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I've seen them in the teens before, but nothing higher. Wow

I was wondering if anyone knew if pushing hydralazine fast has an increased risk of SVT? Here is why I ask: I received handoff on two of my four patients from one nurse. On patient #1 she reported to me that she had given the patient hydralazine 20mg IV and the patient went into SVT. She didn't say anything about patient #2. That night I of course didn't push hydralazine on patient #1 (her pressures were fine anyways), but I did on patient #2. I couldn't get his diastolic under 100 all night long, and his systolic was always around 160. I didn't have any problems with the medication other than it didn't work too well. Next day I give report back to that nurse, told her I pushed hydralazine on patient #2. She then told he had also gone into SVT when she had pushed hydralazine on him. She hadn't mentioned this the day before. So basically I was wondering if she had pushed the hydralazine fast and that had caused SVT in both patients. My other thought was that maybe she didn't dilute it. Just seems weird that both of them did it to her and I have never had that problem on any patient I have given this med to. On the other hand she could have done everything right and still had it happen. Have any of you seen this? What else could have caused it? Any ideas?

Continuity of care. There is an additional handoff every 24 hours with 8 hour shifts as compared to 12s. This is another chance for patient information to be lost, and another nurse for the patient to have to get to know and trust. With the time spent searching charts and reading documents it just makes more sense to have less handoffs.

Oh there is an IM injection, 75mg, my mistake. I assume this is what you injected? Although from what I can find it isn't used here...

It doesn't look like there is a IV dose for this med. Did you use a topical cream and inject it? Or crush a pill and inject it? Or is this a joke...

We had an aide that was sitting and would update her FB from her phone about how she had just watched 2 movies and how she couldn't believe they were paying her for it. Well I guess she forgot that she had many coworkers on her FB and word got around. Needless to say she isn't with us anymore.

So texting while driving? Don't want to end up as your patients roommate! Our unit got so bad with texting and inappropriate use of the computer that now both are banned. Sucks for the rest of us, but something needed to be done. Unfortunately it was only a few nurses that were abusing, too bad they didn't just write them up.

Water follows salt. If you have a lot of salt in your body then you will retain water, thus gaining weight, increasing edema and blood pressure, etc.

Wow that really seems to be way too much. I don't like driving a hour to work but one of the reasons I stay at my job because I am scared of situations like that. You are braver than I. Good luck to you

Same. We fill out a form and then it shows up next day for 0900 meds. I have had a Dr say he didn't want the patient to get the shot before though, but never an order to give it.

They come monitored with a nurse from our ED (or anywhere else) to our Tele. For tests we have some rules to follow to see if they wil go with a nurse or not. The most common reasons to send with a nurse are: 1. 2. Chest pain in the last 24 hours 3. Positive Trop in the the last 24 hours 4. Any GTT 5. Afib with HR > 100 6. Any fresh vascular (but they never go anywhere anyways) If they don't go with a nurse we send them on a "pack" which is a small monitor that our monitor room can see but we can't.

I think it depends on a lot of things. Like how much lantus and how much are they used to getting? What are their trends like after they get the lantus? If I have a patient with a blood sugar less than 100 I always go back and see what their blood sugars have done in the past. I would rather hold the lantus and have to treat the higher sugar later than have someone bottom out on me. But there are nurses on my unit that give the lantus no matter what and swear by it.

I graduated High school with a 2.8 and a baby. After years of working at burger king Bush took away the assisstance I was using for daycare so suddenly it was too expensive to work, I would bring home $200 every two weeks after taxes and daycare. So I went back to school and started on the prereqs. I used these to make my HS GPA invisable and eventually graduated Summa Cum Laude with my BSN. So don't worry jsut start working hard now and you will get to where you want to be

Ok so benzos are ok to have in your system, with a prescription? And narcs are not? Is this correct information?

