scribblerpnp

I will say that when I came home from the hospital the first day of breastfeeding was so hellacious (my milk had not come in yet) that if I had formula in the house I would have used it. I was SOOOO close to running into the office where I work to get some. My husband really guilted me into NOT doing it. And I am forever thankful for that. 8 mos and my child hasn't had a taste of formula. So I am all for no formula to be sent home with these breastfeeding moms.

Sorry, we can't give medical advice o this forum. Best to call the doc and ask them these questions.

Bless you for the work you do. Those older people don't know how lucky they really are.

I'm a PNP and yes, I get jaded at times. Especially when I have a parent talking or playing with their iPhone during the exam, but who can't afford Tylenol to give their child. Or a sixteen year old cries like a baby and has to practically be run down to give her the gardisil vaccine. Or a 9-year-old throws a see-and-say at your head and the parent just shrugs. Every job has its moments. You just have to have an idea of what you are willing to put up with. And I would like to meet a peds nurse who doesn't SOMETIMES relish giving those vaccines to the bratty kids. My job would probably be easier without parents. Some really don't know how to raise a kid, and no amount of teaching on my part seems to help. But I would rather be a garbage collector than take care of adults 100% of the time. The only adult pt I have ever liked was my mama when she was sick. Poop, pee and vomit just aren't as bad coming out of a 2 month old vs an 80 year old.

Just validating. I am a PNP and work in primary peds. MMR and Chickenpox vaccines are SUBQ. All others are IM, and should be given with a 1-inch needle (this is according to our state health dept) In kids less than 2 years, the vaccines should be given in the vastus lateralus (legs). At most 2 vaccines to extremity (if possible) and at least 1 inch from each other. If you have to give synagis, that needs to be in its own extremity, and at that time it is acceptable to give the vaccine in the arm if the legs have been used regardless of age.

Where I am from a 9-month contract starts at 37,500/year in a BSN program for an MSN. Years of experience mean nothing. Yup, BIG BUCKS

I would like to add that if you turn it down, there is a good chance that you will never be able to join later on- unless you further your education and re qualify for induction. But if you pay the first year's fee and then decide you don't like it and decide to not renew your membership fee the next year, you are still a member- just "inactive. So 20 years from now if you decide it is to your benefit to get back into STTI, you can re-activate your membership. I

How WONDERFUL! Making such an effort obviously had a positive impact on the dean. Hopefully from now on she will be smooth sailing!

I am an NP too (who works/teaches full time in pediatrics) and am very confident in the safety of giving 3 vaccines at a time on the VAST majority of cases. It is not uncommon to give four (two in each appendage) in cases where children are behind in the schedule in the US. But I do agree with you on the dad being involved and the importance of providing the other family with information concerning the vaccines.

It is quite legal to obtain the vaccines with a primary care provider's order and give them yourself 9or whomever is on the prescription) if you are a nurse. A doctor doesn't have to be present when a vaccine is given. It sure is more convenient than trudging them into the office just for a shot. I have written orders for vaccines for children to get them at their parent's place of work by a nurse (since it is usually a free clinic). I myself obtained an order for a vaccine (rabies-don't ask), obtained the vaccine via special order at the pharmacy and gave it to myself at home. As a pediatrictric nurse practitioner, I applaud a mom who is making sure her children are up-to-date with the current and recommended vaccine schedule. But it would have been considerate of her to let you know, so you could monitor for common side effects.

JessiD, Thanks for mentioning about the jaundice! I have started to see (this is anecdotally) in the office that the babies with the delayed cord clamp seem to have worse jaundice in the follow up than those that don't. Especially if they are breastfed too (compared to breastfed and no delay in the clamping). Since this is becoming a new Thing to Do, I hope someone does some research in the delay-jaundice area. I haven't run across anything in my journals yet.

I guess being a peds nurse, I'm not really shocked about this. When I worked in the hospital, this has happened a few times with my teenage boy pts. I usually saw it as a sign that their pain was under good control and they were feeling better! Very funny when sitting at the desk, I would see their heart rate jump up on the monitor, and would go to check on them, only to find... :chuckle This is normal behavior for a teenager, even if they are in the hospital. Luckily, they were so interested in themselves, they didn't know I saw what I saw, so I was able to back out, wait about 30 min and return for what ever. As far as the perv comment, I don't buy that. Probably the boy was so caught up in what he was doing that he just didn't see you. INow when I worked psych and this happened, THAT was a different matter. Also, I very nice reminder to ALWAYS wear gloves when picking up dirty linens off the floor!

I e-mailed the student about the CNM in Pittsburgh. He is planning on following up! I just hope the CNM in Pitt e-mails him back. I think he could really do with some +encouragement from another guy!

The littman cardiology III is a good one. It has an adult diaphragm and an infant. I work in peds and find it to be a great stethoscope. I can easily assess a newborn or an adolescent. No problem picking up those early newborn pesky heart murmurs at all. I've had mine for 7 years now and it looks as good as new. At the time allheart.com had a good price. Definitely worth the extra money.

DO you know the name? PM me if that would be better. Thanks a bunch! We are in WV, but maybe he could do e-mail or phone interview?

