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mrf0609

mrf0609

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mrf0609's Latest Activity

  1. mrf0609

    PARTING GIFT

    Gifts for what? Leaving? I don't think anything is necessary, perhaps a nice dinner out with close associates would do, but I do not feel that you need to provide anything to anyone. Just my opinion.. Best of luck in your new venture! Michelle
  2. mrf0609

    Nurses with Attitude

    In listening to nurses interact with their patients, it is so true that the nurse has basically complete control in setting the environment for the patient experience. I think that this article is well written and really wish that many nurses would read it, unfortunately, those with poor attitudes often have little desire to better themselves or their mindset and will never see something like this. I appreciate it and even if my world is crashing around me, it is never ok for the patient to feel my pain or stress, this is why I can be sucked dry at the end of the day, having a calm and pleasant demeanor really takes it out of you.. at times they may feel my stress, as I can't keep it all inside all of the time, but I would never let them know exactly why...
  3. mrf0609

    Iv antibiotic running as primary?

    No, We do not flush with a 25 ml bag post administration. We also do not prime the line with ns. Medication mixed in the pharmacy is often more than ordered dose, if primed appropriately and the pump is programmed exactly as directed, there is often medication left in the bag. If the first dose of a 100 ml bag is hung at 90 mls instead, due to priming, then all subsequent doses after are programmed as ordered. If the original line is primed with ns, then all doses can be given as ordered. We honestly have no policy at my facility, it is how I was trained.
  4. mrf0609

    Iv antibiotic running as primary?

    I was taught that even giving any NS or other fluid, as a primary, without orders is administering without orders. I have a few issues with hanging a separate primary line of NS if the patient does not have fluids ordered. First, fluids need to be changed every 24 hours, most of the times when I see people hang a ns primary with an abx piggybank no one ever changes that fluid every 24 hours. The other issue is that many times the patient does not need additional fluids due to other conditions, kidney failure or chf, they do not need the extra fluids given. Often times I find the night nurses tend to hang the small saline bags so that they can run the fluids, albeit slowly, overnight and not have to deal with mapping the patient. Just my thoughts on it, and what I was taught.
  5. mrf0609

    Foley Catheter Issue?

    My biggest concern is that you state that you inserted the foley until urine return and then inflated the balloon. I was always taught that you insert the foley until the "Y", inflate the balloon and then allow the foley to drop until resistance. If the balloon is inflated in the urethra it can cause discomfort and ultimately ischemia of the tissues. Sometimes men do have bladder spasms, but they are not that common. I once inserted a foley and it actually looped around in the urethra. The urologist said it was not a common occurrence, but it does happen. Prior to that I always thought that foleys in men were the easiest because you can see the urethra, and there is only one hole. Now I take my time to make sure it is inserted properly every time.. Best of luck!!!
  6. mrf0609

    Labor as a spring board to acute care?

    As others have stated, L&D is a specialty. It would not be a good way to go into critical care. One year in med/surg will give you the experience that will help you move on to other specialties. I do not recommend going the mother/baby route unless that is where you want to be. Good luck on your path!
  7. mrf0609

    Shifts

    I first became an LPN prior to my RN and worked in a hospital as a team. The RN did all assessments and called the MD for orders, since the LPN could not take orders, which I am not sure why... As the LPN I did all med passes, dressing changes and did most hands on care. We had CNAs, but they did the bare minimum and it was allowed. We typically had 8-12 patients. The RN would hang blood and give IV narcotics, some would do more, but most sat at the computer and charted all day. To this day I still get frustrated thinking about the RNs who would not assess wounds, how do you chart on them??? The LPN did have charting, but I primarily wrote a lot of notes. When they phased out LPNs we were told that patient outcomes were better with RN as primary care givers. I think cost is a factor when establishments use team nursing.
  8. mrf0609

    What if I'm the Bully?

    But I can be highly aggressive and have had a tendency to speak without thinking causing undo pain and bad feelings. Although I am aware of my communication style, I still believe I am a bully but am working on change. I am not empowered at all by my behavior but nevertheless belittling and demeaning a person is not nice and a behavior I am working on changing...I am finding it ebbs and flows, at times it is worse than others but it should never occur...thanks for your thoughts!
  9. mrf0609

    What if I'm the Bully?

