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Well, She wanted to prove the doc wrong and she has sure surprised all of us! It's been 2 1/2 weeks since he told her she only had "days" left b/c her WBC was 80k and her platelets were 10. She has been surrounded by family and enjoying the great grandkids as well as 20 years worth of home videos. The nosebleeds have started though and get more frequent every day. She's also developed several lumps/tumors. I am thankful she is still feeling fairly well and has little pain.

My 80 year grandmother was diagnosed with AML in August. She has been taking hydroxyurea and getting blood transfusions every 2-3 weeks. She did get 1 platelet transfusion a few weeks ago also. On Monday, her oncologist told her she only has days left to live. Her WBC is 80, platelets 10, and Blasts 96. Se has been feeling fairly well, which is making it hard to believe how close she can be to the end. Several family members are having trouble accepting whether the oncologist is right b/c she looks so good right now. My Mom and I have been stressing to them that this is an acute disease that can change very quickly. Does anyone have any advice on how to help them understand this?

Our facility has a pharmacy policy for OTC meds given to the staff, the staff receiving and nursing giving them have to sign them out. I get Ibuprofen frequently for headaches. I would talk to your instructor about the incident first and then maybe the two of you could talk to the DON for the unit. Tell her that you did not observe anything but maybe they could monitor that nurse specifically for a period of time and see if they are able to catch her.

This is what I need to talk to the actual nurse about b/c I'm not sure how she found out. I think he was out of town and possibly one of his friends is from town and posted the pictures but I haven't had a chance to ask her about it yet.

awesome, thanks so much! Do you have signs warning patients that they can not post pictures of staff or how are they made aware of the policy?

Every time I've looked into getting my BSN I have decided the cost is just not worth it. In my rural setting it just doesn't gain me much. I know there is always the chance that I could move to another area, but considering this is DH and I's hometown it's pretty unlikely. I have no desire to be a Director and can still be a supervisor with my ADN if I wanted to. I think last time I looked there were several pre-req's that I didn't think should be necessary but it's been awhile. I graduated in 2005 with my ADN.

Thanks for your reply, is there anyway I could see your policy?

We had an ED patient over the weekend that posted pictures on facebook from his visit. 2 of the ED nurses were in the picture and had no idea that they'd even been photographed. They were very upset to find out that it ended up on fb. One of them does not have a fb account. There wasn't really anything they could've done to stop it from happening, our risk manager is looking into this right now. I'm not sure exactly how the nurses saw the pictures because it was the risk managers understanding that the patient was from out of town and the nurses did not know him, so would not have been his friend on fb. I thought she could just report the photo but not sure, I will have to talk to the nurse that found it to find out the exact details since the risk manager doesn't have a good understanding of how facebook works. I've seen a few times that one of the OB nurses will end up on facebook and that's never surprised me, patients and families are always taking tons of pictures in that area. It's never seemed to be an issue before. Does anyone have any policies regarding this?

I had to stop one of the docs in the ED from putting an NG in a patient b/c I hadn't done it before and wanted to! They are not all that way, most of ours will help out a little if needed. I've seen a doc put a foley in a patient and also attempt to start an IV on a ped. Odd thing is that our one and only NP is the one that is least likely to help the nurses even though she worked as a nurse for several years.

I told ya that she had C-Diff!

In most systems even the IT dept. does not know what your password is, they only see stars as the characters are hidden, so if you forget your password they reset it, then make it expire on the next sign on, so that you will have to change it right away. Since this person was in a management position it would make sense that she may be able to reset passwords for that dept, but what she did sounds EXTREMELY illegal!

Yes, I really am a 40 year old Man!

I hadn't ever seen it until I helped with the advanced EMT class and they were taught how to do it. This was the first time I actually saw it on a real patient though. They use the MAD devices also. It seemed like the IN worked even faster than the IV, but he'd also had lots of morphine and ativan before EMS arrived to help prepare him for the transfer. A few weeks before this he'd been transferred by ambulance and had to be given 10 mg of Valium because the 400 mcg of Fentanyl he'd had in the ER wasn't enough and he was trying to crawl off the cart because it was so painful!

Does anyone have any experience with this? Thought I'd share a personal experience. My Dad just passed away from Melanoma, he was at home on Hospice and the roxanol/ativan combo just wasn't cutting it anymore. The ambulance was called to take him to the hospital for a palliative care admission. He had 4+ edema EVERYWHERE, so IV sites were very limited. The paramedic opted to give him Fentanyl intranasally and I am still amazed at how great it worked!

