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AJpcvRN

AJpcvRN

Oncology
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AJpcvRN has 3+ years experience and specializes in Oncology.

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AJpcvRN's Latest Activity

  1. AJpcvRN

    Walden PhD

    Hello all, I was wondering if anyone has any experience with the Walden University PhD public health policy program. I'm only recently graduated with my FNP but I have been interested in policy for a while. There aren't a lot of nursing degrees that focus on policy, and I am just wondering if anyone knows what the progress is like or worth the cost/effort. Thanks!
  2. AJpcvRN

    Patient Thank You Gifts

    Hey guys! So I'm preggers and due at the end of the month. I have been struggling over what to bring for the L&D and Postpartum nurses when I give birth. Everyone non-nursing (doula, birth classes, etc) suggest some kind of sweet treat, but I am curious... Do you guys ever get sick of all of the cookies and chocolate? I work in medical intermediate care and we get treats fairly often and enjoy them, but we don't have every patient taking a class where they're told to bring something. Do you every just wish someone would bring in something else (and if so what!?) I don't know exactly why I'm stressing about this, but as a fellow nurse I want to do right as a patient (it'll be the first time I've ever been admitted to the hospital). I'm planning a low intervention birth... which means I may be a bit of a b*tch and I would like to at least provide something tasty people like
  3. AJpcvRN

    quick questions re abx and

    Hey all I have a couple of quick (unrelated) questions. Kind of a survey 1) Do you hang two IV antibiotics (not first doses) at the same time? Multi-lumen central line, several peripherals, compatale Y site, ect. If you do or do not what is your reasoning as to why it is or is not safe? 2) Do you hang chemo on a dedicated line or would Y-site a compatible medication? Again why our why not? This isn't for school or anything just frequent debates among co-workers. I thought it might be a couple of good EBP topics but alas I can't find ANY research done at all on either question. If you have any suggestions on where to find research please share! Thank all PS I have already done a scan on the ONS chemo book for the chemo question and didn't find anything
  4. AJpcvRN

    credential

    Hey all. I am interested in being credentialed in pain management but I am torn. Should I get the ANCC pain management cert or the AAPM clinical associate credential? I am planning on joining the American Academy of Pain Management over ASPMN because there is a clinical journal with the membership but I am unsure of their credentialing. Since the ANCC one nursing focused while the AAPM one is open to other disciplines I'm leaning that direction but would love some advice. Thanks!
  5. AJpcvRN

    Weather Policy

    We had an attending and a resident call out due to weather. I asked another resident what happened to the guy who called out and the resident looked at me all confused "we divided up his patients of course." When I clarified, "no what happened to him, personally, was he disciplined?" The resident looked at me shocked, "he couldn't get in, what was he supposed to do?" Considering a resident can get his ass handed to him for muddling through rounds after a 30hr call I found this very telling. Didn't bother to ask about the attending. I think it's clear that some hospitals have better inclement weather policies than others. I like the 'code white' policy. I know the hospital my mother worked for during the Loma Prieta earthquake (yup, she went in, worst night of my life. I was 8) was pretty good too. She and the other's who showed up got overtime and a thank you luncheon. Nothing happened to those who didn't come in. My hospital seems to be fairly unprepared, so I have two options 1) change hospitals or 2) one day work for upper management and change things. I like option two, and I hope 'well I made it to work when I was at the bedside...' will never play into my decision making.
  6. AJpcvRN

    Weather Policy

    First of all, let's compare apples to apples. A Colorado, Minnesota, Upstate NY, etc nurse cannot say to a Georgia nurse 'well I make it to work in the snow.' I drive in the snow here (Mid-Atlantic), but it scares my husband to see me go. When I remind him I've lived in Colorado, he reminds me, they have more plows, salt, ppl know how to drive in the snow, etc. He's right, I've seen more spin outs here than I even did in Colorado. There was a hundred car pile up last night in PA. The fairest thing to do is give some sort of weather/hazard differential (defined by each state and hospital's unique situation). If a nurse who wasn't schedule comes in s/he gets overtime and a differential. Those who are forced to stay and sleep at work get on-call while sleeping, and differential pay while working. Those who can't come in have to take PTO. What they shouldn't get it 'punished', dinged on their evals and such. The exception being if they take too many. Too many sick calls is brought up at evals, so inclement weather should be the same. Money is the great equalizer, and people should get credit and compensation for going above and beyond. Of course this isn't going to happen, because we won't ask for it. The culture of nursing has always been, 'lives are at stake, be compassionate, and do what has to be done.' It’s always been this way so it can never change. Instead of criticizing the hospitals (and other care centers) for not taking care of their staff we criticize each other for not being good enough. Seriously, does anyone know what firefighters, police ect do for inclement weather? Do they have the same ‘show up, end of story’ policy? Someone’s got to have a cop in their family.
  7. AJpcvRN

