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Jenneu's Latest Activity

  1. Jenneu

    No More Demerol?

    We use it for rigors during bone marrow transplant and if the premedication for amphoteracin B doesn't work. For pain relief we use either morphone or dilaudid.
  2. Jenneu

    WHat floors are more fun/social??

    Not trying to flame anyone here, but the social lives of the people you work with should be at the bottom of your list. Why not look for a specialty that interests you? It scares me that the nursing part of your job search is secondary to looking for a good party atmosphere.
  3. Jenneu

    Child with rash

    Take him to the doctor.
  4. Jenneu

    I NEED MAJOR HELP PLEASE! Scared of needles

    You had the vasovagal reaction because you were on the receiving end. Don't sweat it, like everything else, you will get used to giving injections as well. Good luck!
  5. Jenneu

    I am an RN but am NOT getting training. HELP!!

    Something just doesn't seem right here. After central orientation, you should be paired with (ideally one for consistency sake) an experienced nurse for a few months. I am glad that the other nurse refused to accept that type of assignment as well. As a licensed professional, you are expected to work up to your license. So even if you are doing vital signs and taking people to the bathroom, you are still expected to assess and react as an RN would. But without the proper training, how can you be expected to do that? You need to talk to your NM, even as a GN you should have been receiving training as an RN. As a GN, I checked and hung blood, gave chemo, IV push medications, performed assessments and did my own charting. I had a preceptor who kept up with what I was doing, and did not have an additional assignment. After a while, she brought a book to work! But that is what was supposed to happen, so the day that I was on my own for the first time, I was ready for it. Good luck, and start looking around to see what your options are! Jen
  6. Jenneu

    pic line or mid line

    which is supposed to sit in the right atrium. A midline is just a longer peripheral - a few inches longer than a regular peri IV. They can stay in place longer than the 3-5 days that a peri. can stay in place. Also a PICC can remain in place indefinately as long as it is well cared for and no infection develops. The facility where I work started using triple lumen PICC lines - and they are great especially when you have patients on multiple antibiotics, antifungals, antivirals, needing packed red cells AND chemo in the same day! Hope this clears it up. I've never seen or used a midline - anyone else? J
  7. Jenneu

    What's your opinion? Unethical???

    take patients, no matter how in need, into our homes, crosses the line. These are adults who are in a bad spot, but a call to social services, and then following up to make sure that they were taken care of, is an appropriate level of caring. To be quite honest, and maybe it is my cynical side coming out, but it sounds like these people are playing (or maybe preying) on this person's misplaced good intentions. I think that learning to maintain a healthy professional distance is key. My patients have my complete attention when I am there, but when I am not, my family and friends are front and center. J
  8. Jenneu

    Removing a Catheter from a male pt

    your poor husband. You just deflate the balloon and have a basin ready to catch the catheter and any spillage that occurs. I *guess* she did that to avoid the urine spilling, but I'd say with reasonable certainty that particular practice was not in the facility policy and procedures. When doing a procedure for the first time in a new facility, check out the P&P manual - it should be at the nurses station and it will impress your instructor. As a student with only one or two patients, you have the time! Good luck with clinicals!! J
  9. Jenneu

    How do Doctors treat nurses

    because it surely seems like the hospital and nursing management is implicitly allowing this treatment to go unchecked. night shift or not - would a nurse who spoke to a doc go undisciplined? we are expected to be our same therapeutic selves no matter the time of the day, so why do nurses (as a profession) accept this kind of behavior from the doctors? the unit where i work isn't perfect, but the attendings have never been verbally or physically abusive. we have a moonlighter on call at night, and that's who we wake up with anything necessary. but i don't apologize for waking the doctor at 2am when the patient needs an order for pain meds, or spikes a temperature, or has a critical lab value. that's what they are there for. we don't get a nice cozy room with a bed, tv and a shower when we work nights, therefore i don't apologize for making them do their jobs! (i'm still polite and professional!) i think that nursing has come a long way in the past decade or so, but we still have quite a way to go before we are recognized as a true profession by most of the docs, considering that they come out of school not knowing what a nurse actually *does*! i wonder if we learned to collectively stand up for ourselves (not just union-wise) and showed these docs that they can't get away with this garbage anymore! anyone else reading nursing against the odds by suzanne gordon? i am about 1/4 way through and it is enough to angry up the blood!! j
  10. Jenneu

    New Bone Marrow RN ;-)

