HamsterRN ADN, RN

I'm not sure what the rationale was the first Doc was using. It's not unheard of to have supratherapeutic INR and a thrombus, since the the thrombus could have formed when the INR was lower and Coumadin won't dissolve a clot. Usually what I see do...

We have a similar rule where I work but it doesn't group a dreads into the same category. Our policy allow's dreads that occur naturally, such as with AA employees. The issue is with those whose hair can only be maintained as dreads by never washin...

Where would you consider it appropriate to draw the line? Do all standards of care need to be charted on specifically? Pt specific standards of care only? Interventions only? How do we define an intervention?

At my facility, we are going to be changing our charting system to one that will be truly "by exception" and I foresee some friction from some staff. We currently use an EHR that is essentially "by exeption", but it allows a lot of leeway for nurses...

The pump senses the supposed volume based on the height of the plunger, this can vary slightly and I rarely see it say exactly 50ml.

That's extremely unsafe, we can't all be as spoiled as Cali nurses but that's excessive. Normal tele units should not be higher than 1:6, your description of your floors falls somewhere within a step-down unit and progressive care, depending how you...

Being a floor nurse myself, I believe floor nurses should have the final say in how they chart since it's their practice and their license. My personal preference is to only chart what others need to know to care for the patient, so I'm trying to ma...

Wouldn't every patient have the call light within reach? If so, why chart that was done for some patients but not others. What happens when a patient falls that you didn't see coming and chart specifically that the call light was within reach? Th...

In our system, we don't consider an IV insertion site or CT insertion site a wound because we chart on the condition of the insertion sites under the assessment of the IV or chest tube. Once a CT is D/C'd, then we consider it a wound a chart on it a...

We check CBC's on day 3 of DVT prophylaxis heparin therapy and every 3rd day after that if they don't already have CBC's ordered. I've been told the reason why we don't monitor PTT's on these patients is that while the PTT will rise from the patient...

Diagnosing and treating is not outside the scope of practice of an RN, in fact it's the bulk of what we do. The procedures you describe are are not by definition outside the scope of an RN, but they aren't in your scope if you are have been trained...

Coughing is one way the body removes excess fluid from the lungs, lasix helps do the same thing through a different route.

So they drew blood first and then did the U/S but the blood draw didn't include a d-dimer? That does sound like bad form if they were concerned enough to do the U/S but didn't think to run a d-dimer first.

While it is true there are no RCT's involving the injection of glass particulates in humans for the final confirmation of a risk, there are also no RCT's that compare jumping out of a plane with a parachute to jumping out of a plane without a parachu...

As much as we all hate them, there are a few reasons why glass ampules still exist. The primary reason is that some medications just cannot be stored in any type of plastic. NTG for instance is absorbed by plastic over time. It's not a significant...

When I first started on nights it was actually easier than now, I think because my system was so confused it didn't know when it was supposed to be asleep and when it wasn't. Now, after years of nights, I find I can't to a complete switch to a dayti...

The evidence suggests that the chances are closer to 1 in 1, not 1 in a billion. There are more important things to concentrate on than filter needles, hand washing, aseptic technique, documenting allergies, etc, but they are still important, and I ...

The rationale can be found here (starting on page 22, it's a long article but there is a summary at the end) http://www.calnurses.org/publications/national-nurse-mag/nn_mag_apr2010.pdf While you do need to consider that this is the position of not on...

I get the same amount deducted from my paycheck for health insurance that it would cost me to get insurance on my own. I know this because my employer dropped coverage of my newborn daughter because they said they were missing a form, they neglected...

In this job environment, if you can find a job you should consider taking it. I would base your decision more on the location than Magnet status, since Magnet status does not always produce the environment it was intended to produce, which is why t...

While 1-10mg is an unusually huge range, sometimes a patient's minimum and maximum pain control needs do not equal a 1:2 ratio; sometimes their pain might be controlled with 1 mg and sometimes it might take 3mg, which is why my facility didn't go alo...

Now that we're a few years out from the Joint Commission's suggestions on Narcotic range orders, I'm curious what the response has been; How many facilities have done away with range orders all together? How many still use range orders but have sig...

Mentors by definition are not meant to be instructors. Instructors are often the reason why students need mentors.

It is sort of frustrating to be taught to think in Nursing Diagnoses and yet to think critically as well, sort of hypocritical.

There seems to be some confusion about the difference between "walking rounds" and "safety checks". Many have responded that they like walking rounds in terms of checking drips, dressings, equipment settings, etc but they don't do the whole report i...