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dura_mater

dura_mater

Med/Surg/Tele
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dura_mater specializes in Med/Surg/Tele.

15+ yrs in retail/food mgmt......well versed in PITAs

dura_mater's Latest Activity

  1. dura_mater

    Contract Issue

    Nursedolphin, It has only been 11 days that you have been on the job, correct? I guess I am having a hard time understanding how you can have your mind so made up after such a short period of time, save there being some egregious issues. My advice to you would be to stick it out, new grads are a dime a dozen these days, and new grad positions are quite hard to come by. You may think that you will be able to find another job that is "a better fit" immediately after quiting this one, and I am afraid that you may be in for a rude awakening and a very long wait. Just think, if you stick it out for the full 15 months, not only will you be much more employable, but you will have grown as a nurse and a person, having learned how to deal with a less than ideal situation. Whatever you decide I wish you much success
  2. You know what gets me, even more than the ubiquitous "help me" thread, is the thread titled "advise please" It's advice people, you are looking for advice. So, I will advise you that even spell check will not catch all the nuances of the english language, but I don't know if you will take my advice.
  3. dura_mater

    Starting Nursing salaries by State?

    $28, Southern California, very tough market for new grads
  4. dura_mater

    Nurse to Patient Ratio

    I read posts like this, and my heart truly goes out to all who have to endure such unsafe working conditions. All I can say is protect yourself and your patients, and thank God for state mandated staffing ratios here in California!
  5. dura_mater

    Concerned...allnurses store product

    Sounds delicious even better if the sunflower seeds are salted, I absolutely love sweet & salty combos!
  6. dura_mater

    Concerned...allnurses store product

    Is it just me, or is anyone else wondering what a chocolate covered sunflower seed tastes like??
  7. dura_mater

    Some crazy/funny things that patients did.

    All of these responses remind me of a joke I once heard. It's been a while, but let me see if I can tell it correctly. ~~A student nurse goes into the hospital one morning for her first day of clinicals. She was quite nervous, and kept telling herself over and over that she would go into her pts room, introduce herself and give her pt a bed bath. She kept rehersing all of the tasks involved in her head so that she would not make any embarassing mistakes. She walks into the room, and cheerily says "hello Mr. Jones, my name is Amanda and I am here to give you a bed bath" The patient says to her "are my testicles black?" The student nurse replies "huh?" The patient again says "are my testicles black?" Now, the student nurse was in a bit of a panic. She was thinking to herself, now Mr. Jones is caucasian, so his testicles shouldn't be black, should they? What are black testicles a sign of? Does he have some sort of disease? Do I really have to look that closely at his testicles? Oh gosh, what have I gotten myself into? She mustered up all the nerve she could, and proceeded to examine Mr. Jones' testicles. After which, she proudly said "no sir, your testicles are not black" To which Mr Jones replies "oh honey, that was great, but ARE MY TEST RESULTS BACK????"
  8. dura_mater

    Some crazy/funny things that patients did.

    I had one lol a few weeks back that had been severely constipated. She had come into the ER and had had a bowel movement, and she just kept telling everybody "oh my gosh, it's a lobster, it's a lobster!!! Come look at it" I can't get that sweet little voice out of my head, nor will I ever look at lobsters the same again. I also had another sweet lol whom I was assisting to the bathroom. She wanted me to stay in there with her, now mind you this is a 3x3 room with no ventilation. This pt had been on venofer for a few days now, and she was also somewhat constipated, she managed to have a bm, and then proceeded to ask me repeatedly if I could smell the iron. What??? I had to bite my tounge from saying "oh honey, you have no idea how hard I am trying to mouth breathe right now and not smell anything!"
  9. dura_mater

    Skin breakdown or prevent infection..

    What do you think? Which one is going to kill your pt faster?
  10. dura_mater

    Please Help

    a & b are incorrectly stated because they use a medical dx in the nursing dx, and that is a big no-no. c & d seem to be correctly stated to me. hope this helps
  11. dura_mater

    UTI/Kidney

    I know that a lot of elderly pts with UTIs will often present with neurological s/s like altered mental status and such. Maybe this is where this question is going? Curious to see what others think
  12. I think you are spot on with your answer and rationale, I was taught the same as you, that unlicensed personel and gestures are not an appropriate way to obtain consent/explain procedures. I would disregard what your book says, and stick with what you have learned is correct. I know when I was studying for NCLEX I found a few errors in some of the review book answer sections. Don't fret too much over this one question, you have sound rationale behind your answer. HTH
  13. dura_mater

    Would you question this order?

    they didn't do any lfts. just yesterday, i was wondering the same thing. hindsight is always 20/20
  14. dura_mater

    Would you question this order?

    I will definitely use this case as a learning experience, and next time have the conviction to suggest the hematology consult (or whatever the pt truly needs). Thank you all for your input, being on the floor as a practicing RN, in these types of situations, just reminds me of how much I have to learn. I just want to be the best pt advocate I can. This pt in particular really touched my heart, and I am struggling with the thought that I might not have been his best advocate.
  15. dura_mater

    Would you question this order?

    The platelets were 101 on the day that the INR was 7.7 I was watching this pt very closely for s/s of bleeding, I didn't see anything. Mouth, nose, skin all looked good. Also stool for OB was negative x3. I don't think they did a head CT, there was no neuro doc on the case either. I think they were thinking that the ALOC was r/t dehydration and advanced AIDS. There was a GI doc on the case as well, but we don't have hematology at our hospital. The primary MD didn't even write an order to recheck the INR in the morning, so how would we have even known if it was increasing or decreasing. My preceptor and I at least got the GI doc to write an order to recheck the INR in the morning. I just keep kicking myself for not questioning this order further.... I did come back the next day and a different primary MD (one within the same group as the 1st) was on the case. Now the pts PT/INR was 92.3/>9.5 (apparently the lab can't even quantify an INR >9.5), and the platlets had dropped to 88. This new MD thought it was crazy that the prior one didn't want to treat the high INR, or even be notified. So she wrote orders for Vit K 10mg x 2 days, and to call for all critical labs. This whole case just left me so confused as to what/which order I should be questioning since they seemed to be completely opposite of eachother.
  16. dura_mater

    Would you question this order?

    A little background first, I am a new grad, still on orientation and the other day I had a MD write an order that just didn't seem right. I asked some of my colleagues, and they all seemed to be ok with it, but I wanted to get some more input. So I was taking care of a pt admitted for ALOC, dehydration and weakness. The pt's history was advanced AIDS, MI x2, pacer, BPH, and atrial thrombus. When this pt was admitted the INR was 6.7, he was on coumadin at home but obviously it was not to be continued while admitted. Fast forward to the next day, when I was getting report on him, his INR is now 7.7. The off going nurse and I catch the MD and bring up the high INR to him, and his response was basically: "well, I'm not going to do anything about it, because he has an atrial thrombus, so I don't want to clot him up any more". The MD proceeded to write an order that stated: Don't call unless the INR is >10 or the pt is actively bleeding Our policy is to call the MD for any critical lab values, and an INR gets to be critical way before it reaches 10. This order just seemed to be weird to me, it almost seemed like I was just waiting for him to bleed out before the MD wanted to address the situation. I would love some input from you all, as I am just in the process of learning what/when to question and/or stand up to improper orders. Thanks