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therapeutic phlebotomy
OH WOW...iluvivt...thanks soooo much...this gives me SOMETHING to look forward to now. Yes, I was told to go bevel up, and I inserted very slowly, tentatively. So much appreciate your help. I am going to print off your advice and keep it safely in my pocket! thanks again, and will update on my next attempt!
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therapeutic phlebotomy
Hi All, Am an RN working in very busy Cancer center. I finally attempted my first therapeutic phlebotomy. Pt had some man veins, so I thought no problem. Well, as soon as even TOUCHED the vein he just started bleeding all over the place. I couldn't see what was happening so I removed the needle. Long story short, my colleagues stated that this happens with so much back pressure and that I should've just kept pressing forward with the needle....wow...now i'm scared to try that again...was it because of the 14gauge needle or what??? any suggestions?
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blood transfusion
Hi..working in a hematology/oncology center. Just a question about blood transfusions. When Lasix is ordered between units...do you push the lasix when the first unit of blood is done and cleared with NS?....or can you push when line is clearing with NS and is a little pink?? a nurse on my floor said to push it even when there is blood in line.... Also...is what exactly is the STOP time on the transfusion? Is it when the blood is done in the bag...or when it is cleared from the line with NS? Thanks!
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IV flulids/solutions and WHY??
huh??
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IV flulids/solutions and WHY??
ok..psu__213...you have 2 pt's that are fairly stable...both post op several days. One gets D5 1/2 sodium chloride, the other gets LR. Labs both normal. Vs stable. Hemodynamically stable as well. No past medical hx. Healthy adults. Ready for discharge any when dr rounds. I wasn't asking for a rocket science answer. Textbooks ONLY provide basic nursing thinking, not real life practical applications.
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IV flulids/solutions and WHY??
I really would like someone to EXPLAIN to me, or guide to a resource. Seem to have some confusion as to why a solution is given to a patient. When I ask my preceptor(just started on a med/surg unit), she says "I don't know, different doctors prescribe different solutions, so I don't know why they did it". And that we're not about to page the Dr to ask him/her why the pt is having the solution!!! Well, aren't we suppose to know why a solution is prescribed and what it does in the body in relation to fluid shifts, electrolytes and cautions?! I tried to find answers online, but google just lists basic iso/hypo/hyper solutions with no explanations?
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Help with med/surg
Well, I am a new grad to RN, but have been an LPN for 5+ years, all of which were in LTC. I still had a tremendously hard time. It is like moving to another continent!! The PACE is way too fast for me...I will not be offended if someone tells me that this area may not be right for me. It was a miracle I did not kill anyone yesterday!! I still haven't recovered, spent all night crying and woke up crying....my poor husband...glad there is this site for some relief..
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Help with med/surg
thanks Katie....still crying...and crying....and more crying....
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Help with med/surg
So, my fourth day on the floor and I walk in and my preceptor hands me the full patient load....I thought ok, by this time I guess I should have a full patient load i guess! What a total disaster to say the least. I was sooooooo overwhelmed I had no idea where I could run to. My unit manager and educator called me into their office just to see how things were going. So I told them I was not ready to walk in here and do a full load and this was going way to fast for me. I cried all the way home (i hour drive), did not eat or drink for over 14 hours....I basically don't even THINK I can return to another shift on a med/surg floor.. I could not handle this in the least way...
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Help with med/surg
Hi All! Ok, I am new to the med/surg culture. I had 3 days orientation so far (need I say with 3 different preceptors...but I think that was just for last week). I thought it was completely overwhelming. I am already a timid person by nature. I need some advice or tools to help me to come in tomorrow and get to it with confidence. There is SO much to do and I don't even know where to start. My unit is mostly post surgical patients and I hardly recognize what their surgeries are! I know my preceptor is helpful and so is the staff, but I still struggle with the question: "is this really for me?" And I don't feel comfortable called physicians either....
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PCEA
Does anyone have any info regarding patient controlled epidural analgesia? Med/surg book gives no real details. Just started on med/surg floor with post op patients on pcea. How do I assess? Why do they get urinary retention? Any help would be great!
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Burned out from floor nursing, need advice, please..
EXCELLENT post! finally someone that understands that nursing is NOT just about paycheck but the WHOLE picture of healing! Thank you so much!
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Burned out from floor nursing, need advice, please..
excuse me...but...he says he is not able to "minister" to people. Do you have any idea what that means??? Nursing is NOT just giving meds, assessments etc...it IS ministering to them in this TIME of need!
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HELP!! NURSE BURNOUT
Working in an oncology infusion center. No prior experience. RN for only 1 year. I FEEL BURNT OUT. I hate going to work. It is soooo stressful. I was an LPN for 6 years in long term care. I just don't know anymore if I want to be a nurse in a hospital. The pace is very fast and we had a code today that was frightening. My boss micromanages me....I stink at IV's and drawing blood...but wait-- they can't even train me properly b/c they're so extremely busy...i try to start an IV but their veins are so hard to find. I'm already down so please no comments that i don't need. Any ideas would be greatly appreciated.
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skin breakdown after total knee
OK...FYI..was not asking for ANY medical advice...but just for the ortho nurses to relay how they handle TKA and mobility. Thanks for all the responses. The patient was up as listed above but just wondering if they were required to stay in same position in bed....Yes, pain is an issue!!