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diddoms

diddoms

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  1. diddoms

    I have a question about humor etiquette

    In my experience Patients cope well with Nurse's foibles. Being open and honest with them is often an ivitation to them to open up to you and tell you things they have never told anyone else. One of my favourite sayings is that" If you don't laugh you cry". If that doesn't work try an apology. That usually works. Patients start getting upset and mistrustful when you stop being open with them. I think that's one big reason why a lot more Dr's get sued compared with nurses. It''s got to do with being open with your patients and not too defensive.
  2. diddoms

    SAD: Just Wondering........

    I live in Australia and our winters are pretty short compared to you guys. I once met a woman from USA travellin g in Australia . She was the first person who I had met with SAD. She used to get quite manic in summer and severly depressed in winter when she lived in Maine. She successfully managed her SAD by moving to Hawaii. She said it made hwe feel like a new person. I know it's a bit further south than AZ, but it's still the USA. I wish you well.
  3. diddoms

    Negative CVP?

    CVP measures pressure in the Vena Cava which sits in the Thoracic Cavity. During inspiration we create a negative chest pressure in order for air to fill our lungs, and then a positive pressure to expell air.( Boyle's LAw) CVP should always be taken at END EXPIRATION. This is when the air pressure in the chest equals the air pressure outside. Since at end expiration there is no difference in air pressure what you are reading is purely the CVP. It is actually quite a skill to read a CVP accurately. Patients with any respiratory condition can have abnormally high or low chest pressures, and these thoracic pressures are all reflected in the CVP. If you want more info I'd recommend you read "Hemodynamic Monitoring" by Gloria Darovic( Saunders) Q1 Are you reading the CVP frm the wave or just the number? Whilst the number is often accurate, it only gives an average or mean pressure. Q2 I think you mentioned you checked the equipment,I'm assuming that included a re zero. ? In my exerience transducers often wander. If you had a faulty transducer that may have accounted for the problem. If all these things had been checked try another cable. A faulty cable will lead to loss of zero. YOu can get sucked in because you've just rezerod and the numbers are going wild. Wiggle the cable around and see if that makes a difference. After the cabl;e I'd then try a new transducer. Hope this helps. Regards
  4. diddoms

    Are ABGs, Arterial Blood Gases an invasive procedure?

    Definately Invasive. If they have an art line that is an invasive line and can be very painful even when local is used. ABG's via a an arterial stab are also invasive, and as the earlier post suggests, very painful. Oxygen Sat can be accurately read from a non invasive finger probe if there is good circulation, but when the numbers aren't looking good most peopel will want a gas before changing management, eg intubating.
  5. diddoms

    More Strange Baby Names

    I know a girl called Dung...Dung is a common Vietnamese girls name. It is pronounced like the famous philopsher's surname, Carl Jung.
  6. diddoms

    How do You deal with Man-Hating Female Nurses?

    I'm male and I've had that experince too .Only once in 18 years, but it was hell at the time. What you are experiencing (isolation) is a covert form of bullying. Conversations suddenly stopping when you walk in the staff room, not being acknowleged etc, being left out of coversations, being ignored.eg Having to listen to 'why women need men as much as fish need bicycles'.( when was the last time you saw a fish putting out the rubbish bin? is what i usually reply) Having a quick retort can help, but don't get upset , because that's what they want. If you get angry and rash and are provoked into saying something they can use against you it will only reward their bad behaviour.:) Having said all that Discrimation and bullying is something women have had to deal with for years in male dominated workplaces. Males can do it to other males and females likewise to each other. I worked in an all male culture once and hated it. What's the answer?? I think work places that have a good gender mix are best. Ying and Yang and all that. A few women in an all male envirinment are jsut as important as a few males in an all female environment. In my experience the culture of bullying is rife in nursing. We take great care of patients but treat each other cruelly at times. Bulling usually occurs when soemone is a bit different, and being a different gender is but one exapmle of this. The up side is that most women I workl with really enjoy having a male about to break up the all female work place. Being different people remember you name and if you do something good it usually egts noticed.The one rule I adhere to I think was alluded to by This is perhaps one reason men do generally get promoted ahead of women.They get noticed more for doing exactly the same work. Because nurturing and caring are not traditionally seen as male traits I do IMHO think most ( not all) guys also choose nuring because they really want to do it. I'd either try and get some more males in to your work place. If there are 3 or 4 of you I think the problem will stop by itself. If you an't get more males to join consider leaving and finding another ER to work in. Try confronting the ring leaders. eg " I notice every time I walk in the room the converation stops. " Revealing 'The Game' might take the fun out of it for them. The best way to really **** these bullys is as someone else said to be really good at what you do, keep a clean slate eg never take longer than you are entitled to for breaks, and keep being reasonable and nice. Eventaully they'll give up when they realise that it's not working and they'll move onto someone else. That's my observatin of bullies. Generally I love working with women. I have always had one rule..Don't dip your pen in the company ink... One of the other women mentioned fear as a possible motibvation. There may be something in this. Once women know you are happily married or gay and not a sexual threat they tend to really open up a lot quicker. I think the fact I never had a sister is the reason I went into nursing and that's the best way to relate in the work place. Good luck and let us know how you get on. Hope this is of some use. Regards Diddoms
  7. diddoms

