Tsatalstrana

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!

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?

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!

huh??

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.

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?

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..

thanks Katie....still crying...and crying....and more crying....

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...

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....

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!

EXCELLENT post! finally someone that understands that nursing is NOT just about paycheck but the WHOLE picture of healing! Thank you so much!

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!

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.

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!!

Nurses on the ortho unit! I don't have much experience with ortho but have a question. If a patient has TKA, can the patient be repositioned after the surgery? My mom just had TKA in Canada. I got a report from a family member that her coccyx looks like beginning of stage I. They are not repositioning her. Is it b/c you have to stay on your back, or it is not allowed by surgeon? If one is to be repositioned after TKA, then how do you do this with the operative knee? I know with total hip you would log roll on the non-operative side to change positions. Anyway, some input please.

thanks everyone..that helped...and i did ask one of the NP's and she basically said all the above!!

I hear ya...i would really like to...I got my RN is March from 6 years of LPN and wanted to try something new. Just got hired about 2 months ago into this Oncology clinic as a sort of "get foot in door" with hospital and it is sink or swim with it. Not very many friendly and helpful people...pharmacists and techs just don't have any time for me and they are soooo snobby. Nurses also say don't ask doctors any "stupid" questions. That is why I have to research day and night for my own answers. Please tell me it gets better in nursing? Thanks for all the great replies.

OK, makes sense, but I still don't understand the "24" hours thing. Why choose 24hours as opposed to 48 etc...Does this have to do with the chemotherapy's drug half life?

Hi, I am an new RN and just got hired into a chemotherapy clinic. First off, it is sink or swim...no orientation and not really helpful people, doctors are snobs and nurses are all STRESSED OUT. It is my foot in door job I am desperately trying to learn my job outside work time. So I need to give a drug called Neupogen, a G-CSF med. I cannot seem to find online or anywhere WHY the drug has to be given 24hours after chemo. Does anyone know the reason. I just tell my patients it has to be, but they ask why? Thanks

Hi! i need some advice regarding Nclex study books. There are soooooo many out there. Also I understand there is new setup for 2010 testing. Is there anything out there that is CURRENT for 2011? and how much should you consider doing before the actual test. I'm a little discouraged b/c i tried one question online and flunked it...is that a foretaste of the test?

Hi, I'm an LPN with one semester left in the RN program and wondering why I don't feel anything close to being an RN! I just clean patients and change their beds. The nurses I follow won't let me do hardly anything and my instructor just sits in the staff lounge and reads. I wondering why I even went back to school. I don't even want to finish my last term eventhough my grades are 4.0. Any help out there?

please give yourself one month and believe me you'll become very proficient at it. LPN for 4 years in LTC....congrats on getting a job