I took care of a family member, actually my husband's family member. Not taking care of family isn't always an option in a small rural hospital, but I try to avoid it as much as possible, since having to call my FIL and tell him his brother died!

LOVED this article! It brought tears to my eyes and hit close to home as my Dad is dying from Melanoma. I never knew so much about skin cancer as I've learned over the next 6 months! I hope I can help teach others from this experience. I had a nursing instructor who'd been diagnosed with diabetes at age 3, she was definitely able to use her experience as a patient with a chronic diagnosis to help in her teaching.

DH and I have talked about me doing this once our kids have grown up, so I've got many many years to prepare. I can't wait to hear all about it and anyone else's experiences!

There's not a whole lot that make me want to vomit, other than vomit. I was very close to vomiting one day when emptying a foley, the patient was on palliative care due to the end stages of cancer and her urine was very thick with a very foul odor. I had also just found out a couple weeks before that I was pregnant, which I'm sure made it a lot worse :)

A new nurse was just hired at the hospital. Her and I have the same last name, we also have the same first inital and are both RNs. I didn't think too much about it until the other day when she said, "I don't know how I'm going to sign my name now, since our signatures would be the same." We do have different middle initials, so initialing things wouldn't be a problem. I'm wondering if it will really matter if our names our signed the same, I'm sure our handwriting isn't the same. She is in the OR dept and I don't usually work in patient care, but I do occasionally help out on the floor when things are busy.

I've listened to a nurse give a report including every detail of the labor and delivery on a patient that is scheduled to go home within a few hours! Unless there is a pertinent complication I really don't care how long it took her to dilate.

I have worked both night and day shifts; I even spent a little time doing a combination of both shifts. The hardest thing about alternating between the two shifts, other than sleep issues, was that I had to constantly hear each side complain about each other. I always felt like I needed to defend each shift to the other. The day shift obviously has to get out of bed earlier in the morning; I'm not much of a morning person and know very few people who actually enjoy getting out of bed in the morning. The day shift tends to be busier since they are usually giving the majority of the meds and treatments. The patient is generally more active during the day making the workload heavier. I work in a rural facility, so the day shift is also dealing with taking care of outpatients, as well as pre and post-surgical patients. One thing that makes the day shift more desirable is the hours. They get to spend every evening at home with their families and rarely have to miss out on school activities. The night shift obviously has the disadvantage of having to stay awake all night; these hours will wreak havoc on anyone. The rest of the world continues on whether you are awake or not during the day, so unless all of your friends and family are also working night shift, it makes it hard to stay in touch. The night shift definitely has its own advantages. Things tend to be quieter, although this is not always the case and depends on what area you work in. There are less extra people around, which can be nice until things go haywire. When things aren't running smoothly and you have to call in the "on call" person, you are made to feel guilty for waking them up. I've worked many very quiet nights, where you have to find things to keep you busy, like update and review policies. I would take a busy night over a night watching every minute slowly tick by on the clock any time. I know there are many more pros and cons that could be included in these lists. My point is that both shifts have their own set of advantages and disadvantages. If we can all work together as a team with less bickering about each shift then I think we could improve the morale of staff as a whole.

I worked with a nurse that during the influenza/croup/RSV/Nasty bug season will go home (her shift ends at 4am) and strip naked in her garage, put her clothes in a plastic sack while still in the garage, then walk directly to her basement, dump the clothes in the washer and wash them immediately (doesn't even add any other clothes to the load) then she takes a shower. At 4am, unless I have been vomiting or defecated on, I'm gonna strip my clothes off at the side of bed and crawl in.

In both LPN and RN school I remember losing 5-10 students in the first month or two of school, after that it was only 1 or 2 for the rest of the year. I don't believe any of these actually just dropped out, their grades dropped and they failed out.

This always has annoyed me too, it even made me wonder if I was saying it wrong a few times! I'm glad to know that I'm not the only one that pronounces it cent!

I think these nurse's that are worried about losing their licenses are just misguided. They are probably taught in school that they may be in danger of losing their license for these trivial things. They should be taught to cover their backsides and document well because unfortunately there are so many people out their ready to sue the first person they can find and make an easy buck.