damrcngrl95

Thank you. I had heard of the term Cadillac tax, but had never taken the time to understand what it means in context. This makes the original post clearer now.

Maybe I have read this wrong, but this post doesn't make sense to me. How would a company suffer a "Cadillac tax" for offering better insurance coverage at lower prices? The whole idea of the ACA was to get rid of " junk insurance" and offer a good insurance at a better price. Not a lower price than the junk insurance, but a better price than the quality insurance that should have been offered.

I wanted to clarify that I mean respiratory rate and not time.

You can bring down high CO2s with higher volumes, increased respiratory rate, and longer expiratory times. If the patient is maxed out on volume then the next step would be to adjust respiratory times. This will increase their expiratory minute volumes and blow off more CO2.

I'm in the same boat as you. I have been working for a month. Each week I get a little faster, my charting gets a little better and I feel like I'm handling things a little better. I made some of the same mistakes such as a skipped medication and documentation errors. I try to remind myself that this is all new. I have the knowledge and now I'm learning how to apply it. I'm just not going to be as fast or as smooth as others on my team right now. It will come with time. I'm learning a big lesson of not being so hard on myself. My preceptor told me that I need to learn to crawl before I can run. Practice and exposure is what we both need right now and we are getting it. Our time management and smoothness of charting will come with time.

I saw this video the other day and instantly thought of AllNurses. Lol

No matter what field you choose to go into please do your research for the area you plan to work in. RNs have a lot more areas that they can work in. They may start off at close to the same pay as RTs, but do end up making more as the years pass. I love being an RT, but I'm very new to the field. I knew the challenges I would face, but loved the field so much that I took the plunge. I did shadow nurses for about 6 months and RTs for about 2 months before I ever committed to school. Doing a search on jobs in the medical field will tell you that some areas of the country are saturated and getting a new grad job will be tough. My philosophy is that I should love what I do and the money will follow. So far for me it has worked out that way. The market in my area is tight, but not completely saturated. I started talking to managers in the spring so that when I graduated I had an idea of where to start to get a job. I was lucky and landed a full time day position at my first pick hospital. Many of my friends are working PRN and nights at that. Plus many are still looking for a job. As an RT in my area you will start off the same as every other new grad....doing floor work. It's a great place to start, but you won't start in a specialty area like you could as an RN. Generally, you can't work home health or do travel as a RT until you have hospital experience so you really will need to start out at the hospital doing bedside care.

Ok. My dealings with mucomyst has been purely nebulized treatments. That is good to know in the future. :-)

One more question.... Was it a nebulized treatment or orally given?

Lack of a good cough reflex is not a contraindication nor an absolute contraindication. For mucomyst, it is recommended that suction be available to maintain the air away. The only recommendations that I'm aware of is that asthmatics use albuterol either before or with a nebulized treatment of mucomyst and to not mix with antibiotics. I'm not sure exactly what happened with your patient, but it seems to me that a lot went wrong if the patient was able to fall out of bed with medical personnel at the bedside. I would agree with what you are saying as far as breathing comes first and the head trauma a very close second. Maybe the RN felt that O2 check wasn't as important as to getting the patient back to breathing properly? I'm not really sure what was going on at that point. It seems you have good reason to be upset, but is it specifically because of the mucomyst? Do you feel it was inappropriately given? Or the person giving it didn't understand how to properly maintain patient safety? Since it was a doctor's order, do you feel someone should have spoken to the doctor about concerns with this patient? I am only asking because I'm learning new things every day and this case is very interesting with all the things that went wrong. It's puzzling that people just stood around as this patient began coughing so hard that they fell out of bed and did nothing to help the patient until they were on the floor.

My son used mucomyst when he was a baby. My understanding of the drug was that it breaks down the disulfide bonds making the mucus very watery and easier to cough up. If the patient doesn't have a spontaneous cough then the mucus needs be suctioned. I do know that mucomyst is very irritating and it is recommended that albuterol is given before or with the mucomyst.

It's actually worse than that. The person doesn't have to be a heavy smoker at all to cause them to have an asthma attack. Just having the small hint has been enough at times in their lives. If they are already having breathing problems a person who has been around smoke can cause an attack.

Yes. There is talk in Texas of delicensing. There are several great sites my favorite is Respiratory Therapy Cave. Do a search and you will find his blog as well as other helpful sites to go on. He has been a therapist for over 20 years and his wife is a nurse. He pointed me to this site when I was trying to decide which career I wanted.

My boys are very sensitive to smoke. It even being on someone's clothes has caused an asthma attack. I would hate for one of them to be in the hospital and someone taking care of them smokes. It would just make things worse.

One of the wonderful things about living in this country is that we are allowed to have our own opinions about things. This topic has been a very educational topic that I hope we will continue to have as we see how the ACA will work in the states that accepted the Medicare expansion and the states that didnt. I do want to hear opinions like fitopp's. It's not my opinion, but it does have some merit no matter how small others may think it is. The thing I do enjoy about this board is that we can agree to disagree. Thanks to many of you I have learned what the ACA is and is not. I am of the group that it didn't go far enough, but I do think its a start. For now, I am optimistically watching how things will go and the changes that will occur with this new law.