Nitengale326

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

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!!!

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.

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.

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?

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

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

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

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

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!!!

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...

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

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

: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

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

I have one that work made up and don't have access to email it to you... but I can lay it here for you... Room ____ Pt Name_____________ Dr____________________________________ Consulting Physicians:____________________________ Diagnosis______________________________ Allergies_______________________________ PMH__________________________________ IV Fluids__________________ Site change due date___________ CODE STATUS:_______________ NEURO: CARDIO: VS DUE________________ RESP O2___________________ GI: DIET: GU: SKIN: DRAINS:_______________ MS: ACTIVITY:_____________ TESTS: LABS: COMMENTS: MEDS: PAIN MEDS: (LAST GIVEN) THIS IS THEN LAID OUT VERTICAL AS LISTED HERE AND WE HAVE 3 PER PAGE. i HAVE USED MANY REPORT SHEETS BUT THIS ONE WORKS GREAT FOR ME. WANDA

Glascow... You are amazing . Thank you so much for taking the time to share your story with us. You and all the other HERO's are in our thoughts and prayers. Please stay safe and remember when this is all over... take care of you. This has to be so emotionally taxing (not to mention the physical aspect) and there will be post traumatic stress issues for so many ... volunteers and workers included!!! Please let us know what we can do for you... give us an addy... we'll find a way to get it to you. Relief trucks are leaving daily for that region... so you name it... we'll do what we can. Wanda

Hey Sweetie, Don't beat yourself up! Congrats on making that stand for SELF!!! Thats one thing they do not teach in school but you were able to find it and follow thru just the same. A couple of recommendations and advice... 1st... did you at any time talk with your manager about your feelings of stress and being overwhelmed. Not feeling ready to handle all of it, requesting to go back into orientation for another round. I had been a nurse for 24 years (the last 17 in long term care... loved it but tired of it and wanted a change) I came to a new area and found a hospital that was close to home... and requested a lonnng preceptorship. My manager scoffed at first and said, "Your recommedations all said you were strong... you won't need that long" I stood up and said I want at least 6 weeks if not more or I'll go elsewhere. I do not feel comfortable coming into a brand new higher acuity environment with little or no orientation. At 5 weeks, I felt my wings spreading.. It took me a few more weeks to get a good organized routine, stealing this bit from nurse A's routine, another bit from Nurse B's and just fine tuned it to meet my needs. There are days that I still do that and I've been here almost 2 years. At 6 weeks I went to my manager and told her I wanted to try it on my own for one week with the option of going back into orientation if I didn't think I could handle it. She agreed and said I could have up to 12 weeks if needed. It worked and I am so glad I took that stand. 2nd. Your med-surg experience is gonna be critical to many areas of nursing that you may venture to. Without it, your not even gonna get an interview. Think of it as a right of passage. Get about 18 mos (24 is ideal) and then they will no ammunition. It will also give you insight into other areas of the hospital that may offer your niche... PACU, ENDO, etc. 3rd. If you do go back to a hospital... go to a small non-trauma hospital. It still give you all the basics that you need for transfer later on... I work in a 140 bed community hospital... we have 7 peds beds, 25 medical, 35 surgical, 10 oncology, and 20+tele beds... I work on the surgical unit and we get mostly appy's chole's, resections, a few chest tubes... nothing really challenging ... anything big we fly it out and across town. 4th and final... (I know ...thank goodness...) Consider working nite shift. It will take a while( months maybe) to get used to it but think of it as only temporary. Your patient ratio will be higher than what you had on day shift but it is a different kind of busy. You will have time to follow up on pain meds, help settle them in, alleviate fears etc. AND form a bond with your co workers that you may not have had time to do working days. Yes, I know day shift staff form bonds but it takes a while for newbies to find her place in that group... so don't attack me!!! During all of this you may also want to take some courses in stress management. (I know you didn't get any in nursing school which should have been mandatory for all of us!!!) I hope this helps... keep you chin up and just know that even though its necessary... its temporary... and you will be the better nurse for it. Wanda

This was not so long ago... (1979) we had metal everything... bedpans, emesis basins everything... and yes we had to wash them BY HAND in a large utility sink. Clanking and banging... all night long. We had an OOOLLLDDD nurse that got peeved at us one night for laffing while cleaning the pans... she took a bedpan and threw it at us.. it hit the window, hit the floor, banged on everything, broke the window...(thank goodness it was spring time)... she got fired for disturbing the patients!!! Our unit was 31 patients and I think 29 of them complained the next morning!!! gone are those days! Also, thermometers were glass and no covers... we had 31 of each... oral and rectal and we sterilized them in alcohol 6 times a day!!! Not fun!!! and yes I have chased mercury around the floor!

Pay them no mind.. having worked in LTC for 17 years as an LPN and RN... they are so far from the truth!!! An LPN is a NURSE... I don't care how you spell it, what alphabet is behind his/her name... and they provide excellent care!!! (The caring and concientious LPNs that is... same goes for RNs). LPNs deserve to hold their heads high and be proud of the work they do!!!

I graduated from school in 1979 and never was I more proud than to have my new cap placed on my head! I have never felt it as a symbol of sexism or any other negative connotation!. I am probably one of the very very few that still wishes we could wear them. I honestly don't buy this crap about it being a source of infection... if that is the major concern, then why are so many STILL wearing artificial nails... whole other post... Sure sometimes it was a bother... getting caught up in curtains, having your head hurt from the "brain patch". BUT my patients knew who was the nurse and who was the housekeeper!!! My patient's family's also knew who to seek out for info. My cap, for me... a source of pride and fond memories!

There are many times that I wish I had gone into vet medicine rather than human medicine... but I knew I wouldn't be able to handle it... I cry at Bambi and refuse to watch Old Yeller!!! But after reading your post... I KNOW I made the right decision!!! God bless you!!!

I find it ironic that these shows aired just after nurses week/day and right in the middle of May sweeps. Are we the new targets??? Got enough on bad cops with excessive force, stealing or falsifying evidence, stealing or working the drug deals to benefit themselves. And we can't say anything negative about a fireman since 9/11 (not that I want to) or the underpaid teacher!!! Just on observation. I agree that the state of PA needs to yank the wife's license. I was wondering while watching that program how she manages her stress and anger at work and if she worked in LTC. After seeing that program, and after having worked nearly 20 years in LTC myself, I am willing to bet the majority of my vital organs that she has struck a patient at some point in time. Not to mention the verbal abuse and possible emotional abuse. If she "blanks out" when she's pissed and doesn't remember kicking him repeatedly and walking on his abdomen (and she ain't no petite thing either!!!) how could she possibly remember striking a patient. There is a dead fish in there somewhere!!!!

Kelly on MASH was one of my favorites. I'll never forget the episode when the young soldier was actively dying and hallucinating and she pretended to be his girlfriend... reminescing about a picnic at home... she called him "darling" within the next minute or so, he died. She played that part so well, after seeing it so many many times, I still cry. Also the nurse in WIT... it touched me the way she could kick back and share a popsicle, talk about DNR options and fight so deligently for her patient after she had passed!!! A true inspiration for us all!!!

I am a true arachnophobe... a few years back I stepped on a spider... not knowing she was pregnant... and not knowing that when a spider is pregnant there are like 10 gazillion little spideys in there... yep you guessed it... one dead spider and 10 gazillion baby spiders scrambling around looking for moma... needless to say... I was literally climbing the wall... I was perched on the hand rail screaming for someone to get me a chair, a table anything to help me escape....