notanumber

notanumber

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All Content by notanumber

  1. Palliative Standing Orders

    notanumber posted a topic in Hospice, Palliative

    Hello, I'm working on putting forward to our DOC a replacement for our facility's current palliative order sheet, one that is more customizable to the resident, presents the physician with more...

  2. Dry Gangrene to Lower Leg

    notanumber posted a topic in Wound, Ostomy, Continence

    Hello, looking for some suggestions for an elderly resident with advanced ischemic disease to lower limbs. One leg has dry eschar from toes to half way up the lower leg. Not a surgical candidate....

  3. Raising them right.

    notanumber posted a topic in Patient, Colleague Relations

    I like working with new nurses, generally, because we learn alot from each othee and I get a chance to help them mature into competent, confident professionals. But. What do you do with a young...

  4. LTC Wound Care Kit

    notanumber posted a topic in Geriatric, LTC

    Hi all, myself and another LPN will be working on overhauling our wound care strategies. Managers would like us to start asap to get better continuity, although we will further certified in Advanced...

  5. Tylenol for 10/10 pain?

    notanumber posted a topic in Patient Medications

    LTC - had a LOL with acute pain, likely exacerbation of undiagnosed compression # after a fall a week ago. Screaming, grimacing, little to no relief with repositioning. She did have a PRN for extra...

  6. Sliding up bariatric residents

    notanumber posted a topic in Geriatric, LTC

    This is a difficult one, apparently. Bariatric res, never leaves the bed, doesn't tolerate bed laid flat or feet elevated very high, doesn't like slider sheets because they slide down too much...

  7. Are there any certifications for LPNs?

    notanumber replied to HawaiianDreams's topic in LPN, LVN Corner

    What sort of certifications are you looking for? I have Advanced Foot Care, Palliative Care (LEAP Core through Pallium), and am going for Advanced Wound

  8. LTC Wound Care Kit

    notanumber replied to notanumber's topic in Geriatric, LTC

    I mean a carry-kit or tray that has basic wound care supplies ready to go, to be brought to the resident room for treatment. It's help to have certain things ready due to time constraints, but all...

  9. Nitrospray Questioning

    notanumber posted a topic in Patient Medications

    Situation - resident with cardiac hx presents with severe chest pain, altered heart rhythm (which may or may not have been chronic) and mild hypertension. Dr gives telephone order - "give him three...

  10. Nitrospray Questioning

    notanumber replied to notanumber's topic in Patient Medications

    I understand you are not bashing, you are educating and advising and I appreciate it. I've been in the field for several years and have never (to my knowledge) made an error like this where a...

  11. Nitrospray Questioning

    notanumber replied to notanumber's topic in Patient Medications

    We don't have a set protocol for nitro (due to the side effects) and it is rarely administered, so the rx is specific to the patient and usually a one time only order. Yes, I made an error in...

  12. Nitrospray Questioning

    notanumber replied to notanumber's topic in Patient Medications

    Three together. I explained that point to the NMs as well and they both agreed that it may have been an appropriate order and I followed it correctly as stated. The typical protocol is one, wait five...

  13. Klazomania in Dementia

    notanumber posted a topic in Psychiatric

    Wasn't sure whether this topic should be in neuro, geri, or psych, so apologies if this sounds misplaced. Does anyone have information on compulsive screaming in adults with either neuro or psych dx...

  14. Klazomania in Dementia

    notanumber replied to notanumber's topic in Psychiatric

    I can only say that it is the term that best fits the symptom. We are short on geri-psychs and neurologists (well, all MDs, really) in this area and the one in charge of this case isn't particularly...

  15. Come On People, How Stupid Are You??

    notanumber replied to CapeCodMermaid's topic in Geriatric, LTC

    That is painful. More than one? Excrutiating. I've had some "what, really?" moments with some nurses, but nothing like

  16. What do you do during down time?

    notanumber replied to Orion81RN's topic in Private Duty

    If she has an iPad, look through some apps designed for young children and/or developmentally disabled, especially those that provide direct cause-effect interaction (e.g. press a button, make a sound...

  17. Patient Fell and Got up?

    notanumber replied to princesspunch's topic in Patient Safety Issues

    At our facility, transfer to acute care is dependent on approval of a physician (with some judgment-based exceptions, e.g. traumatic amputation or code on someone who is not a DNR), and the decision...

  18. Tylenol for 10/10 pain?

    notanumber replied to notanumber's topic in Patient Medications

    Monitored for not quite two hours with no change in symptoms, then saw some improvement, and further repositioning resolved it almost completely. Still very painful on lying->sitting->standing....

  19. Choking elder

    notanumber replied to mindywright3's topic in General Nursing

    For residents in w/c's, you would position yourself behind the chair (sitting, standing, kneeling, whatever works), wrap your arms around the rib cage and administer abdominal or chest thrusts, making...

  20. What works for your facility!?

    notanumber replied to Lpn1226's topic in Geriatric, LTC

    Positive reinforcement, frequent check ins, asking how I can help if I have time, finding time to listen to venting/concerns, rewards like ordering food in or bringing coffee, etc. If people feel...

  21. First day as CNA

    notanumber replied to mcbn2u's topic in Medical Assistant, CNA/MA

    You did nothing wrong. You sound like a conscientous CNA and unfortunately got paired with a patient who has difficult family members. They probably picked up on your newness - it's like chumming the...

  22. Required to stay after night shift?

    notanumber replied to notanumber's topic in Canada

    In these cases, it's not typically a late nurse, it's that I receive a sick call in the middle of the night and can't fill it by 0700 (shift change). It's happened more lately because of people on...

  23. Required to stay after night shift?

    notanumber posted a topic in Canada

    I'm in Canada. Work 12 hr nights, four in a row. It is generally expected that if days is short then the night nurse has to stay and finish a morning med pass. There is no such expectation for days to...

  24. Information please.

    notanumber replied to GrumpyRN's topic in Canada

    Medical treatment is fairly well covered, but many families still struggle with expenses indirectly tied to it - time off work, temporary housing near facilities, childcare, travel, everyday expenses...

  25. Negotiating Night Differential

    notanumber posted a topic in Collective Bargaining, Union

    Our facility is non-unionized but we do have an Employee's Association which is in charge of negotiating employment policies and wages. The annual wage increase is 1% across the board (which is dismal...