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tokebi

tokebi

Hem/Onc/BMT
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tokebi has 11 years experience and specializes in Hem/Onc/BMT.

tokebi's Latest Activity

  1. tokebi

    drug computation.. help!

    If you're certain you copied it correctly, then the only explanation is that you've got a crappy book full of typos. For the first question, maybe option D is supposed to be 4/3 tabs instead of 3/4. 1.3 is approximately one and a third (=4/3). For the second question, maybe option A is supposed to be 0.3 instead of 3? Whoever wrote those questions, they really need a proof reader...
  2. tokebi

    Are 24-Hour Open Visitation Policies a Bad Idea? (Yes)

    In our hem/onc floor, many long-term stay transplant patients have a family member or a friend camp out 24/7 at the bedside. It does get cramped in the already small room, and I do get tired of the obstacle course nursing, and yes family members can be demanding and over-protective. In spite of all that, I see the benefits everyday. My patients ambulate more when their family member is there to encourage them. They bring foods that are more palatable, and patiently help with feeding. Their mere presence is the cure for depression and boredom that are so common in lengthy hospital stay. They provide the level of care that I wish I could but cannot.
  3. tokebi

    Evolution and Nursing

    At the risk of stirring the pot even further, this news came out just in time for this discussion: Poll: Religion Trumps Belief in Big Bang Theory for Most Americans - NBC News
  4. tokebi

    Floor nursing making me question....

    I know what you mean. But I really hope you try different specialty before denouncing floor nursing altogether. I started as an LVN working tele floor and SNF. At some point I swore I've had it enough and decided to leave nursing. Years later... I am an RN working on a hem/onc floor and absolutely in love with this floor nursing job. I like having the knowledge to understand the complex medical condition my patients have and their progress. It gives me a great satisfaction knowing that my nursing role -- observing patients, quick action when their condition changes, my support -- is crucial in their positive outcome and successful treatment. What I do now is far far from a low-level service job, a pill-pusher, glorified maid... which I know too well from my previous jobs...
  5. I understand why you end up automatically apologizing. You feel terrible for having to ask other nurses, and you feel like you need to say something to alleviate the uneasiness and tension. How about expressing your gratitude instead of apologizing? If I were the nurse showing you something, I would feel pretty good hearing a thank-you rather than an annoyingly profuse apology. And please, stop worrying so much about what other nurses think of you. You're absolutely doing the right thing by asking for help when you don't know something. Everyday, you are learning more and more. Gradually you will be asking for help less and less. You are constantly progressing whatever you may think. Focus on learning and give yourself a pat on the shoulder whenever you learn something new, instead of worrying about inconveniencing your colleagues.
  6. tokebi

    Long term effects of chemo on children?

    First thing that came to my mind was that childhood cancer survivors are at a greater risk of developing secondary leukemia or lymphoma in their adulthood. I work in adult oncology and the memory problem is common after chemo (aka "chemo brain") which does go on for years. I didn't know that kids experience the same thing.
  7. tokebi

    Brain sheet for new grad on heme/onc/BMT

    BMT-specific brain sheet should include: - Type of the transplant: auto, allo, cord?, and the day. For example, "Allo (matched unrelated donor) Day +6" - Conditioning regimen - Immunosuppressants the patient is currently on - GVHD if any - Date of the last full fever work-up - Labs (CBC, BMP, Mg, Phos, coags) Just add the above to your usual med-surg sheet and that should be good. Then, personalize it further as you go along.
  8. tokebi

    Awkward and Shy Student Nurse

    I wholeheartedly agree. The turning point for me was a forced group-living (=military). Talking to people became so much easier after that experience. It really is easier to talk to people in a controlled setting where you must talk, but with a certain script, as in a customer service job, than talking to people in a voluntary setting like a classroom. It will help provide a practicing ground as well as build more confidence.
  9. tokebi

