BRANDY LPN

If you had a pt with sudden CP lasting 3 hours(at the time of hospital visit), radiating to left arm, back and neck, and labs and EKG and chest xray were normal. pt rates pain 7/10, b/p 146/94 p 72-128 on monitor, Sp02 95-97 on 02 via NC, and resp, 24. Pain is not better with rest, nothing makes it better (or worse). Smoker, strong family hx of heart disease, (father died at age 47, mother, mother grandmother hypertension, paternal grandmother died of unknown cardiac disease) This is my s/s list from Friday nights ER trip, I will let you guys guess then will tell you the dx.

Chiming in to say that once when I tested the balloon it WOULD NOT deflate, can you imagine the pain THAT would have been upon d/c? Anything can be defective, the safegaurds are put there for a reason.

I am tired and kind of lazy tongiht, so forgive me for not reading the whole thread, and if this has already been mentioned I'm sorry..... How in the world will being able to differentiate between staff decrease med errors????????????????? I don't care if you wear cutoff shorts and a tube top to work, how many of you have heard of a med error meing caused by an aide, or housekeeping? What a bunch of crap, another of the long list of reasons I am no longer practicing. Sorry, continue on.... I am all done griping now, and I feel a little better for venting that.

I am in the minority here in that I never minded the family video-taping or taking still shots, and would generally even try to give them an opportunity to get "posed" pics of baby in warmer, if everything was going fine. Other times during the actual birth of baby or during a resucitation I was generally explaining to mom and dad exactly what was happening, what we are doing about it, and why, for one reason saying the steps outloud helps ME remember them and talking to the parents instead of outloud to yourself just seems more professional/competent. I have never had a problem with a support person asking me to move out of the cameras way during a birth, and I would like to think this is because I have kept them informed at every step along the way. If I were a lawyer I would be questioning why no video exists, I would bring the parents into the court room and I would ask them what was said to them regarding video, I would review the policy, I would question EVERY hospital witness regarding this policy. After all if you are practicing competently, what do you have to hide, if you did nothing wrong why would you care if video exists? If you followed standard of care then the video should exonerate the doc, the nurse, and the hosp. right? If it were altered it could be proven, and the plaintiffs would be charged with tampering with evidence, and would lose their case.....that's what I would do if I was a lawyer.

Thank you, all the ones I only put in ( ) I KNEW I was mis-spelling, was just trying to get as close as possible to pronunciation as I could. I have a question about "Que hacer por ti" a husband of a former pt told me that and even worte it down for me, he was fluent in english but spanish was his first language, so is that slang or something? Here's a funny story, I had a completely non-english speaking pt and was trying to get her out of her room because a tornado was coming towards the hospital, I could NOT think of a word for "tornado" and finally got flustered enoguh to try using english LMAO. tornado=tornado

Que hacer por ti? what can i do for you? via con mio come with me orinar urine aqui (a key) here (con- TAR- say las ropas, pon-TAR-say las bata) take off your clothes, put on this robe el bano the bathroom ayudar help (beber) drink (comer) eat (yay-low) ice mi quero I want relaja e respiro relax and breath (sangray) blood also always remembre to say por favor- please I don't know how to write spanish and only speak very little so may wanna check some of these. lol a bunchof these are in the back of a tabers dictionary.

At my last nursing job we wore the scrub tops that snap up the front, and while leaving my pts. room i caught my top on the door handle, while simultaneously walking out and opening the door, unsnapped it almost all the way. Pts dh was in the room, and I was mortified. They both thought it was hilarious.

I know how she feels, I won't go into details but one of my laceration scars still twinges a bit now and then.

Is it possible to have shingles in more than one area? For instance can you have the rash around your eye AND on your chest at the same time? I have never seen shingles first hand before and don't remember what they said in nursing school about this. I know it follows a nerve path and is unilateral, but havent been able to find the answer to this question anywhere.

OMG Dawngloves, that is horrible, I cannot imagine how bad that must have been for all involved.

