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mappers specializes in Med/Surg/Tele/Onc.

Late Bloomer RN

mappers's Latest Activity

  1. mappers

    Pregnant Oncology Nurse

    We don't let our pregnant and breastfeeding nurses hang chemo. Our clinic has triage, lab, coag, and injections as well as chemo, so they rotate through those positions.
  2. mappers

    Should I dress up?

    So she should dress in Sesame Street scrubs??? She wants a job in peds. I think she should dress professionally in slacks with a jacket or a suit.
  3. I'm suspicious of this stuff too. I an certified in Oncology. I do not deny that I learned a lot through the process of getting my certification. However, I now need to maintain all of these CEUs and, guess who will gladly sell me the courses at a pretty inflated price?? You guessed it, the same people who created the certification to begin with. Seems like a little bit of a racket to me.
  4. mappers

    Are American hospitals ready for Ebola?

    Since Ebola is not airborne, why would you need negative pressure rooms? It is spread similarly to HIV and because it is only contagious when the person is sick, you know they have it, unlike HIV? I think we the precautions we have in place, we can handle it.
  5. mappers

    Half Question/Half Pet Peeve

    Because when men do it, they are just getting ahead and showing "assertiveness".
  6. mappers

    LPN working at compounding pharmacy

    There really are no nursing actions involved in what you have described. I'm not sure there is a problem here.
  7. mappers

    Medicare and Magnet status

    Someone told me the other day that soon Medicare will no longer reimburse hospitals who are not Magnet Status. I have a hard time believing this and can't find anything to verify it. Has anyone heard of this? I teach in an ADN/LPN program. This woman who has an ADN was saying she is having a hard time finding a job because she does not have her BSN and doesn't understand why we still have ADN programs. We live in a city that has a very competitive hospital market and lots of nursing schools, with several BSN programs. I understand that in our market, hospitals are demanding BSNs and they have the luxury to be able to do that. However, that is not true for a lot of the country. Rural areas do not have a plethora of unemployed BSNs that we have. Nursing Homes and not-for-profit clinics cannot afford BSNs. I still think there is a market out their for ADN degrees. I also think the Medicare/Magnet issue she proposed can't be true for the same reason. There are lots and lots of hospitals that will never be Magnet because of where they are and who they serve. I just can't see this as being true. Has anyone else heard of this?
  8. mappers

    Charting"No s/s of infection noted" when pt comatose?

    I think what you are saying is that since a symptom is what a patient tells you, how can you write sign and symptom when the patient is comatose. I would put, "Patient non-verbal and unable to communicate needs...." or something like that. Tell you superviser, "Thank you for your input. I will take it into consideration," and move on...
  9. mappers

    Size matters? (IV question)

    For vesicents you want quick hemo-dilution and the smaller the gauge the better More blood flow around the catheter creates more hemo-dilution. Larger bores can sometimes occlude some blood flow. We give chemo through 24s. Also we do CTs through 22s unless it is PE Protocol.
  10. mappers


    This happened to a friend of mine. Recently put on a statin and began an exercise program and diet in the way of lifestyle change. Ended up in the hospital on fluids because of Rhabdo. I doubt the exercise alone would have done it.
  11. mappers

    What didnt you do in school?

    With evidence and best practices always changing, equipment being updated and new things being invented, skills are constantly being re-addressed throughout your nursing career. It's great to have skills opportunities in school, but in some places, the opportunities don't present themselves. You will have to learn how to use the latest and greatest XYZ equipment (foley, IV cath, etc) at the next hospital in-service. Learning disease process, the basics of pharmacology, good assessment skills, and most importantly, critical thinking are much more difficult to learn outside of school. A good nurse doesn't just practice a check-list of skills. A good nurse sees the whole patient and helps guide them through the healing process to help them regain the best level of function they can. Sometimes this means starting an IV, but often it means helping the patient and family understand how to incorporate new medications and new limitations into their daily lives.
  12. mappers

    Nurses Talk To Nurses. Doctors Talk To Doctors

    This is my chief complaint about my current manager, there is no support or advocacy for the nursing staff. I work in a large clinic with 12 MDs. The majority of the MDs are professional and respect what we do. However there are two who act like king and queen of the castle. A few weeks ago, King MD was the back-up doctor. They take turns in this role to be the go-to person if the patient's regular MD is not in the office. They are supposed to remain at the office until all patients are seen and we are open until 6:00. Pts can be scheduled as late as 5:30, depending on what is going on. We have an infusion area, injection area, a coag clinic, lab, and phone triage to deal with. This MD insists that we call him at 4:30 (infusion area only BTW) to let him know how late we will be. #1, how are we to know how late we will be when we still have patients to come in? Believe me, we have had train-wrecks come in for their 5:15 Coag appointments who have to be direct admitted to the hospital. #2, only the infusion center is expected to call. I guess it doesn't matter that Coag patients are scheduled until 5:30 and that phones don't go on service until 5:15 at the earliest. Even if the infusion center is done by 4:30 (sometimes, but rarely), these other areas still need an MD on site. #3, our hours haven't changed in 10 years. We are always open until 6:00. If you are back up doc, I don't understand why the expectation isn't that you stay until 6:00. The other day, no one called him at 4:30 because we were busy. He left. We only found out after someone in triage tried to find him about a call. He got paged by QUEEN MD, who also hates being back-up MD and would very likely pull the same stunt. He ends up calling my boss and yelling at her about not being called at 4:30. Does she stick up for us? No, we get a big note on the bulletin board saying to make sure to call at 4:30. I can understand calling when the last patient arrives to give an estimate of how long we will be. I can understand calling at 5:15, when the phones go on service. The other MDs will often call us when they are finishing up to see how long we think we will be. With this particular scenario, if the infusion center happened to have been done at 4:30 and called him, how would we have known that the patient was going to call us at 4:45 when phones don't go on service until 5:15? I am angered that the MD is a jerk, that he is allowed to be a jerk, and that our boss just rolls over and does what he says. It is infuriating! We are professionals, but are not treated as such in many situations.
  13. mappers

    How does chemistry apply to your RN position?

    Acid Base is great. I love Arterial Blood Gases and figuring that stuff out. You can also look up electrolytes and how they effect the electrical activity of muscles especially the heart. Chemistry was one of my favorite pre-nursing courses, next to patho-physiology. I find it very useful in my nursing practice.
  14. mappers

    Dreaming About Work

    I was dreaming one morning that pumps were beeping everywhere and I was winded running from room to room, trying to find the bleeping, beeping pump. When I woke up, a neighbor was having work done and some type of back hoe or something kept backing up, with that annoying beep those things make. Sigh!
  15. It's against the law to pay based on grades or pass rates. However, colleges are required by BONs to have a certain pass rate for the NCLEX or they will loose accreditation. I don't think the state matters though. I think you could still take it in any state and the school would still get the "credit" for it.
  16. mappers

    comfort care?

    This sounds completely wrong to me. Sounds like your facility (MD or MDS maybe) doesn't understand the theory behind comfort care. See if you can't get a trained palliative care person involved.