nutella

nutella MSN, RN

Member

All Content by nutella

  1. How is sepsis treated in a patient who is on comfort care only?

    nutella replied to joseyjo's topic in General Nursing

    There are several things to look at. 1. Advanced directive - meaning what? a POLST ? a Living will? not all states accept a living will for example ... 2. Is is VALID? I run into this problem...

  2. Pendulum Swinging too Far on Pain Meds?

    nutella replied to Emergent's topic in General Nursing

    I and my coworkers wonder a lot lately... Granted, I work in end-of-life care and there is a lot of symptom management related to terminal illness. There has always been the group of providers who are...

  3. Liaisons/Non-Clincial..Never seen this before!!!!

    nutella replied to CHPNRNTX's topic in Hospice, Palliative

    yeah - it happens. I have seen non nurses go out and have the patient sign the admission papers with the RN coming out as soon as possible for initial admission assessment /care plan/teaching. Hospice...

  4. Accepted dialysis clinic position, now having second thoughts - advice please?

    nutella replied to Lucky724's topic in Dialysis, Renal, Urology

    Once a clinic is run down with a revolving door it is hard to keep staff. There is usually some coming and going with the staff that stays getting overworked and starting to call out sick, which in...

  5. 5/29 This week, I have learned... One year later!!!

    nutella replied to ixchel's topic in General Nursing

    soon enough there will be like 12 rights plus a bonus right if you feel inspired to go the extra mile - which will probably "right customer service" ... of course medication administration time will...

  6. 5/29 This week, I have learned... One year later!!!

    nutella replied to ixchel's topic in General Nursing

    This week I have learned that I am not 100% clear on how I want to utilize my MSN once I am done - hopefully next spring. I am not studying the NP curriculum as I do not feel strongly about becoming a...

  7. My first death

    nutella replied to catebsn25's topic in General Nursing

    I found that for most coworkers just sharing what keeps you busy a couple of times (without violating confidentiality but that is self explanatory I think) with other people who understand, will help...

  8. My first death

    nutella replied to catebsn25's topic in General Nursing

    I am very much in the end of life business and can tell you that a lot of nurses /staff need some time to process after a patient dies. I think especially the first code is something that is a very...

  9. Magnet status...yay?

    nutella replied to mysonsmama's topic in General Nursing

    I worked for magnet and non magnet hospitals - one very large busy teaching hospital, another one medium teaching hospital and a medium size community hospital. The non magnet ones were major teaching...

  10. "I do the same thing as an RN"

    nutella replied to WheresMyPen's topic in General Nursing

    I think everybody has to get real. LPN education and scope is just not equivalent to the RN. The other day I met a CNA who was convinced that she is doing "the same as a nurse" and "I guess I am...

  11. Need help to finish BSN: Looking for mentor in LA area

    nutella replied to joluczak's topic in General Nursing

    When I worked for home care we had students all the time. Have you tried all the

  12. Nurse practitioner or Medical Doctor

    nutella replied to Kenny Rogers's topic in Pre-Nursing Students

    For what is worth it... I think just looking at what happened with your previous attempt in nursing school it is important that you look critically why you failed that time and make sure that you are...

  13. Nerve pain with cannulation

    nutella replied to GeauxNursing's topic in Dialysis, Renal, Urology

    It sounds to me that there is perhaps some nerve damage involved. I wonder if when they did the graft surgery they came close to a nerve or injured it or scar tissue. Anyhow - I guess the best option...

  14. How did you decide your specialty?

    nutella replied to Irish_Mist's topic in General Nursing

    I knew that I wanted to work critical care after graduation and was in neuro ICU in my last year of nursing school. I made good connections and got hired for the unit right out of school - I was a...

  15. Anybody working at Dialysis Clinic, Inc.?

    nutella replied to ginty777's topic in Dialysis, Renal, Urology

    As mentioned above the company itself is fine and highly regarded in many areas. In some places they have become the "go to" alternative for customers who are not satisfied with the big 2. However,...

  16. What do you hate most about your job?

    nutella replied to PancakeSaturdays's topic in General Nursing

    I do not hate anything about my job. What I do not like about the healthcare system is that the amount of work for floor/bedside nurses and the pressure to perform tasks for more and more acute...

  17. non-emergencies

    nutella replied to Fruit Sucker's topic in Hospice, Palliative

    Sorry but you need an attitude adjustment. Hospice is not like traditional home care. It is all about the family and the patient. Families and pat can get nervous about things you may perceive as...

  18. Calling in for no sleep

    nutella replied to Nurse131382's topic in General Nursing

    You can quote as many questionable "sources" as you want. Fact is that it is easy to make a mistake as a supervisor or manager when asking why somebody calls out. If you "request" information and it...

  19. Calling in for no sleep

    nutella replied to Nurse131382's topic in General Nursing

    You are not required to give a reason when you call out. Granted, there may be a policy that you have to call out at least 4 hours before your shift but other than that you do not give a reason. The...

  20. Educational path to Pain Management

    nutella replied to INN_777's topic in Pain Management

    I work in a palliative care program (not a NP) and can tell you that the NP I work with is a regular FNP who got trained in palliative care by the MD. There are some extra courses you can take but it...

  21. mental health CAPSTONE question QUALITY IMPROVEMENT

    nutella replied to imallinbaby2262's topic in General Nursing

    Perhaps you want to look at those links for some inspiration: http://www.who.int/mental_health/resources/en/Quality.pdf CQAIMH - center for quality assessment and improvement in mental health...

  22. Hospice in Hospitals

    nutella replied to nurse0079's topic in Hospice, Palliative

    Hospitals have their own staff who are capable of providing CMO care. The only time an agency sends out a hospice nurse to the hospital is when a patient in the hospital is admitted to GIP service...

  23. LVNS with ADD & 2 Concussions!!

    nutella replied to MuayThaiLVNS's topic in General Nursing

    Here is advice from somebody who grew up in terrible circumstances including poverty and abuse. By the way - I picked up martial arts later on as well .... In my opinion, based on personal experience,...

  24. Coworker physically abusive to patients

    nutella replied to Depressed_RN's topic in Patient, Colleague Relations

    I have never encountered that "defending" in that way is ok or would be "ok". The fact that he felt the need to explain his behavior says something about that as well. If this is the behavior he is...

  25. Was I wrong?

    nutella replied to blueskyy's topic in Geriatric, LTC

    Yeah - those things happen. You would not believe how many patient with a DNR/DNI do NOT hospitalize and on hospice or some kind of comfort care are brought to the hospital from a facility.... In...