Five&Two Will Do

Thank you very much

\ Ok, let me try again...I believe that I apologized for any misunderstandings from my earlier post. Either way, the OP probably doesn't need you to defend her/him. I never cease to be amazed with the touchy people on this site. I apologized to you to for that matter, so if that is not good enough for you or there are some other reasons that you feel like continuing to argue with me.....too bad..I am done. To all of the others that may have understood what I meant, CHEERS!

I don't know what kind of unit you work on, but it is nice too leave the monitors and gtt's and definitley doctors behind for a day!!!

And sooner or later after many hard shifts of work overload and all of the extra responsibility that comes with the letters "RN" a good shift of patient care or sitter duty is quite appealing to me too!

PM any questioins you may have. I am in NC, where are you going?

I hardly think disparage is a word that would rate my comment appropriately. All I am saying is that "patient assessment and meds, treatments, dressings" are only part of the entire nursing practice. Do you think that each level of licensure builds upon the last? I do not think it is acceptable to promote the concept that once one has the letters RN after his or her name, it removes the responsibility for the lower level duties of the nursing practice. You clearly share the OP's opinion. The beauty of the autonomous practice of nursing is that you can do it how you see fit. I know for certain that the largest hospital in this city will flex nurses home and have them use their PTO if the census is low enough to allow a nurse to be a sitter. Surely it is better to do "CNA work" and get paid RN $. I do think it is repulsive for an RN to make it seem as though their title means that they should no longer have to do the CNA work. I went to school to expand my scope of practice. That does not mean eliminate part of it. Sorry if you disagree and sorry also to the OP if I was too harsh.

Congratulations and welcome to the largest healthcare network in the world! I love the VA. I would work at another hospital, but it would have to be a VA as well!

I work in a medical ICU, we do not have any nursing assistants most of the time. I was a CNA for 5+ years before going to nursing school. The term "CNA" work is really really insulting. NURSING begins with the basics. This includes being a sitter, or feeding someone, or bathing, or even, heaven forbid, wiping some poo. It is repulsive to hear any nurse make these types of statements. No I do not personally like doing a lot of the things that I do, but it is all part of promoting dignity for the patient.

I love being a nurse. I like the ICU more than I did the floor, but it was fine too. I do not mind working hard, and that seems to be one of the important components to enjoying this career. The people that I hear complain about work and how it is so terrible at my hospital usually seem to be the lazy ones. That is just my observation. I can imagine, however, with the amount of work place bullying that has prompted the civility in nursing push, that some nurses may be miserable because of the way they are treated by their coworkers. I work on a great unit where most people seem to get along. I have a wonderful nurse manager. Nursing is the best career choice I could possibly have made.

Hi does anyone know how much volume is given per squeeze from an adult ambu bag? Just curious and I could not seem to find this info on the manufacturer's site. I am not asking about the assessment for adequate ventilation, ie. monitoring chest rise, just the volume delivered with a full squeeze of the bag. Thanks, Mike

I never understood putting all of your personal life on the internet. I have personally seen nurses call in sick to work and then our coworkers see that they post later that afternoon what a wonerful time shopping at the mall. I had a FB page for a minute, but i get bored with it. I am convinced that people that put all of the profanity and "girls gone wild" party nights on the internet do it merely for the attention. The reality is that most normal people find it pathetic. I am certainly not any kind of self righteous goody goody, but I would hate for one of my ICU patients or their families to see me throwing down on the internet and the next day titrating meds on them.

I like Tarascons pocket critical care guide, but as has been previously stated each facility has its own guidelines for gtt's. For example we have several nurses on this unit that came from a major medical center in the area. I received a patient from the ER the other day that coded in the elevator on the way up. RT was bagging as they rolled through the door. VFIB= shocks with epi and CPR and finally we have a pulse but no pressure. levo, dop, and neo all running wide open along with NS bolus. Our max neo is 180, apparently where the others came from it was 300. Go figure, it worked at the time, but I did titrate the neo down asap.

We always send them with the body to the funeral home. I have never put them into a person that had expired. I guess they could fall out or go down their throat or something, but if it made the family happy, good for you. I have never been asked to do something like that, but I probably would too.

I am not talking about central lines. We just need a better alternative for patients that are difficult to maintain access on. A short term bridge until central line placement can be acheived. This hospital is small and the PICC nurses do not take call or work on the weekend.

