JenMarie

HI I am not sure how I go about starting a new thread. My question is kind-of related. I have just found out I am 7 weeks pregnant. In New Zealand antenatal, the delivery and postnatal care is all basically done by "independent midwives" who are either RNs as well as midwives or just midwives. What has amazed me is how difficult it has been to find a midwife. So far I have rung a few and those that got back to mostly said they were booked for JULY 2005 births already! Maybe people pre-book them before getting pregnant?? I understand your education system in the USA is different, but if any were me, would you go for an Midwife who was an RN too. Or would you go for someone who is just a midwife. As an RN myself, I am worried about experience, competence and safety. Does anyone have any thoughts Thanks in advance. Jenny

I note that it is interesting that nurses I work with imply that the VG site is a new site. They are always surprized when I tell them the site has been around since 1954 when it was introduced by Hochstetter. Thanks for the feedback so far.

Thanks again. I am enjoying reading the posts that people written. Correct as you say that the literature states that the Z track closes off the track that the medication is given kind-of sealing it. I am also interested in the following: (1)Feedback on locating the ventrogluteal site versus thbe dorsogluteal site. This is in the view that the Ventroglutaeal site is thought to be safer, without risk to the sciatic nerve. There is a lot of literature about this. (2)The angle of giving an IM injection. Literature that I have read recommends a 90 degree angle. However at a course I went to recently on immunisations, we were told a 60-70 degree angle. It is a contentious issue. (3)whether nurses swab the injection site first with an alcohol swab. literature i have read states that this is not neccesary unless it is visibly dirty. I look forward to your responses. Jenny

Thanks for the 2 replies since yesterday regarding IM injections. I have completed a literature review of this area before I write my best rpractice guidelines. Much of the literature I have read states that the air bubble is an outdated practice. Also interestingly the literature seems to recommend using the Z track method for IM injections now. I would be interested in anyomne else's ideas and practice. Thanks.

Hi. I was just wondering if anyone had been involved in implementing best practice guidelines for IM injections? I am specifically looking at IM injections in children. If you are happy to share what your workplace does, that would be wonderful. I will acknowledge anything that anyone shares as I am currently writing best prac guidelines for this. Thanks Jenny

Hi Shelly I private messaged you also. Thanks Jenny

Hi Curly I sent you a private message Thanks Jenny

Hi everyone I am a peds nurse that works and lives in New Zealand. I am doing a project related to my workplace on fluid balance charts since they are a huge issue in my workplace as there is no consistency. Does anyone have any feedback as to how they do their fluid balnce charts at their workplace. i would be very grateful for any ideas. Thanx Jen

I suggest that you look up the NZ min of health website (http://www.moh.govt.nz/nursing). I live in NZ and work as a nurse. I have live in the UK, but not worked as a nurse so could not tell you specifics about comparing health systems, but What do you want to know?

We take bloods from PICCs using similar protocols as discussed as above. However we are told it depends what size the PICC is. Only able to use it for blood draws if it is greater thatn a size 3 french. If it is smaller than that we always have to have fluids running...which is a real pain for the patient being attached to fluids the whole of their hosp stay.

Hi. I have always wanted to work with DD kids but here in NZ I have found that there are little opportunities to work in this area as an RN. Unfortunately many of the people who work in DD areas are nurse aids and occaisionally ENs (similar to LPN role). I think that it is more a budget thing for places not to employ RNs. However I am also not prepared to work for less money since I am an RN. The closest that I currently come to working with DD kids is working on a paeds ward and severely disabled children sometimes come in for a while for respite care. As an earlier post stated it is best to treat them as normal as possible. I get so many rewards from working with this group. Is it a similar scenario in thee USA with not amny RNs being emplyed in that area due to the financial factor? I would be interested to know.

I worked for a while on an oncology ward that I thought had the strangest protocols. I guess because of morphine and other pain relievers that are so comon at causing constipation. They were always charted on strong laxative medications and if they didn't work we used to give 20 mls of olive oil using a rectum tube in the evening and then follow this up the next morning with a fleet again using a rectum tube. Anyone else done anything similar?

I was interested to read this post. I am an RN, but I am opting to go teaching instead. Some people I have talked to think that I am doing it for the wrong reasons. I have always wanted to make a contribution to society and I think that I do make a small contribution as a nurse. However I also want to be appreciated and employed for who "I" am. I have always found with nursing jobs that I am only employed because I am a nurse. I agree that the same will happen in the field of teaching, but personal attributes will be also important. I hate the shiftwork, the politics and the lack of autonomy in nursing. I am sure many of these things will occur in teaching too, but as far as nursing goes I am burnt out. What is it that you hate about teaching to want to make a change?

Hello I have been working in a sugical ward in Auckland, New Zealand for about 18 months and am about to leave in 5 days time. The main reason I am leaving is beacause I feel so under-valued. I asked my charge nurse for an appraisal several times and I never had one in the whole time I was there. She hardly ever spoke to me. I asked her for a written reference and she didn't even know what my full name was (meaning people mostly called me by a shortened version of my name). In the refence she wasn't even specific in what was good about me that made me a good nurse. What blows me away is that a lot of people think she is wonderful, but how can you be wonderful if you don't even acknowledge you staff? I think it is really hard to feel valued especially if your immediate boss does not value you or take the time to give you feedback. I'm just glad I'm leaving and going to another hospital.