mightymitern

thank you for that. I too was called by U of P many many times. I told them I was looking at a few different colleges and had not made my decision yet. One college even called me at work one night, and was upset that I asked them not to do that and did not have time to talk. I have decided on WGU because theyy understood that when I was ready I would make the choice. I am sure my decision has been made to attend WGU. Once again thank you for the information.

Hmmmm, Diabetes is not caused by bad choices. When I was 6 and lying in bed in a coma, it was not my choice. Type 2 may be caused by (overweight, no exercise and such) but I still think " caused by bad choices" is not a good choice of wording. Ummm my blood sugar can get to 400-500 without changing a thing I've done or eaten. There are many things that can cause a high blood sugar. I take very good care of myself , been living with Diabetes for 38 yrs. Please be careful in saying your residents are lying to you, do you really know that or is it a guess? Not trying to be nasty here, I just want to give you a perspective from a Diabetic. We as Nurses treat the blod sugar, educate Pt's on diet and what not, but we are not here to judge anyone.

hey everyone, it's me again the T1 Diabetic. Definately definately do the fingerstick, especially if the Pt is on a S.S. Call the MD, it's an honest mistake. These are the ways we learn.

I LOVE that! lol

This still bothers me. Sorry, but as a Type 1 Diabetic for 38 years, and now a registered nurse, Lantus is not an insulin to hold, it has no peak, it is a basal insulin and works like a regular functioning pancreas. The rapid acting and short acting are the insulins I will hold. I also ask the Pt what they would do, if I am really nervous of a patient getting too low then I would ask the MD. Even if a person is NPO Lantus is not a held insulin, a diabetic can get into trouble very fast if it is. OK with that said check out your facilities policies and always call the MD if you are unsure.

HI FIREBALL, My first job out of school was with Hopsice. I loved it. I don't think it mattered whether I had M/S experience or not because the RN's I worked with taught me what I needed to know anyway. Well.... I left Hospice and now work on a M/S floor (my husband likes the whole union idea), and let me say... I MISS HOSPICE very much. I learned a great deal. New nurses go right inot M/S or ICU or other places without knowledge, why not Hospice. I say go for it, if that's what you feel is your place. Good luck.

wow, I am just amazed that many of you have had Tele Techs. I have never heard of this. We monitor our own tele's9 sometimes 5-6 at a time), but we have alarms that go off when something is askew. I am imagining the tech is only doing what their job entails. Good for you for calling them back to let them know your Pt is ok. A six beat run may/may not be something underlying. Are you supposed to chart each time they call? Anyway, just curious how the whole Tech thing works.

Hello Home Health Nurses, I am from Massachusetts and will give a little info on my experience before I ask my question if that is ok. I worked as a Hospice RN in an inpatient house (which I LOVED), but then got steered in the direction of a nice hospital "union" job. You know the kind where you always get your dinner break and know when you will get a yearly raise. I now work on a Tele Med/Surg floor and have learned a great deal. However I do not remember being so stressed and achy after leaving work before this particular job. Ok here is my question, I was inquiring into a home health service (preferably hospice part) which is still part of our union (belongs to the same enterprise). My husband and I are having a debate about whether home health care itself will change dramatically with the HC changes coming about. I say more people will need this service because insurance companies only allow a certain amt of days in the Hospital, then send pt's home. My husband thinks HHC will slow because insurances won't pay for the private care, and I am better off staying at the Hospital, and finding my niche. (chuckle, it's not there) I am only looking for thoughts on whether you think HHC will grow or may be in jeapardy. I feel HHC companies are needed and expanding. If this is not an appropriate topic, I apologize. Any feedback is appreciated.

Maasachusetts here. Days: 5 max mostly 4 with most of the D/C's Eves: 5 max with most of the admissions Nights: 6 sometimes 7 we are a tele floor as well charge nurse on eves may or may not have a 4-5 pt assignment, and overnight charge always has an assignment of 6. Not good if you're handling a crisis or two AND have to handle all of your own pt's. and make up the assignment for the next shift, and run ppl to xray,mri etc.

don't ever be ashamed or embarrassed to ask questions, That is how we learn. I have benn working for only 1 year on a M/S tele floor and ask questions every day, especially if I have not done a procedure. Many nurses would rather you say... " I've never done this would you be willing to come into the room with me and walk me through it". I find that line good. Don't get frustrated you will get it. I think every nurse gets a bit scared sometimes because we are the ones at the bedside, and we deal with different situations each day. Good luck you are a good nurse by admitting you're scared in the first place.

I've had pt's tell me they're allergic to water and can only drink the bottled stuff. hmmm I wonder if their bodies are made out of the bottled water as well.

yes but being a Type 1 diabetic myself, (38 yrs) you do not hold Lantus insulin. It has no peak, if a person without diabetes is sick they're pancreas still produces their basal insulin. Even of they're NPO, my Doc did this to me when I was in the Hospital and my BG went up to 953, I had to sign myslef out so I would not go into DKA. I agree with calling the MD absolutely, but I would hold a short acting or maybe even NPH, but not Lantus.

Holy cow! Thank god you noticed. As a Type 1 Diabetic I would have been down and out. Thank you for being a responsible Nurse who checks. Diabtes is a quick lecture in school.

I only have a 12 minute drive to work. Would I travel 1.5 hrs for the experience, and or money, yes BUT would I want the aggravation of traffic, delays,etc No. I also would not like the drive home if I was emotionally and/or physically exhausted after a shift. That's a tough decision, with many pros/cons to look at. Gas, wear & tear on car and yourself, summer/winter traffic and weather.

all I can say is.......AWESOME! I am too.

I have to admit I watch reruns of Gage & Desoto, and Nurse Daisy. " start a line, give d5w, and transport" No gloves, no PPE, lol. You are all wonderful, intelligent, nurses. Thanks for the letter General E. Speaking.

