aathomstew

Does anyone have to chemically, and 4 point physically, restrain psych pts who are refusing to go to their dialysis treatments. You know pts who end up coming thru the ER after their family finds them unresponsive. Then they are so out of it, violent, etc. psych gets a 72 hour hold and judge orders forced dialysis. (until the pt is stable enough to realize the need for dialysis and of course he will miraculously come to his senses!!!) I would like to know how other places handle this and possibly similar situations. Of course I'm refering to people who have at one time consented to tx because of their ESRD. thanx

I left Vegas a couple of years ago. Working 3 days a week 12 hour shifts my usual daycare bill for 2 kids was 750$ a month. It is very difficult to find decent childcare. The schools are beyond bad, overcrowded, poorly funded , violent unsafe, best thing I ever did getting my kids out. So put private school or homeschooling into your budget, 1200square foot house 200,000$. Make sure you save up a down pmt. That's if you're lucky enough to find one. I would say not family friendly. It can be a fun place to stay for a while for adults but raising kids in a party town is a bad deal for them. I've seen too many kids turn onto drugs, raves, and the bigtime sex trade in that town. I worked at Valley, UMC, and did agency extra shifts at Sunrise, Desert Springs. I've worked so short staffed so many shifts that I couldn't count. Yes it's been a couple of years but it was common nightly to have 10 to 14 pts per nurse and maybe 2 CNAs to help out the whole floor. I couldn't count how many times I cried all the way home in the morning overwhelmed beyond belief. I worked Ortho/med/surg. That was my experience in LV. No amount of money could get me back.

You are totally cool!! What awesom timing!!

This is a great high PRO shake I got from my Dr after my gastric bypass. It's cheap tastes good and low cal/low sugar. 1 pkg carnation instant breakfast sugarfree. (I like cho. you can use vanilla and different flavored extracts if you want) 8 tbls powdered milk 1 cup non fat milk shake up good and keep refrigerated. Has 60 Gm of PRO and costs about 25 cents a serving.

We used it about a week ago on a peds pt for a procedure. Had an immediate allergic reaction. turned bright red rash. we ended up giving benadryl and O2. Had to use fentanyl for the sedation.

I was wondering how many nurses have to take report from the primary nurse during dialysis. We do all our treatments at the pts bedside so they still have all their cares done by the primary nurse assigned to them. So during the HD run my concerns are mainly focused on the tx. I have the pt push their call light if they want anything else. Of course I don't mind helping out with small request. Since I work for the dialysis center which is separate from the hospitals I try to keep boundries. How do other units handle this?

I work acutes and I'm always wondering how other places do their dialysis in the hosp. We have offices in 3 different hosp. so when we get an order for dialysis we are assigned by the charge and sent out. Usually we have about 5 RNs at work each day. We mix up the bicarb and push the machine, RO and cart of equipment to the pts bedside. During the run we stay at the bedside the entire time. I usually keep in touch with the pts primary care RN about any meds the pt might need etc. When the tx is finished I clean up, push my equipment to the next pt and set up all over again. We do 2-3 runs a day. 12 hr shifts sometimes go over to finish up. Our team does CRRT, TPE, all the hemo and PDs for all the inpatients at all 3 hosp. Also we take turns being oncall about 1 night every 10days. So if you worked your 12 hr shift and it's your call night you could feasably work all night too if the Dr's have people coming thru the ER . I just thought it would be interesting to find out how other nurses units run. Acutes and Chronics.

You can soooo be the one to affect a change. I like so many of us was in a very toxic environment as a new grad. I drove home in tears every morning.. I just refused to give in. I made sure to start every shift with a smile. It wasn't easy but I would not be beat down. After I became more confident in my skills I decided no new person would ever be left out in the cold when I was around. I always checked on them. Always took their beeper and made sure they went to lunch I would be friendly. I think eventually I just wore the meanies out... I wouldn't give them the satisfaction of thinking they could get to me. For me it took time . I wouldn't say I ever became a part of them but I think eventually I got some respect and made some great friends with the new people who came on. It changed the environment at least for me I enjoy going to work now.

When you have a PICC line for home antibiotics don't decided to flush with vodka - because it's clear and you ran out of your saline- PS more addictive than crack.

I worked 7p-7a and our pt. load is about 5-6 pts. But up to 4 pts. can be post-op and have 3-4 pts. with PCA/Epi's.