Hello all. We are working with the PICC placement nurses to develop a competency for EJ insertions. I wonder what size catheters, length included, taht you have seen used for this. Does anybody have a link to good policies for this procedure?

This topic comes up periodically. I do not believe that it is alright for an unlicensed individual to refer to him or herself as a nurse. As has been mentioned, it is illegal. If the CNA's or MA's that practice this had worked there way through nursing school, they would understand why people like me are dead against it.

I certainly like the "hanging the arm over the side of the bed" trick, and the one on the underside of the forearm I have nicknamed "Old Trusty". Practice practice practice! Look for chances to try on difficult people, but do not just go in there sticking them. Think about what you are doing and what you will try differently this time. Everyone has a batting slump, so do not be sad-it will pass.

Everyone has their own struggles. Perhaps I could exercise more, or eat a bit better, or take more vitamins or whatever. Maybe I smoke too many cigarettes or drink a little too much a little too often. Who cares! I am not perfect nor do I really give a hoot what anybody else thinks. We all have chains of some sort or another, perhaps some people feel compelled to be too perfect. That does not sound like a very fun existence to me. The bottom line is that I give good appropriate teaching to my patients and their families, whether or not I take my own advice is of no consequence to anyone but me!

If I tested positive for anything, I would certainly request a new test immediately. You are waiting, hoping that they "lose" it? Really! Please for goodness sake go ahead and request a repeat test unless you have something to hide.

We had clinical instructors that were not nearly as nice as you sound. There is a lot of fear generated by nursing school. What if I miss too many hours and fail. We had people go out in the last semester for that. I think it owuld have been wise to have her leave early whether she wanted to or not, reassuring her that you would not count the time against her. What if the administrators of your program found out? I think ours would have counted the time against us. How pitiful! Don't worry, I am sure she is fine. Was that a manual pressure?

We can disagree just fine. If you read my earlier post, I said ONS/INS standards and trainings. The "O" stands for Oncology in my last post. As Muno wrote, there are many many incidents of infection r/t central lines. The cause of which is currently being researched by countless groups including one here at this hospital. Standards of practice and evidence based practice constantly evolve. This does not mean that aseptic technique is failing, but perhaps operator error so to speak. I would just like to see one credible source that states it is acceptable to push, flush, irrigate or however else you would like to say it, a central line with a 3ml or smaller syringe. I understand and agree that a power picc or port that can handle radiological infusion rates probably isn't going to rupture a tip with a 3ml syringe. I am just saying that there are plenty of central lines that are not power injectable, and plenty of students and new nurses on this website that should not be confused by the techniques you describe. Alas, this is my end in this discussion. I will say that I prefer to dilute most medications and push them with a 12ml syringe. That is how I practice, and if you are all licensed you may adapt your practice to fit your own interpretation of law and manufacturer recommendations as you wish. Have a great day!

I am well aware of infusion standards as I have been through ONS/INS training for the proper administration of chemo/biotherapies. There is never a time when a syringe less than 10ml should be attached to a central line of any sort. The pressure itself is generated by the small diameter of the syringe, and whether or not the nurse can feel any sort of resistence when flushing/aspirating, the same pressure is appled to the catheter. And yes, my hospital follows EVP.

No offense to you, but this is not the best practice as the pressure generated by a 3ml syringe is too great to be considered safe for a central line. This is the policy at the hospital where I work. Aseptic technique certainly allows for the transfer of the med from 3 ml to 10 ml syringe.

That is for certain. I had to take a break from AN for a while due to the utter negativity. I like the technical posts about actual nursing practice, not the whiny nonsense that is put on this website about nursing school, old nurses, new nurses, no jobs, bad jobs, mean bosses and the like. Let us get back to talking about issues that will help grow our practice. If people are mean, oh well. If instructors are tough, oh well. If your job is terrible, oh well. Deal with it like the rest of the world does, and remember that YOU chose to be a nurse. If all else fails, there is always a job at walmart or as part of the waitstaff at the local dive!

It is terrible that the job market is so competitive right now. I would say that if you start in a specialty like psych or L&D taht you can become trapped in that field due to lack of experience in other places. That is why they always say start in general med surg nursing. Good luck and I am sorry that you are scared at work. That must feel terrible.