Booty Nurse

I was going to post this useful link to reusing N95s, but the page is currently down and says it’s being updated with new information. Hopefully it will be back up soon. https://www.sages.org/n-95-re-use-instructions/?fbclid=IwAR0ys_dzosLtcFQp9O4UAAz6i1Gcdt8E6M8fH6KFZHtt5Ww2OJlLS5pClLM

I’m an OR/PACU nurse and went down to per diem a few months ago. On Monday my hospital finally decided to cancel elective surgeries, and I was temporarily laid off. But not for long - yesterday I was asked to work in our new negative pressure unit with a presumed COVID-19 patient (awaiting test results). Yikes! I have a choice of an N95 or a PAPR. Which is more tolerable for a 10 hour shift?

My unit sounds just like wvgi's. We are a small hospital; we have scrub techs, LPNs, and RNs all do the scrub role, depending on what's going on in the rest of the unit (the rest of the unit being an OR). In addition to the sedation and other tasks mentioned, the RN is responsible for monitoring the patient. I haven't heard anything about techs no longer being OK.

You sound very motivated! I'm doing the Slippery Rock (SRU) program, but at a very leisurely pace compared to what you are planning. SRU is cheap at ~$800 for a 3-credit course. One of the reasons I chose it was because they didn't require additional general education courses. In contrast, U of Wyoming (which I also considered) requires you to take Wyoming history. I decided against FHCHS because of the religious aspect; also, they were very aggressive in trying to recruit me (such as calling me at home a few times, unrequested), and that turned me off. I think they are a for-profit school? I have had a pretty good experience with SRU; there have been a couple of professors who I was not impressed with. As far as the shortest to complete, look at the list of required courses, including any prerequisites and general ed courses, and count up the hours. Why the big rush to get all the way through school so quickly? You're already ahead of the game, graduating from high school so early. Don't forget to enjoy yourself and experience life outside school. On the other hand, I think it's great you are so gung ho. You go, girl!

Slippery Rock University doesn't require general ed classes, and it's cheap! http://www.sru.edu

I've been an endo nurse for just over a year. Every colonoscopy I've assisted with has been under either fentanyl and Versed or Demerol and Versed (or with MAC). One doc I work with has done colos without any medication if the patient requests it, but no one has requested it since I've been working with him. I think a narcotic alone would be fine if that's what the patient wants. However, I see huge benefits to Versed; patients come in very nervous, and with Versed on board the anxiety goes away. Patients can chill out or snooze through the procedure. Versed also help make the procedure go easier because the abdomen is more relaxed. I don't buy the argument that the only reason for giving Versed is for the amnesia. In my hospital, the CRNAs give propofol, Versed, and fentanyl to almost every colonoscopy patient.

My son had a mysterious GI issue when he was 10. His symptoms were mostly pain, but also had nausea, headache, and dizziness. We went through several diagnoses, many drugs, a barium enema, and a colonoscopy & EGD. He missed almost six weeks of school. It was so horrible to watch my normally rambunctious son doubled over in pain for hours every day. All tests came back normal. His final diagnosis ended up being recurrent abdominal pain disorder, a functional disorder similar to IBS but higher in the GI tract. It went away by itself after about two months, thank god. I would begin a workup with the least invasive tests first. Good luck and hang in there!

Check out Slippery Rock U. of Pennsylvania (http://www.sru.edu). It's about $750 for a three-credit course. I'm attending there now, and I've been generally happy with it. My big complaint is with the few classes that require a clinical component. I have had trouble with the school and setting up local clinicals.

Never put something yummy on your member and scrotum, then entice your dog to lick it off (Very Bad Outcome).

I heard about fecal transplant at a GI conference I attended recently. It was a new one for me! If I remember correctly, it can be used for C-diff that is not responding to other treatment -- kind of a last resort. The idea is that in severe C-diff, all the patient's "good" bacteria have been overwhelmed by the C-diff and are very depleted. Stool is collected from a family member (who would tend to have similar bacteria as normal colon residents) and is administered by NG tube (not PO!). The influx of "good" bacteria will then, hopefully, overwhelm the C-diff.

I used to work evenings on med-surg, and I was cross-trained to OB where I worked every shift, a few shifts a month. One morning the OB manager (not the supervisor for some reason) called at 5:15 AM after I had worked 3-11 on M/S the night before, to ask me if I could work 7-3 on OB. The thing is, I was already scheduled for 3-11 that day too! She didn't even have the courtesy to check my schedule before calling and waking me up. Grrrr. Of course I was too mad to go back to sleep. I got caller ID a few years after starting work as a nurse, and it made a big difference. I tended to turn off my answering machine too, so I wouldn't have to return calls. Now I work GI endo and never get called!

Um, not exactly. Not according to the American Society of Anesthesiologists, anyway. From Practice Guidelines for Sedation and Analgesia by Non-Anesthesiologists: I much prefer doing endos with a CRNA providing MAC, and wish they were all with MAC. Propofol works great, the patients are more comfortable, and I know I have an expert in the room in case anything goes wrong (in my state, an RN can't give Propofol, which is fine with me). But hello.... RNs are not in charge of hiring! Payment for MACs is a huge issue, and with health care financing getting tighter, and CAPS and fospropofol waiting in the wings, I imagine that CRNAs will be in the rooms less, not more (not a good thing, in my opinion). Not sure what you mean here. To know the A-a ratio, you need to get arterial blood gases, which are not done for a routine colonoscopy/EGD. Care to elaborate?

Father of baby provided with bedside vasectomy by this nurse.

Hi JoAnna, Welcome to the world of endo! Here is a good website to help you learn about sedation meds: http://www.sedationfacts.org I use Demerol & Versed or Fentanyl & Versed for my patients. In Vermont, RNs are not allowed to administer Propofol, so we have anesthesia come in to give that if the patient needs it. Propofol works great, but can cause a lot of respiratory depression, and there is no reversal agent.

I worked on med-surg for 4 1/2 years, and moved down to the OR in January. I like it much more than med-surg. I should note that I am not a "real" OR nurse; I work mostly in the procedure room within the OR, doing mostly colonoscopies, EGDs, and some local anesthesia cases. I also help out in bigger surgical cases and am working towards being a second nurse in the PACU. The biggest difference for me is that in the OR, you have one patient at a time. On the floor, you are constantly pulled in different directions by patients with different needs. I also found the floor depressing after a while, seeing the same chronically ill patients who were never going to get better, having elderly patients facing a move to a nursing home, or caring for young dying cancer patients. It wore me down. Also, in my small hospital, the OR staff is a more cohesive group of co-workers; on the floor, there was a lot of infighting between different shifts. I really like the OR. Maybe you could spend a day shadowing a circulator?