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LouisVRN

LouisVRN RN

Med/Surg
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LouisVRN is a RN and specializes in Med/Surg.

LouisVRN's Latest Activity

  1. LouisVRN

    What was the lowest diastolic bp you have seen?

    Yeah lowest I've seen was 34/16 on a med surg unit because pt was dnr. Pt had adrenal insufficiency and was s/p fall with brain bleed she wasn't ambulatory but was A&O x3 When I was having an epidural with my first son my bp dropped from 200/110 I had PIH to 80/30 I felt horrible and promptly threw up.
  2. LouisVRN

    Where is the shortage??

    I don't believe there is a nursing shortage any longer. Except maybe in rural areas.
  3. LouisVRN

    Just let me go!

    Yeah i've definitely made my wishes to be DNR well known. I have no desire to "live" on machines and never recover just to drain my family and the healthcare system of resources.
  4. LouisVRN

    Giving meds "on time"......

    We do bedside report so i get to my patients and a quick introduction at that time, I'll also ask about pain at that time and check levels on IV pumps. It really depends on the patients i have but I will either go around and get vital signs and update whiteboards first, which is what i prefer to do. Then go around and do full assessments and med-passes together. We have an hour before and an hour after in which to pass meds and I would say I'm able to (barring pharmacy issues) administer 99.5% of my meds "on time"
  5. LouisVRN

    What have other nurses done that have freaked you out?

    Holding all of a patients meds for an hour period of time because they didn't have time
  6. LouisVRN

    Calling a Patient 'Sugar': Abuse?

    I think it can be patronizing and paternalistic but if I have a confused pt that is not cooperating with me sometimes a reassuring voice and some "i understand this hurts sweetheart but we have to do ____ because ____". can get you somewhere.
  7. LouisVRN

    Advice on Cushion Seating

    See if his facility has a wound care specialist? I know we have air cushions at the hospital and have seen pts go home with them.
  8. LouisVRN

    What should I do about the patient from hell?

    Order a home safety eval? (LOL joke pt from hell. Sorry not enough sleep) But yeah like another nurse stated try not to give any reaction. I am concerned that you are not already telling her what all her meds are anyway, even if they have them memorized its an expectation where I work to tell the pt what the med is and why they are taking it and a couple side effects. As the other posters also mentioned with a psych patient it doesn't matter if they are A&O x3 or not, they have pscyh problems. Have you tried giving her additional pain medication before doing the dressing change? Or asking her what other people do differently to make the dressing change more tolerable to her. While i understand it is hard to be empathetic when someone is being verbally abusive you shouldn't dismiss her complaints of pain.
  9. LouisVRN

    So do you really...

    For the most part I agree, however I routinely defer reproductive exams unless the patient is admitted for that reason as I feel it would often times make the patient uncomfortable but I wasn't sure if this was standard practice.
  10. LouisVRN

    Getting Sick at Work

    Never in the ER thankfully! I did have one night where I had to leave in the middle of the night because i was having intractable n/ and throwing up every 5 minutes. There have been several times when I have nearly passed out but thankfully I have been able to run to the closet to sit down.
  11. LouisVRN

    So do you really...

    I mean just more in general though - granted any assessment will be tailored to the patient. But in a non-emergent impatient situation anything that you wouldn't leave out or anything that is regularly left out?
  12. I really thought I wanted to work in L&D because i find antepartum fascinating. I ended up getting a job in med/surg and honestly no longer really have a desire to do anything else at this point.
  13. LouisVRN

    So do you really...

    do a complete head to toe assessment? What are things you ALWAYS assess? I've been told by patients that I'm the first to listen to them with a stethoscope. How do you document when you did not do a complete assessment on an area (ex. deferring a reproductive exam on an appy pt)? I have a list of always assess things - cardiac/lung/bowel sounds, radial/pedal/post tibial pulses, sensation, basic neuro status, access device, pain. Then focus on whatever the problem is and assess that. just curious on everyone's practices.
  14. LouisVRN

    Compassion required???

    IMO it all depends on the area of nursing you work and the population you work with. Working in the ICU or a SICU sounds like a great fit for you. It is more about caring for the patient than caring ABOUT them. L&D on the other hand you will probably hate your life everyday because they expect you to care ABOUT them and their families. Med/Surg I think you might have a hard time with. The majority of the medical patients we see are there because of their own actions whether its diabetes, alcoholism, etc. The surgical patients however you might enjoy, especially elective surgical patients like knees and hips as they are often highly motivated in their own recovery and want as much information and independence as possible.
  15. LouisVRN

    Pre-spiking IVF

    Yeah our policy is that once spiked IV fluids are only good for 24 hours. If you are doing a lot of boluses and have a way to ensure they are clearly marked and disposed of on schedule
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