Sue McGann

What kind of storage cabinets do you use to keep floor stock medication and narcotics in? We are looking at investing in new cabinets, but we are having trouble finding something big enough to suit our needs. Thanks Sue

We use saline to flush peripheral and central lines. No heparin. One of the benefits are some patients are allergic to heparin and can have nasty allergic responses. Sue:cool:

The hospital wants to change their policy stating that nurses may initiate IV therapy prior to catheter position confirmation with a chest x-ray. I can see that you are also have sort of the same problem. I do not agree with the practice due to my years as a hemodialysis nurse and a Critical Care nurse. But I have a list of articles that support the practice. Now I want to research the number and typrs of law suits due incorrect line placement. I will copy the references below Guth, Amber A. M.D., F.A.C.S. Routine chest x-rays after insertion of implantable long term venous catheters: Necessary or Not?" The American Surgeon. January, 2001. Vol. 67, pp. 26-29. Riblet, Jeffrey L. M.D., Shillinglaw, William D.O., Goldberg, Amy J. M.D.; Mitchell, Kevin M.D.; Sedani, Khemraj H M.D.; Davis, Frank E. M.D.; Reynolds, Neal M.D., "Utility of the routine chest x-ray after 'over-wire' venous catheter changes." PP. 1064-1065. Cullinane, Daniel C. M.D.; Parkus, David E. M.D.; Reddy, V. Sreenath M.D.; Nunn, Craig R. M.D.; Rutherford, Edmund J. M.D. "The Futility of Chest Roentgenograms following routine central venous line changes." The American Journal of Surgery. September, 1998. Vol 176. pp 283-285. Sanabria, Alvaro M.D.; Henao, Carlos M.D.; Bonilla, Romulo M.D.;Castrillon, Carlos M.D.; Cruz, Herman M.D.; Ramirez, William M.D.; Navarro, Pablo M.D.; Gonzalez, Mercedes M.D.; Diaz, Abel M.Sc. "Routine chest roentgenogram after central venous catheter insertion is not always necessary." The American Journal of Surgery. 186 (2003) pp. 35-39. Lucey, Brian; Varghese, Jose C.; Haslam, Philip; Lee, Michael J. "Routine chest radiographs after central line insertion: mandatory postprocedural evaluation or unnecessary waste of resources?" Cardiovascular and Interventional Radiology. 1999. 22. pp 381-384. Gladwin, Mark T. MD; Slonim, Anthony MD, Landucci, Dante L. MD; Gutierrez, Deborah C. BSN; Cunnion, Robert E. MD. "Cannulation of the internal jugular vein: is postprocedural chest radiography always necessary?" Critical Care Medicine. 1999 Vol. 27, No. 9. pp1819-1823. Amshel, Craig Edward MD; Palesty, J. Alexander MD; Dudrick, Stanley, MD FACS. "Are chest x-rays mandatory following central venous recatheterization over a wire?" The American Surgeon. June 1998. Vol 64. pp 499-502.

Thanks for the quick replies. We used to enter everything into the computer but have realized that it was an unlicensed person( Unit secretary) doing this and have rethought the process. Now we want to get the order to the pharmacy for the pharmacist type person to enter in the order. Another problem we have found is that when faxing the addressograph patient information become illegible. Do you have the same problem? :eek:

We have had a recent trend in medication errors. The hospital that I work in continues to use a physician order sheet with a carbon sheet that is torn off and sent to the pharmacy. We are finding that many of these errors are due to these carbon sheets. One error was noted when the different set pre-printed orders on the carbon was attached to the front order sheet. This was an error in the printing process. My question is: Does your hospital still use paper order sheet with a carbon sheet that is sent to the pharmacy? Or are you all computerized? Are you using CPOE(computerized physician order entry) Thanks Sue

Dayray wrote And the nurse who said that men are coming to nursing for the money.. I need to know where you work becuse The money here is nothing that would attract a person to nursing. Sue reply: I live in St Joseph MO. 60 miles north of Kansas City. And Yes the guys do go into nursing for the money. They is little else here that pays as well. Most jobs here are unskilled and pay $10 an hour. Top of the pay scale here is over $28 an hour. Pretty good. Most nurses here make a very decent living even with working minimal overtime. They more than I do in management.

Stella 123 rn Can you tell me what state you live in?

Cybercat. Can you please tell me what state you are from?

Mr D wrote: What was your experience in nursing school? Was there male/female tension in this environment? Did you/any one you know struggle with this? Guys, Has nursing, aka working closely with mostly women, negatively impacted any of your relationships? Reply : 25 years ago there were no men in the BSN program I attended. Sorry. However here in St Joseph MO there are an unusual number of men entering nursing and has been for many years. Why? the money.

I have a question that I thought was a no brainer. At the hospital where I work they are questioning what NPO means. I think it means what it says. Nothing by mouth, NG tube, G tube or any other feeding device. Some people are suggesting that it does not include medications. Meaning if a patient is NPO you can go ahead and give medications with sips of water without a physicians order. I have never hear of this. So I would like to know what your experience is where you work. Please let me know what state you live in. thanks Sue