaos ensues. Families wandering the hall looking for the nurses room. Public health moved into the conference room off the office, then out of there because the screaming kids getting their shots was too much for the staff. But moving them into a bathroom! Really. Are you f***ing kidding me?! A bathroom to give shots. Great impression that will make. How about the counselors office at least? Kids come in to get their hearing and vision checked. So do you have a birth cirtificate? No. Shot record? No. Anything? No. We were just told to be here today with little Johnny. Two families, three or four kids cramed into my little office, screaming, talking, confusion, no wonder Johnny can't pass his hearing test. I'm losing my mind. Public health is wondering who set this up? Me too. Kids see the public health nurse and start crying afraid they're getting shots again. Can't talk with Mom and Dad about kids health history, dental care. Just get them out the door. Frigging nightmare. Only 21 days letft. My motivation is totally gone. Wish I had another job.
  4. Gampopa

    How busy are you?

    I have 6 schools in the half of the county I'm responsible for. Schools range from 6 kids in the more rural schools to 100+ in the pre k - 8 here in town. M,T,F i'm in town. W,Th out on the road. In town it's- 1) PreK-8 about 160 kids; HS on the other side of town about 80. 2) I see anywhere from 10-20 a day. 3) I have a part time health assistant about 20 hrs/week 3) The office staff handles daily meds. I see a lot of scrapes, cuts, vague feelings of being sick (Mondayitis), sore arms/legs,1 DM kid I have to track down 2-3 times a day although he is getting better, HA, lice, poison oak, bug bits, unexplained rashes, and a big one- tooth pain from no dental care, 1 kid who is either going blind, deaf, limbs are numb, etc. depending on the day. We've also had numerous kids dx w/Lyme disease but that's more because the NP in the health clinic in town is incompetant.
  5. Gampopa

    Should men be school nurses? Have you ever heard of any?

    I'm a male school nurse for the past 2 years and replaced another male school nurse who was in the position for 20 or so years. So far there's been no issues. I do have a 15 yr old w/c bound quad girl who insisted on having the female teacher's aids change her. I have no problem with that. I do have to remind the kids that I am a nurse and not as they think a doctor. I do keep myu door open at all times unless there is a need for privace with a studnet. I would bring in a female "helper" if need to just to have another adult in the room and to avoid any accusiations. I also have a female health aid if the girls would rather talk with her. Often times the older girls come by for a pad and it's not a problem.
  6. Gampopa

    How to become a School Nurse in CA

    You need to have your Cali RN license with BA or higher degree. Application with Cali teacher credentialing and of course the fee. Preliminary license good for 5 years. Clear license must be obtained w/in 5 yrs. see http://www.ctc.ca.gov/credentials/leaflets/cl380.pdf
  7. Gampopa

    Parents!

    OK, Yes I live in a very poor county. Yes there are few dentists who take Medi-Cal insurance and those that do are 45 min. away. Yes over the past year, your car did break down, you couldn't get off of work, you didn't feel like it this week. But now how do you feel when your 3rd grader has 14 of her teeth pulled?! Guess you'll just do another hit of what ever it is you're smoking, drinking shooting and have a Merry Christmas. And yes, CPS did visit you several times. Thanks for finally bringing your kid to the dentist.
  8. Gampopa

    Diabetic care for a 5 year old kinder

    I need a doctor's order to change the care of my kids with DM (or any other chronic illness). I have one 6th grder who's mother, after a recent doctor check up, poped her head in the office and said so-and-so is to have his BG tested only before lunch. Sorry. we live in a rural area and it took 2 wks to have the doctor sign off on the new DMMP. He's chronically hyperglycemic 300s-500s so to be testing him before lunch was against my better judgement but the MDs opinion and orders prevailed. (Still think it's a stupid order.) I will consult with the parent but not take orders from them. Also, an RN is the only school staff that can give or confirm insulin. If the parents want they can appoint a nonschool person to come in and give insulin. Regular scool staff are prohibited from doing so.
  9. Gampopa

    Tummy Ache ideas??!?!?

    Keep in mind that a persistent tummy ache may indicate emotional issuses at home, stress, etc. that may need additional scrutiny. I'm a school nurse in a rural and poor community and when I have a kido coming in for tummy aches there's usually family issues going on. A little TLC, maybe a nap and they are good to go.
  10. Gampopa

    Diabetic students

    I have 2 kids with T1 DM a 6th grader and a 4th grader. The 6th grader has to be watched with his sugar checks. He has a habit of leaving his hands wet then poking his finger. He also has the habit of blowing off the sugar checks completely. Today he was 440 "Oh, Guess I forgot to check." The office has to call him down 3 times a day and of course they get caught up with other things and lose track of him. He's also been down to 32 I am glad there's only a few more days of this year The 4th grader is more reliable. She comes to the office when she needs to and isn't yet caught up in any shenanegans.
  11. Gampopa

    Exercise induced asthma

    Hi All: I'm posting this in the Pedi section because I wanted a broader reach. I had a 8 yr old in my school nurse's office with exercise induced asthma. Rapid breathing, tight chest, anxious etc. All the signs of severe asthma attack. Couldn't reach parent, and she has no inhaller at school. We were able to settle her down and after about 30 min she was OK to go back to class. My question, can exercise induced asthma lead to respiratory arrest? Do you know of any cases of this? Thanks
  12. Gampopa

    School Smoking Cessation Programs?

    Does anyone have a resource for a successful school based smoking cessation program for High Schoolers? Do any of your schools offer smoking cessation classes/support groups?
  13. Gampopa

    Wait for info or make the call?

    Why would te student need to be kept out of the sun? Doesn't make sense to me. When I get wind of things going on with my kids I either ask the teacher and if they don't know give a call home to find out what's going on.
  14. Gampopa

    Woo Hoo......6 more weeks !

    2.5 weeks, that's only 12.5 days of school! But lots to do final scoliosis checks, free dental van at 2 schools, puberty/hygiene talks at 3 schools. Why did I leave everything to the end?!
  15. Gampopa

    Best and Worst of Pediatric Nursing

    I've been a pedi nurse for the past 5 years, 1st worked on a acute respiratory floor, then rehab, and now school nurse. What I loved: being a 45 yr old man w/o my own kids and being responsible to feed/change/comfort newborns when they were sick. Seeing really ill kids of all ages get admitted and w/in a couple of days seeing them jumping and playing around the room! Quick recovery times are great. Making sick kids smile by being goofie and silly with them. Lots more. What I don't like. Many famililes are not prepaired or interested in parenting their kids. Seeing a new father who would rather watch the TV then hold his newborn boy. The abuse some kids suffer at the hands of their parents/others can be unimaginable. Giving kids shots. Kids can have painfully high pitched screams and when these are directed right into your ears they really hurt. Seeing kids with EB, chronic pain, head injuries and not being able to do much to help thier suffering. I've never worked with adults so can't compare, but kids in general have smaller poops, and don't gripe as much as adults.
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