    PE and R. to L. atrial shunt

    I used to work in a hyperbaric facility where we treated amoungst other things scuba divers with the Bends or decompression illness( DCI). Every once and a while we would get some one who had relatively severe symptoms given the nitrogen load they were exposed to. We would send them off dor testing and usually they still had a patent forame ovale, which is supposed to close over after birth. Sometimes the opening occurs with straining( valsalva manoever). Small bubbles of nitrogen return to the pulmonary circulation and are usually filtered by the lungs, but when a R>L shunyt occurs the bubble are free to move out into the circulaton where they cause all the problems.
  8. diddoms

    All You Lefty's Out there....

    I'm ambidextrous. Does that count? I do some things with the Left hand and some with the right.
  9. diddoms

    Open or restricted visitation in ICU/CCU

    I've worked in 3 teaching hospitals in Melbourne Australia. It is our custom to have what you would call open visiting. We limit to 2 visitors per patient, but people can visit 24/7. Having said that we stingly encourage relatives to go home and get some rest. We encourage 1 contact person per family who is the spokesperson for the family. They are the only person to be put through to ICU telephone, however soemtimes this doesn't always work. A big part of our job is talking and reassuring family. We have a holistic approach that whilst our duty of care is to the patient, so long as this is not compromosided by visitors we will let them in. Do we keep them waiting?. Yes often, but people are pretty understanding on the whole. Because they see us working so much they can see how busy we are. Regards
  10. diddoms

    Need advice about failure to thrive

    This sounds like a complex case. I think this kid needs a bit of "tough love". This kid has used food as a way to control his parents . Being a poor eater obviously gets him a lot of attention form the parents, albeit in the form of anguish, frustration , despair. Nothing is going to happen until the parents give him some very clear boundaries. Consistancy is the key in my opinion. They seem more the indulging types. If they have trouble managing him at 3 this kid is going to be uncontollable in his teens. Kids being human are always wanting to exercise some control over their environment. The way I've always managed the food issue with my daughter is to give her a choice of 2 things that I think she should have. Would you like apple or orange? She will usually reply chocolate, but I then introduce the third choice which is nothing. Then she ususally choses something on offer. I'm happy because she eats something healthy. She's happy because it's not a control issue and her hunger is satisfied; I'm not telling her what to eat, she is exercising soem control. Another thing a MAternal Chiuld nurse told me is that kids will eat when they are hungry. If the kid throws a tantrum and refuses to eat they will usually eat if they are hungry.My guess with this kid is that he might hold out for a few days, but eventaully he'll give in. Sometimes if my daughter is a bit ferral I just leave food out on the bench and give her a bit of space. As long as I don't make an issue of it and remain out of sight she will go and eat when she thinks I'm not looking. She's happy, I'm happy. It sounds like this kids eating habits are pretty ingrained, and I think it's going to take a lot of resolve from the parents to crash on through some major behavioural modification with this kid. They are going to need a lot off reasurance, but until they stop denyiing that there is a problem this kid is going to keep l;earing that he can hold his parents to ransom. I get my daughter to help me prepare the food, then she is more interested in eating it. We make bread( occaisionally) or use vegtables form the garden. Home grown vegetables taste so much better and the broccoli and couliflower we harvest from our veggie patch taste sweet. I get my daughter to help harvest things from the garden and I'm sure that has helped her to eat healthy food. Good luck. Hope this is useful.
  11. diddoms

    What does your spouse do?

