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janleb

janleb

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janleb's Latest Activity

  1. Where are you, Janice? I miss you.

    1. goodstudentnowRN

      goodstudentnowRN

      Sorry, just found out you died!!! 😭😭

  2. janleb

    I have to be bathed by my classmate???

    We did somthing similar. We wore bathing suits or sports bra and heavy duty undies. Just get over it, and do it. The reason why they are doing this is to put you in the position of the pt. Let me tell you an experience I had. I was working one day I am an RN and had a student nurse under me this particular day. I walked in the room she had my pt laid out nude no bath blanket or anything. exposed to the world. I helped the student nurse, but after this experience I asked if she thought she gave good care to her pt. so I went on to tell her that what if you were my pt and I had you laid out for the whole world to see exposed, whether or not the door is closed. Laying naked with nothing on relying on your caregiver to keep your dignity intact. So when giving your classmates a sponge bath, keep in mind respect for the individual, cover up body parts not being washed, and keeping pt warm and dry. also when putting on a new night gown I always unsnap the old one and lay the new one on top, and put the new one on and pull the old one from underneath. If you just remember one thing the pt you are caring for , you treat them how you would want yourself or loved one cared for and I can guarantee a happy pt and family. preserving a pt dignity is just as important as any nursing duty.
  3. janleb

    "I didn't know you were gay"

    I have been a heterosexual female nurse for three yrs now. My husband is a nurse. I think people don't have a clue all that nursing involves. Not just holding someones hand, being compassionate but also some very critical thinking is involved. I think people think of nurses as a motherly figure. So therefore femine, so any man who dares enter the world of nursing is compassionate, feminine, and therefore gay hmmmmmmmmm. My husband has been an RN for 12 yrs. In that time I have a whole shoebox of letters from families thanking him for the care he has given their loveones. So if my hubby is gay he has been fooling me for many years. So if you hear any more of such comments just consider the source. Because they don't have a clue. Janice
  4. janleb

    detox

    I work on a med surg floor/tele. I was working tele last night a 22 yo male admitted to etoh detox, MI from cocaine abuse, On the third upon admission he tested positive urinalysis, for cocain, marijuana, barbituates, neg for etoh. I looked at the last labs on the sixth still positive for the cocaine. Very manipulative. Late night visistors I escorted out but I am sure they left something behind. The paper they handed him looked similar to what I would say blotter acid would look like. very strange behavior. He is noncompliant. The previous day they used narcan on him. We are not a lock down unit , we are not a drug detox unit. what are my boundaries as far as searching the room . I sent the paper to the local police to be tested still awaiting results. As far as safety issues with security do you think I had the right to search the room? I asked lab the urinalysis lab the cocaine is notdetectable 24-48 hours after admisssion if not using. The doctor only wrote pt not allowed to leave the floor. I told him if he kept up with his lifestyle that explicitely what would happen to his heart, his lungs and his liver and he would be lucky to see 30. But like most 22 yr old risk taking males with psych issues are invincible to everything that the normal population are not. we have no real protocol concerning this kind of issue. As far as I was concerned his third set of CE were negative, SR, using and his BP would be hypotensive, use narcan send him to a psych lock down unit. It is not my job to babysit, he actually had the nerve to ask for a sponge bath, so I told him that I would get Bob the tech to help him if he felt he needed that much help. I had one othe pt cp and on cardiac gtt, pt with CT, confused pt pulling out lines left and right. I think I am angry that a 22 yo has the nerve to throw away a life God gave him so sorry for him that he just doesn't get it. A very bad night thank you for listeningJanice
  5. janleb

    Should new LPN grad go into Med/Surg right away?

    yes definitely for a yr or two. you arenvolvrd in a lot of different procedures. And th e expertise you learn is involuable. Learning procedures are important but also is time management and prioritizing. Which you hear over and over in nursing school but the thing is it is the truth. I fugure if I can walk on a floor and handle 6-8 pt and do my best. Sometimes its eating on the run and holding your bladder for 12 hours. If you get comfortable with that crosstrain telemetry which is also a wonderful experience. Never be afraid to ask for help.
  6. janleb

    Can someone help me with this med-surg question?

    after surgery, especially with the use of general anesthesia. It slows down peristalsis. In a way your body is in a state of shock. think about how traumatizing abd surgery is. Without peristalsis fecal matter cannot move through the intestines. Therefor if you were to eat a full meal you would be sorrry you did along with vomiting, nause, and feeling your going to pull out the stiches put in. Your bowel has to have enough time to heal.. Most of the time start out on ice and sips move up to clear liquids, soft diet bland and so on as well as the pt tolerated it. So to keep your pt comfortable there are mouth washes, ice chips to keep the mouth moist and vaseline lip therepy. But bowel sounds eventually come back but you have to listen for more than two seconds. Janice
  7. janleb

    What are your routines like on a medsurg unit

    You will be amazed how fast a head to toe gets when you have been doing it for al while. fore example as soon as you walk into the room. Introduce yourself dialogue might go as such hi I m your nurse today my name is Janice and you are.......... Don't say are you mary smith I have had confused pt say yes I am. Boy ms Smith how many days have you been here???? are you feeling better than yesterday (that opens up dialogue to any subjective changes that the pt may have. When I ask about where a person is I usually say I ask these questions because some of the meds you are taking can cloud your thinking, Especially with the elderly that are completely alert and oriented are not affended by there mental status being scrutinized. just look around the and get a eye vew of iv infusing any swelling and fluids at the right ratet rate. Foley andy other tubes ect by just glancing as you are talking. Mind you there are certain days when a "comlete" head to toe are not like in the morning so I sometimes listen to lungs , mental status, major reason why pt it here. dsg dry and intact, do any central line dsgs need to be changed, check I & O for the last few days to reduce risk of overload and check for edema in lower extremities. One thing I always do at first thing is check the pt histroy and physical for previous conditions.
  8. janleb

    Do you wear makeup?

    not to much. Just enough so I don't look as bad as my pt. :) base, blush and eyeliner just a little color. With three kids and a twelve hour shift to go it kind of falls to the back burner.
  9. janleb

    IV on the 1st Stick...

