MartyL

I had a few of these same type of episodes at different times in my life. I don't think however, that they were stress related. Once it was when I was about 17 years old and I felt a cold draft, I tried to open my eyes but I could not, then I heard my friend's dad call my name and since I couldn't respond I next felt a harsh squeezing on my hip as if he were trying to wake me. Finally, I was able to open my eyes and turn to push his hand away, the cold feeling left and I woke to find noone there. My friend's dad was asleep! The next time, I was in my bed and again I felt cold and I was unable to move or open my eyes. I felt a cat jump on my bed on my pillow and heard him growl. I tried to scream because it felt evil, but I could not, then just that suddenly the "feeling" left and I was able to open my eyes. Although there are medical explainations for these events--namely the sleep paralysis, I can't help but feel that it may also be a connection to the spiritual realm. That may sound goofy, but since I believe in life after death it makes sense, that during this "sleep-paralysis" we may be more in tune with the spirit world than when we are fully conscious. I don't think I am dreaming when this happens because it happens when I am trying to awaken and the "dream" I had been having has nothing to do with the new "event" just before I am "released" and able to move.

We use the NLN tests which still give us a 96% fail rate because of the specific drugs that are tested. The best way to come up with a fair test is to develop one yourself, do a validity and reliability study on it and use it at your facility. Have drugs that are commonly used at your facility on the test, and of course, calculations should be included. Realistic calculations like if you have 15cc/hr of drug Xmg mixed in Ycc, how many mg/min is being administered? If you use dial-a-flows or run fluids off an IV pump, include the VTBI/Time x tubing factor calculations. Good luck!

Here we go again guys. This RN vs non-RN hogwash. It depends upon your STATE PRACTICE ACT what is deemed an "RN" task vs a task that can be "delegated." It has NOTHING to do with 20+ years or any + years and ability. It has to do with what our nursing law in each state! There's enough "outsiders" ready to throw rotten eggs at us to have us bashing each other. Look to your state boards for assistance in what can or cannot be delegated!

I agree with most of the posters. It is important to maintain a professional appearance and that means being conservative! Freedom of expression is a right, but patients have a right to feel that those they entrust their health to are serious. It would be VERY hard for me, as a patient to accept a person with 2-inch acrylic nails, pierced eyebrows, nose, lip, vampire make-up and tatoos to be MY nurse! I too will wear my "Nursing" whites (all minus the bedpan hat) but only when I am Supervising--that way the patients and doctors know I am a nurse and not just an "administrative" representative!

Oh guys, between the laughing and the gagging I think this is the best I've seen yet. Having been a respiratory therapist you would think secretions are a breeze for me--well they are so long as they don't touch any part of my skin! I had a luggie lunged at me from a trache with me at the foot of the bed and the sprinkles across my face made me want to barf right there and then! I ran to the bathroom as soon as I put the vent back on the patient and scrubbed my face with betadine soap! Next would have to be teeth--dentures! I'm sorry but I tell my patients I don't "do" dentures. I will given them the cup and the essentials but I cannot stand teeth. Nor can I watch someone brush their teeth. The white foam churns my stomach -- I myself rinse my mouth AND toothbrush a dozen times to brush my own teeth. I can't stand that yuky white foamy stuff in my mouth. And last but not least, would have to be any kind of malodororus hinny. Its bad enough having to hold your breath through a catherterization; I could NEVER be on the other end of the speculum! Yuk! I have no idea how male GYN docs can go home to their women after a heavy day at the clinic! [This message has been edited by MartyL (edited March 20, 2001).]

If only my CNO would let me use your stuff to give to new employees as a "pre" for the meds test! I'd use it! Can I?

