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calicamper

calicamper

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calicamper's Latest Activity

  1. calicamper

    Dirty Needle Stick....

    If your needles are the same safety needles that we have, the best way to do it is to slide the needle against a hard surface, a table, with enough pressure that the resheathing device will slide up over the needle. Some resheathing devices, will just click over the needle. It is still safer to do it against a table than to take your hand and attempt to click the device over the needle. I almost got stuck this way. Now I always use the hard surface of the table rather than my hand. I am so sorry you got stuck and hope for the best.
  2. calicamper

    Question for the experienced cards rns

    I had my first code two weeks ago after working for 13.5 months. It was such a relief for me b/c like you describe, my anxiety was so high. My colleagues got me very involved, though. I took turns giving drugs, doing compressions, handing drugs to others. I even made an epi drip. I also helped doppler the femoral pulse. I know the next time there is a code, I have experience...and I won't be as scared for a code as I'd been over the past year. I recommend you follow the code team at your hospital. There should be a code nurse from an ICU on call for codes that day.
  3. calicamper

    RNs in CT scan c pt

    I've seen a couple of times at my hospital the RN be in the CT scanner room with the pt while pt was being scanned. As I understand it, a CT scan is the equivalent of 300 chest xrays and a CT scan for pulmonary embolism is the equivalent of 50 mammograms. (This is what a radiologist told me). She told me also that no radiologist or MD would go into a CT scanner room with a patient in their right mind...while the pt was being scanned, that is). What do you see at your hospital? Is there a double standard for nurses? (That is....we're doing something that most physicians absolutely wouldn't do?) Cali
  4. calicamper

    Anchorage Hospitals

    I am moving to Anchorage. If you could move to Anchorage all over again and pick a place to staff nurse, which hospital would you choose? I'll be doing either cadiology, ICU, or ED. Thanks, Calicamper
  5. calicamper

    Looking for nursing area with less physical expectations.

    Thank you all for your comments, suggestions. I had already spoken with my manager and she said that unfortunately, hospitals in our region weren't using lift teams. I just got the feeling from my converation with her that nothing was going to change soon on my unit. I don't feel safe. And I want to move on to another place where I would feel safer. I'm not a cripple, I can move weight. It's just these really heavy total care patients. I use trendelenberg position, but I guess the sheet doesn't slide well. Maybe that would help, like people wrote, a more slidy sheet. I was hoping a few more people would comment on what they've experienced lifting on some of the floors, as opposed to ICUs. I don't have any experience on floor units. I was wondering if it might be less, but then again, if you're walking the patients around, maybe it's not if you're practically being the PT. OB,NICU, and Jail nursing....you guys commented might be more back friendly. Hmmmm. Any thing else? I figure maybe office nursing too, and maybe psych nursing. I think ideally, I'd work in an ICU with lifting assistants for the really big patients. It's the really big ones who are making me concerned. I do like ICU. I know I could also look at urgent care type nursing too. Thank your for your comments/concerns/help.
  6. I have worked in an ICU for 7 months now, and LOVE the job except I am VERY worried about the physical expectations. I am in a coronary care unit (ICU), which also gets overflow medicine and burn ICU patients. Our patients are often hundreds of pounds. I am 5'4" and 105 lbs. I injured my back and my right shoulder and arm a few weeks ago trying to pull a 250 lb total care patients up in bed with one other RN. Turns out it was probably a muscle strain and I am feeling a lot better now. I spoke with my manager about my concerns, and she said that it is the expectation that I am able to do the physical demands of the job and that I should try to recruit more help. Our unit has 13 beds and 6 nurses. We have no other help. I have a lot of trouble getting more than one other nurse at a time to help me b/c we're all busy. Sometimes, I'll ask a 3rd nurse and she'll say "it only took 2 of us yesterday to move him." My manager told me to learn better body mechanics, but even with the best body mechanics, I don't think that someone of my stature can safely maneuver these heavy weight patients. So I am thinking about applying for other types of nursing jobs. I had worked in the ED my first four months of being a new nurse (before switching to ICU) and there was lifting, but not nearly what I have with all of my total care patients in the ICU. Plus with the paramedics and more male nurses in that deparment, there was more "muscle." I do not know if I want to go back to the ED at this time. I have never worked on a "floor." Could anyone suggest adult floors that might have the most patients who can shift themselves in bed? I am also thinking about switching to peds, but am not sure. My manager seemed to support my moving to peds...said she'd even speak with the peds managers at my hospitals and that there were positions open. I think I would prefer to stick with adults, but don't want to leave the ICU just to end up doing almost as much lifting somewhere else. I would appreciate any suggestions on nursing floors I might find less physically dangerous...as I start to think about changing units. Thanks, Calicamper
  7. calicamper

