darren_callcareer18

darren_callcareer18's Latest Activity

1. 

   Crash Team call?

   darren_callcareer18 replied to Pab89's topic in General Specialties

   I think it depends on the protocol of your place specially if the patient is full code. In my opinion, there’s no harm to call the crash team so atleast it can be documented that every possible steps were exhausted to save the patient considering it is a sudden death.
2. 

   Opioid overdosing?

   darren_callcareer18 posted a topic in General Specialties

   How are you all? Just wanted to ask for your inputs if you already dealt with patient who seems to be having an opioid overdosing? What are the symptoms you have seen to that patient? I don’t know if I am just overreacting but I was working night shift last night and I had this patient who is very sluggish and her pupils were 4-5mm dilated but they are reactive to light. I have noticed that she is bradypneic (RR 2-3bpm) but the rest of her vital signs were okay. She seems to be alert and oriented plus GCS-15 but her response was very delayed. It is just her respiratory rate was seems to be depressed. This patient is on methadone but only 10mg PO BD and has PRN morphine 10mg PO. According to the handover that I have received from previous nurse that the patient LOC was “abnormal” since AM shift and up to PM shift. Her baseline was normally conversant, walking around and alert and oriented. I called a second nurse and ask her to count the RR of the patient and she got 7. I could not think of any reason why her RR was low so I thought she could have OD herself with opioids. I informed my supervisor and she told me that the patient was in our ward before and she had this history that she secretly take some of her opioids without telling the RN on top of the opioids that nurses were giving her as regular pain relief. So I called the doctor on call plus 1 of the code team nurse to assess (I did not coded the pt since she seems to be not in distress). The patient vomited as well and apparently a little bit confused as she was going to drink her vomitus from the receptacle but I stopped her. So, while the oncall doctor was assessing the patient, this nurse from the code team angrily arrived, and was so upset to me and telling me “I almost dropped my phone when you sent me this message! Your message is ridiculous!” She poked her head in the patient room and said “she is breathing it is just very shallow!” I looked at the patient chest and I can see the normal deep breath she is taking and I couldn't see a VERY shallow breathing. For me she was really bradypneic. She was so upset to me but the doctor wasn't. The other RN rechecked the RR and it was 7bpm. I told her that I am not going to bother sending this message to all of you if I am not worried that the patient might have overdosed of opioids. I just felt bad after that incident as I questioned myself if all this years working as a nurse I still haven’t mastered taking respiration rate.
3. 

   Heparin Infusion + bleeding

   darren_callcareer18 posted a topic in Nursing

   Hello, Have you guys ever experienced a patient receiving a continous heparin drip then the doctor told you yo remove the inter-jugular central line? Then when you did, the bleeding won't stop despite of pressure? It was horrific. But luckily bleeding stopped. Guess I won't be removing central lines if with Heparin drip otherwise stop it first or pause it. ☺️
4. 

   Is this enough training for experienced nurse?

   darren_callcareer18 replied to Jaellys's topic in Med-Surg

   I worked at SNF and was hired to work in Med- surg Tele, I only had 3 days of orienting to the floor and shadowing and then the next week that came I am already by myself. I had to make my eyes and brain open and read read read and ask ask ask. I am working here for more than 5 months now and I am enjoying it. I love the MS ❤️
5. 

   Clinical Experience with "Clog Zapper" for G-J Tubes?

   darren_callcareer18 replied to cal06484's topic in Med-Surg

   I remembered when I used to work at SNF one of the patients PEG tube was clogged. They would like to send him to the hospital but one of the LPN said NO and borrowed a Sodium bicarbonate to another patient who is getting dialysis and the next day the patient with clogged PEG tube died. I am thinking that time, that maybe NoCh3 uis not safe specially if it is not indicated to the patient. I thing bicarb is being used to treat acidosis.
6. 

   6 Strategies for Writing Great Articles

   darren_callcareer18 replied to Joe V's topic in Entrepreneurs

   People are too sensitive nowadays. Every words has something to say. tss.
7. 

   NOT an ICU nurse but assigned by SUP

   darren_callcareer18 replied to darren_callcareer18's topic in Nursing

   Thank you for being straight forward and sounded like a big brother after telling my day from work. 🤗
8. 

   NOT an ICU nurse but assigned by SUP

   darren_callcareer18 replied to darren_callcareer18's topic in Nursing

   Thank you very much! I will do that. ☺️
9. 

