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Southern Fried RN

Southern Fried RN

Critical care
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Southern Fried RN has 9 years experience and specializes in Critical care.

Southern Fried RN's Latest Activity

  1. Southern Fried RN

    Visitation policy of children in L&D/ Mother Baby/ LDRP

    NICU: No visitors except immediate adult family members (mom, dad) unless the adult visitor was escorted by mom or dad. No children, not even siblings. Otherwise, pretty open about children except when all that H1N1 was going around. No children under 12 were allowed during that time, siblings included.
  2. Southern Fried RN

    Well.. I *was* a cardiac nurse

    Anyone with an acute process that is requiring q1h neuro checks belongs in a neuro ICU, period. Neuro patients who are that acute can and do go bad quickly, the results of which could be devastating for the patient. It puts the hospital in a position to be sued, just imagine an acute CVA who vasospasms and has a decline in neuro status that doesn't get caught because the nurse has too many patients to get to the q1h check. Not to mention the learning curve with neuro assessment, subtle changes to be aware of and medication side effects masking things. Acute neuro patients need to be in an environment where things will be caught and intervened on in a timely fashion. This is no disrepect to your type of nursing, OP....your hospital is setting your floor up for a bad outcome. My second reaction to your post is about the NIH scale....really!?!? How can they expect nurses with 6 patients to go through that properly? My hospital uses the MEND scale for the neuro patients both in ICU and the stepdown (once they are stable and not q1-2 h anything!) When my hospital became a primary stroke center and the neuro stepdown was created, it was integrated into an existing tele unit. However, their ratio is 1:4 or 1:5 most days and they were all put through comprehensive neuro training (ASLS and Apex hemispeheres courses). The MEND scale is more more user friendly. Maybe the hospital would at least consider that. http://www.asls.net/mend.html Hopefully things will change. Maybe this is your chance to move into hospice. You are being put in an unsafe situation and it is not worth the risk to your emotional health or RN license. I once left a CVICU with some unsafe practices, there had been 2 lawsuits in 2 years and I didn't want my name to be next one. Best decision I ever made.
  3. Southern Fried RN

    Telling The Truth: A Nurse Who Stutters

    I work with a nurse who stammers. He tends to do it more when he's stressed out. He just takes his time speaking slowly to get his point across. It's very tempting to fill in the word for him when I know what he's trying to say, but I feel that would be rude so I don't. The NM and patients/families don't have a problem and neither do we. People just let him finish what he's saying and go on about things.
  4. Southern Fried RN

    lethargic(and need ABG) or just tired???

    Agreed. I've seen patients with 100% o2 sat, RR 16, obtunded with a pH of 7.19 and pCO2 of 90. Some patients may be undiagnosed OSA, then add general anesthesia and narcotics....you are definitely right to be concerned and not brush it off as just medication. I've heard two horror stories where a patient with undiagnosed OSA getting Dilaudid post-op only to be found dead (both at local hospitals).
  5. Southern Fried RN

    What do you say when calling out sick?

    I work in a very small, specialized department. We only have a few full-time people and even less PRNs. Our NM expects us to be "dependable" which means come to work when you are sick and if you can't then make calls begging the other FT people to come in on their days off. "Dependable" to me means you don't get falling down drunk and call out due to hangover, or when you have a mild cold that Sudafed, etc can be taken. However, some of my other co-workers come to work febrile or even with N/V/D! If I have that I will call out, and I have to call out occasionally when Grandma can't watch my sick kid. Also our NM expects to find people to cover our vacations. So if you can't find someone to cover all your shifts....guess what? Vacation is cancelled. I'm not even sure this is in accordance with hospital policy. It's ridiculous because some people can't/don't want to work extra to cover and then it causes tension in the work environment.
  6. Southern Fried RN