    I have not only read your post but all of the comments which follow it. I am not sure that some people get it.. While the situation you discuss is a patient safety issue, it is how you dealt with it, including the feelings you had and projected is what hit me. I can completely relate. You discuss the test you took. I am afraid that I too would have far more than one yes to the questions. Am I a bad person, no.. I am a great nurse and my patients love me but my co workers are not so fond of me. At 50 it is difficult for a tiger to change it's stripes, but it is possible. Often it is how something is said, not what is said and I can honestly feel it sometimes as it occurs... that it is wrong but can not control myself. I have little tolerance for mistakes and patient safety is important, it is not how it often appears. I can be short and abrasive. I can really help a younger nurse, it is the way I say it. What could have been a teaching moment is lost due to the nurse shutting me out because of my attitude. I always say I wish I could just be a nice person, very easy going, and fair to everyone. I am a work in progress, awareness is the first step. Will I ever be that nice person? I do not know, but I can at least try to practice new skills which will help me communicate more effectively. I am passionate about nursing, loud and outspoken, always have been, I just wish I wasn't considered a bully. Thanks for your article, I related in so many ways and can only hope to grow and change to have better relationships on the floor. Good luck to you too!!!
  10. mrf0609

    Nursing, Hurricanes, and Floods.

    Now that the storm has hit, hope you and your family are doing well. In South Florida we have to choose to be on two teams -A and B, A must arrive when the hospital says, no matter your shift and you must stay until relieved by the B team. If the B team can't make it you are there until.... I decided to pick B last time, it was a huge mistake. It is just my 10 yr old son and I and I was stressed getting everything ready for the storm prior to, stayed up all night, no by choice, but worried about tornados, during the storm then had to go work 12 hours the next day... This year I signed up for A shift because I would rather just stay at the hospital with my son, they offer that, and go home afterwards. Although I have pets, they will be ok, I have friends who will help. If they were calling for a Cat. 5 and it was going to be a direct hit, I do not know what I would do, Andrew was horrible and the damage was incredible. Many things have changed here in Florida = gas stations and grocery stores have generators so food and gas are available right after the storm now, this is as long as they have supply. It is tough, but we have a responsibility....
  11. I was thinking of maybe the new cpr rules. Apparently for 2010 it is Circulation, Airway and Breathing, if I am not mistaken instead of Airway, Breathing and Circulation. Just a thought.
  12. mrf0609

    Please tell me I'm not crazy...

    No, actually it is LTC/nursing homes where they have received the higher offers. I just think I will get much better experience in the hospital, if I want to change it will be easier to go somewhere else rather than getting a job in LTC and trying to change later on. Am just trying to do the right thing. I have ALWAYS gotten everything I need, and I know to be careful what you wish for. I just hope that wishing for this job was the right thing.
  13. mrf0609

    Undecided LPN/RN?

    I'm an LPN also - a new LPN. This is a second career for me so I have a few years under my belt. I didn't have any desire to be a nurse early on, I have had a highly successful career and decided nursing would be a great transition. I don't know how old you are, but I would tell anyone that has the strong desire to get into nursing to go straight for the RN, preferably BSN. I wanted to make sure this was really what I wanted to do, that's why I got my LPN. Hindsight is 20/20, had I known then what I know now I would have just gone straight for my BSN. At least I will have a good foundation for my RN classes, and I plan to work while I get my prereqs done. Go for your RN if nursing is your calling! Good luck!
  14. mrf0609

    Please tell me I'm not crazy...

    Hello, I had posted a few weeks ago about not being able to find a job being a new LPN. Everyone wanted 1 yrs experience. I was getting desperate and spent 8 hr days going around applying everywhere I could think of. I had a few home health agencys very interested in me, but without money I was not going to be able to pay for my backround check, fingerprints, physical.... Was starting to get really nervous, this is my second career and I have never had a problem getting a job. Well.... I finally got a call from the hospital I have always said I wanted to work for. It is one of the few that hire LPN's in the area. I am starting school in Nov to get my RN - BSN - prereqs 1st, and the job offer shifted from nights to days(although the pay is less, it fits into my life a bit better). I went and interviewed and was offered the job on the spot. I was so excited! I never really discussed money at all. Then I get a phone call to set up orientation - Monday, and she says "you do know the positon pays $13.68?" I look at it as if I really want to work in the hospital long term and will get a great education here. I have not had a job thru school and have lived basically on nothing for so long that something is better than nothing. It has moved so fast... getting the offer, accepting, doing the paperwork, starting monday. This is the way it is supposed to be - graduate one week, start work the following? I start school in November again and can defer my student loans hopefully till I am a RN ( who knows how high they will be, but if I die owing...) I have a young son and have been so blessed to have the support of many people around me. I have a few people I have to repay a few thousand dollars to. This is where my fear comes along. Did I do the right thing? I have talked with some friends at school and they have job offers at $20 - $23.00/hr. I am not doing this for the money and many people have told me that it has happened the way it is supposed to and the money will come eventually. After my 8 wks of orientation, I can work overtime, so I am hoping I can at least boost my salary that way. They say no raises until 1 yr, I am afraid of how little it will be. Please tell me I am doing the right thing. I was ok with it until I filled out all the paperwork and was leaving and got a huge pit in my stomach. Thanks so much in advance Oh yea - I am REALLY grateful to have gotten a job, please do not take this the wrong way!
  15. thanks so much and good luck - it sounds really positive! Keep me posted...
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