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Peds Critical Care, Dialysis, General
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AlabamaBelle specializes in Peds Critical Care, Dialysis, General.

I started my career in 2005 in Pediatric Critical Care. After 5.5years, I transferred to Pediatric Dialysis in an in-hospital setting. I took a break to spend time with my aging dad. Glad I did, as he became acutely ill and died during this time. I explored other non-nursing interests. I recently moved from North Carolina to Alabama (my home state) and now work in a community hospital.

AlabamaBelle's Latest Activity

  1. AlabamaBelle

    Room Temperature

    Some centers have the nice chairs with heat and vibration. I was in a Peds unit and even the 5 year olds hit those two buttons first!
  2. AlabamaBelle

    Social Media and Doxxing - Your Thoughts???

    I'm more appalled at the pettiness of the nurse who reported Jonathan. This is a petty, vindictive individual. Everyone who works around this person should be wary. I don't do selfies and I don't list who I work for.
  3. AlabamaBelle

    What is your "thing" and how do you deal with it?

    UGH! Ostomies. I will do any other task for any coworker if they will take care of my ostomy patient. I gag at the thought. Just no.
  4. AlabamaBelle

    I wanna quit

    I've been doing dialysis for 4 years, part pediatric and part adult. Some days you got it and some days you don't. My 2 missed accesses were with the same doctor who does not like me. I actually call for changes in patient condition (patient bleeding profusely after 45 minutes of pressure, to the NP who told me to hold manual pressure, like my fingers weren't already cramping, took another 45 minutes to control enough to bandage. 30 minutes for the upper access. Though he might want to know about the patient who coded (DNR) while on treatment. There were other factors in play and another doctor is in hot water for a bleeder that he refused to come in and check. Be patient, you got what it takes. It's just like with IVs, you go through dry spells.
  5. AlabamaBelle

    Dilated Cardiomyopathy

    First, I want to say I am not asking for advice. I am an experienced Peds ICU RN, Peds Dialysis RN and Acute HD/CRRT RN. I only ask for some things to expect...not a fan of surprises. My husband was just diagnosed with dilated cardiomyopathy and aortic regurgitation. He has always kidded me about writing notes on paper towels...how ironic I find it that he wrote notes on a paper towel. His EF is 25% (he does not know I found it or know his EF, he is trying to protect me). There are ischemic areas in various areas. His cath is upcoming and, of course, we will know more. He is in denial, he's also a veterinarian, but this human stuff can get past him. He will be a patient in the hospital I work in and I know the staff in the SICU where he will spend some time afterward. I am comfortable with them and they know me well as I spend a good amount of time dialysing patients in their unit. I just need support, know what to expect as I am outside my comfort zone. I am fully aware of the seriousness. And please hope I behave myself and don't act like "one of those awful RN family members." And I will become the major source of income. Good thing I am well paid and have good benefits with one of the Big 2 that I work for. I'm not stressed, not stressed at all....
  6. AlabamaBelle

    You COBs Were Right After All

    I make appointments very quickly after schedules are posted. I don't explain who the appointment is with, not their business. If the scheduler forgot to put me on, oh, well! I have had to learn the hard way to not let people push me around. Being nice only goes so far. I take care of me first, now. Especially since we found out my husband has some serious issues going on. Our time may be cut short, so us first, them second.
  7. AlabamaBelle

    new nurse advice. screwed up?

    Dear youngling... Accept now that you WILL get yelled at or the MD will be extremely annoyed with you in the field of nursing. Grow a thicker skin. The Charge or Preceptor is just a cog in the wheel. You will chart that you notified your charge nurse. Then you will call the MD, as he is the only one who can give you orders. You will chart this also, as well as his orders (or lack thereof). You will carry out orders and note responses to interventions. Protect your license. Try to group questions to the MD, if at all possible. You can always ask if anyone else needs the particular doctor. This thread has given you valuable information. Use it.
  8. AlabamaBelle

    new nurse advice. screwed up?