    blood exposure and intact skin

    Last week I got blood on my pants from a known Hep C patient. It soaked through my pants and through my hose underneath. (this was not an obscene amount of blood, just a couple splashes about an inch or so in diameter on my leg). It took me 10 or 15 minutes to get to the linen room to get a new pair of scrub pants. Then I went to the bathroom and washed with soap and water. So now the blood had been on my leg for 15 minutes. (I regret that I couldn't/didn't have washed it off sooner). A couple of my colleagues said that I did not need to worry since it was intact skin, so I didn't file an incident report. But since then, I've been thinking about it, and was wondering what you all thought b/c it's been stressing me out a lot, as in A LOT. I've found myself thinking, well, if intact skin is such a great barrier, then why do we wear gloves all of the time (when dealing with body fluids)? And since we're supposed to wear gloves all of the time to protect ourselves, then, by extension, does that mean that I shouldn't consider myself safe after this exposure to my intact skin? I just feel really anxious and I'm not sure if it's unfounded anxiety or not. What do you do when you get blood on your skin? Do you get anxious?
  8. calicamper

    Embarrassing Incident/Klonopin?

    Hi, I'm the original poster, Thanks all for writing to me. I know my post was really long to read. I really appreciate your commiseration. Also, thank you for your support for getting more physical health care if necessary and for commiserating with me that sometimes if you have a hx of pyche, the doctors can overdwell on it (although they certainly did not at the ED that night). I will keep you posted. I'm going to just keep my cool tomorrow and act like nothing happened, nothing's wrong, and not let myself think what others are thinking. They can talk all they want....while I'm getting my job done. (FYI...it is a nice group of people...it's just embarrassing that they know my hx).
  9. calicamper

    Embarrassing Incident/Klonopin?

    Thank you JentheRN05, I really appreciated your post because it seemed like you could kind of relate. Yeah, I don't know if they should give RNs in the unit special confidentiality tx. Usually when we have patients, there are 4-5 nurses at the nurses station and we huddle and give report on all 30 pts on our side of the ER. I'm inclined to say that our unit's nurses shouldn't get special tx. On the otherhand, maybe it would be better if they just kept one or two nurses informed about us pts. If the chest pain persists, I guess I'll try to go more the medical route again. It's just embarrassing to be pursuing medical reasons when the family practice resident decided it was anxiety. (In the ED, there was no mention of anxiety....I read my own chart). I understand your concerns now that you brought up the xanax at work. I think you're right that since it's been prescribed for you, then you are allowed to take it. I haven't felt particularly anxious at work since I've been working there 1.5 months. Who knows, though, maybe it would be smoother sailing if I was on a benzo at work? Someone suggested to me that maybe what happened the other day was just a bunch of anxiety that I had hidden away coming out all at once. But I just don't know if it's a good idea for me. I don't know that it's necessary. Everyone is anxious when they first start a job. I'm very scared of making a med error, either now, or if I were on a benzo. There are other drugs for anxiety/depression (the SSRIs), but those haven't worked for me. So it has surprised me that the doctor relegated my chest pain to psychiatric anxiety and wants me to have a Pdoc put me on klonopin. thanks for telling me that your friend does have chest pain with her anxiety. It's reassuring to hear a support of the anxiety theory for the pain.
  10. calicamper

    Embarrassing Incident/Klonopin?

