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cav5

cav5

School Nurse; ICU
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cav5 has 13 years experience and specializes in School Nurse; ICU.

cav5's Latest Activity

  1. cav5

    Shutdown

    I know exactly what you mean. I am working but under an IOU status-meaning I have to work as I am not exempt but I may or may not get paid. My husband isn't getting paid or working at all. We have over 40 years combined government service work and now here we are. I wanted to call in sick today-fever, flu, you know the drill. However, the minute I do so I become put into a different category of furlough--not just for today but for the weekend with no housing benefits, COLA, etc until Monday. 1 day of probably getting paid vs 3 days of definitely not getting paid wasn't worth it. Add the 14 days that they furloughed us this summer (some were just coming back to work) and it makes for a lot of frustration. I still love what I do, still think it is the most fantastic job in the world but some days you wonder why the people who make the decisions got a pay raise and we may or may not get paid at all-how is this legal not to mention fair....
  2. cav5

    epipen STAT or wait?

    You have to follow the doctor's order and if they say CV or respiratory compromise then that is when you give it. Having said that... Mild Nausea and vomiting (in my opinion) is where it became tricky. Lots of times gastrointestinal effects indicate a much more serious reaction ,particularly in a known allergen student. We have had great allergests who have given great in-services and they changed my way of thinking ( A LOT). New protocols and recommendations state that antihistamines should not be given, rather epi should be the first line for any problems that are above mild. They have always said if in doubt then give the epi-pen as children with young, healthy hearts will only have a bruise if you are wrong and give it when not needed. However, if you are wrong and wait then you have a dead child. I have seen children literally break out within minutes as the benadryl they took that morning has started to wear off. I shudder to think if that would happen on the bus or when they aren't near medical service. Our standing orders always say monitor then epi. However, I have seen other doctors write specific orders for when to give anithistamines and when to give epi and I would follow those orders for that child (unless unsafe).
  3. cav5

    Parent Interview

    Parents will make or break a school nurse. That is just a fact. Having said that-if they have given that much power to their parents I would step back and make sure you really really want this job and it is worth it to you. If it is then I say good luck, if not then.... I believe they will want to hear what you would want to hear if you had a child (or other family member) in their care. good luck either way.
  4. cav5

    RhoGAM

    Mother must be RH- and father must be RH+. I do not know about the Coombs test as I was not a nurse for the first 3 and was only a nursing student for the last 2..sorry. On a side note-that shots HURTS A LOT!!!! It truly feels like concrete being injected into you. I would advise having the affected? leg (if given in the buttocks) "up" on toes as that seemd to help quite a bit. Also, make sure and stress that they need to keep moving for a while after it has been given. I rode home for about 35 minutes stationary after my first injection (I have had 5) and could hardly get out of the car. Granted, I was a lot younger and had less of a pain tolerance than I do now but I remember each of those 5 shots very vividly! Hope this helps
  5. cav5

    Kinder pooping pants

    I had a few children with this at my school. I believe the advice is sound-referral to the school counselor or psychologist is good but[COLOR=#003366]mmc51264 is also right on the money-I had a great doctor a few years back that really discussed this issue with me and the children really do lose the urge or sensation to go to the bathroom-in that case you do have to retrain them to go even though they don't feel like it-that is why the waiting on the toilet works. The doctor said it takes at least 6 months to a year to do this. the retraining and the miralax were the treatments he suggested along with the counseling. It is more common than one might think-holding a child's education back for something like this isn't in the best interest of the child as it can take some time to get this sorted.
  6. cav5