I wasn't even THAT lucky, my epidural had ran out several hours before delivery and they wouldn't give me any more because "you will have to stay in recovery too long" and wouldn't give me lidocaine for the repair because " you aren't feeling pain it is just pressure, you had an epidural after all" hmmm ya, NO I felt every single needle stick thank you, and of course was too young and stupid to really stick up for myself, I was crying the nurse was crying it was really bad, the whole reason I did OB nursing, you can bet that I NEVER allowed that to happen to any of my pts., and I have seen forceps with good results and even small epis. but would still rather just have the c/s, I know it is major surgery but forceps are just so dangerous.

My son has a DENT in his head from the forceps, it is still there he is ten. I was 19 when i delivered him and remember pointing it out to the ped who said "oh it will most likely go away, and if it doesnt his hair will cover it" I was much more concerned with brain damage! He obviosly doesn't have any brain damage but his hair doesn't cover it either. And whoever said that forceps are barbaric is right, 3rd degree epis and SEVEN lacerations- was not a good birth experience, would have healed faster from a c-section I'm sure.

I have seen it happen once and like alot of others it was during a stat section, was also the only time I ever witnessed a prolapsed cord, and from prolapse in LR to delivery in OR it took a whole 7 minutes, and I believe that the rush to make sure the baby was born HEALTHY was worth the stitches to the scalp....

Okay who knows how common is it to develop septicemia from recurrent boils? Have any of you seen this? Any good links/with statistics? Thanks Brandy

Read this article on pica, and try not to worry too much unless it becomes a persitant problem. I just found out my 4 year old that has been potty trained forever.... just pooped in her brothers candy bucket, when asked why she did it she said "there was no candy in it" like that explains everything......Kids are weird, and pretty gross. http://www.emedicine.com/ped/topic1798.htm

I saw 1700 in the hosp. when I was a student, he was comatose, and had a stroke the thing I remember most is his temp was like 110, because of the stroke, he died.

I had a problem with this when my dd was little, and as a parent who was then a nursing student I want to add my story and opinion. My dd was in PICU for one week with RSV and while in the PICU I slept in a chair at her cribside, there wsa no bathroom, no shower, I did not recieve a tray I did get a voucher for the cafeteria. The day shift nurses in the PICU were awful, would not even watch her while I went to the bathroom down the hall to relieve myself, let alone actually leave the floor to shower or get food, so i would wait everyday for my mother to bring my son to see me and I would take him to a fastfood rest. and get food and have lunch with my son, smoke, use the restroom and be back in 30 min. to an hour. The night nurses were wonderful and would sit with my dd while I went to another floor to shower (that they gave me directions to, in the hospital fitness center) I never used that oppurtunity to smoke or do anything other than shower and brush my teeth. When they moved her to the floor the nurses would also not watch her not even for 5 minutes for me to run to the cafeteria for food, and also would not pick up food for me with the voucher, so again I waited for my mother to come and got 30 min to an hours break q 24. Same nurses tried to bypass the pediatrol(sp) on her IV pump on a kid that was already borderline CHF and when I called her on it she said "these are really not needed, this pump cost the hospital (insert ridiculus amount of money here, but i think she said 200,000$) and I am sure it wont malfunction".......well sweetie I dont give a good gosh darn if the thing cost 200 million dollars its still a machine and can break, you WILL use any and all safety precautions available to you when you are dealing with MY dd. They also woke her up from a deep sleep to weigh her at 2 am, then left our room (isolation) and went directly to room next door with scale did not stop to clean it, and then just as I got her to sleep again at 4 wanted to wake her again to do V/S, which I wouldn't let them do, told them they could count resp and pulse without waking her and would have to come back for temp and b/p. So for two weeks I ate once a day and spend a total of maybe 14 hours more than ten feet away from my dd. It was my opinion that these nurses were LAZY(and possibly stupid) not busy. Like several ppl have said parents need (and deserve) a break and need (and deserve) the piece of mind knowing someone is there with their child not at a nursing station down the hall to feel comfortable enough to take one, even if you can only spare 5 minutes that 5 minutes might make all the difference in that parents day, it may be the only time they have to stretch their legs, get food, relieve themselves, practice basic personal hygiene or to just get out of the room and away from their kid who is most likely being tearful, whiny, and clingy. Noone should be expected to stay in a small room with a sick child 24/7 for numerous days without any type of break even if it is their own child.

