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

tokebi's Latest Activity

  1. tokebi

    Sickle Cell Disease!

    It depends on the degree of genetic defect. Normal hemoglobin is made up of four "subunit" proteins -- two alpha units and two beta units. With sickle cell gene, the beta units are defective and has wrong combination of amino acids that will result in the shape change. People with only sickle cell trait will have plenty normal hemoglobins to carry on normal life. But extreme conditions may bring about SCD. People who have inherited the trait from both parents, on the other hand, will have crises often and may have various complications like stroke, anemia, etc. The trigger for crisis is lack of oxygen; it can be from dehydration or infection, or... That's all I can think of right now... Anyways, when enough hemoglobins undergo shape change, the RBC will sickle. And when there are enough sickle-shaped RBCs, blood vessels will get occluded causing pain and they will also hemolyse easily causing anemia. This is is by no means comprehensive but I hope it helps!
  2. tokebi

    Area of nursing with greatest amount of vomit

    It's totally a parody of the other post. The title is exactly the same except "most" instead of "least." If someone has a fetish of vomit, I highly recommend oncology!
  3. tokebi

    how to study for OCN in march 2015

    Here's the amazon listing of the study guide: Study Guide for the Core Curriculum for Oncology Nursing: 9780721603599: Medicine & Health Science Books @ Amazon.com You'll also see the Core Curriculum under "related materials." Like I mentioned, however, I'd say study guide is a "must" and core curriculum as "optional." Provided of course, that you'll study from any reputable sources on the topics that you find yourself lacking while solving through the study guide questions.
  4. tokebi

    how to study for OCN in march 2015

    Hi Drcricket, I took OCN exam last year. I studied from both Core Curriculum by ONS and the study guide (with questions.) Core Curriculum is a nice book to have although I felt some information is outdated. The most helpful preparation in my opinion and several others I've talked to, is do the study guide questions, go through them twice if you can. Good luck!
  5. Hello all! I will be teaching the immune system portion of review class offered at my hospital. Immunology is my passion but... I haven't actually taken med-surg certification exam (I'm an OCN.) The content I inherited goes over HIV, SLE, RA and allergies. For those who have taken the exam, any tips on what would be helpful? What immunological disorders did you see if any?
  6. tokebi

    worth the debt? Im stuck on this decision...)

    My opinion is complete opposite. You already have a debt of $45k. You say the program will cost you additional $35k even after getting financial aid. And then you still need living costs. When you are done, you''l be left with $80k plus in debt with no job guarantee. It's impossible to work full time while pursuing ABSN. Not to mention you live in expensive city and already struggling paying your bills. Your dream will still be there after a few years, so will the schools and nursing programs and opportunity. They're not going anywhere. They will still be there after you pull yourself out of the financial mess. I think it's incredible that you have a brother who's offering you a place to stay. That'll will save you so much money already. Go there, work, reduce your debt, build up some emergency savings, bring up your credit score. And then go back to school. You already know what the smart thing to do is. But I understand how hard it is. Best of luck to you.
  7. tokebi

    Should I go to school to become a nurse or PA?

    Whether you pursue nursing or PA depends on which model of care you want to provide -- nursing model or medical model? Don't settle on one or the other because of convenience or cost or prestige. Really think about this one. With that said, if you choose nursing, your background seems quite perfect for a direct-entry Master's program. The student profile of this type of program is very similar to accelerated BSN programs which a few people have already suggested. Look into local universities that offer such programs. The advantage is that even though you will start as a brand new RN, once you obtain enough experience, you will have wider opportunities to climb up onto management or education roles without the need for further schooling. Cost is probably the biggest hurdle. If I remember correctly, I don't think you're eligible for federal aid for a second master's. I could be mistaken.
  8. tokebi

    False Facebook Health Messages

    Problem is, even the perfectly intelligent people will believe the stupidest BS when they are desperate. And hearing stuff like "eating this fruit every day will cure cancer" seems like a certain, immediate answer they crave than a physician's long lecture on cell cycles and chemo regimens and probabilities. They don't understand the language, so how could they trust medical establishments? It is partly our responsibility to be able to speak on their level of comprehension. I've seen some amazing hematologist who can explain things to people who didn't even know there were different blood cells. Then I've met some terrible physicians who barely talk to patients...
  9. tokebi

    Scrub the Hub

    This is why I suggest developing a more mature perspective. I have no intention of going tit for tat, so I'll just stop there. OP, none of us meant to make you feel worse about making that one mistake. We all make a mistake, it's true. When it comes to scrubbing the hub, however, there are ways to make it into as natural routine as not forgetting about your pants . It's very unlikely that your patient will suffer serious adverse outcome from that single incident. Nurses do sometimes omit (or shorten) scrubbing in emergencies where every second counts. There are, however, neutropenic patients, for whom you should always always keep aseptic technique when accessing their central lines. I think that about sums up this thread pretty well, minus the petty arguments...
  10. tokebi

    Scrub the Hub

    Sorry, I work BMT where patients walk the fine line between recovery and fatal sepsis daily with zero neutrophil count, where nurses absolutely have to be neurotic neat freaks so that our patients do not end up in ICU or even DEAD in the first place,... which is quite a considerable feat given that there tends to be a lot of vomitus and diarrhea around our patient population... Look, Dranger, it's obvious you take a great pride in working critical care. How about grow up a little and recognize that no specialty is superior to another, and that nurses from different specialty will have different focus? Obviously no fool will spend 15 precious seconds scrubbing the hub when pt is coding. But your cavalier attitude is something that could truly kill a patient on our floor.
  11. tokebi

    Scrub the Hub

    How funny, I was going to comment how I don't forget to swab just as I never forget to put on my pants before walking out of my house. You beat me to it with the "pants" analogy! Yes, it should be a completely ingrained part of the routine. But sometimes interruptions happen and that's when the "routine" gets broken. If I ever forgot to swab, I was probably interrupted by something and resumed the task in the middle.
  12. Do you know the reason? We are taught to draw from PICCs using vacutainers. I once had a pt who was an RN working in another state request that I draw her labs using a syringe. I wondered if she was just being paranoid or if there really was a safety issue. If vacutainer method really is sub-optimal, why is that? Is the reason serious enough to push for a policy change at my facility?
  13. 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...
  14. 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.
  15. 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
  16. 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...