    Fired After Fifty: Redux

    I truly believe (even if I forget in my darkest personal moments) that a window does open when the door closes. You don't have to see the window yet-you will when it is time to move on through it. Please take care of yourself and wait for the window-there will be light. I truly believe after having read everything you have written that you could be an author. I am serious-ponder it. You truly do have a gift for words. Don't know if that is your window. From my standpoint you are a source of light for many of us.
  7. I am never a better nurse than when I have just been a patient. A recent ER visit highlighted this fact. I was in pain, anxious, and very very tired of being sick for the past year. I will stress quite clearly that I do not like being on the gurney side of a hospital bed and that, coupled with my pain, made for very bad vital signs. The next few hours were what I had expected as a former ICU nurse-EKG ,blood work, etc. However, what struck me the most (probably because I DID expect those things and had time to think about the other stuff) was how different I was treated between my doctor and the two nurses who cared for me. Now, I want to make a very clear distinction here because I don't want to get into a conversation about doctors vs. nurse. I want to clarify that it was THIS doctor and These nurses who I was comparing. All of them did assessments and history and monitored me for the hours that I was there. All of them were competent at their jobs. The doctor had more knowledge base but was neither congenial nor friendly and truly looked at me as vital signs, symptoms, and orders. The nurses did their assessments, talked to me about my year long struggle, and cared why I had chosen to come in on that day at that hour. They advocated when I didn't want a particular pain medication due to a bad reaction in the past and requested we try something else-the ultimate outcome of that little adventure. As we go into the next chapter of nursing I wanted to take a minute to capture these two very different approaches. Nursing is changing. A whole new role of Nurse, and more specific to this case, Nurse Practitioner is developing across the country before my very eyes. The scope and practice of this new nurse will be different. I don't know what the parameters will be but I for one am very excited to see it unfold. Having said that, this new knowledge base brings with it a new set of responsibilities as well as a very new set of challenges. As we move into this new era of nursing we need to be very cognizant of our foundations. We are nurses; we chose nursing school for a reason. We have been taught the codes, ethics, and beliefs of nursing. They were drilled into us at the same time as those new IV, blood draw, and suctioning skills were being practiced. If this new brand of nurse and nurse practitioner does have more of an independent role and voice in the upcoming years, as I suspect, we will all have a say in the shaping of what that new nurse will be like. Not only of what is expected of him/ her but also what they will stand for and represent. A new paradigm will be created and I, for one, hope that our old codes and ethics evolve, not change. Evolution keeps fundamental components and adds to them, making them more adaptable to their new climate while keeping the best of the core individual intact. Evolution, for the most part, is an improvement to an already functioning thing. Change is like a mutation, it could be good and it could be bad- favorable or deadly. So, as the medication infused through my IV line on that gurney I began to imagine a day when one of those two nurses might choose the path of more autonomy through education, all while keeping to their listening abilities, their full assessments, and their great advocacy skills. For one calm, pain free moment I was much like Don Quixote in his madness; I saw the windmills, the knight, and the world not as it is but as it should be.
  8. I have to ask-if you cover for the high and the number two hours later is normal then it is not machine nor the technique-it is a true high. I work with kids-the patterns always tell the tale. One number may be out of wack but the pattern never lies. If you work regular shifts (Tuesdays and Thursdays etc) then sometimes it is something they forgot they did on Tuesdays and Thursdays or didn't do for that matter. the AIC is also a good indicator-quick check on a pattern of highs and lows. I don't think anything is wrong with the technique or the other nurses-I believe in innocent before guilty. For me, it was a kid who walked to art and music class only on Tuesdays and Thursdays-drove me crazy until I figured out the pattern and what was causing it and corrected for it. Who knew! :) Look for the patterns-they always tell the truth. Sometimes I miss the days of ICU when you got to control everything in and out-OCD and I know each other well:)
  9. This is a lot to work through. Right now there is a lot of "blame game" going on, while expected it is not helpful to anybody. You did the best that you could-teenagers especially don't open up. I say that as a school nurse and a mother of 3 teenagers. My thoughts and prayers go out to you because there for the grace of God go I and every one of us. I won't say don't let her get to you because it already happened as she knew it would. I will say this...don't believe it to be true.
  10. cav5

    Should I go back to the military?

    I am not understaning this-if you have a BSN why would you only be an E5? With that much college you should be an officer...something doesn't sound right. I would definitely go back to the recruiter because I don't think that you are getting a fair deal. Again, something isn't right for a BSN to be an E5...
  11. cav5

    Looking for some guidance!

    I would apply for every position that you are interested in-if you get the OR and that is what you love then you have gotten the golden ticket. If not, then you at least tried. Every first year in a new position is hard. You will have to understand that if you move (which you may or may not do down the road) that you start over again from ground zero and you will have to learn at that level again. Nobody likes it but that is the way it is. You may love OR and stay there for the next 50 years-why would you want Med Surg experience if that was the case? However, if you change your mind, you know that starting over again is the price that you pay for the move. I never understood not going for a dream job. I know life never turns out the way that you want it to (from experience) but sometimes it turns out better than what you had planned. Apply for everything and take the job that you WANT if it is offered to you.
  12. cav5

    So I might be going to China...

