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oldiebutgoodie RN

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  1. oldiebutgoodie

    Adult CNS-EXAM

    I would strongly recommend you take the ANCC review class, it is a telephone conference class. They send you a book of Powerpoints, and it "meets" (via telephone) once a week for 8 weeks. I did that, and passed. Here is the information: Adult Health Clinical Nurse Specialist Study Group Event Type: Study Group Start Date: 5/14/2012 - 8:00 PM End Date: 6/11/2012 - 9:30 PM Location: Telephone Conference Calls Good luck, Oldiebutgoodie
  2. oldiebutgoodie

    LPN taking wound care course; skin tear question

    I don't recommend Tegaderm at all. Many folks getting a skin tear are elderly or with fragile skin from steroids, and trying to removed the Tegaderm can be impossible without causing more skin tears. I have seen patients from nursing homes covered with Tegarders, with wound fluid bubbling up and leaking out the sides. For skin tears with a flap, just irrigate with normal saline, put the flap back down over the tear, and you can secure with Steristrip or put a non-adherent dressing on it, like a foam (Polymem), vaseline gauze, or Adaptic. You may only need to change dressing every 2 or 3 days. Telfa pads seem to stick, don't use them. Here is a good article on skin tears: http://findarticles.com/p/articles/mi_qa3977/is_200005/ai_n8894280/?tag=content;col1 Oldiebutgoodie (certified wound RN)
  3. oldiebutgoodie

    Breast Cancer Wound Care

    It depends on what the wounds are from. Are these radiation burns? Surgical wounds from lymph node resection? Fungating tumors? (I hope not). Mepilex Lite foam is a wonderful product that conforms to the skin, can be tucked under the axilla. If too much drainage, could use a regular Mepilex foam tucked under. They have a gentle adhesive that will adhere to the skin, but should not be traumatic to take off. Other options would be Mepilex Transfer, tuck under armpit. This allows drainage to come through, and then regular dry gauze underneath. Securement can be challenging. May try a leotard sort of top with short sleeves to keep the dressings in place. If these are radiation burns, I recommend an ointment called Miaderm, seems to work well. http://www.miaderm.com/ Good luck, Oldiebutgoodie
  4. Oh for heaven's sake, your manager is foolish to allow tattletaling like this. We will never be a real profession if some RNs "run to mommy" to tell, and the manager allows it. Oldiebutgoodie
  5. oldiebutgoodie

    If I see one more post titled....

    This may have been already asked, but... can I still get a license as an RN if I am a convicted felon and am a registered sex offender? (The whole sex offender was just a big misundestanding... I thought the paperboy was 21, not 13).
  6. oldiebutgoodie

    Teach me about Thyroid Problems

    Yeah, but she didn't even say please. Jeez.
  7. oldiebutgoodie

    New grad orient possibly going to get fired...Plz help!

    Is anyone giving you concrete examples of time management and prioritization issues? If not, and they are just picking on you, you might think about transferring to a med-surg floor to get a better handle on nursing, and then go back to the ICU. ICUs have a certain culture which is sort of unspoken. If you don't "get" the culture, the RNs there will be all over your backside. Good luck to you! Oldiebutgoodie
  8. oldiebutgoodie

    How does your unit orient new nurses?

    You might want to check out this article by Linda Morris and others: "Designing a Comprehensive Model for Critical Care Orientation". http://ccn.aacnjournals.org/content/27/6/37.full Here is their evaluation of the program: http://ajcc.aacnjournals.org/content/18/3/252.full Oldiebutgoodie
  9. oldiebutgoodie

    Do Nurses Eat Their Young?

    Unfortunately, I think too much of the horizontal violence in nursing is a result of managers either ignoring it or encouraging it. They encourage it by allowing "tattling", "writeups" without appropriate documentation, and just plain favoritism. Until nursing management puts its collective foot (feet?) down and refuses to allow this, it will continue. Been eaten, won't be eaten again! Oldiebutgoodie
  10. I just think that it is interesting that as soon as I entered grad school for my MSN, nursing diagnoses were never mentioned again. EVER. It was all medical diagnoses. Oldiebutgoodie
  11. oldiebutgoodie

    "Not a Good Fit"

    It's very sad, but it just reinforces that it just doesn't pay to dedicate yourself to your job. Companies that bemoan lack of loyalty in their workers need to look inward. Oldiebutgoodie
  12. oldiebutgoodie

    Do Nurses Eat Their Young?

    Yes, they eat their young, and I still have the bite marks to prove it (5 years later). Oldiebutgoodie
  13. oldiebutgoodie

    Disturbing Job Ads: 'The Unemployed Will Not Be Considered'

    I dunno, but I learned as a child to never kick a person when they're down. Oldiebutgoodie
  14. oldiebutgoodie

    Disturbing Job Ads: 'The Unemployed Will Not Be Considered'

    Very sad. It makes me wonder, did any of these hiring managers a) read the Bible b) go to Sunday school/temple/whatever c) learn right from wrong d) hear of the Golden rule e) ever deveop a sense of morality? Oldiebutgoodie
  15. oldiebutgoodie

    Making Acetylcysteine bearable?

    Just an aside: It is refreshing to read a clinical thread in which the participants disagreed on a civil level, and I learned something. Thanks! Oldeibutgoodie
  16. oldiebutgoodie

    Pushing Dilaudid?

    Pass the popcorn. Oldiebutgoodie