Lynx25

Hey, that might work! I've never seen them used before, but I can get them through Medline. Thanks for the assist.

Oh I called the surgeon- he told me to dc the bag and apply xeroform. I just don't have any idea how to secure the whole thing to avoid further trauma. I can't get it through anyone's head that he has to be handled with caution. It's a 15:1 aide ratio- and I think they are going in there doing care by themselves. The treatment isn't my problem- it's protection.

Oh my goodness, I've only been inside two burn centers, but BAMC's unit was freaking beautiful.

I tried to ask this on another site- was met by a barrage of "OMG CAN'T DIAGNOSE ON THE INTERNETS!" Let's see if this does any better. I have a very obese patient, with split thickness grafts to his entire abdomen. He has a small fistula to one area, that occasionally leaks stool. Someone decided to slap a colostomy bag over the fistula, and now we have a large area of graft missing, because of the fragility of the entire area. I've also noted that he's acquired several smaller areas of shearing from what I assume is improper handling during care. The ostomy bag is no more, and I've covered the whole thing with Xeroform and ABD pads after a call to his surgeon, but does anyone have a particular product that you think would be good to stabilize and protect the area? Maybe something to put over the Xeroform and gauze? I really don't have anything large enough to protect the whole area- it's a bit of a loose patchwork. It's not currently infected. Total graft area, I'd say 2'x1.5' roughly.

I have a patient with a stage 4 ulcer, that's not making any progress. It's about the size of the top of a Gatoraide bottle, were someone to punch a hole in his thigh with one. There's some pale pink granulation at the base, but the periwound has a thick, soft white layer that extends down the sides of the wound. The layer extends above the level of the healthy skin. The previous wound nurse was charting this as eschar, but I was under the impression eschar was a darker color. I would be hesitant to chart it as slough, as it doesn't really resemble it. It's almost like a thick moist callus. (Moist due to moist wound dsgs) I'm of the opinion he could use a sharp debridement and a vac or graph, but it's not something we do here, and it's like pulling teeth to get a wound clinic appointment. Could someone with more experience help me out a bit?

I'm so glad we don't have "Customer service surveys" here. I get away with this- "I'M GOING AMA!!!" "K. Here's a box."

We got some storebought cupcakes, and a threat... "If the weather gets bad, you are required to stay overnight at the hospital. You will not be compensated for time spent sleeping at the hospital, if staying greater than 16 hours." I called our board of labor. Apparently that's legit. Whatever- if weather gets bad, my SO has a little bronco that he built for rock climbing, so it should be just FINE on the ice.

I was a medic, and was quite annoyed when I discovered, that in my state I was ONLY allowed to drive the ambulance. I went LPN, and rather wish I had gone for Paramedic instead. Nurse or not, Combat medics aren't given enough credit to apply to their civilian careers.

Protip: That New-Skin stuff sold at pharmacies is exactly the same as super-glue. Source: Boyfriend went into their facility to do some industrial type welding on their vats they make it in. Two different vats (Newskin, regular superglue) in the same room- he asked what the difference was- they told him: "Price."

We are a smoking facility. It's a pain in the ass. We only do it three times a day, but nursing/CNAs do it each time. It's terrible because if we are behind, the patients are NOT understanding, and will often begin to curse, yell, and sometimes chant about SMOKE BREAK SMOKE BREAK SMOKE BREAK. Like the OP, they gather to go smoke right by my nurses station. I'm very glad we do not have to do it every two hours, I'd never get anything done.

You can have mine. I quit! Best thing I've done for myself in years.

I imagine that "these LPNs" don't particularly care for your attitude. Most "people" wouldn't.

Uhm.... Have you guys EVER seen facebook ads that make any dang sense? There was one on mine with a woman smearing what appeared to be fake blood all over her face, with the ad reading, "Woman finds MIRACLE cure for wrinkles!!! Doctors HATE her!!" Seriously guys. It's the internet. You're going to have to be more discerning about what gets your feathers ruffled.

D: As a LTC nurse, I was always reassured that "Granny" who has been acting out a bit lately, would be kept safe and seperate, in her own little geri side of the mental health facilty. How awful. What is WRONG with the administration?

If this is the worst thing that happens to you in a day, you have had an excellent day.