    "Option 1, work with ex-pats: Imagine you were an ex-pat with out great language skills, where would you look for healthcare? Where ever that is, they probably have English speaking staff. Look for English speaking doctors and resources for ex-pats. There might even be potential for something like starting an English "call an RN hotline." Look for opportunities through/at your embassy or if there is any foreign military base nearby. Look for international schools and see if they need a school nurse who could try her hand at teaching health/bio/?? " Definitely this option is a good one. You will be surprised at the number of expats you meet all over the world and how many "American, International Schools" there are. Too bad it can't be Japan-lots of bases over there. As an expat, I love love love the life! It isn't for everybody but for those of us who love it we can imagine no other way to live. Good luck!
  13. I would say take the job that makes you happy. I have never worked med surg and am fine with that. I did do ICU and so I know cardiac, respiratory and those type of things very well. I learned a lot about those specific patients and skill sets. I would have a hard first year on a med sure floor but I don't plan on working on a med surg floor so that is OK. I had a hard first year as a school nurse as that is a different skill set but now I know those things really well. I think you need to look at where you want to go and learn that skill set. If you choose to change jobs then know that you will beging anew and have to learn that skill set as well. Med surg is a nice all around start-I am not saying that at all. However, I don't think that you have to start out as a med surg nurse to be a better nurse at other jobs. I do think a few people brought up the good point that if you want hospital nursing then you might want to start out at the hospital. However, if you love corrections nursing and think that is your path then I say go for it. I know that paths aren't always straight and we rarely end up where we thought were were going but it sounds like you might have found your niche and that is a good thing. The other good point somebody else brought up were your pay and hours-sometimes those things get forgotten and become really important really fast. Good luck on whatever you choose!
  14. cav5

    Medication Error...KINDA.

    Everyone makes med errors, good nurses recognize they have done so, make it as right as possilbe, and learn from it. You have done all of those things. I know it is hard but really learn and let it go-you both will be OK. Ever wonder why someone is a stickler for something-well, now you know. Years from now you are going to be known as the nurse who has asked every patient coming in from a procedure if there is a med change...and that is good. Personally, I was the nurse who checked the refill bags from pharmacy ten times to make sure they didn't change the dilution ratio on the med-almost quit nursing that night! I cried for two days, thought nursing wasn't for me and got the same advice you are getting now. I am glad I did because 12 years after that night I love being a nurse.
  15. cav5

    School Nurse

    I love being a school nurse. You take care of sick children with acute and chronic illnesses, work on prevention and health teaching for staff, families, and students. You give meds, do screenings (vision, hearing, scoliosis), and monitor immunizations. You will also participate in special education and student support teams. I think the hospital job and school nursing job are apples and oranges and can't really be compared side by side. You are dealing with the sick but in a very different environment. You are also dealing with the healthy. The goal is trying to keep them both as healthy as possbile. There are two overlaps though-there isn't a "normal" day, each day takes on a life of its own (even with the best of intentions and planning) and the charting never stops, same as in the hospital. You will be just as busy as in a hospital and will use and update a whole bunch of skills. I have children whom I take care of with different needs and disease processes every year and that keeps me new and fresh so to speak. I like the kids, I like the hours, and I like the pay. There are things I don't like but I think that is anywhere you work, within any specialty. There is a whole forum on school nursing and I think if you look through it, it will give you some insight into the day to day goods and bad of it all. As it is June and the school year wraps up you will definitely see both:) I hope this helps.
  16. I don't want to keep this thread going but somehow I....just...have...to...respond... Even knowing that it will lead to nowhere. You are not listening nor debating, that would mean that you would really listen and take in some of what is being said-some you will like and some you will not. Debating isn't typing back messages from every post you don't like about what you don't like. It is listening and taking in new things-again, some of which you will like and some of which you won't. You ARE getting upset and it is translating to the typed word. You do talk a lot about patient comfort and safety while using the word "I" A LOT. (it is not one and the same) You are not the future of nursing....nursing is your future. There is a difference.