Yes, I have a good job. It is only one of our pods that goes 3:1 and it is when we have fresh carotids (fresh is

I work on a Telemerty floor and we have 6 "pods" that are divided into 3 separate catagories. We have 2 pods for medical tele, 2 pods for post CABG, and 2 pods for chest pain/vascular/post cath. I work on the last. Normally you work on your home pods but you can be floated at any time. Once on a pod you usually stay on that pod until you have a break between your work days. So I started my week on my home pod. I was working with some nurses from my home pod as well as two that were floated from the medical tele floor. One of these nurses just kept commenting on how easy his night and how easy his week was (he was on his 5th shift on our floor) because we were 3:1 (we go 3:1 on our floor if we have fresh vascular patients, have a-lines, fresh carotids, etc) He didn't have any of these kinds of patients (thank goodness!!) because he has not had the classes for these patients. I didn't really mind the comments because being 3:1 really is great, you can spend the time you need with your patients and not worry about neglecting you other patients. Having said that, here is the problem. We have wonderful clinical managers on with us throughout the shift. One of the things they do is go around and get report on all the patients. It is a short report that includes what procedures the patient just had or will have the next day (I work nights), what gtts they are on, and if they will be discharged the next day. It also includes who has central lines, PICCs, foleys, or anything else that is high risk for infection. While listening (eavesdropping) to the nurses report who had floated and was having such an "easy night" I over heard something awful. While giving his report on a patient that had been there for quite some time, he mentioned she had an Ileostomy but no foley. The aide (our best aide I might ad, she is wonderful) piped in and said yes she does have a foley! He was like no, she doesn't, her ileostomy was just draining into a foley bag. At that I point I leaned back on my chair and looked into the patients room. From there I could see that there was a foley bag that was filled with urine. I of course said "Joe (not his real name) there is urine in that bag." Him and the manager (the aide and I watched from the door) went into the room to look. The manager pulled up her gown and you could clearly see that there was an ostomy bag on her side and that a foley in place. So this means that this nurse had had this patient for 5, count them, 5 days, and didn't know she had a foley and an ostomy. Had he even been in the room? No wonder he was having such easy shifts, he didn't even assess his patients!!!:angryfire It is so scary to think what could happen to his patients, he as been a nurse for a long time so I am sure that this is not a one time thing. For the rest of the night I kept peeking in on his patients. Thank goodness we have heart monitors that are seen in the nurses station. And thank goodness for our aide, this patient was one of his total cares and she had been doing all the work on these patients (turning, cleaning, emptying the ileostomy AND the foley, etc) How could someone, especially a nurse, be so negligant???

SOB exacerbation :yeah:

I was hired on the floor where I did my last clinicals. The nurse I did them with got me an interview. This was May 2008 before all this hit.

I wouldn't be so quick to say "of course she was way off" I work on a Tele floor and I had a patient once that was waiting for a med/surg bed. She was there for asthma exacerbation, and considered non tele so we didn't have her on the monitor. When I looked at the vitals the aide had recorded her pulse as 40. I called her over and asked what her pulse really was and looked at her paper and said 40. I ran in there, took her pulse, and it was in the 40s. She had just bought herself an extended stay on our floor and a monitor. (This also goes back to my earlier post about aide reporting abnormal vitals right away, not waiting a hour, this of course was at least a hour later)

Our hospital restricts visitors under the age of 12. They do it every flu season, this year is nothing new. Hate it when I see little kids crawling around on the floor (during the off season) and if you say something to the parents about it being dirty they give you nasty looks lol.

We lost our Baylor program as well, but those nurses just started doing threes, they didn't have to get rehired. That's crazy that you have to interview. Good luck!

did you have a mean doctor yell at you today?

If it is on your shoulder than I would think that no one could see it under scrubs. It would be just like any other job, cover it for work and your interview. I have one and it is always covered and I haven't had any problems

I'm confused, I thought you only had a CNA, LPN and new grad BSN. Where did your RN come from?

I've never seen it mixed either. I push slowly over a couple of minutes, but I have also never given more that 1.5mg at a time.