Whoa! Excellent point, if she is in some sort of facility you did the right thing, if she is at her own home, or the home of her daughter, then you didn't. We commonly had family sign for meds in the LTC setting to cover ourselves as well as covering the facility. It is the only way to make sure the pt still has their meds and your narc count is right. We always had them sign the actual narc log.

Homecare Worker, You did do the right thing by having the daughter sign the narcotics out and you don't say but I hope that you also had her sign any that remained back in. You did this to protect yourself, to insure a correct narc count for your agency/facility/??. The daughter's attitude REALLY has no bearing on the complaint and while it is fine to vent about what a rotten, horrible and irritating person she is here, it will not help you in court. You need to hire an atty. one who is familar with the healthcare industry, you can find RNJDs at you state bar association's website. I understand the financial situation, but consider how much worse it will be if they do win. Who exactly is the complaint with? Is it a civil suit? With the BON? Contact an atty BEFORE you speak to anyone from any agency contacting you about this complaint, then let your atty speak for you. Be cooperative, not defensive, simply state that you would like to cooperate fully and that you will have your atty contact them ASAP.

Check with your nurse practice act under mandatory reporting, but I believe it is also YOUR responsibility to report this. Of course it would also be the responsibilty of the facility, but YOU could be held accountable for not following the nurse practice act if you are required to report and you don't. Someone jump in here and tell me if I am correct or not.....

LPNs and LVNs are the same thing just different title in different states FNPs and ANPs are RNs with advanced degrees CNAs are NOT nurses nor are they allowed by law to adresss themselves as such. They are still a valuable part of the health care team but they are not nurses, nor are NPs doctors and to call themselves such is a CRIMINAL act in most if not all states.

I agree that you need to report this to the BON, this person will continue to abuse pts. and also you can always call your local ombudsman if you suspect abuse. Doesn't the mandatory reporter laws cover elderly abuse? if so then if you dont report this to the BON yourself and they find out, YOU can also get in trouble with the BON.

I too was wrongfully accused of "professional misconduct" by my BON. All I received was a letter of reprimand, which doesn't SEEM that bad, however it will remain on your record FOREVER and will cause your license to be "flagged" every time you apply for a job or to go back to school, so I went to the hearing which was a complete joke and a waste of time. Someone stated the purden of proof is on them, not from where I was standing, the burden will be on YOU to prove your innocence. I was accused by my ex during a custody suit, one of MANY harrassment ploys he used. I am happy to report that he has since had HIS professional license suspended for 5 yrs on a completely different matter and his star witness has also had her professional license REVOKED. Karma......aint it great? I will no longer practice nursing, and like someone else said it is only a loss to the pts I could have cared for, I am happy to be doing other things with less stress and more respect. Not to mention the fact that it would be VERY hard for him to attack me using my career again. Good luck to you with dealing with this, it took me alot of soul searching before I was okay with my decision if you ever want to talk or just vent feel free to PM me. Brandy

I agree with you that we should not and should not be expected to treat them any differently, but I have never taken it that way in report if anything I have always felt it made my job easier by being able to use medical terminology and not having to teach the basics before starting into more specifics. JMO But I would be very upset if I was expected to treat soem pts differently than others, I remember this from working in a military hosp. and it was one of the only things I didn't like about that job.

I like to know all of my patients occupations, it helps to understand them and to help plan for discharge, someone working a very physical job (such as nursing) is not goimg to be able to return to work as soon as someone who has a less physical job on crutches for instance, and some jobs are going to be much more sensitive about breast pumping ect ... the list is endless. Pesonally it depends on the situation, I will tell someone that I am a nurse so that they will educate me in more medical terms, I know it is crazy but I hate being talked to like a lay person, I make sure they know if I don't understand something, but it is generally easier to understand if presented in language you use, when I teach patients I try to use both medical and lay speak, tellign them in medical terms and then explaining in lay terms and I make sure they understand by asking them questions. With my kids I always give it away when I go to tell them my daughters dx. LOL instead of saying "she has a hole in her heart" I tell them she has a ventricular septal defect and a patent ductus arteriosus with a coil embolization done at 20 months, and they say "do you work in health care?" lol I am also teaching her to know her true dx, in the event that I am not there in an emergency situation (like say she knocked a tooth out and I couldn't be reached). But im rambling now...