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meds late from pharmacy
You should start the antibiotic right away. There has already been a delay in treatment and further delay could be big trouble for the patient. This is about care of the patient not convenience
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carbo/taxol/avastin order of admin
For us...inpatient unit...we always do avastin last...run it over 30-45 mins and then scoot them out the door. Let me do some research and I'll get back with you. Good luck with your "google" doc...sounds like a peach!!!
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Need positive reason for palliative radiation
I know I am late posting but I just found this thread. Just last month, we had an end stage bone mets pt with a new lesion found on her spine. The lesion was causing cord compression and she was experiencing significant pain down her rt buttock and on into her rt foot. No meds were helping. After 2 rad txs she was up walking with her little ones in the hall way... had a bit of a limp ...which resolved with 2 more treatments... but she was so much more comfortable. She was able to see her littlest graduate from kindergarten and made it for another one's birthday before she passed. In my opinion... it was worth every bit of effort for her to have those extra "good" days with her babies. I'm sure she would agree. Hope this sheds some lite on the positives of palliative xrt.
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2-day Oncology Course-where??
i'm not sure about the Baltimore area but I live in Northern VA and the INOVA hospitals offer them 2-3 times a year. Also the hospital in Winchester VA offers the class a couple times a year. I would think Hopkins would offer it as well. It is a national certification so you should be able to take it anywhere... not MD specific. If you have not obtained it yet, let me know and I'll keep an eye out for you for the INOVA classes. Your best bet would probably be at Fairfax. You could also ck out ONS and see if they have a schedule and places for the classes.
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Thinking about Ped. Onc.
I am starting to get flutterings of interest in peds onc. the downside is my hospital (which I love) does not have a peds onc unit (yet I'm hoping). But I was wondering ...what is the AOPN certification class?
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Day shift vs. Night shift in Oncology
I work nites and 12 hour shifts on ONC... (7p-7a). Sometimes it can get VERY hectic but for the most part it is pretty laid back. Very few meds are given... a few pain meds ( most have PCA's) and a few antibx. We rarely run chemo overnight unless its something like 5FU. Due to the sheer number of resources that are available during the day vs the night, our docs and our manager prefers that most chemo be given during the day. It also allows the family to be available and present when the anxiety levels are higher. We have 10 beds on our unit. 8 are in private rooms and we encourage families to stay overnight in the private rooms. They help out alot! I personally let the family member know I am there for them as well. I give them footies, coffee, heated blankets, etc. I spoil them just like I would my patients. They are so appreciative and in doing these little things, it eases their anxiety as well and their nit picking and micro controlling because everything else is out of control. You will have some folks that will become lifelong friends! Hope this helps... wanda
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Your honest opinion...
My unit is a mixture of everything med surg and last year they designated 10 beds as ONC beds. Of course we all balked at the idea and management stepped in and put only the stronger nurses on that unit. (whether we wanted to or not). New grads have to complete orientation on the med surg portion and be able to handle a full patient load (5-6 patients) before granting them a position on ONC. This has proven to be very effective. Our onc has everything the others said... the repeat patients that you just fall in love with and their families are so so supportive of you and your intentions. Sometimes it does get hard and very emotional. We hug each other alot and yes we do cry sometimes but we know we can lean on each other when we are feeling the emotions of the day. I had thought I didn't want to work this unit full time. Last week they pulled back to the surgical unit and OH MY GOD.... they are SO whiney!!!! I wanted to wheel them over to ONC and show them they needed to shut up!!! So needless to say...I'm back on ONC and I want to stay!!! I am studying for chemo certification. You might want to look at ONS.org and see what info they have as well. That might give you some additional insights. Things I didn't expect on ONC.... drug seekers, telemetry, laffter!!!! It all works out and at the end of the day... you hope you have done your very best for those that needed it the most. Good luck! I read that some were peds oncology nurses. I am considering switching from adults to peds... can anyone share some info? Wanda
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Low level or High level?
Granted my boards were 11 years ago but it was the beginning of the computerized boards... I will go to my grave believing I only did 57 questions rather than 75.... I looked up and saw "QUESTION 54" I answered 3 more and then the computer shut off.... I absolutely freaked out!!! I went to the proctor and she checked and said..."No it says you did 75 questions"...she couldn't explain the "question 54" at the top other than saying..."you must have flown thru the last 21 questions" and laffed at me. I do remember my med questions...2 were on Tylenol of all things.... the doctor orders Tylenol 650mg... you have 325mg on hand...how many tabs do you give?.....I KID YOU NOT... that was my board question!!!! The next 48 hours were total agony.... I knew if I didn't do all 75 I would have to retake and OMG>>>> not enough valium in the land for that to happen... and then the Tylenol question on top of that....I thought that maybe I had failed eveything else and the computer wanted to have at least one right answer.... any way...I passed...so don't sweat until you have results because honestly you never know... Good luck
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Make up...?
OMG... I don't wear makeup at all...I find it very uncomfortable and irritating. If my eyes are dark ...oh well...I work nite shift!!!! Blame it on the lites. I honestly don't see how your instructor or future boss could make you wear it!!! Just my 2 cents
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I have insomnia!!!
Sorry you have insomnia... I have it some days too.... have you tried Valerian Root. It smells awful but it works... settles your brain, makes you drowsy and allows you to stay asleep for a good 4-6 hours. No hangover feeling the next day. I am going thru menapause and have insomnia off and on and didn't want to try any of the meds like ambien or lunesta... my doc said to try valerian root and see what happens... I take 2 caps and poof... in about 20 mins...its sleepy time.... Now that its almost 5 am... try the new MDX ..mountain dew energy drink... sugar free, caffeine free... works like a charm!!!
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JACHO patient safety goal
We just implemented a very simple...ticket to ride form... it is basically for professional to non-professional hand offs. It has a place for the transport person to sign and contains basic info.. fall risk, dnr status, meds due, other issues...etc. Our transporters were told they could NOT transport unless they had this paper completed by the nurse. Initially it was a little hard (as usual) to get all on board but it has taken off and the simplicity is wonderful. If you need more info...let me know...
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Dont want to bankrupt husband. Please help.
Google for scholarships and grants rather than relying solely on loans. With the shortage there are tons of goodies out there...just have to jump thru some paper work hoops. You may qualify if you are a mom over 30 on some... do a little research and you will save yourself a ton. If google can't help...contact a University Book store (a University that has a nursing program)... I have seen books with info on such grants and scholarships at UVA. Good luck... wanda
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Hedis 2005...
Just reading thru the posts and find this very interesting. How did your audits go? Is it something you would like to do again? I am interested in learning this process and looking into it for the coming spring... is it something I can do while working my other job? I work full time nights at a hospital in Northern Virginia. Thanks for any info your willing to share. Wanda
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Interviewing for QI Position in Acute Care Facility...Need Advice
:balloons: :balloons: :balloons: :balloons: :balloons: :balloons: :rotfl: :rotfl: :rotfl: Congrats on being offered the opportunity to pee in a cup!!! That usually means you got the job...pee'ing in a cup doesn't come cheap when they are just interviewing... We only offered that benefit to those that we REALLY wanted. Good luck and keep us posted. I am just getting my foot in the door and learning about QA/QI and risk management. Hopefully, you can teach me a thing or two once you get your feet wet and your butt comfey in your new position!!:rotfl: Wanda
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help with the qa process
Thanks for the links and the info... went to a Quantros Conf. last week in St. Louis... learned alot and it piqued a real interest in this area for me. Now just looking at basic info trying to learn more about it.. to see if its something I'd want to give up bedside nursing for... something to think about... good luck to all. wanda