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cheezwizz90

cheezwizz90

Registered Nurse
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  1. cheezwizz90

    Criminal Charge

    Report the incident to The Board, as the law requires, and join Alcoholics Anonymous, it will look good the The Board. They can't babysit your children during the AA meeting so you will need to get a sitter. This conviction probably qualifies as an offence of moral turpitude to The Board-conduct that is considered contrary to community standards of justice, honesty or good morals. That would typically prohibit someone from beginning nursing school. What state are you in? We will look for your name in the back part of your state BON's magazine where they publish names of nurses who have been disciplined. Hope it's not a revocation.
  2. cheezwizz90

    Central line dressing days

    I agree that the risk of infection is increased with scheduled dressing changes if it just got changed the day before, but the chance that it will actually be changed is also increased, which may actually decrease the risk of infection. Not all nurses have the time to worry about looking at IV site dates/times and changing lines/dressings. The weekly set date allows for easier auditing and checking and one nurse could go around and change lots of them.
  3. cheezwizz90

    Central line dressing days

    We change them all on Sunday. If a patient has one placed on Saturday, then we still change it on Sunday to keep everyone on the same schedule. If it was found to be no longer intact on Friday and changed, we still change it again on Sunday to keep it "on schedule." It can be annoying in those situations where it was just changed or placed the day before. Exceptions to the Sunday change would be a soiled, non-intact dressing or bleeding/infected line...in those cases, we change it as needed and then...Sunday :)
  4. cheezwizz90

    Silvadene or??

    At my burn center, we place new burns in silvadene dressings BID (or we have a protocol for silver nitrate soaks if I'm on-call, the burn isn't life-threatening and the attending isn't coming in until the morning) for the few days before they are grafted. Then we switch to xeroform. They keep in silvadene (SSD) for long term if they aren't getting grafted, then downgrade to xeroform and then perhaps plain bacitracin. I have read that the burn center at Mass General has long used silver nitrate soaks instead of SSD. I started work at a new wound clinic that hardly sees many burns, but whenever we get one, the doctor says that there is "new research" that says silvadene causes terrible infections, is ineffective and it's hard/messy for patients to do at home ( I agree with the hard/messy part. It takes dedicated BID changes and SSD can macerate intact skin) and so he prefers to use just bacitracin and gauze. I was shocked to hear that and I can't find this research, nor have I heard of it. I have seen SSD heal many many burns plus it is antimicrobial. It would be sacrilege to forgo the SSD at my burn center. I can see infection setting in if the silvadene burn dressing isn't changed BID, but not otherwise. Plus, the benefit of SSD is that it cools down the burning sensations. What topical do you all use in the acute phase of burns? What is best practice?
  5. cheezwizz90

    To tell or not to tell!

    Let's say that the computer is only located in the nursing station, not patient rooms, hallways, alcoves, etc etc since this is 2015 and computers are now beyond the nurse's station in any reputable, updated hospital setting. Let's not forget that iPads and tablets are coming into use and those defintely go out of the nurse's station. OK, so let's say ALL computers are ONLY in the nurse's station because its 1999. Are nurses the only people in that area? NO!! Housekeeping, maintenance and others are in the area and have NO business reading patient medical records. Actually, other nurses have NO BUSINESS reading the medical records of patients that they are not caring for. In short, it is a big violation of the information security agreements of many hospitals, not to mention HIPAA, to leave the EMR open and walk away. I usually log out the careless nurse and have a discussion with him/her about it. They've always appreciated it and so do I. We all make mistakes, let's not minimize our impact as a guardian of a patient's privacy.
  6. cheezwizz90

    To tell or not to tell!

    I AM in a position to judge the practice of other nurses when they write about what those practices are in these comments. Thanks. "If the computer is at the nurses station & the public has no access to the computers then the patient is never harmed." That's a BIG "if." I'm used to computers being in alcoves and hallways, encouraging nurses to spend less time chatting in the nursing station and ignoring call lights. The computers are certainly visible to the public. It's even more loving to save strangers!!! Think of the Titanic's men shoving women and children THAT THEY DIDN'T KNOW onto lifeboats first. America's unwritten social contract is called SELFISHNESS. And I'm NOT signing that contract.
  7. cheezwizz90

    To tell or not to tell!

    @OrganizedChaos-Leaving a patient's private medical information available for the public to view on a computer screen IS totally harmful to the patient. Not physically, but in many other ways. And no, I wouldn't tell the manager. I would tell the nurse personally. I'm not a tattle tale. Secret reporting is dumb. @TheCommuter- When did I ever mention that I didn't think the nurses who post here are not real nurses? I said that they don't advocate properly. I hope the OP remains true to himself when he is established on the unit. It isn't foolish to save others before yourself. I would save my friends and children before I saved myself. That's love, that's admirable and that's bravery.
  8. cheezwizz90

    The Fat One

    I say call her fat or obese. If she hears, then maybe she will change her weight to something more reasonable.
  9. cheezwizz90

    To tell or not to tell!