How low is too low a 'crit? How does it affect the patient. I had a C-section with my last child. My hgb droped to 6 and 'crit was 20! If my doctor "rushed" to give me a transfusion when all I was feeling is tiredness and mild exertional shortness of breath, I would have ran the risk of a blood-related disease such as Hepatitis!! There are alternatives to blood transfusions and as nurses we should educate ourselves about these safer, better alternatives. Check into the "Bloodless Medicine and Surgery" programs that are in place at many progressive institutions. There are many things that the body can cope with and adapt to without resorting to treating the patient with the most "comfortable" treatment for us. For every treatment there are options, alternatives, and hazards. Currently when it comes to blood products, the Jehovah's Witnesses are best educated patient population. (They know more than we nurses do about blood alternatives and treatment of anemias!) We should all learn a little about alternatives to blood and NOT just for the sake of JW patients but for ALL of our patients. I am glad that I did not have to run the risk of a transfusion.

I have been fortunate to work with some pretty great nurses. We don't always get along, we sometimes disagree, but like a "family" we set aside our differences and celebrate the holidays. We usually bring in the ancillary departments too--pharmacy, respiratory therapy, housekeeping--all who want to share in the in-house celebration. We take turns eating and invite the docs to share our meal. It makes an otherwise dreaded occaision into a tolerable occaision when we pull together to try and make the best of a not so good situation. I hope you will find a group of nurses to work with that will show you nursing at its best! Good luck

Comments like THAT is what brings this profession down. Childish reactions, negative feedback--I don't think I would like to work with a nurse that has such a narrow minded view of the world that one cannot express opinions with out being **** on. Do nursing a favor, grow up, Sheri.

Comments like THAT is what brings this profession down. Childish reactions, negative feedback--I don't think I would like to work with a nurse that has such a narrow minded view of the world that one cannot express opinions with out being **** on. Do nursing a favor, grow up, Sheri.

I've said it before and I will say it again. There is no "short-cut" school for doctors. There has to be a baseline level of education for nursing to become a serious profession. I am a BSN school graduate and I totally disagree with those that say that the BSN is less ready to function once out of school, and believes certain duties are "beneath" them! That's like saying all apples that grow on a particular tree have worms in them! There are "poorly" prepared nurses from every level of nurse-producing schools! There are nurses who do not LOOK, BEHAVE nor CARE to be "professional" there are nurses who are in this profession because it is a better paying "JOB". I started out as a respiratory therapist. When I started, many of my ADN counterparts were bitterly jealous of my BSN--I didn't make a big deal about my degree--THEY DID! They would even joke and call me, RN, BSN, ACLS, BICTH--just because at our hospital HR decides what to put the degree you EARNED on your badge! I would have had it simply read "MARTY" 'cause that's all I tell my patients. I don't tell them "I'm your EDUCATED nurse today" Get real folks. Stop the bickering and let's raise the bar so we can raise our profession to the level it deserves to be at! [This message has been edited by MartyL (edited March 20, 2001).]

I've said it before and I will say it again. There is no "short-cut" school for doctors. There has to be a baseline level of education for nursing to become a serious profession. I am a BSN school graduate and I totally disagree with those that say that the BSN is less ready to function once out of school, and believes certain duties are "beneath" them! That's like saying all apples that grow on a particular tree have worms in them! There are "poorly" prepared nurses from every level of nurse-producing schools! There are nurses who do not LOOK, BEHAVE nor CARE to be "professional" there are nurses who are in this profession because it is a better paying "JOB". I started out as a respiratory therapist. When I started, many of my ADN counterparts were bitterly jealous of my BSN--I didn't make a big deal about my degree--THEY DID! They would even joke and call me, RN, BSN, ACLS, BICTH--just because at our hospital HR decides what to put the degree you EARNED on your badge! I would have had it simply read "MARTY" 'cause that's all I tell my patients. I don't tell them "I'm your EDUCATED nurse today" Get real folks. Stop the bickering and let's raise the bar so we can raise our profession to the level it deserves to be at! [This message has been edited by MartyL (edited March 20, 2001).]

