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I was a cartographer, meaning that I used to draw street maps for a living.

I worked at a camp with 72 thirteen-year-olds last year. They kept me very busy. Many girls got their periods for the first time at camp. Since most of the children were undergoing growth spurts they weren't very used to their bodies and they seemed to get injured a lot more than children in other age groups. Between all of these problem and other miscellaneous problems, the health center was usually pretty busy. My advice would be to work with a smaller amount of campers if possible, or maybe even ask for an assistant.

I once took care of a pt on a medicine unit who was there for three days because nobody could figure out whether she had cellulitis or gout and they weren't letting her go until they knew. I suspect that the two dxes are frequently mixed up.

I also wonder what would move an employer to think that it is reasonable to be so controlling of staff. Please, do tell us what led up to all of these changes. Is finding work elsewhere an option?

The University of New Brunswick has an advanced standing program that will let you get your degree in two and a half years (but it ends up being three once you do the prerequisites)

We do have oxygen at our camp. We were able to rent a portable tank from a local medical supply company for something like $20 or $30 a month. And no, the benadryl isn't IV, it's PO. As for who writes our standing orders, I really don't know, to tell the truth. My camp director handed them to me to get signed by the camp pediatrician, and I'm not entirely sure that our director would know the source either. (I am not at camp anymore, otherwise I would just ask). Every year our camp doctor gives us his signature approving the orders, but if we ever had to have any serious ammendments like the DOH is asking you to make, I'm not sure where I would turn. Is there anybody out there who knows how one would go about making a major ammendment to camp standing orders? If the camp that bonemarrowRN worked at this year came under scrutiny then it probably won't be long until the Massachusetts DOH starts asking for the same type of changes in our standing orders.

I work in a camp in Massachusetts. Our standing orders say the following about anaphylaxis: Anaphylactic shock reaction to bee sting insect bite/food / latex If any of the following conditions apply, administer epinepherine, oxygen, benadryl, call 911 and notify child's parents: Tachynpnea, tachycardia, cyanosis, poor air movement, air hunger, anaphylactic symptoms such as hives, selling of mouth or eyelids, throat itching, shortness of breath, wheezing. Benadryl dose: 25 to 40 lbs give 12.5 mg 40 to 90 lbs give 25 mg 60 to 90 lbs give 37.5 mg >90 lbs give 50 mgs Epinephrine dose (1:1000 aqueous, subcutaneously) 0.1 cc if under 60 lbs 0.2 cc if 60 to 100 lbs 0.3 cc if over 100 lbs Hope this helps :)

I think it would be important not to have preconceptions about people with mental illness and to view those who are afflicted as no less human than anyone else.

I also applied as a mature student after having gotten a college diploma. My OAC average was 85% and my college average was somewhere in the upper 70's. I'm in 3rd year now. One more year to go.

Well said, smkoepke

I am a third year student in New Brunswick, Canada, but have done a clinical rotation in Toronto. In both places I have removed JP drains, hemovacs, etc. The first few times I would do it in front of the instructor, but after demonstrating competency, I was expected to do it on my own.

:rotfl: :rotfl: :rotfl:

I think the vials should be re-designed, not the needles.

If I were an employer judging the situation, I don't think that I would hold it against you. Especially since you were in one position for three years just previous to this one. And I would also appreciate the fact that you were being honest.

That's horrifying!

I think it's really hard to watch people make decisions that we feel are bad. It's also hard not to blame ourselves when the obvious consequences of these bad decisions come to be reality... even though we know and understand that others have the right to autonomy, we still think that maybe we weren't clear enough, or we must have done something wrong... In my personal experience in living, I've seen that the decisions that people make always reflect what they believe to be right at the time. So in some way or some form, your patient thinks that she is doing the right thing for her. I can't get into her head, but I agree that her behavior might be an expression of control over a life that has gone completely out of control. But I wouldn't assume that. I wouldn't assume anything without finding out from her directly what her reality is. It may help to change your entire goal from gaining patient compliance to understanding your patient's reality. In a practical sense, this may be difficult because she has already labelled hospital staff as the enemy. But you can still try. Perhaps you can say something like, "I can understand why you're so frustrated, you probably think we're trying to control you and you don't like that." She can either affirm, deny or say nothing. If she does say something, I would lay off trying to convince her as to why she is wrong. Just give her an open ear. Portray to her that you are interested in listening to her and that you have respect for her and her opinion. In this way you may be able to develop trust, and once you have trust, then you can mutually explore other options than her current behavior. Hope this helps.

I used to feel the same way you did. Without even knowing it I started to pick up the terminology. It happens unconsciously.

As a teenager, I used to be a volunteer in LTC at the hospital in my neigborhood. I asked the nurses if I could take one of the full care patients outside for a stroll in her wheelchair. They said yes, I put her in her wheelchair and away we went. So we were outside and as we are strolling along I notice the patient sinking in her wheelchair - rapidly. (She had no control over her body) I realized that I had forgotten to put the seatbelt on her before we left, but it was too late. I put the breaks on the wheel chair (thank goodness I remembered that much) and whipped around to grab on to her legs and try to push her up. By this time her bum was no longer in the chair. I had stopped her from slipping, but I didn't have the strength to get her back in her chair (she was about 200lbs), so were stuck! I thought I would be the only person in history to get fired from a volunteer job! Luckily a friendly stranger came along and helped me get her back in the chair. We went back inside like nothing happened. But now it's been more than a decade later and I've been in nursing school for three years, but every time I put a patient in a wheelchair, I remember that day and always buckle up!

:chuckle Too true!!