    Weather Policy

    I actually re-upped my membership just for this conversation... We got over a foot of snow overnight. The hospital did not provide sleeping arrangements for the night prior, but began penalizing AM shifters who called out. Of those who made it, at least half had stayed in hotel rooms at their own expense. They kept the PM shift through the day on mandatory on-call and provided sleeping arrangements. Most of the next PM shift folks (including myself) made it in, but barely. It took me 2.5hrs for my husband and I to dig out my car, and if either of us had been under the weather it wouldn't have happened. Here's what I found unfair: I don't know about ya'll, but hotel rooms are an expense. Money I have but can't just throw away. If the hospital wasn't going to supply sleeping arrangements, they can't expect the nurses to come in after a foot of snow. Not just nurses, housekeeping, PCTs, etc, they're being penalized too. If a hotel room is an expense for me, what about someone who makes half (or less!) what I make. Penalizing PM folks who couldn't come in wasn't very fair either. They kept folks over because things were bad, so penalizing someone who didn't come in isn't fair. They also can't expect people to come in a full 24hrs before their sift. 5-6, fine I'll do that, but 24... Heck no! Here's what's fair: Keep the PM shift on-call. They were given sleeping arrangements and were paid on-call pay while they weren't working. I would have expected it for myself and would have had a bag packed. That's fair, somone's got to take care of the patients and you're already (safely) here. If the AM shift had been given sleeping arrangements, I would have expected them in as well. I also got my butt into work because I could. I wouldn't have expected my 55 year old single co-work who lives in my region to have done it, but the gal who lives walking distance... Yea I would have given her hell if she called out. It's our responsibility to be honest and keep each other honest. I am wondering. How do firefighters, police, and other essential personnel handle things, what are their policies? Also, if you live somewhere where it snows, the community is prepared for snow. When I lived in Colorado I drove in the snow in my tiny hatchback all the time because they plowed the roads. Ever notice how planes that take off in Denver are grounded in DC? Same with nursing, some places ppl get in with two feet of snow, others are in chaos with three inches (ahem Atlanta...) Lastly, saying 'well what did you expect' isn't a good response. My mom was a nurse, so I've lived with this all of my life, and I thought it was unfair as a kid too. Christmas, weekends, etc that's to be expected. Making every effort to get to work, that is to be expected. Borderline exploitation, has been expected, but should it?
  8. AJpcvRN

    Antibiotic vs Blood

    Hey all Okay, so I had a situation at work theother night that I would love some feedback on. I had a very sickleuk on day 28 of HAM. He was neutropenic, and had had a fever acouple of days before. I work the PM shift, and when I came in hislabs from that morning showed a hemoglobin of 7.3 and platelets of 9.We transfuse under 8 and 10 of hgb and platelets respectively. He hadgotten platelets that day and bumped to 13, but the nurse was unableto get in the two units of ordered blood b/c of his many antibioticsand a trip to CT. He only had a single lumen mediport, generalized+1-2 edema, and was sporting a rash probably due to cefepime(on top of a clearing cytarabine rash). The AM shiftmade several attempts to get in a peripheral but was unable,phlebotomy couldn't even get a flash. So I arrive, and plan to givethe first unit after his Vanc. At 2200 the tech helps him to thebathroom and we notice the chucks under his bum is saturated withblood. He has a small tunneling wound next to his anus, an externalhemorrhoid, and horrible diarrhea r/t mucoscitis. So I bagged theVanc and got his first unit of blood up, followed by a unit ofplatelets. We even called rapid response to see if THEY could get aperipheral on him, alas, no dice. By the time the blood and platelets were in, it was too late for the Vanc, so I gave the rest of the antibiotics ontime followed by his second unit of PRBCs. The resident and charge both agreedwith my decision to hold the Vanc, but I caught a little bit of hellfor it from his nurse the next day. I'm a fairly new nurse (1+ yearsof experience), and while I'm still standing by my decision, whatwould you have done? Normally antibiotics are my first priority, and he ended up remaining hemodynamically stable.We didn't have any more incidents of large bleeds, but he could haveeasily gone the other way. I've had colleagues run in 5 or so units on a bleeding pt overnight. Has anyone ever given blood aroundantibiotics? I know we have six hours to get the blood in, but thetubing only lasts four. I've never stopped blood mid-infusion before,how do vitals work if I had tried that? We actually have this problemon a fairly regular basis, so any suggestions would be nice. Thanks PS- It dawned on me later that I couldhave asked the resident to start an IV via ultrasound, but she didn'tthink of it either. Plus our docs aren't too comfortable with theprocess. Thinking I may get trained, but I'm a pretty crappy stick...
  9. AJpcvRN