    I was mortified earlier this week. I work in an ED and during this story, keep in mind that I am a 25 year old healthy-looking female. I have taken lamictal for depression for 4 years and have not had problems with depression. I have been happy as a clam. I also have a prescription for ativan, which I had not taken for 4 months. When I took it, it was because I had obsessive thoughts about things my dad had said to me (he's very heavy handed) and I was up for hours at night regurgitating these thoughts in my head. The ativan helped me to sleep. Well, the other day I was at work and kind of felt odd, and I purposefully did not drink the one mountain dew that I normally drink at work. Later during the shift, I felt a little odder. When I got home, my heart was beating rather fast, but I did not take my pulse, and I fell asleep. When I woke up in the morning, I took my pulse and it was 100-110. I decided to push fluids, wondering if I might be dehydrated. I went to work. My chest started hurting that morning before I headed to work at 2 pm, when my shift starts, but I didn't tell anyone. Then, I was just standing there at work a couple hours into my shift and I could feel in the snap of a finger, that my heart had kicked up its ticking by 100 notches. Then I took my pulse and it was 145. The charge nurse was nearby and took my vitals. My blood pressure was 140/85, when it's normally 100/60 and pulse was 137 (pulse is normally 88). So charge nurse said that I needed to be admitted and get a stat ekg. So there I was admitted in my own ED where I work (can we say mortifying--esp. with a psych hx?). I told them that I take the lamictal for depression and that I have ativan, but haven't taken it for four months. They put me on the monitor, did a portable chest x-ray. Did an ekg (which looked like sinus tach, but they didn't rule out stable svt [with a foci really close to the sinus node]). They gave me 3 bags of NS, even though I had no reason to be dehydrated. They gave me an aspirin and nitro paste. Then they did blood work and found a positive d-dimer, which means you might have a PE. So then they took me for a spiral chest CT with contrast. I got quite anxious about the idea of a PE and waited to be offered ativan [felt weird asking for it....didn't want to be thought of as a psych pt by the nurses I work with]. The nurse came over and ask me nicely "how much do you usually take." I was so embarrassed because I hadn't been taking ativan for four months and had told her that previously. The CT came back negative for PE. They finally gave me metoprolol or labetol, which slowed down my heart and I left the ED after 8.5 hours with a heart rate of about 100-105. I didn't go to work the next day and my chest still kind of hurt. I went to work the next day and my chest still kind of hurt. But I was working. Well, at one point I had been standing for a while near the nurses station and suddenly my chest felt stabbing pain and I started sweating a little and put my hand on my chest. Well, the nurse nearby looked at me and sweetly said in her normal tone of voice (i.e. not a whisper) "do you have any ativan?" I said "no... IT'S not anxiety." However, I was just mortified that she'd say that at the nurses station (how could she say it out loud like that?). She told me she was sorry later and that she thought that the thing she had asked me to do immediately prior to my chest pain had made me anxious [which it had nothing to do with it]. So she said she had felt like she caused it. So...I'm thinking....she thinks I have an anxiety disorder. So I go find myself a family practice doctor the next day to see, who happens to be a resident and she does what I perceive to be a very unthorough exam. [i mean...I would at least get a follow up EKG or set of cardiac enzymes if I had a pt with chest pain]. She left for a while, probably talking with her attending and came back and said she thought it was anxiety. She said that I should probably get on klonopin. So I said, why don't you prescribe that? And she said she didn't feel comfortable prescribing it. Well, later I wondered if she was just nervous about prescribing a psych drug if the problem wasn't a psych one. She also suggested an antacid, which was probably a good idea. I've never had a problem with acid reflux before, but it's a good idea to try. It didn't help. I took 4 mylanta yesterday and it didn't help. I took two this morning while we were hiking, and it still didn't help. Today I went hiking with some friends and felt more chest pain 2/10. It was a fast paced 7 mile hike. In terms of anxiety, an example of anxiety more typical for me would have been an incident that happened last night. I was at a party and someone showed me that someone else was crumpled on the floor. My heart rate increased. I took some deep breaths. Walked over. Checked responsiveness. The woman was reponsive and there was a nurse at her side talking to her (and several other people). Once it was okay, I walked away and my heart slowed right down in 3-4 minutes. And during that whold incident, my heart did not increase near 140 beats a minute. So...my question is.....fine.....I suppose I *should* trust the doc and treat this as a psych problem. Obviously starting a job in an ER is anxiety provoking, as is being away from my family for the holidays for the first time. Given that I'm so young, it would be odd to have something else major going on with my heart. But klonopin during the day? Can people work on klonopin? The doctor said that lots of people work on klonopin. I'm not an expert, so I thought maybe some of you would have thoughts on this. If klonopin will prevent another incident of 140 bpm heart rate and quell the recent chest pain....fine....but I've never made a medication error before or done anything unfortunate, and I'm worred that taking a benzo at work might make it easier to make a mistake? As for the ativan that I hadn't touched in four months, well, I am so mortified that all the nurses know I have ativan and how they might think of me that I have been taking it to help me fall asleep at night the last two nights or else I keep thinking about the nurses' station for hours (I hadn't taken it for 4 months). As for the job. I love the job. I love working in the ED. I know I have what it takes to work there. one piece of advice someone gave me yesterday is that I absolutely must not mind-read what other nurses are thinking about me now that they know what is supposed to be confidential information about me [which was shared at report and through word of mouth all around the ED]. My supervisor was even at the nursing station when the nurse asked me if I had any ativan (mortifying, I say). Any constructive feedback would be greatly appreciated.
  11. calicamper

    Tagging HIV status in chart?