Why worry about other peoples reasone, sounds like you have a pretty epic story of your own. You know why you want to be a nurse, that's enough. You already hit it on the head, by saying "how" they help people. Good luck, sounds like you will be a great asset to this field.

Awesome! I worked as an EMT-B for 8 years, and when I decided to go to nursing school was scoffed at. "you can't do anything without a Dr's orders, (we can we have protocols) you'll be wiping butts all day(we don't have to). but wait, many of those medics I worked with are, guess what, nursing school. Some of them are doing an online program, they think it's that easy, that they do not have to do any cliniclas. Oh yea the money's better as a nurse that's why they are doing it, not because they think nursing is a valuable, HARD, physically, and mentally challenging career. It's all about just giving out meds, and sitting at the nurses station drinking coffee. And don't forget that ALL the nurses depicted on TV get a lunch AND dinner break. HHMMM, wonder where they get the idea from. there is a huge difference between the two professions, not one is better than the other. Both nurses and medics are in it (hopefully) to help the Pt's they care for. I know , I did it, w/ some great medics. Sorry don't mean to gripe but I am griping, just tired of all the medics thinking it's easy as pie, anyone can do it. Boy there are days after my shift that I long to be back on the streets in an ambulance where it was "easier". No disrespect to any EMT-B's or P's out there just please stop telling us.... pppffffft nursing I could do that with my eyes closed. OK so come to work w/ me and do my whole shift without me telling you this: 6 patients, 5 on tele, 1) s/p MI w/ new pacer, 2) etoh,pancreatitis, severe pain, demanding more pain med & food, is NPO. 3) from group home (doesn't communicate) picc, trache, suprapubic, bowel regimen, pulls out tubes, g tube w/ hourly meds, and tpn and bolus which can only go through the J-tube because G-tube is not functioning, so all meds need to be crushed into fine powder and dissolved and put through J slowly. 4) admission, w/ dementia, UTI, high fall risk, screaming profanities (doesn't realize he is doing this), keeps climbing out of bed,needs posey, no extra staff for 1:1, oh and his Na is 118. 5) GI bleed w/ HcT of 22 getting 2 units blood, and drinking go-lytely for colonoscopy in am, (commode q 10 mins or incontinent, feeling SOB, and dizzy, tachy. 6) CMO Pt w/ all of family, call bell q5 mins because he/she is having perieds of apnea, end of life teaching was not done. How come we don't see this on TV LOL, because nobody would watch. just a couple more things, charting, looking up labs, restart IV, get meds out on time, call MD w/ results, admit assessment, dsg changes, oh and BTW you cannot keep your coffee at the nurses station, JACHO rules. Just use your nursing judgment, who needs you first, etc. it's so easy just close your eyes and do it. ANd yes I, we (nurses) are highly college educated, skilled, professionals. :nurse: OK they're all yours have a great shift, and don't forget to smile.

WOW what a great thread! I am considering HH and am happy to see how the days go. I work in a Hospt. med/surg tele floor, but since starting have never felt so stressed, and have been sick more than I ever have been in my whole life. Are any of the HH agencies unionized, or are they pretty much private? Thanks for all this info it has been a pleasure reading.

Great question, this in fact is why I am reading this specialty. I work 32hrs in a hospt. Tele/med/surg, and am seriously thinking about doing some per diem HH. Also thinking about dropping to 24 hrs. I think staying at the hospt for pt or per diem is good to keep the experience up. Thanks

Tough question, However, being a T1 diabetic myself, I would have called the MD. I was in the hospt for a partial hysterectomy and my PCP held all my insulin because I was NPO, well I finally had to go AMA because my blood sugar went up to 900, and she still wouldn't let me have insulin. I believe a diabetic knows their own body and own diabetes. If you r Pt takes more at home than prescribed in the hospt, then ask them as well. The high blood sugar probably added to his/her not feeling well. For a BS of 309 I would call MD especially if they did not put a hold on novolog. You were thinking the right way, don't forget (your license) She does not have the power to think for you. Next time say s omething like " I don't feel comfortable, with that decision, and am going to notify the MD" you will not get in any trouble for protecting your Pt's, yourself, and your license.

Thanks to everyone who replied. I did not realize there had been numerous discussions about this subject. I was just curious as to tohers opinions on this subject. Thank you to you all.

AHHH the NICU, a career I have wanted for as long as my 2 children have been alive. Thanks to the NICU nurses. 17 & 19 years ago. We did not have the experience to be in a NICU as students because we do not have a NICU close enough. I did, however spend 2 weeks in one when my first son was born and saw just what the nurses did. I now work on a med/surg floor w/ adults, but dream of working w/ children, neonates. Yes it is scary, but I think any new position is. How fortunate these babies and families, and students are to have nurses like you. I give you, NICU nurses my utmost respect and thanks for what you do.

Does anyone else think it is a bad idea to have your last name on a badge? I worked at a place where we had an extremely abusive spouse who cornered most of the staff, and could only visit w/ a police escort. We did not have our last names on our badges @ this particular facility, thankful because this person used to say "if I find out where you live"..... Anyway the place I work now uses first and last names, I do not agree w/ this, since many times a pt will say something like "oh you're a ( last name) did you grow up in (town) or (last name) hey baby are you in the phone book? it's scary sometimes that people know my entire name. Any thoughts on this?

OK so what happens if you had put the patch on, or in this case the Charge nurse had, and the pt had a reaction, or the Doc said no i am not writing an order for that because....., guess who gets in trouble. Not the Pt, the nurse who gave the med before the order came in. I agree 100% with everyone else no meds before orders! period. It was not an emergent med, the pt was not in critical condition. Bravo to you for doing your job right.