Ladybug45RN

Were I work we really are not suppose to draw from an existing PIV. However, there are times we do. If we have a child that is a hard stick or a child that is totally tramatized by getting stuck, we usually will try. I have heard that the PIV is more likely to go bad if used for labs. We have not had any issues with false lab values by using a PIV. However, you did mention giving blood back (waste) which we are not allowed to do ay my hospital. Of course the waste from a PIV is practically nil anyway. But, our CIVs are 5cc's for each draw. That can certainly add up. On occassion we have had a doc write an order where we can give waste back if we use a closed system, but it is certainly nothing we do routinely.

I worked on a psych unit several years fter I graduated. When I switch to medical it was on a BMT unit. I have now been working BMT (pediatric) for 11 years. I don't see myself changing jobs anytime soon.

I started BMT on an adult unit and then went to peds BMT. The transition was not difficult at all. Once you are in peds you may have a patient a few months old up to say, age 18-20. So, there is still a wide range of dosages with in the "pediatric" range. I do think working with parents is one thing that is different. No bad, just different. I tend to be pretty laid back and get along with everyone. But, some nurses and/or parents really try to avoid each other. Kids tend to do better than adults. Not get as sick or as stressed out. I used to listen to women undergoing BMT talk about worrys they had. Who was taking care of the kids...were they getting homework done, are the bills getting paid, was her hubby getting to worn out and on and on and on. With kids it more just the here and now. They tend not to know how sick they are easier to entertain and make happy.

Hi! I currently work on a pediatric bone marrow transplant unit. We have a committee working on grief issues 9for nursing). One thing we are trying to find, are ways to remember children in our care who later pass on. For example: one unit has a grapevine wreath that they put a ribbon on each time a patient dies.Another unit has their patients name eached in glass and call it a "window to Heaven." Is there anything that your unit does, or you as neursing do, to remember those that pass through your unit. Personally, I don't know if I would like a reminder as such of all the kids we have lost over the years (such as a wreath with ribbons). It seeems it would be depressing to look at. I do like the idea a little better of having something with their name and being able to remember them as a person versus a number... Any ideas?

if your sister has pain it may come in the form of mouth sores which makes it hard to eat or swallow (mucositis). usually narcotics can be given if the pain is too bad. the amount of graft vs host she may experience is parially dependent on how close a match your other sister is. there are several types of gvh, including gvh of the skin and gut. with skin gvh a rash appears about the same time her white blood count starts to rise....that might be the first sign. with gut gvh she may start having lots and lots of diarrhea or belly pain. your sister will probably be on anti rejection meds and/or steroids. if she develops gvh they most likely will first increase these meds to see how she does. i have seen some folks with perfect sib matches that have lots of gvh and some mismatch sibs that hardly have any at all. it seems pretty unpredictable. again peple with aa usually tend to do pretty well for several reasons 1)no prior chemo which weakens system and organs 2) usuall don't have to give such high doses of chemo (since there is not much in the bone marrow anyway it is easier to kill of what remains vs a leukemia for instanse) 3) could have less risk of gvh due to your isters own bone marrow failing to produce cells due to the aplastic anemia. there are certainly other side effects that could occur as well such as failure to engraft. her doctor should discuss all these things with her. expect fevers. they happen to 99% of people getting transplants. she will be watched for infections. i've been trying to think about the aa we have transplanted and i think all have them have done very well to fairly well. of course her age is in her favor as well..... good luck to your sister and family!

I have worked BMT for approx 10 years. Fortuneately people with Aplastic anemia often do well going through transplant. Often the horrible liver, renel, and cardic side effects occur because of so much prior chemo as in people recieving BMT for cancers. Because AA don't usually have years of prior chemo they have less risk of these SE although there is some risk. The type of donor your friend receives might be the determing factors on how long she will stay immunosuppressed and/or how much graft vs host she might experience. If more than one doror is available, her doctor will be able to go over the pros and cons of v each with her...

Currently, we are using betadine and alcohol both when accessing a CIV. The question was brought up of why we only use alcohol when swabing ports in the line (as in iV push meds) since it all goes the same place. Others then mentioned that some places do only use alcohol when accessing CIVs. I am curious what the protocals are for other oncology nurses. Any data or articles that you know of that have compared the 2 methods as far as infrction outcome?