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While I was still doing prereq's like you, I volunteered on a cardiac tele floor at one of the local hospitals. It gave me a lot of good experiences.

It's "nurse hand" season. Palmer's cocoa butter works well, and if you have cracks already, you can paint them with clear nail polish. It seals the wound and allows it to heal faster. It hurts/burns when applied, but it is the only way I've found to let them heal.

I wear cargo pants, and mine fits there just fine without bending the tubing, plus it's easy to access, and out of the way.

Well we finally got the little guy to the DR and he has a bone growth study which showed his bones are growing at the rate of a 2 1/2 y.o. They also did bloodwork which my sister-in-law told showed some things wrong, but she didn't know what. He is being referred to a specialist. The DR also added pediasure to his diet. I'm suspecting pituitary/thyroid problems. Anyhow, I just wanted to update all of you that responded and offered your opinions. Thank you all :)

I lost my Mother on 10/27/04. I was taking care of her ( off work FMLA ) and she had brain Ca. She knew she was dying, as we all did. We had Hospice working with us. Several days before she died, at home, I asked her if she was hurting, she told me she wasn't, I asked her if she was scared. She said no, and I found out a day or 2 later that her sister had a conversation with her, and Mom had told her she knew Jesus was going to come and take her with him soon. She wasn't scared, she was at peace with this. She wanted to let us know she was very pleased with all of us for taking such good care of her. At the time, my Dad, my sister and my aunt, not the one she had been talking to, and uncle were all staying with her around the clock. The night before she died, I was feeding her dinner. I was making all of the meals that were her favorites, ones she had made us as kids, she was perfectly A+Ox3, and when she was done eating, she got very tired. That was normal, and I didn't think much about it. I was very fortunate to be able to hug her and tell her I loved her befor she went to sleep. She was comatose and her breathing was agonal the next morning when I got there. I helped the Hospice aide give her a bath and change the bed. I suctioned her very well so she appeared to be breathing much less labored. I had to leave and pick up my youngest from school. My sister, Dad, aunt, and uncle were all there with her. I didn't get 5 minutes away and my sister called saying she was breathing worse and her color was getting bad. By then, I was trapped in the circle drive line of cars at the school. She had waited for me to leave to die. 3 weeks later to the day my paternal grandfather also died of Ca. I was there for him when he died. I made sure the nurses kept the MS flowing so he was not suffering. I told him to say hi to Mom when he left. They were very close, she took him to his chemo/radiation tx, and when she started hers, he took her. I just know they are together watching out for the rest of us. We never told him she died, but the day after she did, he stopped asking how she was doing. I'm sure she came to him and told him she was waiting for him. He told me that he was just too old, 86 to fight any more. I told him not to let anyone talk him into anything he didn't want to do. My Dad is his executor, and was able to convince his sisters and brothers that it was time to let him go.

I have found that most, if not all, of the LPNs I have worked with are very professional and good at their job. There have been several that I feel were much better nurses than some of the RNs I've worked with. I wouldn't want to work at the hospital on the floor again without having one on my team. I was always very pleased if the charge nurse let me have one of the LPNs on my team. The pts get much better care, and I can actually have some time to spend teaching pts, not just running my behind off all night long.

me either. And I knew who to call for anything if we had a problem.

I used to work nights (12's) and did 5 in a row. We had 1/3 less staff assigned, before supervision pulled some them to float, so we regularly ended up each having 10-12 pts per RN, and we were very lucky if we got 2 LPNs usually we had 1, and 2 CNAs. This was a post open heart stepdown unit, with 32 beds. We also took ER admits for arrhythmias, chest pain, pre-op hearts and post cath lab pts. This was like 8 or 9 years ago, and I hope they have better staffing now. We also did the MAR's and any other job days didn't want to do. We got shift diff. I would take any float request to any ICU, and sometimes I'd end up taking the float to med/surg, ortho, neuro stepdown. I got loads of very good experiences doing that. I even used to get calls at home on my day off to come and cover an ICU nurse if they were short. SLEEP ?? I felt like I did a good job if I got everything charted before it was time to go do report to days. Funny how I would have to give report to 2 or 3 day shifters. The only way we got to eat lunch was because we were truly a team. If one of us had a pt going bad, the rest of us would step up and take care of the rest of that nurse's pts, and do everything we could to help with the pt that was going down the tubes. I worked some day shifts, and there was nothing like a team on days.

