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ama3t's Latest Activity

  1. ama3t

    Certified Lactation Counselor (CLC)

    I'm in the same boat! taking my CLC next week but I've got another 1.5 years at least to get my hours to sit for the IBCLC. I'm also stuck on nights :/ good luck! following
  2. I know it varies from place to place.. But to what extent wad this position bedside care at your workplace? I've heard anything from 80% office work with some admission assessments and emergencies, to living up shifts on the floor once a week. I did geriatric med/surg for over3 years, moved to women's health, and really miss my geris! But I'm also over being only at the bedside. I charged on the geri floor and loved it. Out was still patient care but not the tedious parts. I'm interviewing on Monday so I'm got to ask them, but I just wondered about others experiences.
  3. ama3t

    Magnesium sulfate question

    I only care for PP mags. They are strict bed rest, NPO, fluids at 75 (in general). No routine labs but hourly checks including some combo of vitals, breath sounds, DTRs, UOP. They always have a Foley.
  4. ama3t

    Severe hand eczema

    I did go last time this happened and the nurse told me it wasn't up to them. I considered calling infection control or going back to occupational health (it was about 2 years ago last time this happened and I went).
  5. ama3t

    Severe hand eczema

    I have eczema on my hands bad enough to result in cracked, raw, open skin. Dio you feel it is safe, hygeinic, and appropriate to work like this? Or who should I ask? My manager kinda said it was up to me. She advised me to file FMLA but my,doctor said I can work so I'm not sure she would sign the forms. But I'm also not sure I agree with her that its safe. She just said to,never touch a patient without gloves on. But I wonder how clean my skin can get with it peeling like it is, as well as what the risk to myself is with it open. Opinions? Hands Hands - Album on Imgur
  6. ama3t

    Breastfeeding support

    Of course there are occasional medical indications for giving formula, adventure_rn, but this mom didn't have any. Had the mom chosen to give a bit of formula it would have been one thing, but that wasn't the case I'm not a fan of the "fed is best" organization myself. I think it's the mom's decision but I don't agree with putting out the idea that formula is just as good, outside of when it's medically necessary. I say that having formula fed my first. And sorry, I should have clarified we do have IBCLCs. But they have so many patients to see in a day that they can't spend much time with each. I didn't know that about the new nipple sheilds though that makes me feel much better. That's also very interesting about what meds are used in the epidural. I am going to pay more attention to that. We have a lot of C sections and they Duramorph (needed of course) but I haven't paid much attention to whether those babies struggle more. I do know that the one mom I saw that used only nitrous had a more alert baby. We are not designated BF but we are kinda working on it? I can't say too much without being too identifying, but basically we are working toward following all the guidelines, but there is one obstacle preventing us from certifying. We do all the breastfeeding education and stuff. I'm hoping it was just that particular nurse who is so quick with the formula. Although I also saw a nursery nurse pushing a mom to give formula when baby wasn't wanting to nurse post circumcision... I'm hoping to be an IBCLC one day myself, I look forward to being able to focus on breastfeeding education and support, although they don't really get to spend any more 1:1 time with moms than we do...
  7. ama3t

    Breastfeeding support

    I am a new post partum nurse. I breastfed both of my children, the first only for a month due to lack of knowledge and support, they second is still nursing at 15 months. One thing that really excited me about taking this job was helping other women succeed at breastfeeding. I've already become a bit let down by the process though. I was so excited to see that nearly every mom wants to try breastfeeding. But I was shocked to see how difficult it is for almost all of them. Almost every baby doesn't want to latch, and is very sleepy. I know sleepy is normal for the first couple days, but is allot of this the epidurals as well? (I had my baby without and he was alert enough to latch without much issue). Almost every mom is ending up with a nipple sheild, often given to them by the CLC. I know they are sometimes necessary but it seems like they are being used to ignore other issues, and they can potentially set moms up for failure... Since baby has to work harder and there is less direct simulation to increase her milk supply. And finally, allot of times the nurses are too busy to help, or some just don't seem to care to. I saw a nurse walk into a room where a mom was trying to nurse a crying baby, open a bottle, and stick it in the babies mouth without even asking moms permission. Maybe I idealized or romanticized allot off this, but I just feel like these moms hardly stands a chance. We are supposed to be baby friendly, but of all the moms I've sent home on orientation so far, I'd think maybe 10% were comfortable and confident enough to be successful. Is this the norm?
  8. I'll be transferring from med surg to post partum in about a month. I've been on a med surg floor for 3 years so I don't remember that much from school. What could I study up on to prepare? Assessment tools, etc?
  9. ama3t

