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respectall

respectall

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  1. respectall

    Afib question

    If the pt is status post op, there are many possible etiology to his afib. 1. fluid vol deficit or overload 2. electrolyte embalance 3. pulmonary emboli 4. sepsis 5. substance withdrawal ( etoh, tobacco) If all of the above have been corrected and the problem persist then It is a circuit problem caused by an ectopic pacer cell. Electrophysiology study might be necessary or simply start pt on beta blocker or amiodarone po, no need for drip unless pt remains in UCAFIB without conversion.
  2. respectall

    Afib question

    This pt needs cardiology consult ASAP to better handle his arrythmia.
  3. respectall

    Dear preceptor

    WHY was this conduct permitted or even tolerated. There's NO place in my unit that this SORT of narcissistic and condescending behavior is endulge. I am a preceptor and it broke my heart TO SEE how tretous and painful your orientation was. This preceptor should have been given a discipllinary action and sent to remidial class. As a preceptor in our facility, we are required to take a class geard specifically to accomodate the need of the preceptee and NOT to place punitive criticism. Did you REPORT this preceptor's behavior to your DIRECTOR? this preceptor has a case of CONDUCT UNBECOMING! I advice you to report this event and so NO other new NUrse has to go thru this MALTREATMENT. nURSING IS A WONDERFUL AND FULFILING JOB, YOU DONT HAVE TO HATE IT BECAUSE SOMEONE ELSE DOES.
  4. respectall

    how to deal with competitive nurses

    Being competitive for egotistical reason is WRONG. Competitive to be competent is GOOD. Often times the degree of experience in the field makes staff think they have the right to punitively judge other staff who acquire less experience. This is ABSOLUTELY UNACCEPTABLE!. Those nurses who practice this behavior are a danger to the field. Unit policies and protocol changes frequently, so guidelines of practices often gets changes and upgraded. LPN and RN have different scope of practice. If you think this LPN have crossed the line, then go to your chain of command. Report the improper conduct so a appropriate disciplinary action is taken. Adding and or Correcting someones charting is illegal and ground for disciplinary action.
  5. respectall

    My Papa. Why I Am The Nurse I Am Today.

    I'm sorry for your loss. There is really no kind of preparation that can prepare you for the inevitable. My Father died of Esophageal CA, he was given three mos to live. I don't think I was ever ready to accept the loss of my dad eventhough we have time. When the sad reality of them gone forever hits you, it just break you apart. I work in the icu and have to deal with end of life situations and be the pt advocate. There is never a moment that I don't think of my dad when I have to terminally wean a pt from a vent and put pt on Morphine gtt. I feel tha pain and loss that the family go through. I have to think not just a nurse but also put myself in the pt shoe.They may not be able to talk but their physical and vital signs says it all. You're going to be a great nurse and yes.. NURSING truly is a calling. When you take care of a pt, think of your PAPA and you're going to be just fine.........
  6. respectall

    Learn To Say It Correctly!!

    You must have lots of time on your hand. If you know what it mean, then just do it! You have sick pt that you could be doing something more productive, like researching about their DX and PMhx or helping them up the BSC. How pathetic!
  7. respectall

    ICU nurses attitude toward med-surg nurses

    Those ICU nurses that think they're "it", usually have a personality and EGO problem. I personally think they're nothing but bullies. They're so insecure about themselves that they pursue evry oppurtunity to step on something/someones shoe just to get well high and above. We're all nurses why can't we just be supportive of each other.
  8. respectall

    ICU nurses attitude toward med-surg nurses

    YES, there are a few ICU nurses that demean MS nurses. I have a few co worker in ICU who are narcissistic. Their Illusion of grandeur pass well beyond MS nurses to new MDs. Their number of experience and "knowledge" of the field makes them think they "know it all". NOT even that, Just the label of them being "critical care" nurse makes them feel they're much prestigous. I am an ICU nurse and to hear this nurses in the unit talk about how much of a "dingdong" this nurse or doc makes me sick to my stomach! ICU plan of care outcomes are so much different from MS. In the ICU, vital sign stable may mean that MAP =/> 60mmhg and in the MS that may mean SBP>90. Each unit approach crisis in different mode. If you're a nurse regardless of area of occupation you must have that critical thinking capabilities. Some develop those skills naturally and for some it takes time. Its because you have that experience and skills, that doesn't make you superior to the rest. You can make that talent a tool to help others grasp and understand and NOT feel inferior to you. I started my nursing in MS/ortho then to PCU and finally to ICU. I gain tremendous knowledge in each unit from the nurses that I worked. I look at those nurses as my colleage and confidant and NOT a counterpart because we all have the same GOAL at the end of our shift.
  9. respectall

