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  1. bestallaround

    Managing Fungating (Malignant) Wounds

    I once had a patient with one of these wounds from testicular cancer. It was described exactly as above. It was first a hollow wound that we were packing, but it grew quickly pushing outside of the skin until it was just one great big mass in his lap. It was almost as if his scrotum was just one huge wound. It was very foul smelling and drained terribly. We irrigated it frequently with Dakins solution. If we attempted to dab or gently swab the area, it bled, so we just continued the irrigations. Odor control was a huge issue. We made sure to dispose of all wound care supplies and linens that were soiled after each cleansing.
  2. bestallaround

    not looking "put together"

    I didn't think Wooh's comment was inappropriate at all. I feel the same way. Most of my coworkers are older than me and look very put together when they come to work, new figure flattering uniforms and Danskos, makeup, strong perfume, hair done, jewelry. Some of them are great workers, some of them are not. I know I am one of the best at work. I rush to work after picking my kids up from school and preparing their dinner. I am clean and neat, on time and competent. I have not bought a new uniform in two years and I know it's time for a new pair of shoes. I absolutely do not wear perfume or jewelry to work. I see those nurses and think, "boy, they look great. Hope they don't get dirty or work up a sweat." I like to look great when I'm not at work. I don't have the time to really get ready for work. If you have time to primp and iron for work, good for you.
  3. bestallaround

    Nursing Ranks & Employment Grows In USA

    Does it say anything about the turn over rate? I have seen several nurses returning to school to get out of nursing, and many nurses not working as nurses. I knew an LPN who left our facility to be a bartender! I think that nursing school in no way prepare you for what real life nursing is like. I think there needs to be some national required mentorship and counseling for your first year of nursing.
  4. bestallaround

    Nursing Home Blues

    LPNs are very valuable. Don't ever let anyone you feel "puny".:)
  5. I have experienced and witnessed many episodes of spitting, scratching, hitting, pushing, kicking, and boob and butt grabbing from elderly dementia/Alzheimers patients. I have seen cases with some patients who are very strong, who are capable of seriously hurting someone, where physicians refuse to properly medicate them. I'm talking about not even ordering something PRN. I have seen a patient like that who did not get any medicine until he actually assaulted the physician, then of course he got ativan and haldol on the spot! There have also been patients who really needed something for anxiety or PTSD, but other nurses have failed to document consistent bad behavior. I have had a nurse tell me, "oh, yeah, he fights everyday, but I'm not gonna sit there and document it eveytime." I work in a VA Hospital and have seen the worst cases of patients who are A&OX3 abusing and threatening nurses, doctors, other patients, etc. We have mostly foreign doctors and, oh, I have heard some racial slurs that make my ears burn!Many of the patients are mad at the government and see staff as "one of them", not realizing that most of the staff are also veterans. And, physicians and hopital administration not wanting to do anything about it because the patients are veterans.
  6. bestallaround

    Dansko Shoes are killing my feet!!!

    I don't think the Danskos are good for walking. When I wore them on days I worked in surgery, my legs and feet felt great. But on days on the unit walking back and forth, I found they seemed very heavy and hurt the tops of my feet, too. The best thing I did for my feet was go to an podiatrist and have orthotics custom made for my feet. I use them in sneakers, which I find are more light weight and flexible.