    Awkward and Shy Student Nurse

    Wrong. Please think twice before posting such definitive claim to someone you don't even know. She may desperately need to develop social skills but that has nothing to do with whether or not she is suited for being a nurse. ^This. I couldn't have said it better. I had typed a long post and deleted it after seeing your post. This was exactly what I wanted to say. Impression matters a lot. Having a gentle smile on your face and greeting people, that simple gesture will change people's perception of you tremendously. In order to project a genuine, inviting smile, however, you need the self-assurance and inner happiness. It's hard to do all by yourself. Seek out help. Reach out to people you feel comfortable with. But most of all, seek out professional help.
  10. Let me make a quick correction. K+ is not acidic. Remember, acidity is a measure of the amount of protons (H+) dissociated in an aqueous solution. No H+ in K+, or KCl, which is the form in which oral K replacement comes in. It just tastes awful, that's all. Back to original question, I was taught no red color because if patient vomits, it can look like hematemesis. I don't know about orange though. I think it's an overkill. KCl is orange (never seen clear one yet.) I wouldn't worry about it. I think the benefit of electrolyte replacement far outweighs the remote risk.
  11. tokebi

    RN's & Nursing Students

    This is an issue that any nursing student can relate too, I'm sure. I've experienced it as a student, too. I'm also guilty of not having been most helpful to students on my floor. In my opinion, what you have to do is, taking charge of your own clinical education, not your nurse. What do I mean by this? At one clinical site, the nurse I was paired with was very busy and had little time or patience for me. From the start, she bluntly asked, "What's your goal?" "Umm... excuse me?" Rolling her eyes, she spat out her words, impatiently. "You're a student. Don't you have a goal for today?" By that point, what little confidence I had had completely evaporated by her strong personality and I was a bumbling idiot all day. However, that nurse made me think really hard about my attitude and I realized something. I thought I was being receptive by letting the nurses guide me however they saw fit. I had been telling them, "I"d appreciate if you can show me whatever you can. Thank you." However, nurses aren't trained to be instructors as PPs pointed out, and there is no time to formulate any teaching plan when you're suddenly paired with students unexpectedly. If I tell them to "teach me whatever they can," it is exasperating. Once I started telling nurses specifically what I wanted to focus on, the relationship got easier. By telling them what you need in specific terms, you spare them from having to think of what to do with you. So, try something like this: "Hi, my name is QueenAnnissa. This is my second semester and I have learned blah blah so far, and comfortable doing blah blah. For today, I would like to work on my assessment skills. Can I go in with you during your assessment, and maybe you can observe me and see how I'm doing?" Some nurses will still give you hard time no matter how you approach them. But, at least by being assertive and proactive, you will learn something instead of being at mercy of others.
  12. tokebi

    Abuse Culture in Nursing...How Far Does it Go?

    It is obvious, HoneyBeGood, that you're disillusioned and angry. I empathize with you and I really hope you will find a better place soon. It wasn't that long ago that I wrote a long rant venting out similar frustrations against a particular LTC environment I was working in at the time. There are better places. You just have to find them. Many points were brought up and discussed already, but let me just say this one thing. There are idealized notions that outsiders have in any profession, and disillusionment is part of growing up in your chosen field. For example, I always had this romantic idea of academia -- pursuit of knowledge, teaching young, bright scholars in research institutions... But reality is, any academic department is fraught with politics just like any other. Why would it be any different for nursing? Outsiders may have the idea of a nurse with an angelic smile holding their hands. We know better. Whether you become successful in this field now that you're in it depends on freeing yourself from the despair that comes with disillusionment and strive forward. So your idealized notion of a nurse is shattered by the harrowing med-surg experience. You can now either find some other aspects of the job that is rewarding to you, or look for a different environment where you can live closer to your ideal.
  13. tokebi

    Has anyone taken care of a celeb?

    Had a similar experience. I had a prejudiced ideas about this particular celeb based on her public image, and inwardly groaned when I was assigned to her. Shortly into the shift, however, I was pleasantly surprised how sweet and polite she actually was! It's good to know that not all people develop super-sized ego just because they're famous.
  14. tokebi

    Broken RN

    Totally agree with other posters above. You need to get out of there. If your description is accurate, I am appalled beyond words. I've worked in LTC facilities as LVN and have encountered some CNA's who would only do the absolute minimum but none of those places would tolerate the kind of behaviors you describe. This is beyond working relationship problem. This is endangerment of the residents. This place should be reported.
  15. By the way, my husband was looking over my shoulder to see what I was reading so engrossed. After skimming over the thread, he shook his head and said, "You nurses are too nice..."
  16. You know what, Emily? Me neither. I am terrible at comprehending what I hear. But I do just fine academically. Wanna know what I do? I read the book ahead. We keep telling you, all the knowledge you need is in the book! And make outline with key words. During lecture, I fill in the details. Voila! My own Powerpoint, my own study guide.
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