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stellina615

stellina615

Med-Surg/Oncology, Psych
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stellina615 has 1 years experience and specializes in Med-Surg/Oncology, Psych.

stellina615's Latest Activity

  1. stellina615

    VP shunt...yikes

    Hi guys! Thanks for all the replies. Reviewed the sloshing again today with the neurosurgeon, who directed the day nurse to the CT scan of the pt's brain. I took a peek at it myself. About 40% of the space in his head is abnormal fluid collection.....it basically looked like the majority of the L hemisphere was missing and there was a collection of fluid instead. I wish I could share it with you! Unbelievable! The pt is still doing well, and having seen the diagnostics, I have an increased appreciation for how well he is able to function.
  2. stellina615

    VP shunt...yikes

    To clarify, I heard the sloshing as the pt was quickly putting his head back onto the pillow from an upright sitting position, not when he was sitting still. Thanks for any input!
  3. stellina615

    VP shunt...yikes

    Hi guys, Today I had a pt come up from the PACU who was s/p VP shunt revision. Apparently his previous VP shunt had had a crack in it, and was leaking CSF fluid. For the pt, this manifested as increasingly painful headaches. He came to me, VSS, neuros WNL (with the exception of being disoriented to date), PERRLA, everything looking good. After he had been on the floor for a few hours, I was getting ready to leave his room, and he said "come here. Listen to this." Having no idea what he was talking about, I put my head near the head of the bed. What I heard was an audible sloshing noise coming from this guy's head, clear as day, just as if there were a pair of tiny boots walking through a puddle. I called the neurosurgical PA immediately, who mentioned that there had been a large amount of fluid built up due to the broken VP shunt, but she also said that it was unusual. No new orders. My question to everyone is, have you ever been able to hear fluid in a patient's head? We rarely deal with shunts on our floor and it just rattled me a bit. I had to clarify to the PA that it was me, the RN, who heard the sloshing, not just the pt. The pt is still fine, VSS, neuros intact. Anyone have any experience with this? Thanks! -Erin
  4. stellina615

    Burnout

    I find that I'm more invested in my nursing care when I'm doing a good job of taking care of myself. When I work hard to make sure I have enough time to sleep enough, eat properly, spend time with people I love, and have alone time to relax, that's when I feel most capable and willing to give 110% of myself to my work. I wish you lots of luck!
  5. stellina615

    Body Bags

    I apologize for asking such a strange question, but I'm wondering what different facilities use for body bags or other post-mortem shrouding supplies. I recently had to pronounce time of death for the first time. My patient was very sick before she passed away, and the whole situation was very sad, but the thing that saddened me the most was the post-mortem care. I promised my patient's family that I would take good care of her, and having to put her body in the body bag (my hospital uses white zippered bags made of heavy plastic that have that new plastic shower curtain-type of smell) felt almost like breaking that promise. My patient still had her gown on as well as a clean sheet, but something about zipping a person up in that bag was so impersonal and, to me, almost disrespectful to her. Even though the essence of my patient wasn't in that body anymore, I felt really sad having to zip her body up in a bag. I understand that plastic is helpful in preventing spillage of any fluids that may leave the body after post-mortem care, and that they're probably the least costly option for the healthcare facility, but I want to know if there are other facilities out there that use something less cold and stark than white zippered body bags. I guess I'm having difficulty accepting the whole thing. Thanks, Erin
  6. stellina615

    Sooo...What are you doing with your MSN?

    Thanks to everyone for their responses! I'd love to hear more stories of what people are doing with their MSNs. I've attached the description of the program of study. I also emailed my advisor to ask for some specific examples of what students have done with the evidence-based track after graduation. The evidence based nursing track focuses on developing advanced generalist nursing practice in a focused area of study, promoting interdisciplinary collaboration, fostering life-long learning, and prepares students for the leading edge of health care knowledge and delivery. Students strengthen knowledge and skills in clinical decision-making, application of nursing interventions, and ability to critique and appropriately use evidence as a foundation for practice. In this graduate track, students study nursing as an applied discipline advancing their knowledge of theoretical perspectives for clinical practice, with an emphasis on leadership, the cultural, social and political context of health and illness, and quality improvement methodologies. Students are mentored in the enactment of leadership strategies to improve quality care in nursing practice through an intensive clinical practicum.
  7. stellina615

    Sooo...What are you doing with your MSN?

