JustaMaleRN

I'd be estatic if we had continueing education requirements across the states. If that were consistent between states, then there would be better support for advancing the level of education. Especially if they allowed CEU credits to be issued by the BSN programs. It would be a give and give...sort of.

I know when I worked at LUMC in the ER, we just line and labbed everyone. Drew a rainbow off of the IV catheter and had them ready. Everyone had either a lock or a 0.9 tko. The only ones we didn't touch were the obvious walking "wounded" who were looking for a note to get out of work or had some of the "simple" complaints...STD's, Colds, hands and feet. Our docs appreciated being able to work through the patients faster. Some considered it an afront that we were not using our critical thinking and assessment skills if we didn't have this done by the time they got to see the patient.

the majority of my students have been 2nd or 3rd career students. they have all done exceptionally well. they have a maturity that does not appear in those going into nursing from high school. they are able to communicate better with the faculty, patients and staff at the hospitals. you have to remember that there are people out there who are nursing's own worse enemy. instead of finding what is right about nursing and advertising it, they become doomsayers and just point out what is wrong. they are also missing out on the opportunity to band together and fix what they perceive to be wrong. i have worked at the bedside my entire career. even as a college instructor, i continue to work at the bedside, as i know it gives me some street cred with the students. besides, there is so much change going on out there you have to keep up or fall at the wayside. nursing is a wonderful, challenging path. you can change your concentration anytime you want to develop new skills. we don't have to go through a new multi-year residency like md's do if they change. keep up with your plans. you will make it!

That's alright, I am tired of coming in to work an agency shift, and have to deal with family members who are pissed at the staff, and take it out on me. I love being a nurse, so much so, that I am continueing my education as a nurse, and also teach at the local college. I am tired of dealing with "Refrigerator" or "Vacation" Nurses, who are only there to pick up their paycheck so they can buy that new fridge or pay for the next vacation. I see these kinds of nurses both as staff and agency. Both are totally useless. First to complain about their workload, last to lend a hand when everything is hitting the fan. Ah, got to love it!

We have used demerol for rigors or if there is another contraindication for use of an alternative medication. We have 25 mg vials in Pyxis, but any larger amounts are kept in the narcotic vault in Pharmacy.

Do a quick web search...here is what I found. This organization is connected with Monster.com. They help people find educational money. Grants, Loans and Scholarships. Just fill out the questionaires, and they will give you a list of programs you are eligible for. You are also eligible for some programs as a student, depending on the income coming into your home. Pell Grants are the first ones. Talk to the financial aid office at your college. They will help guide you. Don't give up...If the desire is there, God is willing. I just don't see God holding someone back. http://www.fastweb.com/sp/welcome1

Getting a BSN is a personal choice. If you believe in evidenced based practice and current research...you would go after a BSN. WHen you consider that a ADN is about three years, you might as well just stick out that fourth year and get the BSN. Linda Aiken PhD, RN published a study that showed better survival rates for patients when cared for by a Bachelors prepared Nurse. I hear complaints about the only difference being the liberal arts portion. Lets face it, knowledge is power. The more you know, the stronger you are as an individual and as an advocate for your patient. It helps when you can relate to patients on every level. Sometimes that philosophy class does help out. The final push is this. As a Nurse, the only people you will work with who have less than a BSN is your Radiology Tech and your Respiratory Therapist. Everyone else has a BS to an MS minimum for entry level into that profession. You are then attempting to communicate on a level playing field with people who know more than you...doesn't that ADN kind of push you to the back of the group? My advise for everyone is to take advantage of the educational opportunities your employer give you. If they offer a degree completion program, DO IT! Especially if they are willing to pay for it. Get every bit of education you can out of your employer. It makes you a stronger nurse, and gives you the advantage when caring for your patients and being an advocate for your patients and profession. Just a couple of thoughts.

