sheilab

hi im from england. i work as a community nurse for the last 7 years before that i worked in nursing homes hosiptals i started my nurse training in 1978 its quite frightening now to think how it has changed.

i dont know if this is the same i have a patient that is on clexane injections she has breast cancer and is having chemotherapy she developed a dvt and was put on this drug she got a rash all over her abdomen where the injections are going when we refered her to the oncologist they prescribed hydrocortosone cream and piriton tablets as she must have the clexane till she has finished the chemo. its the first rash of this kind that we have seen and hopefully it will clear up once her treatment is complete. doctors do funny things

the trouble is in england we manage alot of people at home they have carers usually visiting 3-4 times a day and also us and our twilight service which work from 6pm to 7am in the morning it usually works very well. people live in their own homes with this support and usually no relatives near by. i have a lady that has been in bed for the last 13years she is 94 she has no pressure sores eats and drinks when the girls come in. we visit to do catheter care and general problems that the carers may have we have key safes on the out side of the houses that we can gain access by and this works very well. thats why we are upset that they are going to cut our hours and our staff.

i am a community nurse and we are about to change the way we work. we will be loosing our twilight and night service and working an 8-8 shift pattern what i would like to know is 1; is anyone else out there doing a similar thing 2 if a patients catheter blocks after 8pm when we finish can they wait till the next morning or do they go to a&e 3 does anyone have any reaserch that will show how long a patient can be in a wet bed before tissue damage occurs. i need upto date info to present to our bosses before the end of jan.

i didnt know what i wanted to do when i left school my friend had gone into nursing so i thought i would follow her she did the two year enrollment and i did what was called the the state final. that was some 25years ago now and i am still doing it, with slightly more money then when i started. its the only career that you can leave have children and go back to. ive done this three times, but never going back to the place that i left. i now work in the community as a staff nurse and i enjoy it.

our rapid response team is totally different as i am in the community we have 4 nurses and health care assistant, senior social worker, occupational therapist, rehab assistant and physio our idea is to keep people in their own homes instead of going into hosiptal.

i am an old timer i qualified in 1981 i have been studying ever since in different ways. i work in the community and have to do mandatory updates for clinical practise we also do exended prescribing and advanced clinical skills, and i know i can show these new nurses what nursing is all about, i am disgusted with the amount of patients they i get out of hosiptal with pressure sores, we never had this, or bad discharges, or lack of communication. i think this is what is lacking in young nurses and basic common sense.

we have a rapid response service for this type of thing they are looked after for 3 days and a care package is set up then they are passed over to the district nursing team.

we stage all ulcers no matter where they are. they are photographed measured then treated appropriately. where is her rationale for what she said

after i finished my training i worked on a busy neurosurgical ward until i left to go on maternity leave. that was the change i needed i then went back to elderly medical for about 18mths went on maternity leave again. went back to nursing on oncology which was great stayed there for years left hosiptal and went to a nursing home for the elderly stayed there for a while then left and now work in the community as a district nurse which is great. the good thing about nursing is that there is always a job for you no matter where. if you are in a rut then it is time for a change.

it may be something to do with her carotid artery in her neck, but from your discription it may be something like an aneurysm. which is a malformation in the blood vessel usually treatable. it could also be something affecting the cerebellum which is at the back of the head this would control balance. my advise would be her to sek medical advise especially if it is not ms. she needs to have a ct scan or an angiogram which would diagnose her. hope ths helps good luck getting into nursing its a great profession

in my experience the tissue vibility nurse orders them they come in their own little vial with instructions how to use them and the main thing is to keep them watered. they are excellent for cleaning sloughy wounds that are not healing and a patient may need only one or two treatments. the good thing is they only eat dead tissue so once all the slough is removed they have done their job.

why on earth would he suggest cleaning a wound with peroxide. i could understand if it was sloughy but then only 50-50 mix you would be better off with either saline or tap water is just as good!!!!!!!!!!!!! research shows

great photos im a community nurse in england our patients have a shower before we arrive to remove the old dressing, we then lightly pack wounds with aquacel or aquacel ag, if it is deap we would use a gel like intrasite to help granulation, to protect the surrounding skin we would use something like cavilon which gives a barrier. then cover the wound with a waterproof dressing that is comto the patient. if the wound starts to look like it is over granulating then we would use a foam to flatten it. we never use gauze to pack wounds

we have just started first contact programme along with evercare and continuing care the only ones i see profiting from this will be the doctors when people ask for house calls they will be seeing a nurse instead