preciousshelby

Does anyone know of how I can get involved in the movie business as a Nurse? I would like to do "standbys" or "on site shooting" and be there for the "boo boos" I hear it pays alot, those studios and those stars have some money to spend!! Thanks

The BEST lotion I have found is a product called Caren. It is WONDERFUL!! I too have dry hands from washing all day and my husband is a Paramedic and washes his hands alot too, he actually took my lotion!!! It has a very light scent or you can get the no scent as well. It does not leave your skin greasy, I have tried Neutrogena and believe it leaves my skin a bit greasy. It stays on for a long time too!! The website is: www.carenproducts.com They are located in Atlanta Georgia!! Great stuff!:rotfl:

I would also leave but I would ask for an exit interview and have your manager and whoever else show up and go over EVERYTHING with them in that exit interview. Have it all in front of you and just go for it, and document, document document!!!! Good luck!:)

Ok, it has taken me some days to post here again due to myself being very upset about the pca not being used with a basal dose. I reread your original over and over about how your doctors (in seattle area, Harborview) do not like using the basal on the PCA because they are "leery of using the basal". I think there is a need of education on their part, and possibly the nursing staff as well. You need to stand up for your patients and their comfort. Pain control is one of the vital signs now a days and it needs to be addressed NOW, not waiting for some pain control service to step in. Harborview is a teaching hospital, but it sounds like MORE teaching in the pain area is IN NEED!!! I worked at a couple of hospitals in the Seattle/Bellevue area and have NEVER came across not using the basal. ( I never did work at Harborview and it looks like I will not want to now). I have worked in hospitals all along the I-5 corridor down to Salem and currently in Portland Oregon. There is mandatory pain classes we have attended to and signs in every patients room about pain control. This is a big issue!! There are articles in every nursing magazine about pain control issues and making it a priority. JCAHO even wants to know about your pain control policy and how do you reassess it etc. I cannot believe the doctors have "narcan on our protocal" but not a basal. Seems like they are more concerned with a lawsuit than comfort. Also, some of your patients go through "40-60 mg of MS in an 8 hour shift" Based on what you wrote about 1 mg q 8 minutes or up it to 1.5 mg q 6 minutes, then that patient is in pain for most of the 8 hour shift because they are having to push the button that often to get up to 40-60 mg in an 8 hour shift, how awful is that???? At least with a basal they are continuously getting some relief (and good sleep!!), it can be anywhere from 1-3 mg an hour basal depending. And you wrote that you are from the trauma/ortho floor ---(ouch!!!) the unit that NEEDS pain control issued!! The 40-60 mg in 8 hours is nothing if the pain relief is not taken care of, the paramedics use 10 mg of morphine at a time on a trauma patient (and that can be in 5 minutes!!). Sorry to go on and on but pain control is a big issue for me, I cannot and will not stand by while patients are in pain!!! I am quite proud to be in the Northwest where our care is "progressive", but I am quite embarrassed to say that we do have a hospital that is not as progressive in pain management as it should be (and no, the pain clinic service does not count)----So Alyca, I hope you are not offended by this but there is a need of education up there, if it is not done soon it will eventually be done. You say the PRS likes to "give massive demand doses". Again, that is not solving the problem, pain is not to be taken like a roller coaster, up and down, you need steady control of it (ie; basal).

I work in a hospital and thank goodness I don't have 20 plus patients to pass meds etc. but what I do with my patients is if they start to refuse and they are alert and oriented I will go over the meds with them and what they are for, give them the opportunity to take them and if they refuse I will simply say "You are in the hospital and this is YOUR care, if you choose not to accept it it will reflect on YOUR recovery. I am not going to force you to take the medications but I will document this in order to protect myself and let your doctor know". Seems to work well with the ones that are on the edge "to take or not to take" and others who don't care about their care, well, at least they are aware that I WILL document this in their record as refused, that way when they go to the doctor and request "other meds" then the doctor is aware that they have refused all the other prescribed meds out of choice. (This also catches the drug seeking patients as well because if they refuse one pain med and not the other, it is documented)

Do you mind me asking where you practice nursing? (Like what city and state???) Thanks

I live in Vancouver Washington, commute to Portland Oregon (only 7 miles away) but will be moving to Atlanta Georgia (whew!!! Thats a mouthful!!) :rotfl: :rotfl: :rotfl: :rotfl: :rotfl: :rotfl: :rotfl: :rotfl: :rotfl: :rotfl: :rotfl: :rotfl: :rotfl: :rotfl: :rotfl: :rotfl: :rotfl: :rotfl: :rotfl: :rotfl: :rotfl: :rotfl:

We use PCA's too but not only the demand dose (where the patient has to push to receive the meds) but also the basal dosing, this is programmed in the PCA to receive an hourly dose (say 1mg/hour) in addition to their demand dose, that way when they are sleeping the basal is still in their system and they don't wake up in horrible pain, I cannot imagine doing a whole ortho floor any other way (or any other floor for that matter) due to it taking up the RN's time. Pain control is one of the vital signs and if it is not being controlled then maybe your facility needs to look into other ways, the outside service you mention would be much more costly I think then just programming the basal in the PCA with the demand dose. When the pt is awake and eating clears we usually will trial them on PO meds (percocet, vicodin etc) of course, with the PCA on "hold" while the PO meds kick in.

Just out of curiosity, why do you hate Atlanta? I know nothing of it yet, but am always wanting to listen to others experience!!

The following is the way I figure it out, I have been taught by a pharmacist long ago while I was a Paramedic and have continued it through my nursing career. It makes sense to me, you see it all on paper in front of you rather than memorizing formulas (which I can't stand): (60gtts) . (250cc) . (400 mcg) . (1mg) = Gtts/min cc 400 mg min 1000mcg The first paranthesis is your drip factor, the second is your concentration and the third is how many mcg per min (after kg was calculated) and finally your conversion of 1mg/1000 mcg. Then you cross multiply, cancelling like figures (such as the cc on the bottom cancells the cc on the top of the 2nd, etc) and what you have left is what you want---gtts/min. And yes, the answer is 15gtts/minute. This drives my husband batty because he is a Paramedic who can memorize those formulas like no tomorrow, but this works in ALL cases, young, old etc Good luck and hope this helps!!!

Hi there, I am from Portland Oregon area and I have worked at my job for less than one year. I make $36.42/hour, full benefts, day shift 12 hours and am in a hospital setting. I just love it! Best job (and money) ever, but again, the cost of living is higher (we live in Washington and I commute the 10 miles across the bridge to Oregon). We just bought a home in Atlanta Georgia and will be heading that way maybe next summer, looked into jobs there, I will be making 34.93/hour for telemetry, day shift. Pretty comparable I thought, and the cost of living is MUCH lower there! I was afraid of going down to the low 20's an hour but guess not! So, I originally was going to post the location difference on my reply but I just found out that it is not too much a difference. hope this helps!!

Hello, I am relocating to the Atlanta area and wanting some info on your class you went to and if any of the hospitals there hire SANE nurses or do you have to work strictly in the ER to be one??? Thanks CHar\

Hello, I am going to relocate to Atlanta (Douglasville) and have done my research on hospitals in the area, looks like St Joes is a good one ( I am a telemetry RN) or AMC. My question is anyone work at these hospitals on the tele floor and if so, what is the days ratios? I am hoping to get a Baylor position (weekends only). Thanks for any input...........any other ideas on the hospitals of choice there????