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laflaca BSN, RN

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laflaca has 5 years experience as a BSN, RN.

*Two previous careers, followed by... *The horror of nursing school in middle age, followed by...*Emergency nursing *Good times in epidemiology/public health nursing *relapse into ED nursing and finallyย *2018 foray into high school nursing

laflaca's Latest Activity

  1. laflaca

    Isolation room set up

    Jen, what magical state do you work in?? I'm guessing you're not here in Arizona, where we invest in guns and border walls rather than HEPA filters. An LPN! Distanced cots! I'm so jealous.
  2. laflaca

    What are you stocking up on?

    Vodka, and not for its disinfectant properties :)
  3. laflaca

    Isolation room set up

    Our school year starts Monday. We'll be virtual until Labor Day, and then the district will decide whether to move to hybrid or stay virtual.
  4. laflaca

    Isolation room set up

    I have nothing. I've bugged the principal and Dean, I've emailed proposals, and I have nothing. Not even a meeting to discuss it.
  5. laflaca

    worth buying this stuff?

    I'm ordering supplies at my new school, and wondering if you happy nurse shoppers have thoughts about these items :) 1) Portable ice machines - worth the $200? If so, any recommendations? (I think the last nurse was just freezing wet scraps of paper towels inside plastic baggies, and that works for a lot of the ice demands we get. But if I need actual ice I'd be making it myself in little trays) 2) Glucometers (we just keep a backup for kids with orders for glucose monitoring, CGM is wacky, they ran out of strips etc. Not for diagnosing or for curiosity questions) ....I'm thinking about just getting one of the super cheapie $20 ones, but not sure if they're unreliable or annoying in some way, and maybe it's better to spend a bit more 3) Splints - like a SAM splint. (They seem like handy things, and we stocked one at my last school. On the other, I think that realistically if it needs splinting I'm going to let the nice EMS folks do that - they're better at it, they have those nifty fold-out ones, and they're going to want to put their eyeballs on injuries anyway) 4) OPA or NPA - we were required to stock these at my last school, but I'm not sure if that's common. (I could imagine maybe popping in an NPA if a kid is really drunk or altered and you're worried about losing the airway before EMS or parent arrives... but an OPA, really, in a school?) 5) Recliners - does anyone use these instead of, or in addition to, exam tables or recovery couches? (Having worked in an ER where the entire fast track side was in recliners, I feel like I can do anything in them, including dragging someone to the floor for CPR if needed. And they take up so much less room)
  6. laflaca

    Random furniture thoughts

    I don't know why I started obsessing about this today - maybe because I was trying to just avoid COVID thoughts for ten minutes - but what is the deal with the weird "recovery couches" or "exam tables" in school health offices? I have a room with two exam tables. They are tall and narrow and without side rails, like exam tables in an outpatient clinic, except in an incredibly heavy wooden base with built-in drawers. I worry about putting a sick or dizzy kid at that altitude! On the other hand my last school had a low, hard, flat, very uncomfortable, not even 6' long "recovery couch," basically a slightly padded bench, far too small for most of my adolescent students. Today I was thinking to myself, "How did these weird cots come to be a school thing?" Why, for instance, don't we have medical-type recliner chairs? Or just regular gurneys? And why are these weird and uncomfortable pieces of furniture $700-$1200?? (sigh). OK, you can go back to thinking about COVID again.
  7. laflaca

    List of questions and requests

    Thanks all! That list is so handy, @Flare - I appreciate it. And I think I'm sharing your watch-it-burn mindset too. I'm new in this district, I have no idea if there was nursing input into whatever plan may exist, and I have no idea when I'll even see that plan. But I am seeing that at this point, whatever happens is not going to be in my control. There is completely uncontrolled community spread where I live, and the hospitals have been teetering on the edge of capacity for weeks. Results on testing is taking 7-10 days, sometimes longer. We don't have a statewide mask mandate; bars are open. Our county PH is so overwhelmed they don't even call people positive for COVID, let alone any contacts, unless they're over 65. I wouldn't be notified of any COVID cases among students unless the parents thought to call me. I tell myself that no one is crazy enough to put teachers in a poorly ventilated room with 35 or even 15 adolescents for 6 hours a day, in this context. But this is AZ soooooo...... All I can do is make decisions about what risks to my own health, family and finances I'm able to tolerate. I'm going to just see what happens, I guess.
  8. laflaca

    List of questions and requests

    I'm pretty sure I saw someone here had posted a great list of COVID/infection control questions to review with admin for this school year(where will isolation room be, policy for quarantine, PPE to request etc). Maybe it was you, @Flare? For some reason I can't find it.... Can someone point me in the right direction, or share your personal list? I am so overwhelmed. I need a starting place so that I can get my head straight. We start next week, I don't even have disinfectant or masks, and I need all the help I can get. Good luck and good health to all of us this year.
  9. laflaca

    Type of mask or face covering?

    I'm buying myself a few n95's on eBay and planning to rotate them, covered with a cloth or surgical mask. I'm also planning to wear a face shield. Pretty sure my coworkers will think I'm nuts, but I am in one of the biggest COVID hotspots in the world, and I promised my husband that I would take every possible precaution. My school administraion has said they're getting masks for students, but nothing about PPE for me. I'm not leaving my safety in their hands.
  10. laflaca

    So if they open no matter what...