I HAD to see this post just for the laughs! I think perhaps I know this neurosurgeon! Or at least there's one like him in my neck of the woods. It MUST be a joke because if he's serious then he must have performed a self-inflicted brain-drain and sucked brain matter out! He, he, he! And you guys, just for the record, he did say he's looking for a "lady." Doc: "Ladies" don't respond to trash! You may be looking for a female, but definitely NOT a Lady. So, how 'bout trying the single's sites--this is not the want ads! Sick-o!

Does anyone know of any websites with help for the PALS? I know about the ACLS sites, acls.net and randylarson.com/acls. Is there anything similar for peds? Thank you for your help

That's my conclusion too. I am not a radical but the good old fashioned "WWJD" movement gives food for thought. Love one another as you would love yourself. Leads to treat one another as you would like them to treat you. And then there is that "do unto other as you would have done unto you!" It may be very, very old, but it is very very true. Lets stop talking about each other and basking in each other's faults and weaknesses. It is definitely easier to see the splinter in someone else's eye than the twig in our own. Can't see the forest for the trees thing.

I have two stories one is my own experience. I was working with a confused elderly man who had a J-P bulb in his abdominal surgical site. He was still NPO and kept saying how hungry he was. I caught him just as he was about to take a bite out of his JP bulb. I said, "Mr. Jones! What are you doing?" He responded irritably, "I'm trying to eat this potato!" I still call JP's "potato's" to this day! In an ER where I once worked, an older couple came in, the husband in severe pain the wife sobbing. In the triage room the wife confessed, "I told him I didn't want to do it! But it is our 40th anniversary and he wanted to try something different! And we can't get it out!" "It" was a small vibrator. The doc could barely reach it with the anoscope and it was still ON (Energizer batteries apparently) and so the poor fellow wound up having emergency surgery to remove the vibrator --which on X-ray revealed it had migrated quite far up his colon! You must admire the loyalty this wife had for not dropping him off at the ER doors and sped away!

PCA and no mainline IV at least at KVO? Is that not like waving the drug over the patient? The amount of fluid infused needs to exceed at the very least the length of the cannula for the drug to be delivered into circulation!? I hope your pumps have a q4 hour lock out and not a q1 hour lock out!

I went to ICU straight out of school but I had 8 years of critical care Respiratory Therapy experience! I knew all about ventilators and ABGs and A-lines and PA's --I even took a critical care course elective. It was STILL tough to be a new RN in ICU. ICU nurses are expected to be "experts" even if you are a "novice RN"; ICU nurses tend to be really tough on ANY new nurse in their ICU--experienced or not. It depends on you and what you can handle. Not every nurse can "hang" in there and learn the technical while learning nursing. If you have NO medical experience, personally I recommend a step-down unit to get your feet wet with drips and EKG interpretation, ACLS algorithms and equipment, then transfer to ICU. A new nurse to ICU has to be a Gladiator to survive unless you work at an institution that ACTUALLY supports education and has real, trained, "preceptors" that will be with you until you are out of "orientation." Good luck!

Having been a tutor for many years I recommend using Ratio and Proportion to set up problems. This keeps the units in the correct order and lets you know where the X goes: Separate the Known (or what you have on hand) by an = Unknown (what the doctor ordered/what you need to give) So the problem is how many mg do you give when the doctor ordered 1/6 gr? Know: 1gr = 60mg Don't know: How many mg do I give? First use all the same units; so convert1/6 gr to mg: Known = 1 gr : 60 mg Unknown = 1/6 gr: X mg 1 gr : 60 mg = 1/6 gr : X mg first, multiply the "means" (the two inside) and put them on one side of the equal sign and multiply the "extremes" together and put them on the opposite side of the =. (60 mg x 1/6 gr) = X mg (1 gr) To get "X" by itself on one side of the = divide both sides by 1gr (whatever is next to the X): 60 mg x 1/6 = X (the 'gr' cancels out) 60 mg divided by 6 = X 10 mg = X You can work out any problem using this method! But the catch is you must memorize your conversions or write them down and refer to them when setting up problems. Memorize your other formulas: VTBI/Time (min) x tubing factor = cc/min. Have fun with math! Good luck! Marty