    Torn between continuing my education and my family :(

    I'm in graduate school, work full-time and have a preschooler and an infant at home. I certainly do not ignore my children and I am very involved in raising them. Does it make me a tiny bit sad to drop them off at daycare when I go to work or class? Of course! That feeling reminds me that when I am with my children, it is about the quality of the interaction and cherishing our time. I won't lie, it is very difficult. I am usually tired and the house is messy. I sometimes sacrifice day trips to the beach or a cookout because of needing to finish a project or having to work. However, there is always clean laundry (somewhere!), food in the fridge and diapers in the nursery. I do find time to take my kids to the park or visit with friends and I appreciate it that much more when I find the free time. I am so very lucky to have a supportive husband who isn't above helping out. I've talked to several NPs who went through their programs with small children. All of them felt it was the right decision for them because their children needed more attention when they were school age. Yes, they are only little once....but at this age, there isn't homework, soccer, piano, etc. The kids are in bed by 7:30 and I can study a few hours before going to bed. I know when the kids are school age I will want to get away from 12 hr shifts and rotating weekends to be there for those activities. Being an NP will allow me to do so. School, work and family is difficult to balance but feasible under the right circumstances. Caring for an ill parent or martial problems seems more important and it might not be the right time for you. School will always be there, in a variety of options--online classes or part-time might work for you. Your home life sounds like a priority right now. Good luck!
  7. Southern Fried RN

    Question about CHF

    Severe left side heart failure eventually results in right side failure. The patient who starts with tachypnea, crackles, cough will have that before developing JVD and peripheral edema. Purely right side failure (cor pulmonae) is not nearly as common and results from disease in the pulmonary vasculature/lungs. Left side is much more common however many patients have features of both. The other thing to consider is whether this patient is edematous from hypoalbuminemia from something like liver disease.
  8. Southern Fried RN

    Question about CHF

    Maybe someone should call the physician or nurse practitioner for additional Lasix (or whatever diuretic). Seriously, if the patient's legs are swelling more lately that probably needs to be addressed. Fluid might already be in the lungs, how is the patient breathing?
  9. Southern Fried RN

    Political Discussions at Work

    I think this might backfire in your face. It's one thing for the surgeons to disparage a political figure. Unless the surgeon is calling *you* a moron for supporting the other side, harassing you with questions about your viewpoint, etc, I don't think you have much of a case to claim it's "illegal" or a hostile work environment. I have to agree with CRNA1982, unless it's REALLY BAD, there is probably nothing that will be permanently change. Think of all the surgeons who have reputations for cursing out OR staff or throwing instruments at them during the case. Then think about how many have actually been fired from the hospital over such matters that are far worse and should never occur. I doubt anything will happen more than a few weeks or so of no political talk and little comments like "oh we can't discuss that since someone will report us." I agree with where you are coming from, I think it's inappropriate to talk politics with patients around. However, the reality is that administration typically does very little to discipline surgeons, while nurses are treated as expendable.
  10. My 17 year old cousin wants to be a surgeon. I think she's fairly serious about it, taking AP courses and planning on a biology or chemistry degree. However, she did make a FB post about being tired from getting up so early (5am) for her Barnes and Noble job. I jokingly commented that it was good practice to get used to waking up early and being sleep deprived for when she is a surgeon. I did tell her about how most surgeon's schedules are with early rounds, call, etc. She didn't get mad with me but I did get the impression she hadn't really considered all that. When people ask me about nursing, I tell them realistic things--holidays, weekends, long shifts, crazy co-workers, bad managers, rude patients/visitors/physicians. However, I also point out that there are good points to nursing as well and no job is ever perfect. I'm not going to sugar coat it because people should know it's a hard job, but at the same time I don't want to dwell on all the negatives.
  11. Southern Fried RN

    slow code?

    I am a rapid response nurse. I would have wanted you to call me for a patient like that because the code status is still "full." To ignore a change in VS/condition like that because someone thinks he should not be a full code is unethical and will get you in legal trouble, as the other posters have already pointed out. I have a "top 10" list of my frequent fliers that I get a rapid response calls on during their hospitalizations. (hmm, make that top 20!) Anyways, these poor souls with every co-morbidity in the book, have decubs, infections, been in an out of ICU, some chronic trach---they have these family members that will insist on everything being done. It is heartbreaking to keep seeing these people die a slow death, us bringing them back from the edge only to see them come back in a few months in the same shape. One man told me "I wish you'd let me go." However, the minute we "slow code" one of these people and they die (or worse have anoxic brain post-code) I wouldn't be surprised if some family member calls a lawyer. So in the meantime we keep transferring them back to ICU, giving them a vent/pressors/dialysis for another go-round. You did the right thing.
  12. Southern Fried RN

    UPS Drivers make HOW much????