Our area has 2 main hospitals, and another about 20 miles north. They do regularly "close" ER to ambulances at both, but then they go to a rotation. They have increased beds and staff, but it still seems to fill up. Not the same as a "unit", but the ones I worked on never ever closed until they were full. They just shuffled staff around, and work at trying to discharge/down grade pts to home, or say from ICU to stepdown, or med/surg. ( that's why I do what I do now :) I have about 650 "potential" pts, and I'm usually busy. I see an average of 30-35 per shift. I might just remove a sliver, and I may have an amputation, or a chest pain....

Ummmm... for the record, I'm a guy :Santa5:

None :) But we don't always work 24/7 here.

I have a fully stocked jump kit, splints, ice packs, sterie-strips, mask, b/p cuff, stethoscope, and various and sundry bandages, and tape. I've actually seen a few MVA's and the first time all I had was gloves. Next one, I ended up digging my way into a rollover van+travel trailer on the expressway. And, yes I checked very carefully to be sure it was safe before I entered the vehicle. Fortunately one of the occupants chose the seat belt, his wife didn't, and had her behind dragged across the roadway for at least 100' while it was sticking out thru the shattered passenger window. Was stuck there until Fire/Rescue got there and cut out the windshield. They were lucky, she lost quite a bit of shall I say, her pride, but lived. Since that one, I won't go anywhere without at least my mask, some gloves and some 4x4's

Thanks for all of the encouraging replies. I knew this would be a good source for knowledgeable advice :Santa5:

Thanks for the reply. I failed to mention that he also doesn't sleep either. However this may also be the lack of discipline issue. My sister-in-law watches my 5 m.o. and I really do not believe this is a neglect or abuse situation. My son has certainly been thriving. I am more concerned that He is manipulating her into giving him what he wants, and it has been a concern of ours ( the whole family ) for quite some time now that he is so skinny. He looks like Gollum from Lord of the Rings if he's running around naked. He looks almost concentration camp malnourished, and I just wanted to make sure I'm not staying out of it, and keeping my mouth shut and he's actually got a medical condition. She "says" the Pedi is not concerned, but we don't know if it just that, "she says" that.

I have a nephew that was born at 4# 1oz on 4/02/01, he is just over 3 1/2 yrs, and only weighs 26#. You can see every bone in this kid's body. He won't eat "food" unless you make MAJOR efforts to get him to eat. He'll eat sweets, and regularly requests them, but when it comes to foo, he's not interested. He is manipualating his Mom into giving him only what he chooses to eat. She unfortunantely avoids any kind of confrontation with him, which I know is a major part of the issue. What concerns me most, is I have tried every idea I can think of to try and get him to eat. I have only had marginal success. I have repeatedly suggested he see the pediatrician, and my sister-in-law just maintains the Dr. tells her he's fine, which I am having a really hard time believing. I would like some better info or criteria to refer to when trying to encourage her to get him evaluated, and or any ideas to try to get him to eat. It doesn't matter what kinds of foods, or preparation types or anything. He will eat cake, ice cream, cookies etc. and absolutely refuses any knid of regular food. Is this really something I should be concerned about ( gut instinct says so ) ? I have a 5 month old, and he is almost 20#, He's a big kid, not fat at all, just tall, and solid, and my nephew is only a few pounds heavier. Just FYI, I only have the opportunity to directly do anything about restricting the junk food intake on Sundays ( after church ) which is our weekly family day. Yesterday, my father-in-law tried to express his concern to his daughter, and she flipped out and twisted his words into " You're just telling me I'm a terrible Mom ". A little background here is in order. My sister-in-law is 30, is 5'6" and only weighs 90-95# herself, has 2 children from different dads, and is divorced from the mentally/physically abuser father of this little guy. He is in prison for the next 6 years, at least, for drug related theft issues. He broke into my house, his aunt's house, and my in-laws all in one day to get something he could sell for crack. She is also being souly supported by my in-laws, and always has been, there is some kind of lower IQ issue with her, that they have chosen to support her, mostly for the kids' sake. They are not there 24/7 with him like they were with the older nephew ( 11 yrs ), and can't control the situation more directly. Anyhow, sorry for rambling, but I want some opinions. I don't want to push any harder than I have if there is just a lack of discipline/behavior issue. I know that's the case. But, if there is something that we as a family need to intervene, medically, I would really like to know. Thanks, and Happy Holidays :)