Thank you for your replies. I have decided that any job prn or not is like a marriage. You have to have the same goals and similar ideas of what is important for the "relationship" to work. I miss the group I worked with before I moved here. We had differences of opinion and that was --here's a shocker --OK! When push came to shove, we were there to take care of patients as a TEAM--and we were more like good friends or even "family" as opposed to being there for our shift, and not giving a hoot about the Nurse as a Person. I miss that and I hope to find a group that I am more compatible with. I have asked to be taken off shifts before I totally loose my ability to smile (I know that meanies hate it if you can remain sweet and unnerved by their attempts to bring you down). I have always been the one to take up for the underdog--students, ancillary staff, and PRN or agency folks. I like to work with people who are precepted with kindness and caring because they tend to be happier during the 12 grueling hours that we work together. I enjoy being a nurse and I wish that people without compassion would find something else to do! I would suggest train fighting chickens; become prison guards; join the MARINES!

The day the guys wear upsidedown urine hats on their heads (like the girls do or did) is the day I will put a nursing cap on as well. Our nursing school class did not even have our pictures made with those hideous things on our heads. I agree with the fact that if the hospital is not providing the uniform, then all they should expect is clean, neat and professional--how THAT translates into all white is beyond me! (And why specify a specific color? THAT doesn't work with pulling staff or staff transfers, etc. In an ideal world maybe. I do try to wear the "color of the day" but if it is dirty, I wear what I have and I have never been sent home, imagine that!)

Isn't it sad that ONE person can make such a negative impact? I know exactly how you feel. I think it is similar to another post I have out there, it boils down to COMMUNICATION. Obviously if nurse-from-the-temple-of-doom is always MAD or UPSET she must have a problem communicating--maybe she doesn't know how she SOUNDS to other people. And maybe she doesn't care. I think taking a cross with you to work those 2 shifts may just be the thing you need to make it without letting HER get the best of YOU. Hey, you may even end up feeling like BUFFY the vampire slayer.

try ACLS.net they had some really good mnemonics and links.

I work prn at an unmentioned hospital and let me tell you that communication between nurses seems to be one of the biggest barriers to effective ANYthing that goes on in the place. To begin with, the nurses never introduced themselves to the "new" person, and because this "new" person has so much "experience" they thought it would be funny to watch her fall on her face with where things are, how things run and even how to "chart"--can't be too hard for an "experienced" nurse, right? Following the visiting rules to the letter is the most important task of the day. So needless to say the patient-family communication I have witnessed fairs no better! Last, the nurse in "charge" seems to think the position calls for a militant approach to communication with fellow nurses and you dare not give a "military" style reply! Am I getting too old and sensitive or are there places where nurses like this seem to congregate? I for one, will look for a more compatible group to spend my emotionally, physically and mentally exhausting 12-hour shifts with! This is the first time in 16 years that I am leaving a job for no reason other than I can't stand the "noise."

Oh, my. I can't even imagine how I would feel if a bunch of pre-scripted people were taking care of me when I am sick! I would feel as if I am not an individual and the staff INSINCERE. It is a shame that because there are times when we forget our basic courtesy and manners that companies feel they must resort to "outputing" a prescribed, predetermined script!! AS IF nurses cannot think for themselves--so we must memorize a script (hey that's how the TV/Hollywood types do it) and use it and don't dare alter it! If this is where healthcare run in a business philosophy is taking us, then health CARE is doomed. Lets just call it "altered health adjustment" institutions and staff are "altered health adjustors/consultants/advisors/providers" anything BUT CARE providers. Oh, wake me from this futuristic nightmare. In my opinion, to "care" requires sincerity, honesty and indivdualization.