    "I guess I am a little taken back by these comments. I thought we, as nurses, are patient advocates and look out for what is in the best interest of our patients." Real nurses ARE advocates, the nurses on this website have proven many times that they are jaded individuals who no longer have the willpower to make change happen. I am consistently "taken back" by the things I read on here. Do something and be an advocate, you know what is right.
  10. cheezwizz90

    Nurses can eat properly if they manage their time

    "Do you have trouble finding the time to eat healthy (if at all) at work and then carry bad habits home?" NOPE. Despite the name "All Nurses," this site poorly represents America's nurses because most of the nurses that I work with are relatively healthy and not obese. Based on responses and emotional reactions to my previous posts critical of obese nurses, I have found that most people who post on this site are obese women who are easily offended at any attempt on these forums to point out their hyposcrisy. They have a book of excuses for why they weigh 300+ pounds and have bariatric charting chairs at their nursing stations, and they want all of us normal people to bow down and serve them, to spoonfeed compassion and empathy to them, to coddle them. Makes me sick. Nurses have an obligation to be healthy. JUST DO IT.
  11. cheezwizz90

    Which to Choose - Main O.R. or Outpatient

    "Is it possible to make the move, if I wanted to in the future, to a main O.R. after only having outpatient surgery experience?" I'm sure it would be possible for you since they are offering the main O.R. job to you now with presumably ZERO O.R. experience and only med-surg floor experience. That's an amazing offer. Personally, I enjoy the acute setting and would be bored out of my mind in the outpatient O.R. Being bored stiff is far worse than being very busy.
  12. cheezwizz90

    Can I work with license number pending?

    I moved to Idaho and had a temporary license number issued via mail about a week after I sent in the mountain of paperwork. It cost $15 extra to be issued the temporary licence number, and it was an option on the license application. Did you have that option to get one? Your best bet is to call the NY BON and ask if they issue temporary licenses. I was hired with my temporary license number and then the real license arrived in the mail. The "real" license number is issued after many weeks, and the temporary one can be retracted if there is an issue with your background check. The temporary one is good for 6 months, but hopefully the background check won't take THAT long.
  13. cheezwizz90

    How do you deal with demanding/unreasonable patients?

    It is hard to be RESPECTFUL yet firm when the patient is a total jerk or needy. I tell them that I have other, sicker patients that I need to attend to, but that I always have time for them also. I remind them that myself or the PCT will round AT LEAST once per hour and that they need to wait at least 5 minutes after pushing the call light before they are alllowed to yell into the hallway for me, since the needy ones tend to wonder through the halls with their IV pumps to find me, or if non-ambulatory, they scream "NURSE!!!!" I say NOT to scream out for help unless they are hemorrhaging to death, or having chest pains/stroke symptoms. A cup of apple juice can wait until I round again. Sometimes I give them a pad of paper to write down their list of desires until I round again. We try to round more frequently on this type of patient and to switch nurses halfway through the shift because they are so exhausting. If those measures fail, I have a very staunch, stern and sassy charge nurse to "put them in line" the hard way. That way, I don't have to be the enemy.
  14. cheezwizz90

    Medication safety what if...

    The lab bag/fanny pack idea is great! I've also gone home with IV narcotics in my pocket...probably three times, which lead to a trip back to the hospital to waste it. I'm thankful that I've established myself as a trustworthy nurse with integrity. I would do the same for most of the people that I work with, but there are a few who I wouldn't trust. After the third time, I made myself a note so that I would always remember to empty my pockets before leaving the breakroom. Being a human is tough!
  15. cheezwizz90

    Medication safety what if...

    New policy in my hospital that we can no longer carry any meds in our pockets, even saline flushes. We have to carry them in our hands and if we can't give them right then, then we label it and lock it in the patient's med drawer. The reason given wasn't because of safety concernes over needle sticks, accidently taking them home, losing them or infection control. The reason is because, no kidding, they say that the body temperature of the nurse can heat up the medication and alter the drug properties. Nevermind that our hands also have heat. I am entirely skeptical of the pharmacy's reasoning, and furthermore it isn't practical. Sometimes you just have to put things into a pocket. That's why scrubs have so many pockets right? I even carry IV narcotics in my pocket, and I've never had the needle or cap come off. Even if it did poke me, I'm pretty sure that I'm not going to plunge it all into myself like another poster suggested could occur. It's going to cause pain and be removed promptly. I don't carry them for hours, just if I can't find a witness to waste with me or the patient needs another dose in an hour or less. I see zero issues with carrying PO meds in my pocket as long as I haven't opened the package yet. Keep it real.
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