Kudra

in our hospital, non-monitored patients can only recieve it sc and patients on a cardiac monitor can have it IVPB... our standard order is for 10 mg vit K and our policy is that it's given in a minimum of 25-50 mL NS and no faster than 1 mg/min...

in our hospital, you can run it as fast as you like if the patient is on a cardiac monitor... on non-monitored floors, you have to run it a lot slower (always over 1-2 hours)...

here's a site that can help you practice your calculations: http://www.accd.edu/sac/nursing/math/phtitra.htm and the adjoining tutorial sites: http://www.accd.edu/sac/nursing/math/titration.html

i use an Ultrascope... i really like it because i've found it louder than most stethoscopes i've used... i also find it easier to pick up on adventitious sounds using it... no one else in my unit has one, so i've not had a problem with it walking off...

our team consists of an ICU RN, a Respiratory Therapist and a MD...

i think the OP wasn't looking to complete a RPN course, rather challenge the RPN exam based on the fact that they were in a RN program... from what i can tell on the Georgian site, the bridge program is only for those who currently have their RPN certificate...

the place where i interned, had the same thing... the only restrictions was no visits during shift change (7:15-8:30 am/pm) and the manditory "rest period" (2-3 pm)... i quite liked it... of course, the visitation was with the understanding that if any procedure, assessment or personal care had to be done, the family would leave during that time... ETA: the open visitation policy only applied to immediate family or 1 non-family visitor accompanied by family...

man, i would love to have such a long preceptorship... ours is 3 weeks of full-time in class and 8 buddy shifts (12 hours)...

in the Calgary Health Region, you must be certified within the Region for certain skills (IVs, central lines, epidurals, trach care, chest tubes, etc)... so even if you were taught in school how to do/manage those things, you basically must attend a class and do a return demonstration to become certified... for example, you start your IV certification in your general nursing orientation to the Region... there's a skills lab where you do a return demo on a dummy arm... then you must be watched by another certified nurse or the nurse educator for your unit for your first 3 pokes... once they've signed off on you, you can start IVs on your own... things like foleys, NG tubes, etc. do not require certification on the units i've worked... i'll pm you re: a good place to start for someone who'd like to end up in Emerg...

our policy is that IV bags must be changed q 24 hours... lines q 72 hours... TPN and TPN lines q 24 hours...

our policy is cleanse with NS during dressing changes (which are q 48-72 hours + prn)...

http://www.unboundmedicine.com/mobile_merckmedicus.htm to get it for free, all you need is a nursing license number... :) ETA: apparently the Merck site is down at the moment... hopefully it'll be back up soon...

i have the free PDA version and i love it... i find it really useful to quickly look up conditions that i'm not familiar with (we get a lot of overflow surgical patients)...

i have both Davis' Drug Guide & Epocrates for my PDA... i use DDG for most of my queries, and use Epocrates when i can't find what i need in DDG... both are good, but i wouldn't pay for Epocrates...

lol, that totally seems like something that would happen down home in Newfoundland too... ah, sometimes i miss rural life...

exactly... if the pt. requires the narc early for 1 dose, i've no problem giving it 30 mins. early... but if the pt. is chronically seeking the med early, i would ask the MD to reassess the pain med and/or dosage... having said that, i once had a pt. tell me that he always asked for his meds early because it usually took the nurse at least 20 minutes to get the med to him after he asked (so if it was due at 1500h, he'd ask at 1430h so he could have it by 1500h in case the nurse couldn't get to it right away)...

For those of you who draw blood work just before giving the dose: how long does it take your lab to run the vanco level? Do you hang the med before you know your lab results? I use to go ahead and hang the med before I got the level back (usually the lab wouldn't come to draw the lab work until 5 minutes before the dose was scheduled... Then, of course, it would take a minimum of 30 minutes to get the lab work back which screws up your med schedule)... But the last time I did this, the patient ended up having a toxic level of vanco in his system... I stopped the infusion (he had gotten approx. 50 ml of a 250 ml bag), flushed the line and informed the charge nurse... The patient was fine, but obviously, I'm at fault because I hung the med without the trough level... I'll never hang vanco again without having my blood work back first...

hate to break it to you, but both orienting and orientating are correct... depending on whether or not you're using British English or American English... http://www.randomhouse.com/wotd/index.pperl?date=19960924

i also recommend Dubin's book... i had to learn how to read EKG's for a course in less than a week... the required reading text sucked (so don't get "ECGs Made Easy" by Barbara Aehlert)... but after reading "Rapid Interpretation," it was so much more understandable...

i'm really curious about this techique... approx. how must saline do you inject to make the bleb... and is it really that easy to start the IV through it?

i just wanted to say that timing has a lot to do with it too... i mean, if you happen to apply right when they're in the midst of a huge turn over, you're more likely to be considered... for the most part, though, the PCM's of ER and ICU suggest working on a floor like the one i work on or trying for a position at the less acute hospitals [PLC (Peter Lougheed) or RGH (Rockyview)]...

true, they're desperate for people, but they're not desperate for new grads... i can't tell you the number of people i've worked who graduated in Spring 2004 and now have more than a year's experience in a Trauma setting that that have been turned down for jobs there because they're still "too new"... you really have to impress the Patient Care Manager to get hired right out of school... as far as paying for people to move from other provinces, hospitals do that all the time... with EXPERIENCED nurses... if you look on the CHR recruitment page, it even says that only those with 2 years of experience qualify for a paid move... they're both hard to get into here... high demand areas... ETA: i'm not saying these things to be discouraging... i just wanted to point out that (from the experiences of my co-workers) it doesn't appear to be easy here in Calgary to get into speciality areas as a new grad...

k, i asked a new grad who just did their final placement in the Foothills emerg... they said it was really hard to get into because of the high demand and that there was only 3 students accepted at our site (it was pretty much the same thing at the 2 other hospitals)... so, the chances of out-of-province students getting a placement (unless it's during an "off" time for local students) probably isn't so good... also, you didn't say whether or not you're planning on staying out West after you're done your placement, but i know that Foothills emerg rarely hires new grads...

my gut feeling (and confirmed by my various drug guides, CPS) is DON'T GIVE IT and call your hospital pharmacy! all the literature i've seen says it's for sc use only...

the Foothills Medical Centre in Calgary is the Trauma centre for Southern Alberta (and parts of Southern B.C. as well)... i'm not sure how easy it is to get an Emerg placement, but i'll ask a few of my co-workers who graduated here to see what the possibilities are... i seem to remember hearing that most people who wanted Emerg experience ended up going to rural hospitals... as for Edmontonians being more friendly than Calgarians, i've yet to see a major difference... i definitely find these Westerners to be more friendly than Ontarians (i still miss ON, though)...