    MD AWARE

    was there a PRN pain med that was ordered for this pt? If so why wasn't it given. A pain of 5/10 is considerable and could get even worse if no intervention is promtly implemented early. When you said "MD Aware" did you mean you consulted him about the pt's discomfort, and since no intervention was made did the doc NOT order any analgesia?
  10. respectall

    Do Nurses Eat Their Young?

    absolutely precisely correct. many but not all new "young" nurse come into the profession with different expectation of their role. although i admire their enthusiasm of their profession. many believe that since they hold the same license as the preceptor that they are synonimous in practice...... i agree but what separates preceptor from them are years of experience and actual field knowledge. new nurses have a great deal of knowledge about pathophysiology but they difinitely lack the ability to integrate the hemodynamics and hematology and clinical presentation to the core problem. although i cant blame some of them especially those who are in the ms floor. they just are loaded with too many pt and lucky if they can eat their lunch!!.... but still this should not be a deterrent to satisfy your kowledge as a nurse. the outcome of your pt lives depends on your skills and knowledges. you put yourselves in their shoe and think, would i want to intrust by life to this nurse hand? will i be able to go back home healthy and without mrsa? will i be able to go back to work and support my family ? will i be able to take care of myself independently?..............
  11. respectall

    Do Nurses Eat Their Young?

    M.D.s' also to some extent "abuse" their new partners. where I work new md associates are given too many pt assignments and are often on call even after hours. In addition, they're kept in house cleaning the mess while their senior partners are in their office catered by their NPs, RN, APs. Furtheremore, In many cases a inpt will have multiple physicians handling the case. In my experience, M.Ds' usually pass the buck to the other and another in making decision and giving orders especially on noc shift. when I use to work noc shift I would always hear this "just wait in the morning when Dr so ans so make rounds to take care of the problem" Or " Why wasn't that taking cared of earlier". Usually those nurses that "eat their young" are the ones who are burnt out of the profession. If you're a new grad try to request a preceptor who possess a great attitude about their profession and has a nurturing mentality NOT destructive. Don't be affraid, NOT all nurses eat their young, only a few practice this sort of malignant behavior. If you are currently with a "witch" nurse request for a new one you've seen in the unit who are compatible with your belief in pt care delivery
  12. respectall

    "Fired for NO Reason"

    TERMINATION was the best thing that could have happen to that employee. Pt safety should ALWAYS be a priority amongst all. There obviously were a pattern of her negligence over a period of time and they were appropriately addressed by her preceptor. It was clear from her responses that she did not acknowledge the real problem. she Instead focused on her will preserved self EGO. I've been in situation were I almost hurt pt and made mistakes when I was a GN . I took responsibility for my action. I took my preceptors criticism to heart and made it a learning tool to better improved my skills and ability to make critical thinking in my decisions. I am now a preceptor and I ALWAYS made sure my orientee are able to make synapses to problems and creat a safe hypothesis to their care plan.
  13. respectall

    Immigration: More Foreign Nurses Needed?

    Foriegn nurses are here because they were actively recruited in their native country to work for our health care system. Hand picked and studied by hired recruiting agency from the USA.
  14. respectall

    Immigration: More Foreign Nurses Needed?

    as a american I am entitled to vote my president, entitled to own a home, entitled to hold an RN job because of my qualification, entitled to be a member of any religous and or political party, entitled to drive and own a car of my choice, And most of all entitled to be a free citizen of this great country of ours.....
  15. respectall

    Immigration: More Foreign Nurses Needed?

    I dont think that you hate foriegners you just hate the fact that Those foriegn nurses that you worked with are in higher position as you. And doing a psychoanalysis on yourself based on your comments here, you just seem to have a severe case of paranoia. Pls if you're willing to worked and perform duties assign to you you can have about any jobs you want. just be nice to everyone and you can get along just fine.....
  16. respectall

    Immigration: More Foreign Nurses Needed?

    So you're saying that nurses from the philippines do not provide great services to this country? and they don't really deserve to come to this country and make a decent life for themselves? I don't have any problem for anyone, anybody from foriegn land coming to our great country to chase their piece of american dream. veryone is entitiled to, if you're great in nursing then chase your dreams using your nursing skills, if your great in agriculture and mechanics then go that way.