CharmedJ7

Hi, I'm a new grad and I've been working on a surgical floor for about 3 months. I've noticed that it's a reasonably common problem to have leaking from NGT from the vent, and I'm not really sure what to do about it. Flushing, changing connector pi...

Had an issue come at work over the last two days that I'd like to get some more opinions on since I couldn't find much on my initial search. I had a pt with a PICC line that had initially been in the SVC then slid out 11cm and on xray was found to b...

Does anyone have any experiences or insight on the University of Calgary? I'm specifically looking at their BNAT program since I already have a bachelors degree. It would also be useful to get a feel for nursing in Alberta in general or what it's l...

It's frustrating. Wet-to-dry dressings at best will do little real harm to otherwise clean and normal post-op wound. It's totally inappropriate for more complicated high-risk wounds. Non-healing wounds deserve a wound consult. Wet-to-dry orders a...

That's strange. Most of the patients on my floor are on PCA and the docs don't write a 4-hr lockout at all. We calculate it as a back-up to what we put in, ie, Dilaudid 0.2/0.2/10, 4-hr lockout is 5.6mg. The vast majority of patients do not zonk t...

We get a fair amount of bariatric patients on my floor. Generally I find them to be reasonably pleasant - a little wary maybe, I see a lot more super positive family members then patients themselves. What I will say though is that I see a LOT of re...

It really depends on the chemo agent in question. I work in oncology and the general rule is that for 48 hrs after someone received chemo they are considered to be on "chemo precautions." Exactly what that means is somewhat debatable, but gloves ar...

We just moved over to uniforms. We tried the ID band thing, but they still flip around a lot which is maybe why they decided they weren't working (I suppose this is a solvable problem though if they just make them double-sided). The funny thing tho...

This definitely seems like a policy and/or order thing. Pre-OR, the order set has a space for docs to specify which meds, if any, they want given prior to OR. All other PO meds are held, IV usually given. If I'm unsure I'll talk to the team. For...

As others have said, it really depends. I received report on a pt, didn't like the sound of it, went it with the off-going night nurse and we ended up having to rapid response here and send to ICU. The night nurse stayed the entire time, as was app...

I find in general new nurses have a far easier time talking to residents than attendings on my floor, partly because they're who we have the most contact with. And for the most part, the residents are receptive and easy to work with. I think a lot ...

I don't know what the purpose of going slow is. Most of my patients prefer it as fast as possible. I've never had any issues.

Thanks for all the responses, I appreciate it! Getting the bed lower for pulling is an interesting thought, I usually bring it up high so I'm not bending down, but potentially it is better lower. As for the too fast/rough thing, usually that compla...

I'm going to try to avoid this being a rant, but my apologies if I fail. I find patient positioning and mobilization to be the worst part of my job. We have lift equipment, and I will say it is helpful with getting patients out of bed more safely, ...

Not the pt, one of the residents (docs) I'm friends with. I love the PTs and they're great when they're there, but they can't be there all the time and they often put the pt in the chair and then we have to get them back to bed. I like trapezes too...

I dilute narcotics because it's pretty hard/impossible to push 0.5ml slowly. I dilute benadryl because it's irritating to the vein. I dilute ativan sometimes for the same reason as narcotics, plus it's kind of thick. Mostly I dilute, usually in 10...

Pharmacologically it is safe to give 1 then the second at 3 hrs vs 2 together. The only risk I see potentially is if at 6 hrs from the first you give another 2 more than the patient has 3 in their system for a time. It's a little scary that anyone...

I actually think this is a great idea. When one of our techs is injured they are designated to "light duty" that means only VS and BS but they did it for all the patients. I actually thought it was a good system because when all the techs are resp...

So I had an interesting case today where I got called from lab with a critical PTT (>200) but the anti-xa, which we use to monitor heparin gtts, was therapeutic. My understanding is anti-xa measures more the levels of heparin in the blood and PTT...

First off, I want to say that WFR and FR are not the same - wilderness training assumes you are farther from aid and thus you learn a lot more techniques and skills (tourniquets for example). Also note there are organizations (like NOLS) that offer ...

I feel bad, but I really don't like having non-English speaking patients because it slows things down so much. The translator phones can be good when you can find them (ours have all gone MIA in the past weeks) but realistically I can only use them ...

This is a really interesting thread - I'm an RN at the moment (first degree biochem) and I'm heavily debating if I want to go back for NP, PA or medical school. The quality of life issue worries me a bit for the MD route, but I am concerned if I go ...

Anyone know how CEU requirements are checked? I've taken more than enough already but I'm not sure if it's automatically sent to the local BON or if I'm expected to tell them and/or keep proof of hours. I'm in DC if it makes a difference.

My first thought when I saw this was that I would love it if in ICU nurse floated down to my unit. But I guess we are more step-down than med-surg, and we get a lot of borderline-ICU patients as it is, and we take into account where a nurse is float...

I am ACLS certified. As an RN, that only gives me the ability and certification to recognize, suggest and execute orders from a provider, not to independently initiate it. I wouldn't personally mess with those drugs even if I had the formula card i...