Its O.K. I feel the same way. I dislike self-proclaimed experts. That is one of the reasons I have followed this case. We have seen "experts" perjure themselves as they write out afidavits on this case, without seeing the pt, examining her or reviewing the chart, films or history. The issue of leaving something in writing would have simplified this whole mess, but...if this had happened 30 years ago, she would have died. We didn't have half of the techniques and treatments for dealing with this much brain damage. We have to admit we don't have the answer for everything. At the same time, we have to realize that we can not force our values on this husband or family. This is a personal decision that has been taken out of privacy of a family, and thrown across the media. To me this is the greatest issue of all. This is a private issue. TPOTUS, religious groups and congress need to see their way out of this and stop using it for their own personal ends. Lets face it, your or my opinion shouldn't mean a thing in this case. This is between Michael, Terri and God.

Interesting, I never saw even half of these problems in dealing with terminal patients in palliative care/hospice. I have been fortunate to witness some of these brave, wonderful souls pass on. They are not suffering, especially not to the point you are taking it. You are listing a reference for what? Looks like a legal case to me. I don't think it really applies here. Suggest you read up on palliative care, end-of-life care and hospice. We have thousands of people in this country die every day from dehydration.

There is a difference when it comes to family law. Our legal system is based on the fact that men are the only ones that count, and that women and children are chattel, property. As gross and disgusting as that may sound, that is what our rule of law was built upon. The biggest issue I have over this whole mess is having some Putz in Washington D.C. write/sign into law a mess that will not allow me to die with dignity. If they have three witnesses that state that Terri didn't want to live this way, then button it, and let the poor woman go to her rest. Again, think of the costs of healthcare. The $1 million is already gone to healthcare costs, legal costs, costs of guardianship. Her family has burnt through the money from the malpractice case by trying to bankrupt the husband. To those who think dying of dehydration is such a terrible death, I would reccomend you start looking at how cancer patients die while they are in hospice. Start reading up on the end of life issues. You will find that the vast majority of our cancer deaths end up in this fashion. It is very peaceful, more so than keeping the body hydrated and twarting the body's means of handling the disease and all of the associated chemical changes that come with dying.

The ironic part of this is that he won't have a red cent left over. The vast majority of the $1 million was spend on her care for the past 15 years. Come on people, we know what healthcare costs don't we?

Listening to all the issues and commentary about Terri, I have a good feeling for what the husband is going through. He has attempted to fulfill what he felt were Terri's desires. He has been twarted the entire way by her well meaning, but misguided parents. (His view) He is lashing out for his rights as her husband and now legal guardian. Her parents are ignoring the true facts of the case that they have no legal say in this matter anymore. They lost that say when Terri signed her name to the marriage certificate and the marriage ceremony was complete. Michael is mad as heck, and he is not going to take it anymore. I would feel the same way if I were trying to fulfill my wife's last wishes and had her family members come in and challenge these wishes. I would become bitter, especially if it went on for more than 14 years. It hurts to see your loved one in these kinds of situations. I have dealt for years with well intentioned but misguided parents, spouses and family members. Keep grandma on the ventilator, do everything, damn the expenses. They have no grasp of what the realities of the situation are. Terri has beat the odds. Bless her for what she has gone through, hell in this life. May she achieve the peace she desired in this life.

FOS=Full of Stool or Full of SH&%...depends if you are talking about a patient or an administrator/physician...just kidding! DHT is a Dobhoff tube. Small bore feeding tube. Clogs easy, pulls out easy and is very easy to sink into a patient's lungs. Good luck with your nursing courses! Besides, there is no such thing as a dumb question...we all are in learning mode, no matter how long we have been slinging bedpans!

Our standing orders were to add 1 amp of lido to each bag of KCl. We were fortunate to have great standing orders written by one of the more progressive cardiology groups in the Chicago area. You can check with Midwest Heart. I believe they are located out of Downers Grove, IL. I know they have shared their standing orders in the past. Their URL is: http://www.midwestheart.com/home.html Good luck!

You forgot about the ashtrays in nurses station. I remember being able to smoke in the hospital. Nurses smoking with their patients, some of them passing medications with a cigarette hanging out of their mouths. I will say that I am glad we don't give up our seats anymore to the docs. Most of these new kids havn't earned my respect to get the time of day, let alone my chair. (Sounds harsher than I meant it, but you get the gist...)

