pricklypear

It isn't required at my clinic. Our crash cart doesn't even have ACLS meds on it.

babykitty - you work in a dialysis clinic that allows you to cannulate and perform dialysis through a native vein? I wouldn't think any of the major dialysis providers would have a policy like that.

A. the tech shouldn't have done anything except turn the pt to her side to allow her to vomit without your instruction. B. look up your policy on BFR with catheters. I'm pretty sure it's 350-400. There's really no need to increase the BFR beyond the current rate to give a bolus. C. 500cc?? You should show your tech the policy on standard treatment for hypotensive episodes as well. Good Luck

My experience has been either 6 or 8 hours, usually in sets of 3. I've never had them ordered every 3.

NT suctioning definitely requires skill! Performing it incorrectly or unnecessarily can cause considerable harm and distress to your patient. Please read up on the technique or ask your facility's respiratory department to help you.

Give yourself some time. If you have some good monitor techs, learn from them - they've seen everything!

Hey! What's wrong with the "Mellow Drifter?" When I worked resource pool, I always tried to be that. Maybe you're misinterpreting the "she will make you feel like she doesn't care what you saying" part. You DO have all the characters down to a T, though!!

Geez, calm down...no need to get yourself so worked up and defensive. If you feel like you need to wear a mask because you can't deal with odors, be my guest. I still think it's unprofessional, and while it may or may not further embarass patients, it has the potential to do so. Wearing a mask to see a MRSA patient. Only if the MRSA is in the sputum, or is likely to become air borne in droplet form. And isn't that a totally different situation?

Sorry, Mochabean, I just totally disagree. I've seen and smelled some really, really bad stuff - and never seen a team of health care providers wear masks because of any "intolerable" smell. As Fuzzywuzzy pointed out, masks do very little to eliminate odor, anyway. A dab of metholatum on the upper lip works better. If you can't stand the heat, get out of the kitchen. Do you really think someone is going to complain that they felt embarassed that you were wearing a mask? I'm pretty sure your patients just suffered in silence, just another humiliation to endure. I used to know a new grad in ICU who expected that she would be wearing a mask whenever something unpleasant assulted her nose. This was immediately nixed not only by the other staff but our manager, as well. It's unprofessional and inappropriate. It non-verbally communicates to the patient, "You're disgusting." Does it really sound ridiculous? How about: It you don't like kids, don't be a teacher... If you don't like blood and guts don't be a paramedic... If you don't like money, don't be a banker... If you don't like animals, don't have pets... Get my point?

I have never worn a mask because of odor. I have never made a patient feel bad because of something they have absolutely no control over. Yeah, stuff stinks. And there are even worse things than C-Diff. Like I said, if you "need" a mask, you belong in a different profession altogether. You just deal with it with a straight face, in a professional manner, and move on.

Maybe you should find another line of work if you can't deal with the smells of health care. Believe me, there are much worse smells and sights than a soaked diaper.

Kind of an unnecessary comment. Have you ever worked in an outpatient HD unit? If you had, you would understand the frustration of having an incontinent patient in a RECLINER who probably cannot stand or be repositioned without several people, poop everywhere, no privacy curtains or nice little bath buckets with hot soapy water. Alarms, turnaround, patients wanting this and that, docs on the phone, BPs in the toilet all around the room. It's not really that HD units are "poorly" staffed, we are just not staffed for that kind of treatment on a regular basis. Having someone be incontinent on the ED gurney with supplies and help convienently nearby is a different story.

I'd add in office/clinic nursing, possibly dialysis, school nursing, home health, case management... Most nursing jobs do involve "direct" patient care, in other words, "having contact with patients." But"bedside nursing" really refers to hospital/staff nursing, LTC, nursing home type of jobs. As for new grads? Dialysis sometimes hires new grads, home health sometimes, too. Although I would recommend getting some "bedside" experience in your pocket. It's not always pleasant, but it does offer tons of learning experiences in procedures, disease process, time management and people skills. These will serve you well and broaden your horizons in the future.

I'm not sure how a short note with a few tasks is improper delegating. I receive written orders all day from doctors, I can't just not do them because I feel that I was treated unfairly. It doesn't matter, anyway. Please understand that the point is: the patients' needs were not met because the tasks were not performed as instructed by the RN (yes, instructed), and the CNA displayed wholly inappropriate and unprofessional behavior.

(((((((JB2007))))))) I'm sorry. Sometimes I wish I had gone into archeology. I have felt like I was banging my head against a wall for most of the 9 years I've been nursing.