   NOT an ICU nurse but assigned by SUP

   darren_callcareer18 posted a topic in Nursing

   Hello! I am a med/ surg tele nurse and was just hired last December 2018 in this floor. So, the assigned house supervisor called in and so our ICU nurse became the house supervisor for this night. When I came to get reports I was told that I will be in ICU. There is only 1 patient there and she is being treated for CHF exacerbation. She pretty much stable and with only occasional VPC's but she has afib and LBBB all the time on the monitor. So I am not sure if I should have declined the assignment since I am not an ICU nurse. I started to question my assignment (in my head) when I went to med/ surg floor to say hi to my fellow nurses. But I felt they are KINDA indifferent and asked me right away " You are not an ICU nurse right?" "The patient was not downgraded from ICU why are you there?". I just told them well I just accepted the assignment otherwise I might be put on call shift. I appreciate them but I don't know if I did wrong accepting the assignment. A little background about me: I have a nursing experience as a PICU nurse (2 years) not in USA tho. But here in USA I worked in skilled nursing fulltime and per diem NICU nurse.
10. 

    NOT ICU NURSE But assigned to ICU by my Sup

    darren_callcareer18 posted a topic in Critical

    Hello! I am a med/ surg tele nurse and was just hired last December 2018 in this floor. So, the assigned house supervisor called in and so our ICU nurse became the house supervisor for this night. When I came to get reports I was told that I will be in ICU. There is only 1 patient there and she is being treated for CHF exacerbation. She pretty much stable and with only occasional VPC's but she has afib and LBBB all the time on the monitor. So I am not sure if I should have declined the assignment since I am not an ICU nurse. I started to question my assignment (in my head) when I went to med/ surg floor to say hi to my fellow nurses. But I felt they are KINDA indifferent and asked me right away " You are not an ICU nurse right?" "The patient was not downgraded from ICU why are you there?". I just told them well I just accepted the assignment otherwise I might be put on call shift. I appreciate them but I don't know if I did wrong accepting the assignment. A little background about me: I have a nursing experience as a PICU nurse (2 years) not in USA tho. But here in USA I worked in skilled nursing fulltime and per diem NICU nurse.
11. 

    IV iron infiltrated

    darren_callcareer18 replied to darren_callcareer18's topic in Nursing

    yes I informed the MD and his main concern was the iron not being completed. So, I started a new line to the patient and finished the transfusion. And as to my supervisors, they advised the usual thing to elevate and apply warm compress (but I alternate it with cold compress basing on the web). My sup also advised me to create a sort of incident report. I just feel so bad because the iron stains to the patient body.
12. 

    IV iron infiltrated

    darren_callcareer18 posted a topic in Nursing

    Hello! I am so frustrated and stressed out because I administered an Iron IV but it got infiltrated. I checked everything and even checked the patient once in a while but it still infiltrated. I dont know what to do. Any suggestion?
13. 

    Aspiring Army Nurse. Suggestions?

    darren_callcareer18 replied to darren_callcareer18's topic in Government

    I am here thinking hard. I feel like my recruiter is not entirely being honest. Sad. I will semd her a message that I am backing out.
14. 

    Aspiring Army Nurse. Suggestions?

    darren_callcareer18 replied to darren_callcareer18's topic in Government

    She told me she is a AMEDD. I consulted to a military website via email and I was told this: “Thank you for contacting me. Most recruiters only focus on either enlisted members or commissioned officers. I don't think your recruiter will be able to do much, if anything, for you after you attend basic training and AIT. At that point, your recruiter will be out of the picture and you will be working for the Army - not your recruiter. Is it possible to commission as an officer? Absolutely. But it may take some time. I also don't know what the rules are as a citizen from another country. I know that can put you on the fast track to American citizenship, but I don't know if it will have any impact on your goal of becoming an officer.” I think it has something to do as me just being an permanent resident and not an american. 😕
15. 

    Aspiring Army Nurse. Suggestions?

    darren_callcareer18 posted a topic in Government

    I hope you can help to enlightened my mind. To give you a little background, I am an immigrant and a greencard holder, means I am not an american citizen yet. It has always been my dream since I was kid to join the US army. I am a registered nurse here in USA and currently working as a registered nurse in a hospital. As of the moment, I am now enlisted and ready to be shipped to basic training on March 11, 2019. However, my current MOS is 88M or transportation. My recruiter told me that she will do everything to change my MOS to a nurse officer once I am done with the basic training and AIT. So she told me that our goal is for me to be sent to the camp and work my way to become a nurse once I am done with all of those and when the board starts accepting this August. I am completing my forms already for army nurse. But I am worried about it. What if she can't help me? What will happen to me? Will I have to finish my MOS contract before I can do Nursing? I love serving in the US army and so is nursing if I can do these both at the same time I will definitely stay in the military for the rest of my life.. Another concern is my pay. As of the moment I am paying too many bills and it seems like 88M pay would not suffice to my needs. I am the bread winner of the family. I feel like I am gambling and putting my entire faith on her. So do you think there is always a chance for me to change my MOS? I am in active duty with contract of 3 years. Hoping for your response fellow nurses! And thank you in advance. Suggestion pls. I got 3 more days Respectfully, Darren
16. 

    This MD culture

    darren_callcareer18 replied to darren_callcareer18's topic in Nursing

    I wish to be like you! 🙂 I wish to work with you so I can learn your persistence. haha