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thehipcrip

thehipcrip

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thehipcrip's Latest Activity

  1. thehipcrip

    What do you think? (warning: vent ahead)

    The OP never said anything about not feeling safe. In fact, she never gave her rationale for pushing the Benedryl 30m after the Dilaudid. Are there factual reasons for giving the two meds separately [e.g. the patient snows out when the two are pushed together or she has concerns about it affecting his respiration], OP?
  2. thehipcrip

    colostomy

    Some folks are able to control evacuation using irrigation -- essentially giving themselves an enema through their stoma. One friend has had such success with irrigation that he covers his stoma with a large bandaid between the times he does his scheduled bowel care.
  3. thehipcrip

    "That nurse is vile" (long)

    If this had happened recently, this is definitely good advice. But since the OP said she's resisted posting about this for months, re-opening the matter with her manager by requesting a sit-down this long after the fact is a really bad idea. OP -- if the accusations were really that serious, you'd have been written up or worse. Listen to your peers' wise words, take a deep breath, and find a way to let it go.
  4. thehipcrip

    What is my legal and Ethical Obligation?

    The OP states that the second nurse asked the first nurse for *her* birthday, the drug and the dose, not for a patient's birthday, drug and dose. Seems clear to me that the first nurse needed a refill of a personal prescription, and asked another nurse to call it in using the name of a doctor who works that unit -- a doctor who had not been present that day to prescribe a refill. As to your obligations, I'm inclined to say there may be an ethical obligation to let the DON know of this transaction if the script that was called in was for a controlled substance *and* was a med not typically prescribed by physicians practicing in the same specialty as the doctor on the unit whose name was used.
  5. thehipcrip

    syringe to collect specimen from foley?

    Many urologists treating people with spinal cord injury consider collecting the first urine emitted immediately after a new sterile catheter is placed to be the best practice. This ensures that the only bacteria sent for C&S are those actually present [as opposed to bacteria colonized in the indwelling catheter, tubing, and/or bag].
  6. thehipcrip

    Long term foley use

    Ack! Forgot my link. The NIH funded study that recommended using the 10 percent bleach solution and found that pseudomonas thrived in bags cleaned with vinegar can be found at: http://www.ncbi.nlm.nih.gov/pubmed/8466427
  7. thehipcrip

    Long term foley use

    He should be on some anticholinergic medications to both prevent painful bladder spasms and to help prevent bladder shrinkage. Just because the ditropan didn't work doesn't mean others shouldn't be tried -- some people may need a combination of meds to prevent spasms, control leaking, etc. NEVER clean a collection bag with vinegar. Studies have shown that pseudomonas thrives in bags cleaned with vinegar. Instead, use a 10 percent bleach solution. Do two tap water rinses, swishing the water around for 15 seconds each. Then fill the bag 1/3 full with the 10 percent bleach solution and swish it around for 30 seconds. Drain and air dry without rinsing. Why is he on antibiotics full time? The presence of bacteria in his urine alone is considered colonization and should not be treated with antibiotics. Only symptomatic UTIs should be treated -- i.e. bacteria and fever, flank pain, malaise, blood in the urine, elevated white count. Run a C&S on the first urine collected immediately after a new catheter has been put in so you're certain you're treating the bacteria that's present in his bladder and not just the bacteria colonized in the old catheter. I'd really appreciate it if someone would post a link to the 'evidence-based research' advocating not changing indwelling catheters on a regular basis. ETA: Are you sure the research you're talking about didn't show that there was no benefit to changing catheters at arbitrary fixed intervals -- i.e. every four weeks -- but should instead be changed as needed based on clinical symptoms [encrustations, leakage, etc.] and tailored to an individual's needs rather than actually advocating *no* cath changes? Someone who only skimmed this article might read the bullet point about no arbitrary cath changes and interpret it incorrectly to mean no changes at all.
  8. thehipcrip

    IV antibiotics compatible with D5W ?

    I'm not a nurse and I found both the correct name of the ABX and the answer to the question! This doesn't fill me with confidence about the competency of some of the new grads entrusted with keeping me alive.
  9. thehipcrip

    Your thoughts/reasons patient is in pain or addicted or what...?