    Always, always, follow your gut. Don't listen to a charge nurse or anybody else. I'll take the chewing, which I had recently. The NP and MD (who has standing orders that we call the NP, not him) complained about my call, but my glutes were covered, just in case. And later, a couple hours after the treatment, there was a problem, not a big one, but my considerable hiney was covered as I had charted and filled out some paperwork on the problem with that particular treatment. It's your license, protect it. Nobody else will.
  9. AlabamaBelle

    Acute Inpatient Dialysis Patient-to-Nurse Ratios

    We are 2:1 in our dialysis unit. We have no techs. If we have an unknown Hep B status, that patient has his/her own nurse. Hep B, does of course, complicate staffing. We also do portables 1:1 in our ICUs. We often have more than one patient in a particular ICU, so we load up as much as possible and go from room to room. Our larger sister units in the largest city in the state have techs. Their ratio is 4:1 and there are at least 4 techs at any given time. The techs get all the fistula/grafts on (and these techs are awesome). The RN must put on any PermCaths.
  10. AlabamaBelle


    Read up on the company for starters. This will give you a great springboard for questions about the company itself. Ask about training, what are career paths with the company. Are they looking at you for acutes or chronics? Your Med/Surg Tele is a good foundation for dialysis nursing.
  11. AlabamaBelle

    Techs vs. RNs in Outpatient Dialysis

    parolang, if I were in a clinic, I would love to work with you! I work in acutes. Our program doesn't routinely have a PCT, just occasionally. We feel pampered when she is there. We have a four bed space in our unit, with 2 patients per RN, Hepatitis status permitting. We do a lot of mobiles and are adding CRRT to our program. I have a different schedule. I do 4p-12a, no weekend, no call. I do treatments that are left from the day, trying to get the on call person out and resting, just in case. I set up paperwork, machines for the next day. The portable ROs are stocked with extra equipment. I initiate all PD treatments. We just all pitch in and do our jobs to best benefit the patients. Acutes is definitely a different animal from chronics (did that, too). Some days are beastly, some days are little or nothing.
  12. AlabamaBelle

    Crap! Am I a crusty old bat nurse?? Carrying pens...

    I've always been known as "The Pen Queen." My collection is embarrassingly large. I have found some pens that are very distinct and I will retrieve my pen from your hand. I have pens that I don't care if you take. I have sharpies in different colors. I have learned to have several dry erase board markers handy because there is rarely a marker handy.
  13. AlabamaBelle

    Inappropriate Conversations in the Workplace

    He certainly was! His parents were Southern, as well. They didn't have a much in the way of formal education, but they could read, write, and reason. They passed that on down.
  14. AlabamaBelle

    Inappropriate Conversations in the Workplace

    I'm just wondering how many people had to look up Edgar Cayce. We're giving away ages! Somethings you just can't engage me in during work hours. I leave religion and politics at the front door and any "hot button" topics of the moment. I'm good at playing dumb, and the moment passes. I will stubbornly persist in silence. The hair may be blond (or least the part that isn't gray), but it's really dark, and only my colorist and I know really what color it is. My daddy always said to "sit back and enjoy the show, 'cause if you give some folks enough rope, they WILL hang themselves."
  15. AlabamaBelle

    Oranges to Apples

    Our school started preparing us at the end of our next to last semester. We were ready with all documentation at the beginning of the final semester. They even brought a company to do fingerprints. We were given a list of places if we couldn't make the time this company was there. Disturbed that your school has not given you this information or resources.
  16. AlabamaBelle


    We have a few "frequent flyers," but for some of them it's a function of ESRD and the co-morbidities. I do know of a large acutes program that acts as the chronic for several patients. They have been dismissed from their respective clinics. For the type patient you are addressing, we just do the acute dialysis and know that it won't be long before we'll see them. I think Chisca brings up a great point of mental health issues. I think mental health should be addressed more aggressively than it is. In all areas of chronic issues, mental health should be given a higher priority than what I currently observe.

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