missmiamoore

Very sad. This is why I am hesitant to post on all nurses.com. It is full of bitter people who seem to enjoy being rude and cold to other nurses. This is pathetic and I would never respond to a comment by disregarding it. I am done posting on this site.

I am going in on modified duties, meaning I won't have a patient assignment for two shifts. It really upsets me hearing fellow nurses not supporting others because they themselves have had bad experiences. This is what I call lateral violence. My manager is very understanding and they took this event seriously. She said she would feel the same as me and gave me lots of support. Perhaps elk park is bitter as she never stood up for herself before in the workplace.

I am feeling traumatized and numb at the moment. Maybe it is because I am 6.5 weeks pregnant and my hormones are out of control. There was an "incident" at work tonight that threw me right off and has left me feeling disturbed. I am sure it is not new to most nurses. I had just started my night shift, received report, and began my initial rounds. One patient in for Falls, 80 year old, with CKD, on daily hemodialysis, appeared confused. The patient had been admitted late in the day shift. On report, the day nurse told me that he had been projectile vomiting and they had to change the curtains, but she said he was alert and oriented with no behavioural issues. That is not what I encountered. I approached him and after introducing myself and him seeming appropriate, I attempted to put the bed rail up as he was sliding down and his legs were hanging out. He then kicked at my stomach. I was able to back away quick enough so I didn't receive the full impact of his kick. He said if you touch this bed I will knock your head off. He then appeared like he was going to vomit and I went to pass him the basin, and when I was just in front of his face, he spat blood-tinged thick sputum into my face. I was shocked and disgusted. I was frightened for mine and my baby's health as the sputum went into my eye, nose and mouth. I screamed when he spat in my face I couldn't help it. My colleagues came running and told me to wash off. I did as best I could and reported to the ER. I was a basket case at this point. I told them of my pregnancy and they could tell I was traumatized. They were quite wonderful. The ER charge nurse was like a kind mother, who told me confidently that she had found someone to cover my shift. The ER doc told me he was generous with time off and gave me the week off with pay. I am just so upset that we as nurses have to be exposed to this type of abuse. These patients are confused and I know they are out of their minds, but how can nurses be protected against this type of violence? I am feeling resentful towards the management as it seems that they do not give a s__t what happens to their employees, as long as they have bodies to cover staffing needs.

Thank you Elkpark. This is reassuring to find out :)

Hi nurses: I am a Canadian RN that graduated in 2008, from McMaster University Bachelor of Science in Nursing Program. I worked for a couple years in acute care in Ontario. Now, I am trying to gain licensure by way of examination in California. The BRN has stated that my education is insufficient, in that I did not do a maternal-newborn placement. They are stating that I need to find a program within California that offers a course with theory and concurrent practical experience in maternal-newborn for registered nurses. Well, let me just say that this is quite a difficult thing to do. I have contacted several schools, who have been unable to help me. I have gone through the list of Board approved schools and considering I also live in the middle of no-where, there aren't many that are practical for me to attend. I would love to do the theory online and the practicum near where I live. Why is this so hard to arrange? No one seems to offer maternal-newborn theory classes online. Has anyone else experienced this kind of response from the California Board of Nursing? I was surprised my education was considered deficient, as I graduated with honors, and the program I completed is highly accredited. I may not have done a maternal placement, but we definitely covered the theory behind it. Also, I have been working full-time for two years. It seems crazy they are forcing me to go back to school to do a subject that, quite frankly, is not my favorite. I don't know what to do. I feel really dragged down by this. Even if I write the NCLEX in anther state, I will not be able to get a permanent license in California unless I complete this educational requirement. Anyways, I would greatly appreciate any input or suggestions from anyone that is familiar with this sort of situation or has any ideas on how I can do this? Thanks so much. *Frustrated in Cali*

I didn't know that UOP offerend nurse practitioner programs. I am in the Lake County area and am interested.

Med aide is such a STRANGE concept to me. I get all territorial and panicky just thinking of someone else pouring and passing my patients their meds. What type of training do these aides have? Do they know how to do the proper assessments and understand the pharmacology behind just giving pills? I personally feel an aide would be better utilized within a PSW role (toileting, turning, ADLs, transfers, boosts). Sounds dangerous overall to have too many cooks in the kitchen and I would refuse to work within that care model.

Oh yes, of course we all do that. It's called reflection. The key is not to drive yourself crazy over these things. What I find helps is I try to think of a positive for everything I have missed. For example, I will think, I should of left a note for the doctor about the family's concerns. However, I did successfully advocate for the patient to have their pain medications changed in a timely manner. Just remember, everything you do makes a difference. Those things you think about at night is your way of processing the information and learning. This makes you a better nurse :)

Morphine, Gravol, acetaminophen, Atasol 30, Percocet, oxycodone, Dilaudid, Zofran, Stemetil, Maxeran, Bendadryl, Imovane, and Ativan. I work on a post-surgical floor (majority ortho and GI). We always have to call for abnormal labs (potassium, hemoglobin) and get an order for Slow-K or transfusion.

Hi there.. At our institution we follow hip and knee care paths. On day 1-2, we would be assessing for pain and symptom control, hemodynamic status (hemoglobin and potassium levels), urine output, ambulation (should be 2 assists to sob or chair), bowel sounds and elimination pattern, increasing independence of ADLs, reinforce physio teaching regarding proper use of assistive devices, hip precautions (no crossing legs, flex more than 90 degres, etc), surgical dressing dry and intact. If you look on google under total knee/hip replacement care path, you will find many. Good luck!

Yes, I also feel as if this line would be questionable for harsh agents such as chemo etc. However, drawing blood is also an issue, as we all know that doing so from a peripheral line can potentially collapse the vein and would ultimately damage the site itself. Did the lab use this line to draw up the blood or did they use another site and poke the pt. I think I would feel more comfortable with the latter.

No way in hell...Would not want any of my co-workers catheterizing me, toileting me, seeing me vulnerable. I don't even like to socialize with these people. I like to keep my work life very professional and that includes not being a patient on my unit!!! I work in in-patient surgery. I would however consider having a baby in our hospital though!!

Thank you for your thoughtful replies. Shedding some light on this situation. I personally think this patient is "on his way out" he does not look good and I get that gut feeling, but he has not been deemed a terminal patient. As far as TPN, I am in Canada and although there is still the cost issue, we don't really hear about it so closely, as the system absorbs the cost. I think a family-team meeting is in order.

This patient did not eat anything all day. Just kept drinking juice and water. We finally got a Boost into him but only at the end of the day. How do we maximize nutritional status when they don't want to eat anything?

So a scary/strange thing happened today at work. A patient of mine who has chronic edema and very sensitive skin recieved a nasty skin tear under his eye when I was wiping morning mucous out of the corner of his eyes. I didn't put unusual pressure on the face cloth, I just used what I considered normal force. He flinched and when I saw what happened, the skin had torn and rolled away revealing red tissue underneath. I put a saline soaked sterile 2x2 gauze on the site and left it there for about 10 minutes to help soothe the discomfort. He was left with a redened under his eye, which is unsightly and I feel quite bad about it. I consulted with our wound care nurse who said there was nothing really that could be done in terms of dressing it or ointment. Of course, I informed the MD and documented appropriately. I am just really mysified why the skin came away this easily. This poor man is quite ill and has a history of multiple medical conditions, namely cardiac and subsequent edema. He also appeared to have the starting of shingles or chicken pox. He had the typical rash pattern including forming along the dermatome. Have any nurses had patients with this kind of skin before who were edematous? What causes this and how do we care for it best in terms of bathing and pressure sore prevention. Any thoughts would be appreciated. Thanks!