    I've been thinking about this for a few hours and I guess just reading up on the pathophysiology of leukemias and lymphomas are key. Also, a lot comes with practice - I learned way more in my first week than I did in the entire half semester or so of cancer lectures! We have a good computer system and a lot of reference books, not to mention a lot of experienced people, so I've been able to pick up a lot of information. I also make sure I know for sure about possible side effects of medications that I am giving, because a patient is bound to ask "What is this for" and I definately want to have that info off the top of my head! Does your unit transfer ventilator dependent patients to an ICU? We are also an ICU, so we keep our patients throughout their disease process. We get induction chemo and end stage patients who have been in and out of our unit for years. Its an unusual mix of long term and critical care. Good luck and let me know how it goes for you! Jen
  11. Jenneu

    New Bone Marrow RN ;-)

    I started as a new grad in the BMTU about 6 months ago. I guess what surprised me the most is how painful mucousitis following transplant can be. And you'll be giving a lot of blood products too. Good luck!
  12. Jenneu

    Morphine/ativan cocktail

    for most of their illness and have built up a tolerance for the meds. So the dosage needs to be increased to maintain their comfort. The patient is on hospice care, they are dying and in pain. Why should appropriate pain management be withheld? I am comfortable with liberal use of narcotics - most orders I've received in this situation is "titrate to comfort" or "titrate to a RR > 8". Like other's have said, if you see the person slipping into unconsciousness, you can give a lower dose or hold it until their vital signs are within limits for your comfort. Not giving a dying person pain medications if they are in pain is cruel IMO. PRN's are good in theory, but then you run into nurses who are unwilling to give them because they are not comfortable with "snowing" someone. That's why I prefer them to be timed meds. The person is dying. Letting them go with as little pain and anxiety as possible is much different than euthanizing them. Pain control is so important. Even if the patient isn't able to verbalize their pain, it doesn't mean that it isn't there. J
  13. Jenneu

    Nurses Who Smoke

    before i went to nursing school, i had an office job where the entire clerical staff, but me, smoked - so they all went out together for smokes and left me to man the busy phones (the office manager was a smoker, so it was no use - i stated my displeasure to her until i was blue in the face!) - which was not my job to do - we had a receptionist who had a pack and a half per day habit, but when they were out, i was the backup!! but as long as i am not exposed to second hand smoke (remember when doctors and nurses could smoke at the desk??) and no one is expecting the other nurses and ancillary staff to do what they are supposed to be doing, then i really can't hold it against them - but i do hope that they have the desire and the success in quiting. j
  14. Jenneu

    is this child abuse?

    you need to find new child care - ASAP. Reputable daycare centers do complete criminal background checks on their employees and many children have adjusted nicely going to a more structured facility from home or home based daycare. Or even finding another in home childcare situation that is licenced through the city or state - they also have to submit fingerprints and such. I work for a large city hospital which offers daycare for children of students and employees, so it may be something you'd want to look into? As for child abuse - that's a fine line, isn't it? If you felt that the woman spoke to your child in an abusive tone in your presence, how is she speaking to him when you are not around? I hope that you find a solution that works for you, it sounds like you have a lot on your plate. J
  15. Jenneu

    Persistant low grade fever in 21 month-old.

    keep up at it until you get some answers. Since her CBC showed an elevated white count, I'd want a repeat if it were my child (with differential). Hope she feels better soon! J
  16. Jenneu

    Horrible clinical day. Just horrible.

    but I was wondering, who did you report off to when you left the floor? Did the nurse know that you were going to leave while she was at lunch? Did you report off to anyone before leaving the floor, in addition to your note? That, above all the other picky things that nurse chose to complain about, seems to be the issue at hand - at least to me. It sounds to me like you and the nurse had some miscommunication. Personally, I would not leave the matter of the po meds not being taken in the hands of a student without discussing what should be done instead (ie - the student giving the IV med instead or if I would be doing it) - no matter how close to graduation - its still my license on the line if something happens. I think that the nurse should have been more attentive to you while you were taking care of these people - especially if you were tied up for 3 hours. (By the way, you had other things to do - could you have stepped out after 90 minutes to take care of them without causing a problem with the EEG?) Ultimately, the nurse assigned to those patients is responsible for their care - whether being given by herself or by a student or other unlicensed staff member. I hope that it gets straightened out. I haven't been an RN for very long, and I hope you don't take my input as putting you down in any way, because that is not my intent. It wasn't too long ago when I felt like I was spitting in the wind when it came to some of my clinical experiences! Good luck with the rest of school and I'm sure that it will all blow over soon. J