    My father works for UPS, he drives tractor-trailors full of packages on the interstate although he did deliver packages many years ago. His salary is in that range; however he has been with the company 30 years and works about 55 hrs per week. I don't know his hourly rate but the OT is what pushes his annual salary so high. Other senior UPS drivers work that many hours. It seems to me that article misrepresented what an average package car driver with a few years experience makes. UPS is also unionized and maybe that contributes to the salaries? I have heard it's also hard to go full-time with UPS; they keep people to the max part-time hours and let the people with more seniority go full-time and get the extra hours.
  13. Southern Fried RN

    OBs doing unnecessary C-Sections and inductions

    I'm 24 weeks with a boy and have a date scheduled for an "elective" c-section. I say "elective" because my OBGYN doesn't do VBACs. My first son was born via c-section for what I am told was CPD. I was 40w5d when I was basically told by the CNM I needed an induction to "get things moving." This induction went on for 30 hrs, my water broke and then a bunch of people rushed into my room. I guess he had decels, my doctor says it's time for a c-section, I was so exhausted and scared I agreed. I am interested in trying a VBAC but I feel stuck because only a few other doctors at my hospital do them. I'm stuck at my hospital since I have the insurance there and it would be big $$ to go out of network, and the doctors that do the VBACs I don't trust. I'd like to think I will go into labor on my own this time but am scared since I am small and my first baby was big this one would get into distress. But yeah, back on topic, I do find myself rolling my eyes at people who want an elective section at the earliest possible time. Why take the risk? One of my husband's cousin's wives "demanded" a c-section because in her culture it was considered a more proper way to give birth. She's from somewhere in S. America, I didn't hear that first hand, but what I found most amusing was that the baby's father was an OBGYN himself! He didn't try to talk her out of it.
  14. Southern Fried RN

    OB Rapid response team

    Sounds like not having 24/7 anesthesia coverage is the first problem. Even if all the other team members are present for the emergency, it's not going to do any good unless someone can put the patient to sleep. Second, why isn't the L&D/PP a closed unit? So L&D nurses are being pulled to places like med-surg? That seems to defeat the purpose of an "emergency L&D team" when that nurse has a team of patients she must leave behind.
  15. Southern Fried RN

    Best and Worst of working CCU

    Purely my own experince but it seemed like I had a lot less code browns happening in CVICU as opposed to MSICU! LOL.
  16. Southern Fried RN

    Pregnant and miserable working

    I am sorry to hear you are so miserable. I was pretty uncomforable with my first pregnancy after about 35 weeks. I'm 14 weeks pregnant again and this time have a job that is a little less physically demanding. Are you working all your shifts in a row? Try just working one day on, then one or two off, etc. It's harder to get a longer stretch of days off but may be worth it to not feel so worn out from working many days in a row. Could you drop down to part time, just 2 12's a week to keep your job and benefits? While you are working, try to delegate as much as you can to ancillary personnel (within their job descriptions, of course). There is no sense in you trying to fetch a pillow or deliver ice water down a long hallway when an ancillary person can do that. Try to cluster your nursing tasks so you're not running around in and out of rooms all day. Of course drink plenty of water and make sure you are eating quality food when you get a chance, not junk food which will make you feel worse. Someone suggested massage, definitely do that to help you unwind! Try to hang in there as long as you can! Once your baby comes, you will really want the extra time with him/her, even if it's a few weeks. I went out two weeks early (no real reason on my part, just worn out, but probably could've kept going) and wish I had that extra PTO to stay home longer with my son. This time I plan on working up to the day before my scheduled c-section. But do what's right for you and your family, and hopefully you can get through working in the meantime! :)