    Hi everyone! Just got the good news this week that I was accepted into the MSN program I've been hoping for. The university I was accepted into offers 3 tracks within the Masters of Science in Nursing Program: NP, clinical nurse leader, and evidence-based nursing. I'm thinking that I'm most interested in the evidence-based nursing track, because I think I'd like to go into research/clinical trials. This post, however, is intended to get some feedback from all of the Masters-prepared nurses out there. What are you doing with your graduate degree in nursing? What types of opportunities opened up to you when you finished your graduate studies? Where has your nursing career taken you, and what does your typical work day look like? I love floor nursing, but I know that I don't want to work med-surg forever, and I'd like to know what options are out there for Masters-prepared nurses outside of becoming an NP. Thanks for any and all feedback!
  8. stellina615

    UNH Direct Entry Masters Program

    Hi guys! I realize that this post was last updated about a year ago, but I'm wondering if either of you (or anyone else) have further thoughts or opinions on the graduate nursing program at UNH. I'm thinking about starting there in 2011. Thanks a bunch! Best, -Erin
  9. Hi everyone! I'm an Associate-prepared RN in NH looking for a graduate program. UNH is the most affordable option that I've found in the area, so I'm looking for feedback from other students who have pursued a Master's degree in nursing at UNH. Specifically, I'm looking at the evidence-based nursing track, but any feedback about UNH graduate nursing programs would be much appreciated. Thank you! Regards, Erin
  10. stellina615

    Interventions for pts with NG tubes

    Hi everyone! I recently took care of a pt who had an NG tube (I believe it was due to a duodenal ulcer). She became nauseated just due to the fact that the tube was uncomfortable. The positioning of the tube was fine, and even though I did give zofran, my feeling was that since the nausea was mostly coming from the presence of the tube itself, zofran wasn't going to do much of anything. At any rate, my question to the more experienced nurses out there is this: what types of non-pharmacological interventions do you use to help a pt who's feeling crappy because of their NG tube? One of the girls I work with suggested a cool compress to the back of the neck, which helped my pt a little bit. Any other good tricks out there? I'd appreciate any help. Thank you! -Erin
  11. stellina615

    Magnet recertification

    My hospital is up for Magnet recertification this year, and my unit has nominated me as one of the two designated nurses to show the Magnet people around when they come to our unit. The hospital is planning on holding some meetings to prepare us for when the recert comes, but I'm just wondering what exactly these folks are looking for and what I should be showing them when they arrive. Can anyone offer some thoughts? Thanks in advance!
  12. stellina615

    OK, Cultural question here, please forgive the stupidity.

    If you're trying a make some kind of valid point, then perhaps you should cut the snarkiness and use a little more respect when addressing other nurses, especially nurses who are going out of their way to learn about how to treat their patients well. Checking your spelling and grammar wouldn't hurt, either.
  13. stellina615

    "Think" about what you say!!!

    Michigangirl, Thanks for this post. You make a really good point. I do see what other posters mean about not being too hard on yourself, but recently I've had a couple incidences where family members and friends have been on the patient side of the equation. As a nurse, it can be easy to forget what it feels like to be a patient. And you're right, the way something is phrased can make a big difference, especially given that really sick patients and their families typically have a less thorough understanding of what's going on (be it an IV pump, a disease process, a procedure, whatever). Illness can make an otherwise calm and sane person feel worried/afraid/confused/irritable/vulnerable. Thanks for reminding us that as healthcare providers, it's part of our job to be compassionate and sensitive, and a big part of that is being aware of what we say.
  14. stellina615

    Do nurses still get signing bonuses?

    I don't want to get the discussion off track too much, but I live in New England and I'm not familiar with the border towns in Texas that some of the posters have described. I'm sorry if this is an ignorant question, but what exactly makes these areas so dangerous that nurses worry about their licenses?
  15. stellina615

    NH market for new nurses

    From what I can tell, things haven't improved much. We haven't had layoffs at our hospitals since the summer, but there's nothing in the way of increased job availability, either. Hospitals definitely aren't creating new positions, and it seems to me that the older nurses in our workforce are holding off on retirement, probably for financial reasons. After 2 years of working at the same hospital, I am still working part time on one unit and per diem on another unit because there's nothing full-time available. Good luck with whatever you choose to do.
  16. stellina615

    Why do I have such a bad feeling about this?

    One of the important lessons I've learned from more seasoned nurses is to go with my gut feelings. It seems like you're already leaning towards trying to get yourself out of this negative environment. If you're feeling a bad vibe and you've only just finished orientation, maybe you should get while the getting is good! Best of luck with whatever you decide to do.