notanumber

notanumber

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All Content by notanumber

  1. Treatming nausea and abdominal angina in end-of-life

    notanumber posted a topic in Hospice, Palliative

    This is an elderly lady with a complex history autoimmune disorders (SLE headlining), history of acute on chronic abdominal pain without significant findings, one physician queried mesenteric...

  2. Treatming nausea and abdominal angina in end-of-life

    notanumber replied to notanumber's topic in Hospice, Palliative

    Thank you for the reply! She's on transdermal fentanyl and morphine PO which has been a longstanding PRN. The GP ordered generic comfort orders for when NPO but declined to d/c scheduled meds at this...

  3. Required to stay after night shift?

    notanumber replied to notanumber's topic in Canada

    For me, it's the opposite. I'm usually reasonably alert in the evening/night even with poor sleep, but by the time morning rolls around I'm getting 'spacey' and having more trouble concentrating...

  4. Tylenol for 10/10 pain?

    notanumber replied to notanumber's topic in Patient Medications

    MRP = Most Responsible Physician This was on nights, at 2300. We had trialled giving Tylenol at hs the night before and the same pain recurred then, but resolved with repositioning. This time it...

  5. Shearing/Pressure Sores in Bariatric Patients

    notanumber posted a topic in General Nursing

    A&O lady who chooses to stay in bed 90% of the time in fowler's, can make small adjustments in position independently, non-ambulatory, foley cath in situ and continent of bowel, developing sores...

  6. Shearing/Pressure Sores in Bariatric Patients

    notanumber replied to notanumber's topic in General Nursing

    I forgot to add - this res is in LTC. Refuses turning, cannot tolerate any position other than fowler's due to chronic pain and SOB. Sleeps in this position as well (which looks so uncomfortable,...

  7. Dealing with sensitive care aides

    notanumber posted a topic in Patient, Colleague Relations

    A big part of my supervisory role is ensuring policy and procedure is being followed. When I saw a care aide's young (minor) relative in resident care and staff areas, I inquired with her privately...

  8. Building-wide burnout

    notanumber posted a topic in Geriatric, LTC

    Hey guys, I'm detecting higher levels of burnout in the care aides across the board, and there's more tensions between shifts as a result. More bickering about tasks not being done before the next...

  9. Small Minds Only

    notanumber posted a topic in Nursing Humor

    What little things/thoughts do you do that you're fairly certain amuses you and you alone while on shift? As the lone night nurse, I like to stack my comm clipboards for each floor according to the...

  10. My co-worker hates me for doing my job.

    notanumber replied to KwowRn's topic in Nursing Professionalism

    Sounds similar to an issue I (LPN) was having with an RCA. I posted about it here. Some people are extremely sensitive to any inference that they may not have been following the letter of the law,...

  11. This is why I do this job

    notanumber replied to Double-Helix's topic in General Nursing

    I still remember a patient from one of my clinicals (LPN) on a med-surg floor. I was assigned a stable patient post-colectomy who needed frequent wound care. She was fairly young, and in a lot of...

  12. Resident fall feel like....

    notanumber replied to KatMaine's topic in Patient Safety Issues

    I'd look at what fall precautions were in place. Bed or chair alarms? If May had an alarm in place, you would've known she was trying to stand before she actually got to her feet so you could've had...

  13. Death and the Soul

    notanumber replied to dream'n's topic in General Nursing

    It's a common cultural phenomenon to associate the heart with the seat of emotions, personhood, essence, or soul. I would wager that if the nurses lived in a culture that associated, say, the liver*...

  14. Liquor Licenses for Nursing Homes?

    notanumber replied to tnbutterfly - Mary's topic in Nursing News

    Our LTC used to require a doctor's order, but no longer, as it was deemed not in line with our other policies that this is the resident's home, and they should be as free to drink alcohol as they...

  15. My Mom passed away. Did I do the right thing?

    notanumber replied to LovingMom1's topic in General Nursing

    You were doing the right thing per pressure sore care. In our facility, we only stop turning when we know death is imminent and repositioning may cause more discomfort/distress than not turning. I...

  16. Physician squabbles and after hours orders

    notanumber posted a topic in Geriatric, LTC

    Scene: LTC/SNF Day 1 - INR comes back, cannot get in contact with primary for new warfarin orders to start the next day. Day 2 Part one - Other MRP now on-call for primary, complains that primary...

  17. Which country is better to work in U.S. or U.K?

    notanumber replied to jnurse816's topic in International Nursing

    I've heard from ex pats that UK nurses have more autonomy and a wider scope of practice, is that

  18. Narcotics disposal in home

    notanumber replied to SCgirl1962's topic in Patient Medications

    Not hospice, but in our LTC these are returned to pharmacy. We fax notification of death along with narc record and request for

  19. Long Term Care Nursing is Lame

    notanumber replied to purplegal's topic in Geriatric, LTC

    I've worked in LTC for several years, and while it wasn't my dream job, the longer I work the more interesting and enjoyable it becomes. Not because it serves up exciting developments on the regular,...

  20. Need tips for night shift!!

    notanumber replied to Psualum21's topic in Health, Stress Management

    I use melatonin, caffeine, and light/dark therapy to manage the switch. First day off I try to only sleep 6 hours, get up and have a cup of coffee while sitting under a daylight lamp (or go outside...

  21. Physician squabbles and after hours orders

    notanumber replied to notanumber's topic in Geriatric, LTC

    We don't have a medical director - DOC and GM are both RNs with experience and higher education in geriatric care. They are great, but obviously can't help with writing orders. Our home runs a bit...

  22. Orders from hell...

    notanumber replied to Leonardo Del Toro's topic in General Nursing

    I agree, but pharmacy put it through. I'm in Canada. No one else seems as concerned about it as me so it's difficult to

  23. Orders from hell...

    notanumber replied to Leonardo Del Toro's topic in General Nursing

    Novorapid 10u SQ PRN for BGL>20.0 So . . . if I check the res 15 minutes later and they're still high, I can give it again? And every 15 minutes after that? Asked multiple times, always refused...

  24. Foley in patient with undiagnosed urinary crystals

    notanumber replied to notanumber's topic in Patient Safety Issues

    About 3

  25. Foley in patient with undiagnosed urinary crystals

    notanumber posted a topic in Patient Safety Issues

    Advice needed, because I'd rather not shred a woman's urethra again unless super-duper necessary. D/C'd a cath on a LTC resident (MRP left it up to her to decide if/when she wanted it out at approx 3...