    Time Off to Vote

    I have actually been wondering about this myself. I had every intention of voting early, but then Sandy hit. Instead of being forced to work in a hurricane (for which I am grateful) I lost every day off I had to vote. I was fortunate and work nights, but I had to sacrifice sleep to stand in line for almost an hour to vote. Several of my day shift colleagues could not vote. While Maryland is not a swing state, we had a very historic ballot measure up and I know everyone wanted to vote on it. What should I and my colleagues have expected from the hospital? Are there any hospitals out there that do help their nurses and techs working 12 hour shifts vote? I'd like to know so I can make helpful suggestions to my unit. Thanks
  10. AJpcvRN

    Emory WOCN program

    Hi all. I am a new grad nurse and will be completing my first year in September. I am currently working on a Heme/Onc floor at a major university hospital, but I have always been interested in wound care. While I don't intend to quit my hospital gig anytime soon, I would like to get WOC certified and possibly look into a 2nd, part time job. Does anyone know anything about the Emory online program. I like it for the price and reputation of the school's nursing program. I'm a little concerned about finding a preceptor though. Working nights, I have no real contact with the WOC nurses at my institution. Does anyone have any insight on the program or finding a preceptor? Thanks.
  11. Hi guys! So I am planning on making some of my own scrubs, but I can't seem to find good fabric for it. I want them to be a cotton-poly blend, mostly to prevent shrinking, but also for that body fluids business :) The problem is, most of the poly blends I found at the fabric store were too light weight. I've turned online, but all of the fabric described at 'durable' is 100% cotton. I even looked at quilting fabric, but same thing, all 100% cotton. Does anyone have any links for a good store, or brand of fabric they use? Thanks much!
  12. AJpcvRN

    Chemotherapy Protocols

    Hello all, I am a new grad nurse who will be working on an Oncology floor in the fall (if I pass my NCLEX that is!). I am looking for a book with chemotherapy protocols. I will be trained for chemo by the hospital, but I thought I book would be helpful, especially since I'll have to take the ONC test next year. Unfortunately all I've found are pocket editions, which are great and all, but I like info and would like a more detailed edition. Any suggestions. Thanks! PS- If there is a previous thread on this topic, please point me in that direction. Thanks!
  13. AJpcvRN

    Johns Hopkins University BSN/MSN Fall 2011

    Hey, I am a current ABSN student (who really should be studying at the moment ) For all you guys worried about not being accepted into the MSN program yet, I don't really know what to tell you as far as timeline, BUT a lot of people I know both in my class and in past classes who were accepted to the MSN program either dropped or deferred. Getting a BSN is intense, especially for accels, but it's not a walk in the park for the trads either. It exhausting and a lot of people want a break and time to work. There is also the fact that some people don't like it here, either Hopkins or Baltimore, and want to go somewhere else. The nice part about Hopkins is your RN is not dependent on completing the masters. Basically what I'm saying is, if you've gotten into the ABSN or Trad program, relax, the first ball is rolling. It would suck to think that you've spent this whole time stressing and making decisions based on something you might not want in a year or two anyway. Good luck to ya'll.
  14. AJpcvRN

    Fraternization (non-nursing question)

    I don't know about someone in a foreign military but I know of a Navy doctor married to a civilian from a foreign country. Her security clearance went fine (they were married before her commission) and his citizenship was contingent on their marriage regardless of her military status.
  15. AJpcvRN

    ANC Nov Board & M5 ID

    Thanks friend, I can't believe ya'll are swearing in already! I guess that's what they mean by direct commission huh. Congratulations and good luck to all of you, see you in a couple of years.
  16. AJpcvRN

    ANC Nov Board & M5 ID

    That's what I understood, but she could have told me that to make me feel better. Good luck, I hope you get good news.