    My wife is also a nurse. We met over a hot resus in ER. :rotfl:
  12. diddoms

    stupid question from a student

    There is no such thing as a stupid question, just dumb answers.
  13. diddoms

    suspended for signing an 8pm med on MAR at 5pm in error

    It looks to me that you've been set up, and you've been a victim of BAD management. Any manager worth their salt would have aske d for your side of the story, and then at least councelled you. It looks like it was premeditated adn someone wants you out. The fact you have 7 years experience compared to the LPN 1 yr the motive may perhaps habve been either jealousy, or a controll issue. Bad managers feel they have to control everyone and everything all the time. I 've met quite a few in my time. I think you're better out of that environment. If you fight and stay it could get ugly. Your next workplace can only be better. Goodluck.
  14. diddoms

    Should nurses return to wearing uniforms?

    1. 18 years 2. Acute. ICU 3. Major city hospital - Australia 4. BSN with Post Grad Cert 5. NO! No and NO. I used to have to wear cotton scrubs when I worked in a hyperbaric facility. That was for safety reasons. They were comfotable but any time i stepped out of the unit I always felt like I was waering pyjamas Scrubs are OK if yu work in theatre. There is a good reason to there. Elsewhere I find uniforms stifling. I think sometimes people in ER (or ED as we call it here) like to create a 'team uniform' for all medical and nursiung staff. It is also a away of creating an us and them distiction between patients and staff. In the time i worked in ED I found that a lot of objectification occurred. The uniform can be a barrier to hide behind. Having said that I was greatful to be wearing a uniform that I could readily change the night a patient vomited a bag a of charcoal all over me. The argument that uniforms help the patients identify nurses from other staff doesn't work in my experience. Even in the days when I wore a uniform patients frequently assumed I was a doctor. I attribute this to the fact that I'm male. As a male I have learnt that the best way to communicate the fact you are a nurse to patients is not by relying on uniforms. They don't work. I introduce myself at the start of the shift with something like.."Hi I'm Rob and I'm your nurse for the next shift." I find that introduction more than any other 'visual communication' is both more effective, as well as being more professional. Historically nurses uniforms have been oppressive in my opinion. When I started training 18years ago the girls had to wear an old fashioned chambermaids uniform complete with starch collars and cuffs. For the mature age students they found the uniforms both uncomfortable, impracticle and humilliating. The efforts the girls had to go to get even a modern uniform was immense but in the endthe end the hospital had to give in and let the girls wear pants and tops like the males,so as not to be discriminating. Not long after that the hospital moved away from uniforms alltogether when it realised that it could save all the money on laundering uniforms. But some nurses don't dress professionally I hear soem argue.You will always get some nurses who won't dress professionally I agree. I believe this is an issue that any unit manager worth their salt can handle at a ward level. The whole notion of uniforms I find oppressive, and there are always soem in the hospital hierachy who like to keep nurses in their places. 6. Smart casual clothes with a namebadge clearly visible, clean shoes, and a friendly face. Nothing too overtly sexual. Low hipster pants with a thong ( G string) showing when you bend over is not going to do anything for your male patient's acute angina. For guys without beards I think it's important to be cleanly shaven when at work, as much as I hate shaving. That's my 10 cents worth. Hope it's what yo wanted.Interesting topic.
  15. diddoms

    were do you live?

    Melbourne, Australia. Hospital trained, Qualified 1990, working in ICU since 1992, would have serious difficulty looking after more than one patient now. Spent 4 years working in Hyperbaric Unit. Currently working as Post Grad Educator. Happily Married ( another nurse) with 5 yr old.
  16. diddoms

    Tracheal Suction Technique

    Here is an excerpt from the The Journal of Clinical Nursing which throws some light on this discussion. Hope you find it useful.>> >> Volume 10(5) September 2001 pp 682-696>> An evaluation of a teaching intervention to improve the practice of endotracheal suctioning in intensive care units>> [Articles: Issues in Research Utilisation]>> > > SUCTIONING