    How do I become a mother baby or ob/gyn nurse

    99% of the time hospitals are only going to hire people onto dayshift that have experience in that area. More often than not, they will just move one of their nightshifters to days. I understand how hard it is, I'm leaving dayshift med/surg in a month to go to nightshift post partum, and I have two kids. But thats just part of changing specialties. I'm hoping I won't be on nights too long, but we shall see!
  10. I hope this doesn't come off jerk-ish. I charge on my floor at night about 1/3 of the time. There are a few dayshift nurses that everyone, particularly all the charge nurses, is aware that these nurses make frequent mistakes, laps in assessment, etc. Every time I make assignments and one of these nurses is working, I give them easier assignments because I don't trust them to handle higher acuity patients, which is obviously not fair to the other nurses. Some of the issues are bad, but don't cause any major harm: not doing dressing changes, meds given late, 1800-1900 meds left for nightshift because she "didn't have time." But other more serious things have happened too, such as not reporting vital signs to the doctor, etc. This has been brought up to out management and I know they have had a couple meetings with one of the but nothing has changed. The last night I worked one of my nurses got report from one of them that the patient had been "really sleepy" since afternoon. Upon assessment she was RASS -4! We immediately contacted the doctor of course (she was +2 the previous night) and she barely even opened her eyes as we drew her ABGs. pCO2 came back at 88! So to the MICU she went but all I could think was, how long did this get missed? I file incident reports when these things happen because my direct supervisor said that was the most effective thing I could do, but I just feel like its not getting taken seriously! Is there anything else I can do? Anyone else deal with this?
  11. ama3t

    Problems with IV starts/blood draws

    We have 20 cc syringes we can use to draw cultures if we also need other labs. (Or if you only need one other tube you can even use 10cc because the culture bottles can take as little as 3ccs.) I find that using a syringe rather than a causing gives me more control. I'm positive if I had to be switching tubes if be blowing veins too. It's hard for me to keep the needle stay even without switching tubes lol.
  12. I feel like sometimes I focus so much on the bad nights. Yes, this post is bragging but no one around me understands when I say how awesome this night was. I was charge nurse. 1. My medical receptionist brought me Ben and Jerry's and a burrito after her lunch break (I'm pregnant. She likes feeding me) 2. I got FOUR sticks that the primary nurses couldn't get. I used to be the worst stick ever when I started 1.5 years ago. For 6 months I passed every lab draw off to my techs because I was scared! 3. I convinced an extremely confused little old lady to take her meds within 5 minutes. She had had a seizure the night before, and needed her Keppra and she kept saying no. OK even got her to take her Risperdal. Yay! 4. I clocked out at 7:10. Those are all such simple things but after so many stressful nights, so many missed sticks, etc sometimes that's all it takes :) Tell me about a GOOD night/day you had at work :)
  13. So, I'm a night shifter. I had the oppurtunity to train as a charge nurse so I took it. I knew that this mean I had to stay on nights but I wasn't expecting an oppurtunity to go to days to come up anytme soon... Well it did, a week later. Of course I was skipped over becasue I was on charge orientation (just a note, at my facility I am considered "relief" charge and will only charge 1 or maybe 2 shifts/week and staff the rest). Now I'm regretting this tremedously. I was just hinking about how good it might be for my career when I agreed to train. But now I'm so jealous I missed my chance for dayshift. I had a three year old at home and I hate being away from her three nights a week. So my question is this: my employer put money into training me. Six 12s, and three approx 4 hour classes. How long would you feel obligated to stay on nights, should another chance to move to days arise? Thanks.
  14. ama3t

    My job

    I am flattered when my patients like me as a person. Its wonderful when they think I'm a good nurse, but that's what I'm being paid to do. I'm paid to take care of them, not to care about them. But when they can tell I do care about them, and there is a little bit of a personal bond there I like it. I've hugged quite a few of my patients when they left. Maybe its unprofessional, I hope not.
  15. ama3t

    Decub care in the developing world

    Pack with homemade dakin's?
  16. ama3t

    How do you give report?

    I was reading a post about nurses coming to report with a blank paper and not knowing anything about the pt they were getting. This is so entirely different that what we do, so I'm curious what all methods people use. I've seen some places that give you forms to fill out as you go through report, to make sure you don't miss any questions, but I love what my hospital does. We get a printout on all of our assignments. It includes Name, DOB, a small portion of the most recent progress note so we know why they are there, their medical hx, allergies, access, and all current orders divide into Medications, Treatments, Respiratory, Diet, Labs, and Imaging/Procedures scheduled. Its really nice because we have the situation and background right in front of us, without having to write it all down. We still discuss this in report, but it leaves more time to talk about assessment, especially if the oncoming nurse is early and reads through it before report, which a good portion of our nurses do. Does anyone else use something like this?