    I had to post this a few months ago I found an Iv that was inserted the opposite way it was suppose to go. I got a giggle out of that one.J
  10. janleb

    Surgical Nursing Advice

    I would recomment at least 2-3 yrs med surg experience for every new grad. You get to learn new skills, and practice skills you already learned in nursing school. A typical med surg day is very tiring, but I feel if you can get a good hand on med surg nursing you can learn just about anything. Along with nursing skills , time management, being in charge, it builds a back bone. A wonderful base for any type of nursing.
  11. janleb

    What are your routines like on a medsurg unit

    also don't forget labs and compare to the previous day. Any thing that is abnormal report. Many time I will call the physician just to give him a heads up on the pt condition even if nothing is ordered. Most docs appreciate this.
  12. janleb

    What are your routines like on a medsurg unit

    One thing that is not routine is your patients. I usually work 3 twelve hour shifts in a row and most of the time have the same pt. I always assess my pt as if it is the first time I have taken care of them. Pt conditions can change very quickly. 1. Get report I keep my previous report from the following shift I worked for comparison. (I usually xerox the kardex and write in red the report I get and in green anything I want topass on to the next shift, saves me time. ) 2. My most serious pt I assess first, fresh postop ect. by just going in and saying hi, get a look at the fluids running Ivsite , foley output good , pain level and concerns pt may have, any mental status change ect. 3. Take a look at the mars 4 report to my nursing tech any concerns I have and to make sure we are on the right page as far as pt care , accuchecks ect. 5. I found trying to be proactive , saves a lot of complications. Know a pt history , for instance I don't know how many times I have had pt with a hx of CHF and had fluids running 125, and out put not good and respiration becoming labored, ect. things that are very preventable. 6. Just don't get in the habit of just because you have the same assigment the asssessment will be the same. We assess pt every 6 hours. With that kind of thinking you are putting your pt and your license at risk. 7. And inbetween all the routine things expect new orders so make sure you check, also make sure equipment that is ordered is in use. Long winded I am but I hope this helps
  13. janleb

    IV on the 1st Stick...

    One thing that helped me is have everything you'll need ready. Once you get blood return stop advancing. Hook up your flush and sometimes you can flush the angio right on in without blowing the vein. Good veins are usually in most healthy adults are the radial, have the pt bend their arm and there is usually a good one there. I usually don't go for the AC because when the pt bends their are it makes the pump beep occlusion. Go by feel as well as by site. If you are having a hard time finding one get a warm compress and wrap around the arm that helps sometimes. But most of all practice, practice, practice. sometimes you just can't miss and sometimes you have dry spells. Janice
  14. janleb

    Questionable Pain

    I just took care of a 19 yr old woman that was having unexplained epigastric pain. This lady lossed 100lbs in the last 2 yrs. N/v. She was also a diabetic. Her pcp seems to think it was all in her head. He prescribed a placebo prior to giving pain medication. I called the surgeon that was consulted and more or less was told by him it was unethical but he was not going to dog another physician. The pcp came in the next day and wrote to dc the pain medication and I was all over him. I told him I wasn't going to lie to my pt and she was in real pain. So he still wrote for the placebo. In between pain times I told her that I was going to give her something and she had to be very honest with me aboout her pain I gave 3cc 0.9 ns and came back in 30 minutes and said your pain is still a 9 isn't it.? yeahh!!!! I can't believe a doctor would do this she had gastric emptying study done. After 90 minutes 88 % remained in her stomach. She was transferred to the cleveland clinic for a possible stomach pacemaker. I went to everyone I could think of and wrote the doctor up also.
  15. janleb

    recreational drug use

    Definite NO NO in our profession as with most others. Here is a senerio, taking your boyfriends prescription for vicodin for cramps is not a very good idea, considering if you work the next day and vicodin is short and everyone on that shift has to take a urinalysis and you come back positive. also taking a previous prescription that is yours from months to year ago is also liable. Most people that do recreational drugs, eg. marajuana, cocaine, ect will most likely have drug problem and steal drugs from the hospital. In our hospital one nurse was caught stealing demerol, fired, charges I am not sure. But he was always eager to give pain meds to other nurses pts. to help out. Just think how many pt were in severe pain due to his selfishness.
  16. janleb

    Bathing - scared to death!

    Hi, before you know it you will have seen so many bare behinds it will be old hat for you. But until then, just remember your pt is the one in the buff. Respect their privacy with doors shut curtains drawn, and warm bath blankets over the areas not being cleansed. Usually if you onlyl expose area that you are working on it goes quicker and more painfree. Throw in a back massage at the end and you will have a fan for the rest of the shift. Sometimes some chit chat will make the time go quicker. Hope this helps;janleb
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