I worked both neuro ICU, and progressive, and on the ortho floor. P_RN has it pretty much nailed. However, we were a regional Level 1 Trauma center, and most of them came to us in NICU. we had a Burn/Trauma ICU, but it was mostly an overflow ICU, if not many burns in the house. Anyhow, I would only add that you also see endart pts, and they are typically older. If the chopper took off out our windows we knew we were in for some extra fun. Due to the avg age of pt you tend to get various and sundry other unrelated issues to handle in Neuro. Good Luck :) see as much as you can, and ask every "dumb" question you can think of. You'll learn more that way :)

Wow, I guess I've been out of the house a loooong time. I was one of 3 RN's and 1-2 LPNs and 2-3 CNAs and we were a 32 bed cardiac tele/surgical stepdown. We all had 10-11 whether we were "Charge" or not. This was is a large regional med center. That's primarily why I started looking at other types of Nursing. We all had 2-3 fresh post open hearts, with central lines, drips, and CT's, and the rest were arrhythmias or stable er admit chest pains. Some were post cath lab, but we only took a few to clear out the lab for their early admits, and they were up and about, just waiting for discharge. I ran my butt off for 12 straight, and that was if none of my pts went down the tubes. I went to ICU primarily because it was much more "easy" for lack of a better term, to take 3 very ill pts on vents and such, than it was to try and keep up where I had been.

The patients that I have had leave AMA were typically those that were brought in, less than competent, and not usually of their choosing. They found out we were going to keep them and once the need to find a source of ETOH became an issue for them, they chose to leave. Even after supervision, MD and significant others all explained til we were blue in the face. If they are stupid, but competent, they can leave. And they do. They will most likely end up coming back again........

That's too funny...:) I just splash some in and call it good, what's that mean ??? :)

All VERY good ideas. And... don't piss off the unit secretary, she can make life very difficult ( i.e. orders, labs, tests etc processed ), or much easier, if you keep her happy, all you have to worry about are all of those other things :)

If you have migraines, why would would you possibly care if you are thought of as " drug-seeking " ? In my experience, most drug-seekers are people that have consistently been UNDERtreated for their pain. If you have pain, you have every right to be treated for it. It is now considered a form of negligence if they fail to appropriately treat pt's for pain.

Never heard of anyone seeking phenergan, just c/o drowsiness. Anyone out there hear anything about the possibility of them coming out with a version of Toradol that can be taken long term ? I had it after a lengthy surgical procedure, and I have a bad back ( 2 discs screwed up ), and I was trying to climb off the table/gurney, as they were taking me to recovery from the horibble back pain. It works better than any narc I've been given. I know they won't give it for long term d/t liver damage issues.

i realy didn't know what to make of it. She seemed to be all over the spectrum, and her DR. wasn't any help at all. I called him because she had such strange sx and I didn't want to just rely on the ECG to rule out anything evloving. That's why I started this thread. I have quite a bit of experience in cardiac and neuro and was just at a loss. I wanted to get her Dr. in on it so I wasn't the one that just "blew her off". I told her that she really needed to have the rectal bleeding investigated more thouroughly, and to go to ER if the headache/back pain got sharper and more intense as the night went on. What really made me wonder what was really going on, was how sure her Dr. was that she was just trying to get out of here for the night. But.... she had sx that I didn't feel comfortable just passing off as BS

Been a RN for 9 years Located in the "Mitten" and/or Lower Peninsula (at the crotch :) of the mitten Have worked in Tele, MICU, CCU, SICU, Neuro ICU, Neuro stepdown, and Home Care (skilled), now Occ Health, was Nurse Mgr, but like being an Indian better that the Chief :) Just crested the 4th "hill" Married, 3 kids, 2 girls 14 & 9, and son 5 mo I have a great amount of automony in my current position, and responsible for over 2100 people right now.

I was working on my Law Enforcement degree, got just about done, and did about 15 ride-alongs with officers. That pretty much showed me that I didn't want to be a "social worker with a gun" and I changed my path towards nursing. I really wanted to do something to help others, and felt the police officer job was just a thankless, and not very helpful way to do that. It seemed that we just kept going back to the same old, same old situations, and really didn't see any progress with it. Nursing gives me the ability to make a difference in someone's life, and I get satisfaction from it. It may be that I help someone progress from a problem in their life, and at least I can improve it, or help them to come to terms with their situation. I really like it that I can help them either get better, or at least come to terms with their situation, and keep a positive outlook. (babble, babble... I just love being a nurse :)