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lady_jezebel's Latest Activity

  1. I also had the BS in biology first, and then returned to school for nursing. I'm glad that I chose the accelerated BSN route, for it has led to a really wonderful job in research nursing. The physicians who interviewed me were very interested in credentials (type of degree, university attended, etc...) in addition to work experience. Prior to this job, I also noticed that my first BS degree is completely irrelevant in nursing -- it's the BSN that many employers want, rather than a combo BS/associate's degree. Just my experience.
  2. lady_jezebel

    First response for severe burn??

    Wow, nerrollus -- great answer.
  3. lady_jezebel

    Nurse dates doctor openly at work.

    I really don't think it's your business. If she wants to talk about it, just tell her flat out that you think it's inappropriate & don't want to hear her jabber; but otherwise, who really cares? You're there to take care of patients & do your job, not to judge the personal lives of coworkers.
  4. lady_jezebel

    People who say they died and were brought back to life

    oooh, I wanna hear the story! I read http://www.nderf.org all the time, and am just fascinated.
  5. lady_jezebel

    Am I being a baby?????

    I love how nurses are always sabotaging one another. We talk about "compassion" and "caring", yet some nurses treat their own fellow co-workers like dirt. Sorry you're working with such a witch.
  6. lady_jezebel

    Concerns over starting work

    Many employers have a checklist of skills, and the job applicant is to self-rate her/himself for competency in each skill -- for example, starting IVs, drawing blood, assessments (which includes auscultating lungs/heart sounds), inserting foleys or NG tubes, wound care, drug calculations/administration, drain management, therapeutic communication, etc... As for auscultation, a med-surg nurse really only needs basic skills. I would know these things beforehand, for they are assumed knowledge & not really part of orientation (ie. all students do it in nursing school over here). Make sure you know where to listen for the heart sounds, but don't worry about s3/s4 sounds or locating murmurs (the regular "lub dub" heard are the s1/s2 sounds); as for lungs, just know how to distinguish "clear" sounds from diminished or coarse sounds, and what crackles sound like -- if you know these things, you'll be fine on the job; crackles can indicate fluid or other things, as can diminished lung sounds. Of course you need to be able to id wheezes too, but often the pt looks like they're in distress or they're audible without a stethoscope; in this case, a pt may need a nebulizer treatment or to deep breathe and cough. Look in a textbook for diagrams of where you place the stethoscope on the body to hear the heart or lungs. For the heart, I usually listen to the left of the sternal border or the heart's apex. You can detect artificial heart sounds (a "click") with implanted valves. For the lungs, it's often adequate to just listen to the top lobes (front/back) & bases (also front/back). It often helps to have a pt take deeper breaths through their mouth while you auscultate, to make the breath sounds louder & more distinguishable. Finally, you count the heartbeats as you're auscultating for 60 seconds & notice if the rhythm is "regular" or "irregular" (or you can palpate the arterial pulse, count for 15 seconds & multiply times 4). As for lung sounds, you can listen for only a few seconds in each field; when you count respirations, do it without auscultation for 15 seconds & multiply by 4 for the breaths/minute. You'll need to auscultate the abdomen as well, for the absence of bowel sounds can indicate an ileus (also, sometimes they're absent after any routine surgery & a pt will become nauseated & throw up if they eat before the sounds return, indicating that the GI tract is still "asleep" from anesthesia). Just use the bell of the stethoscope & hold it lightly over the abdomen, and listen to the four quadrants around the umbilicus; the sounds can be very subtle, like "tinkles" or "gurgles"; in order to determine that bowel sounds are "absent", you must listen to a full five minutes -- this is b/c the diagnosis of absent bowel sounds can indicate something very serious. If you notice the abdomen is firm & without sounds, call the doc immediately if this is an unexpected finding! By the way, what technical skills are regularly performed by UK nurses? Just wondering, for I've always dreamed of working overseas.
  7. lady_jezebel

    Is there away around the nursing school waiting list?

    You could also take just the pre-reqs & then apply to a 4-yr public college as a junior transfer, since you already have a degree. There are also accelerated programs for people with prior degrees, but you do need some recent coursework (the pre-reqs) for a new gpa calculation. Talk to the schools around you, explain your situation, and ask for a plan.
  8. lady_jezebel

    Question about restless leg syndrome

    I had this while pregnant -- it was soooo miserable. It feels like there are ants crawling inside your legs, hence the urge to move & make the feeling just go away (though it doesn't). I found a little relief with tylenol, but my personal cure was delivery of the baby.
  9. lady_jezebel

    what kind of jobs does a RN do

    Yes, this is true. We clean many, many butts, and touch far more gruesome things. However, this is only part of our job. There is a huge cognitive/professional aspect to the work we do, too.
  10. lady_jezebel

    Demoted from GN to TECH

    Because you are NOT a nurse until you have the license. Some states don't even permit GNs to work until they pass the NCLEX. It's a safety issue.
  11. lady_jezebel

    Is there away around the nursing school waiting list?

    Most universities don't have waiting lists, as opposed to community colleges. At universities, the pool of applicants is reconsidered each year -- it's a brand new competition. Most community colleges just stick anyone on the list who meets the pre-req requirements, and all the applicants have to wait their turn (sometimes for years).
  12. lady_jezebel

    "I'm in absolute state of panic" UPDATE

    What you describe is not neglect or a "grave error" at all. You have been much to hard on yourself. All patients are a potential fall risk, so sometimes we don't identify those who need special signs or conditions (ex. bed alarm). Things happen. Sometimes even when we have the signs on the door or bed alarms or whatever, people STILL fall. Even on their birthdays. I've made much more serious mistakes than that, as have most nurses I know. We learn from them & are more aware the next time, that's all. Anyway, it sounds like your floor is way too understaffed, which would make this a "systems error" rather than a nursing error. The best solution would be for the hospital to provide a sitter (someone to just watch the patient) as they do where I work, but it's a more expensive cost for the institution. What you describe is just another example of how hospitals often sacrifice safety to save a few bucks, thereby dumping unreasonable responsibility on the nursing staff. It's your administration that should carry the burden of guilt, not one poor overworked nurse. Seriously.
  13. lady_jezebel

    S/P I&D - what's this mean?

    If it's the surgical dressing, call the doc & inform her/him that the dressing is saturated. If it's not the surgical dressing, get orders to do dressing changes & wound care. It may need irrigation with saline & wet-to-moist (or w-to-d) changes bid or tid. Also, document what you see with each dressing change & notify MD if there are any signs of necrosis or new infection. Finally, you will probably administer antibiotics per MD order; monitor pt for any s/s of systemic infection, such as temperature & changes in lab values (increased wbc count).
  14. lady_jezebel

    Working as RN in Europe

    But you have 6 years experience as an RN & that doesn't count for anything??? Unbelievable.
  15. lady_jezebel

    staying awake on night-shift

    Stay busy & refrain from eating too many carbs.
  16. lady_jezebel

    Children and career?

    I had no idea there was a debate about daycare on this board. Anyway, just wanted to add that I work full-time & place my child in daycare about 18hrs a week, just to get some sleep (I work nights). He started attending daycare at age 5 months, and is now 10 months. He's a very happy kid, and enjoys arriving in daycare, has infant friends, gets lots of attention and love, and sleeps well at night after a day of play. We do pay a lot of money for this particular daycare, but it's excellent (ie. they make nutritious meals for the kids, they teach sign, it's very safe/clean, the environment is stimulating, the teachers are educated, and there is an emphasis on learning & enhancing self-esteem -- it's wonderful!).