    Fergus51 I thought that last statement was interesting and also a good reminder for me. I saw someone accidentally get blood on their hand from a TB patient the other day and my first reaction was "yikes!" It didn't really seem to phase him, but if it had been me, I would have freaked out (inside) ...so thanks for reminding me that we need an open wound to get infected. (of course, he washed his hands right away) Cali "As far as starting IVs without gloves.... I know I'm going to get flamed for this, but unless you have some open wound on your hand, simply touching HIV tainted blood isn't going to infect you. If you think you have any possible open wounds on your hand you should be wearing gloves to protect the patient from you."
  12. calicamper

    Tagging HIV status in chart?

    Here's what I was thinking about when I querried about communicating HIV status to nurses. I found that another nurse agreed with me on this. What we felt was that when a patient's HIV status is first determined, the status is communicated in report between nurses. However, after about two weeks, sometimes this communication fades away until it is no longer passed along in report. Thus the status is no longer passed between nurses. At our hospital, it is sometimes very difficult to find HIV status. It may or may not be buried in the chart somewhere. Otherwise, it might be burried in the computer data. Some of the patients are here for months and it is difficult for the nurse to know if it is no longer being passed along nurse-to-nurse. There is no cardex on our unit where this information would be put. What we were thinking was that it would be helpful to have one sheet in the chart that showed all infectious diseases, like a table to be filled out, as results are found. It coud have HIV status, Hep B, Hep C, status, MRSA, etc; it could have the date of the result, for MRSA, the date of the last culture. We have some patients on the unit who still have contact isolation carts by their doors who haven't been cultured for a few weeks (maybe it should be easily available to know when they were last cultured? Cause they might not need to be on contact anymore). I understand the point of having more needlesticks with HIV patients because of nervousness. I'm not sure how to work around this. Also, it has been brought up to me that patients with infectious diseases get worse care. For example, the pt on TB isolatation gets less nursing care because the nurse does not want to go in the room. However, I think that the nurse really does have the right to know and that it might cause the nurse who does not don gloves for the IV insertion to do so. I know everyone should use universal precautions, but I still think that nurses should be given this information, or that it should be more easily available, for their safety because of some people's ignorance about always using universal precautions. Thanks to everyone who answered my post. I appreciate it. Cali
  13. calicamper

    Want to be an ICU nurse?

    ER sounds like something you might enjoy. The best way to know would be to shadow nurses on different units. Also, in nursing school, you'll get exposed to different types of nursing.
  14. calicamper

    Tagging HIV status in chart?

    Hi Everybody, I was wondering what your hospitals' protocols are for tagging HIV status in the chart or communicating HIV status to nurses at shift change. I know that we should always be using universal precautions, but I think that nurses should have a heads up if their patient is HIV positive so that we can be extra careful. At my hospital, we have bright stickers in the chart for allergies and also for MRSA and such. Some charts on my unit on the front "diagnostic list" sheet will list CD4 count or "very immunocompromised" or some other "code" indicator of possible HIV positivity. If there's a definitive notice of HIV status in the chart, it's defintely not easy to find. This is the same for other infectious diseases. Are there some hospitals where HIV status is more prominately tagged? Do you think that HIV and other infectious diseases should be more prominantly tagged as a safety measure for nurses? Thanks!
  15. calicamper

    If there was one piece of advice...

    For Dixielee especially, thanks for taking the time to write up this advice. I start working in an ED in October. Very much appreciated your suggestions, and everyone else's.
  16. calicamper

    Johns Hopkins BSN Program

    Kayleen-I was accepted to Hopkins accelerated program, Penn 2nd degree program, Univ. of Miami 12 month program, Duke, and UNC-CH (14-month BSN program). I have narrowed it down to Duke and UNC-CH and I'm leaning toward UNC-CH. PM me if you want to know what factors influenced me in making my decision. I did PM you a while ago....not sure if you know how to check your PMs? Cali