    Karen, if you're not a bot, thank you but I'm not needing links. I've read the CDC guidance and I read the news. I'm looking for input from school nurses, specific to our setting/role.
  11. laflaca

    So if they open no matter what...

    I see that our President has made it a priority to reopen schools with in-person instruction. I happen to live in a state (AZ) with a governor who's an ardent fan and politically dependent on Trump. My state is in crisis, but I'm pretty sure that we'll be reopening in August even if every last student and staff member ends up infected with COVID. I will be lucky if we have surgical masks, hand sanitizer and some disinfectant wipes, I think. I sure won't have the negative-pressure isolation room or the distancing options recommended by the CDC. What are you all planning to do, if you face these circumstances? I am foraging around on ebay trying to get some PPE, maybe including a dozen n95s that I can rotate. I feel like I'm going to have to assume that any of the apparently healthy high school kids I see could be asymptomatically infected with COVID. Our state is in a real crisis. I'm nervous. I don't even go to the grocery store anymore - sitting in an unventilated health office with 15 kids seems crazy.
  12. laflaca

    Switched schools! Yay!

    Happy Summer! It's a weird year to say the least, but I am excited to say that I will be starting in a new school for 20-21. Some might have seen my previous posts about the semi-disaster of my first school nurse job of two years at a really rough school with serious safety and leadership problems (the year ended with grievances, investigations, and more drama that I'm happy not to be involved in). I'm changing districts, taking about a 10% pay cut and moving to a bigger school of 1800 kids, but after meeting the principal and the lead nurse I think/hope it's a move in the right direction. COVID is blowing up in my state so who knows what our school year will look like. But, I wanted to say thanks to everyone for all the advice that helped me survive 19-20 and muster up the courage to try again. Stay safe everyone ๐Ÿ™‚
  13. laflaca

    Being Rushed in the ED

    Augh! I left the ED two years ago - but still today, just reading the phrase "pull til full" shot my blood pressure up! I was a midshifter too ๐Ÿ™‚ Although, strangely, I kinda liked opening up a new pod and getting four brand new patients at once to triage, line, and lab. Before ya know it, three hours have disappeared! Not saying it's a good way to manage workflow, but it did keep things interesting. I was lucky to have great coworkers and reasonable charge nurses, so at least no one was throwing a STEMI in the last room while I waded through a psychotic person, a nursing home disaster, and a family loudly demanding a 3-D ultrasound for the woman who did a home pregnancy test ten minutes ago and "wants to see the baby." Anyway, what you're describing is pretty typical for both places I worked. I would just try to eyeball the new ones rolling in and ask whoever was pushing the cart to throw on the monitor if needed. If it was sepsis or something else that was going to be task-intensive up front, people were pretty good about helping, and I was careful to help the 7-7 nurses get sorted out at their shift change. As JKL33 mentioned, the docs are dealing with their own metrics and will definitely be interrupting "triage" by the time you're getting to your third new patient...I would just listen at the same time while getting a line or whatever, and try to interject the other BS questions of triage as quickly as I could. It's inefficient, not patient friendly, not as safe as it should be, and generally maddening...just like most of our health care system.
  14. laflaca

    New Grad Interested in Leaving Bedside

    I thought the period from 6-9 months in (as a new grad) was the worst of it....so you're in the worst of it. But it really does get noticeably better. And if it's any comfort, I had the exact same thoughts about the other new grads around me - they're more confident, they learn faster, they know what they're doing. Only later did I realize that some of the "confident" ones were confidently doing things incorrectly, some of the fast learners struggled with things that I already understood, and none of them knew what they were doing any more than I did. We each had different strengths and weaknesses, but I was hyperaware of my deficits ๐Ÿ™‚ I didn't want to be a hospital nurse either - I started applying for other jobs when I got close to a year of experience, moved on to public health, and then school nursing. You are approaching the top of the hill, and it's going to get easier (not easy! but the OK days start to outnumber the awful days, and then you have actual good days too). Don't give up quite yet!
  15. Red Cross is starting to collect convalescent plasma in some areas: https://www.redcrossblood.org/faq.html#donating-blood-covid-19-convalescent-plasma It's not as simple as just starting to give it out, though. Convalescent plasma doesn't work for every disease, and using it is not risk-free. Even if we had a big pool of young, healthy, recently recovered COVID patients willing to donate, and even if we knew that convalescent plasma would actually help, we'd have to figure out what level of antibodies have to be present....timing and frequency of the dose to the recipient....do you give it as prevention for high risk groups, do you give it as treatment, which affected people benefit...many other things. People want a quick solution, which makes sense when you look at the devastation caused by COVID, but I don't think we're going to get any easy answers in this case. The seemingly basic, slow, frustrating application of public health measures is what is going to save lives in the forseeable future.
  16. laflaca

    Now that we are working from home . . .

    I went to public health too. I previously worked in Epidemiology there, so I texted my friend and two days later I had a temporary job! It feels good to help out, and public health nurses are just as amazing as school nurses :)

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