My favorite Neurosurgeon ordered that we get a 300+ lb patient out of bed and ambulate him. Mind you, he just had a crani for a tumor that returned, he had been using a wheelchair for the past two years, and didn't have the strength to walk, let alone turn himself over to assist in hygeine. God bless this Doc! Then there is the well intentioned but stupid resident who is covering. We called for palliative orders for an end stage patient. Give the resident the current medications. Mention that the patient is having poor pain control, and needs more aggressive pain control. The resident cuts the pain medications down by 1/2, but adds tylenol for breakthrough pain...I was going to strangle him, but one of the nurses held me back. The resident couldn't understand why I wanted to kill him. If you are getting 10 mg of morphine every 2 hours, and are still writhing in pain, tylenol is just not going to cut it...I don't care about a synergistic affect...just not going to do it. I was fortunate to be able to get hold of one of the oncologists, who spoke to the resident, and quickly clarified what the term palliative care was defined as, and how that works. Gotta love them, or find a hole big enough to hide the bodies!

Life in Chicago is never quiet. I have a collection on my office shelf...they came from the oral box, not the booty box. I have two pool balls. A patient came in on a Friday night, he tried to put a pool ball in his mouth on a bet. He managed to get the ball in, but his jaw muscles started to spasm, and he couldn't get it out. Start the IV, give some Morphine, a little versed, a couple of bite blocks and away we go. The other pool ball was from the following night, same place. This member of the brain trust heard about the activities of the previous night, and said that he could do it, and get it back out...no such luck. I was hoping to get a complete set. No such luck! In our booty box, we had such lovely things as bowling pins, x-rays of various sexual devices, both powered and manual, 12 inch florescent bulbs, standard light bulbs, old fashioned rolling pins...the list just grew. We used the box for our own amusement, but also as a teaching tool for the residents as they did their mandatory ER rotation. We used to kid them that the pen we just gave them was from the booty box...nothing like watching a doc throw a pen across the room and run to wash his hands for an hour! Ah...the wonderful days!

We have a right to work in a NON-HOSTILE work environment. This is why people died for Unions and LABOR LAWS. It is about time everyone stood up and said "I am not going to be abused by you!" Get a new job Bull*&^$#! Get a new boss. If he doesn't have the testicular fortitude to get rid of the dragon lady, then you have to move up to who ever is his boss. If he is the boss, then hit him where it hurts...his wallet. I am not pro-union, but I am pro-worker.

Just starting my first gig as a nursing instructor in an ADN program. I will be one of the clinical instructors for a M-S 2 course. Hoping to find my niche, and hopefully a new home!

I have to agree with you. Sometimes the exercise of critical thinking is its own reward. I have to look at things from a practical viewpoint. I have spent too much time working with surgeons and worrying about fluid/electrolyte balance and hydration that I don't worry about hyper/hypo anymore. I know what will help, and don't think about it. Just suggest it to the residents and remind surgeons as we are recovering the patients. Dave

Sounds like my favorite. Get a call that they are bringing in a respiratory distress patient. Have a Critical care room prepped, vent on standby...usual stuff for asthma season. Patient come in on a gurney, no O2, looking as perky as a daisy after a spring rain. Asked her why she was here..."I have a cold" Any problems breathing? "Only through my nose" Did a quick triage on her, and sent her to the waiting room to sit in line with everyone else. She wasn't happy. "The ambulance brought me in...I should be seen before everyone else!" BAHHH! Dave

I know in critical care we consider it hypotonic. We worry about Neuro patients getting too much of it. Brain cells can't handle too much hydration, especially when your fluid/electrolyte and compensation systems are screwed up by a head injury to begin with. Dave

Lawyers are fine, on a vent, with an NG Tube, and pavuloned. Maybe a little anxiolysis. Just Kidding! Dave

the first hospital i worked for was a nun-run catholic hospital. we were under direct instructions that male nurses were not to be placing foleys on female patients. however, we had to be signed off on them. fortunately i worked in the e.r., and we had numerous n.h. patients who were post cva and unaware of their surroundings. i got my requisite number done, and have not done any since. i have done a total of 5 female caths in 8 years. i let my female counterparts know from the start that this is not something i am expert or experienced at, and ask them for assistance. i just pick up the slack for them while they are helping me. no problems so far! dave