    If I discovered a nurse had unilaterally decided to 'stretch out' the time before I received pain medication that was ordered by my physician, I'd file complaints with everyone from her employer to the BON.
  10. thehipcrip

    Out, Out, Damned Spot!

    You should get in touch with the folks who cultured the 'privacy' curtains and released the study on how disgusting they are. The carpet results will make those curtains seem positively sterile by comparison. For the record, this wheelchair user has white ceramic time floors throughout her house and loves the aroma right after they're cleaned with a 10 percent bleach solution. Just sayin.
  11. thehipcrip

    What is wrong with people ?

    The way he went about it is abhorrent, but the info he suggested does make you a more attractive candidate in this tight economy. Stating on your resume that you don't smoke is very savvy advice. Employers are deeply concerned about keeping their health and disability insurance costs down. Those who smoke and drink tend to be less healthy, so in addition to being most costly to insure, they also take more sick days on average than those who don't. Not being a smoker also means you won't be taking smoke breaks during your shift. Saying you don't have children and aren't planning on having a family addresses employer's concerns that a new grad will only work for a year before starting a family -- which then means filling that position during a parental leave and that you will be less available to work overtime or come in on short notice once you have a new child. Ditto with the info about your spouse being dependent on your income. It implies you'd be more willing to work overtime and take extra shifts. Any time an employer can get hours out of an existing employee instead of having to hire a new one, that employer saves money.
  12. thehipcrip

    OK- Freaking out about TB now!

    This is more than a little overdramatic, don't you think? It might not be a comfortable existence, but I speak from experience when I tell you that thrush and yeast infections resulting from extended tx with antibiotics are hardly terminal conditions. Have a little more faith in your own strength and ability to survive hardship -- we humans are remarkable creatures when it comes to enduring the inconceivable.
  13. thehipcrip

    What ridiculous things have you seen happen in the workplace?

    One night in my local ED, a nurse started the process of emptying my bedside urine collection bag without putting on gloves or using hand sanitizer. As a FT Foley user at high risk for UTIs, I ask her to please use either the gloves or the Purell before handling my bag. Her response: "You better have some hand lotion for me because that stuff dries out my hands too much." I responded that she could simply put on some gloves if she didn't want to use the hand sanitizer, but because I was highly susceptible to infections, I insisted that anyone who emptied my bag do one or the other. I also told her that I did have some lotion in my backpack that I would be happy to let her use. She became irate! She raised her voice and went off on a rant about how I had no idea how hard washing and sanitizing her hands multiple times a day was on her skin, and what was I so worried about anyway because she was far more likely to get diseases from me than I was from her, and on and on and on. Pointing out that what I asked of her was hospital policy, as evidenced by the poster over the sink, did nothing but make her angrier. Fortunately, I was in a room directly across from the nurses' station and the charge nurse heard the commotion and came to investigate. You'd better believe I filed a formal complaint against her.
  14. thehipcrip

    why the lack of baths

    Having no one to help a patient bathe or having an inaccessible tub/shower at home may, in fact, be the reason that some patient seek help with bathing just before being discharged. There have been a number of times when I was released from a hospital stay without being able to step into the tub/shower combo I had at home. The assistance of a CNA or nurse with using the hospital's walk/roll-in bathroom right before being discharged enabled me to take one last real shower and wash my hair before heading home to bed baths and no rinse shampoo. Being able to go home with a clean body and hair was a godsend, and I've never forgotten the nurses who made that possible.
  15. I already carry a wallet card about AD, which I presented to both the nurse who checked me in and took vitals, and the triage nurse. The Medic Alert bracelet is a great idea.
  16. While my resting heart rate during triage was 25+ beats per minute slower than my very high baseline, I was still WNL and not obviously bradycardic. @NeoPediRN and Leslie -- That the nurses at my small local hospital didn't recognize the AD is one thing. But hearing from you both that anyone with a BP that high, regardless of a history of AD, should have been assessed immediately tells me there are bigger problems at hand.