Darknights

Hi, We frequently have extremely elderly patients with heart failure and multiple co-morbidities who require blood transfusions. The physician wants the 350ml Packed Cells administered over an hour and doesn't provide an order for frusemide. Is this ...

This is for every patient, including those with heart failure. The rationale is that there is no reason not to administer the packed cells over one hour. However, when the pt has been admitted with heart failure and were overloaded we are reluctant t...

We have med lockers on the wall next to each patient's bed. Nurses are responsible for restocking them or initially stocking them from meds stocked in cupboards in the treatment room. Our DON has suddenly dictated that we must now purchase a medicati...

She said it was to decrease errors. As most safety experts talk about having less steps in a process, to lessen the risk of errors....I can't see how administering from a trolley out in the corridor will decrease errors. And it would be less producti...

My worst scripting experience was dealing with a telecommunications company lately. The call centre personnel were totally unable to deviate from their script and actually stumbled if I tried to divert them straight to my issue. It took me 5 1/2 hour...

You care. From what you said I don't think you sound like a bad nurse. Try to remember that New Grads aren't considered able to work confidently and independently until they have at least 12 months experience. You have a lot of knowledge to connect w...

"Keep your chin up matey and at least you know ur not alone :)" ..................................... I can tell you're an Aussie. :)

Our DON has admitted that morale in our hospital has decreased over the last two years and is now rock bottom. We have been critically shortstaffed and an attempt to address this was to hire a lot of New Grads. Due to the resignations recently it tur...

What programs are in place for New Grads in the U.S? Are they just given a couple of days supernumerary like here, or are there extended programs? When staff are run off their feet it is ridiculous to expect them to hold a New Grads hand. Last week ...

I am an RN working in an extremely remote hospital in outback Australia. We are generalist nurses caring for a patient population ranging from psych to acute stroke, chronic care to palliative care. Unlike other places our nursing has the RN's out on...

Thanks for all your responses. I think I can let this incident go now.

When a patient died a couple of months ago I had an audience of new nurses who all wanted to see a dead body and learn what to do before taking the body to the morgue. When I showed them how to get the body into the body bag one of them said, 'This i...

We don't. I have some friends who work as nurses in the U.S so I know what our equivalents are. The minimum qualification for RN's here as been the equivalent to your BSN, and has been like that for many years. LPN's here are called EN's, Enrolled Nu...

Paracetamol, Coloxyl and Senna, pantoprazole, frusemide, clarithromycin, ceftriaxone, metformin, coated aspirin, perindopril, atenolol.

And I always thought the pillow cases faced away from the door so all the departing spirits didn't get trapped in the pillowcases on their way out the windows. :-) I read some of the original nursing texts last year and I am sure that old Flo didn't ...

Thanks everyone. I expected feedback on what I'd done wrong. I hadn't anticipated your positive comments. I really thought there was some answer on what I should do in such a situation and I just couldn't see what it was.

I am working in a very remote hospital in outback Australia. It is a 5 1/2 hour drive to the next town. We have to fly critically ill patients interstate for care as we are too far from city hospitals in our state. My ward is general Medical/Rehab. O...

I started here as a New Grad so L know what it is like. I graduated from university with a degree and 12 weeks practicum experience. I did 3 supernumerary shifts when I started my employment. My fourth shift was my first afternoon shift and I had a C...

Although this is an Aussie publication I don't think our measurements of blood volumes etc are too different to you. I found this interesting because it has quite a few actual examples of transfusion incidents. Amazing how delayed some reactions can ...

Oh, and Frusemide......all elderly heart failure patients have their transfusion over three hours rather than our standard one hour. They have an order for IV Frusemide between units if a clinical review by the administering nurse finds them becoming...

And if you've read all that.......can anyone remember how much blood loss is required to have malaena (not spelling errors. We spell haem, malaena etc differently down under)? I have an idea it is about one unit but I'm not confident that it is right...

Why do you want to take blood to check Haemoglobin post transfusion? Your Red Cross states: Unless the recipient is bleeding or hemolyzing, and provided the transfused red cells are compatible, the post-transfusion hemoglobin can be accurately pre...

Medical Laboratory Observer 2007 Q How long after the completion of a blood-product transfusion can blood for a complete blood count be drawn? A The objective in obtaining accurate post-transfusion blood counts is to obtain a sample that is a homogen...

From College of American Pathologists 2008 Q. How long should you wait after a unit of blood has been transfused before drawing a complete blood count, or doing other lab work, to ensure accurate test results? A. Optimum timing of post-transfusion ph...

I was surprised when reading about your laws over there and your scope of practice. You do have to be careful about anything you do off duty that can be said to be nursing related. And if you give advice about a diagnosis or medication you also run t...