I'm a PNP and work in a BSN program. Recently a student who is about to graduate came to talk to me about being a CNM. Prior the student was really considering NNP, but after the L&D rotation, is now considering CNM. Though I don't feel it should be a problem, he is a male. He is going to be a GREAT nurse, and he would be a GREAT CNM. But what will it be like for him realistically? We did talk about the sexism common to L&D, but when it comes down to it, OB's are male and female, why not CNMs? I want to encourage him because I think it is silly to see such talent go to waste because of his gender. We did talk about him trying to shadow a local CNM to see if it is really his thing, but right now it is hard for him to have the timw with school and work and all. Of coursse he would need that L&D experience prior to attending school, and I hope he can get it. Sadly we live in a rural area, and there are NO male CNM's to be found. DO any exist? Anyone work with male L&D nurses? Both our hospitals only have females on staff. I don't know if that is because the won't hire males (even though this is wrong), or if there was never the opportunity.

I worked PRN on the weekends and I lived VERY cheaply. But the nice thing was that those quarters I did clinicals, I didn't have any "book learning classes" so I didn't really have to attend class on top of that or study too much. Out of my class, all but one of us worked part time. One guy worked full time 3-12's on Sat, Sun, Mon. I don't know how he managed to get all his hours in, but he did somehow. I also teach at a BSN program. We have an MSN-FNP track and the MAJORITY of the students go to working part time or PRN during their last year because of the clinical time requirements. IN fact, I don't know of a single one who is working full time, but that is our program, so I don't know about the others.

Don't forget that even if you do a NP program online, you still have to have clinical hours (working along another NP) to graduate. So your bookwork may be on-line, but your clinical hours will still be in person working with another NP (like a preceptorship almost). To sit for the NP certification, you have to have somewhere around 300- 400 clinical hours (not working as an RN, but working as an NP student). Clinicals are more complicated. I was in MSN school full time and for two quarters worked as an NP student M-F 9-5 to get all my hours.

I agree with blondie. Our hospital's policy is that only staff have to do it. You do need to follow YOUR hospital policy and convince them if you can, but if it is going to be a battle royale, chart the non-compliance of the family and leave it at that. If they want to be stupid, at least they are just being stupid to themselves.

I had all day nausea for the first 26 weeks. Zofran IS expensive, but for me one phenergan before I went to bed lasted nearly all the next day. I got lucky on that one. I don't know why it worked so well for 24H, but it did. And I slept like a BABY.

When I was in the stages of morning/ALL DAY sickness, sucking on lemon drops or lemon war heads really helped for some reason. Drinking lemonade also helped (but only half-strength). I also drank mint/peppermint tea or ginger tea. But stay away from chamomile as it is contraindicated in pregnancy. I don't know if it is beneficial or not for everyone, but it helped me.

Just adding my school's policy to the mix. When it comes down to it, there has to be a line drawn somewhere, and you've got to play they game by their rules. I teach at a four year BSN program. We have the same policy that all students must pass their classes with a 75% or higher EXAM AVERAGE. Meaning even if the extra papers, assignments give them a 78%, if their exam average is below a 75%, their final grade is determined by exams only and thwy will receive a D or F which is seen as a failing grade and puts them behind a year in course work. If a student is deemed unsafe or doesn't follow the rules in clinical two times in a class, they will fail as well. And yes, every time I teach my assigned classes (soph level), about 10% fail. In the higher sections such as Juniors and Seniors there are students who fail, but the numbers are smaller- around 1-2 in a class. And truthfully, those students who failed the course, really did deserve it. They didn't learn the material, were known to be weak clinical students as well, and it is better for them to repeat it. I have yet to see a student fail who was stellar (and I will say the same about the student in MY class when I was going through a nursing program) It is a tough row to hoe, but I feel that it is fair. I am more than available to my students, and am thrilled to help them when they ask for it. The problem is that usually the ones who don't pass are the ones who never asked for help (AND I AM NO WAY SAYING THAT YOUR DAUGHTER IS LIKE THIS). Does your daughter's school have a student handbook for the nursing program? Our handbook that we give all incoming student and every syllabus in the nursing courses states our policy on this on the out and out. The result of these high standards? We are always in the top three in the state for students who pass the NCLEX on the FIRST try, and our grads are are sought out for by local hospitals. Good luck to your daughter, please update us on the final result, but I have a feeling that she will be fine.

I work in peds primary care and give TONS of IM vaccines and I have only aspirated blood once in 8 years.

It is probably fine. I have had injections bleed a lot and bruise, ESPECIALLY with a fighter. If they contract that muscle a lot during and after the injection, you will have a bleeder. It would be very unlikely for you to hit a vessel in a 2 year old leg even with a 1 inch needle. Why not just put the synagis in a 3mL syringe from now on so you have room to aspirate? There isn't any reason you couldn't use a different size syringe. Most likely next time his weight will go up enough that you will end up giving him two shots, because 1 mL is the max. But for other pts, if you are going to need to give an mL, I would just move up to a larger syringe size. If you are worried about measuring the amount correctly, use the 1 mL to measure and then squirt it into a 3 mL syringe to administer. Just out of curiosity, why is he still getting synagis at 2 years? I've never had a kid quailfy for the stuff if they are 2 at the start of the season. As for giving better injections, the more you do that faster you will get and that makes everyone happy.

You probably would have better results finding a local seamstress if you want it to match your body type.