sweetsounds

Please help! My pt. is to do PICC infusions q8h at home. His technique is good. My question involves cap changes.PICC is in RAC. He has a 12" extension to allow him to handle his line. I was advised to "change caps daily." Extension tubing remains in place for 3days (whereas IV tubings are changed daily). PICC is capped and extension tubing is capped = 2 caps. It does not make sense to me to change the cap on the actual PICC line because I would then be using the same old extension tubing on it. This situation does not fit "hospital" policies because no extensions are involved. Have tried surfing the web, including Mfr. site, still not sure... Any opinions appreciated!!!

A variation on this theme: the visitor with the pt who expresses their "concern" repeatedly even tho' the pt is quite competent/fluent. A friend of mine coined the term "attack friend" for them. Of course, the majority of the time this was a planned stategy; the friend can be obnoxious as possible while the "helpless" pt is so ill they have no accountability (it's not the pt's fault if their fiend is rude to you, right?). P.S. Nurses have incredibly attuned hearing, may be just on the other side of the curtain, OR may be bilingual.

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????Look up Dilantin and you will find (possible) side effect is "V FIB"!!!! Why would anyone push that??? Also literature is pretty clear about using a large vein... What kind of pharmacist would think it wasteful to dilute it? I have had somewhat similar experiences i.e. pt could not tolerate and I reported it to E.R. MD who then changed order to phosphenytoin.

the pump is "incredibly complex"??? The pump is one of my best buds!!!

Please speak to your doctor. I have read that some people have had relief with beta blockers for that kind of anxiety. Also, speak to anyone who will listen. You need to learn how to vent. You'd be suprised how well it works to go ahead and announce an insecure feeling. It usually results in supportive comments from others, as well as possible pointers you can use. Trying to act experienced and/or "perfect" is just not worth the stress. Plus, if you're already perfect how will you be receptive to new learning experiences? Good luck.

IMHO the title of this post could be "...and can I get you some hot wings with that?"

2 incidents, same person? Would love to hear... For every person who clogs up EMS pointlessly your grandmother or mine my suffer, u know?

Amen to everything you said. It's the call the Charge and he/she will get them a bed part that bit me... The hall bed thing is a non-issue, since it has been going on forever. I don't mind statrting IVs, changing diapers, vomit, or intubating; I can handle one thing at a time as you said. Anyway, just curious what the concensus of prudent nurses think. Thanks

where do i get a mgr like that???

I'm sure that really did hurt, but... When will we finally institute a fraudulent or inappropriate use of EMS statute? Maybe the fine should be proportional to how egregious the offense is. Insurance issues aside, we have laws for filing a false police report and we've all heard(or dreamed) of the idea of penalizing frivolous law suit filers. In your pts case I think the penalty should have been ten times the cost of her nails donated to a local homeless shelter or food bank. Oh, and of course, she could substitute community service hours. Maybe there should be a police blotter-type column in the local paper; no names at all, just the basic facts. Sorry, couldn't resist.

Question is, really I guess- how deep do you(or your mgmt)let it get in Triage/waiting room before you have more than one nurse? We used to have a policy more than five deep,waiting for triage, required the help of the Charge or PRN nurse. The other night I was 15 or more deep plus Waiting Room pts who need to be revitalized/reassessed for most of the shift. Of course, this is not to mention the phone calls, registrars informing me of "chest pains","SOBs", etc,etc,crowd control(Why oh why is the security guard thinking I will let the party of 8 pass thru my ER to get to ICU?) AND pts/friends/family who are free to walk up to me at Triage desk and invade privacy of current pt. to ask "How much longer do we have to wait?" Sign me, Trying so hard to wear the big girl panties

My SAGEST advice to fledgling nurses (of any kind), "It's a love/hate relationship, it just depends what day it is." :bowingpur I LOVED the OP!!! .

Just chant to yourself "job security, job security,job security..." You have hit on the one thing there will NEVER be a shortage of.