Pattiecake

Old fella said to me the other night "I don't see very well. I have vernacular disorganization" what's really funny though is that I knew what he meant.

Move on and broaden your horizons. Your tele unit sounds like a comfortable old shoe. Think of how it feels to have something new in your wardrobe. Think of this new ER job as that.

I've been a working nurse for 40 years and am still doing new stuff every day

When I worked in the prison it always amused me that the big mean brutes with the multiple tattoos were the ones that fainted when a blood test was done

Here's one from my mother. An old man should never sleep with his grandchild because he will sap the energy right out of him.

In September I will have been working as a nurse for 40 years. We certainly never had gloves for patient care back then. As a student in CSR I had to wash the intact used surgeon's gloves, dry 'em, powder 'em and rewrap and sterilize them for reuse. I have had my hands in some of the scariest bodily fluids and never thought twice about it. However, the idea of lying in the tub of suction bottle contents really is a turn-off for me!

I'd like to know who the great mastermind was that made the call bell, the TV remote and the bed controller all one unit!!! If I had a nickle for the number of times I've answered an attempt at a TV channel change...or a bed adjustment, I'd be a rich woman today.

One time I was working in a prison where the written word is often outside the inmate's grasp. I had done an assessment for complaints of hematuria and asked the inmate for a urine sample. He wrote a formal complaint (grievance) stating that to do a lab test without an MD order was operating outside my "bounces"..........yes, us tiggers will operate outside our bounces.

How about the signs and symptoms of angina. Easy to teach, lots to say, and many seniors have no clue about the symptoms

I live in Quebec, and 13 miles from my house is Newport Vermont, where I work. There is an acute care hospital with a 6 bed ICU, several nursing homes in a 20 mile radius, a large prison with a 25 member nursing staff, a large home health agency that serves a 60 to 70 mile radius. Plenty of jobs available. Much higher pay than working in Canada.

59, working full time, and lovin' it. Never gonna quit. Each day is so unique.

"There were tears in the eyes of those nurses for a woman who was not their family, not their friend....but who might have been. There were prayers going up for you and your sister, her friend, boyfriend and family that you might not have heard--but they were said. There were people who were in that room who will never forget how hard they fought for her life. Because they cared." Angioplasty That was so beautifully said. I have been that nurse in the ER. I have held the unclaimed when they died and prayed for them and their families. I held them in my heart, in my memory, stroked and held their hand. Working in the ER allows you to become the best friend of the trauma patient. You don't forget them. The unclaimed trauma patient becomes a part of the trauma team's family. I wish I could have put it as beautifully as you.

Hey, I just tried, and I'm not there either. Came up with a "no matches found":saint: Must mean I'm too good for them????:chuckle :chuckle

When I worked in CCU a patient had a standby bag of D5W with Epiniephrine. It was labelled with a red sticker that Epi had been added. All patients in CCU not on IV had a lock, with a standby bag of plain D5W. All plain bags were also labeled with a red sticker and the date the bag was hung. (Only good for 24 hours) At any rate, my patient went into CHF and needed some lasix IV push. The nurse giving the lasix ASSUMED it was a dated bag of plain D5W, and used the bag to flush the IV lasix. She was not looking at the monitor, nor the patient. She was looking at the wide open drip rate that she intended to run for 30 seconds or so. I returned from lunch and saw the monitor showed an extemely rapid SVT. As I rushed over to the bedside it was apparrent the patient was unresponsive. I immediately recognized the cause, and shut off the flow. A code was called. The patient survived without ill-effects. This was a very horrible experience for all concerned. We stopped dating IV bags with red labels. I have never initiated a bedside IV bag since then without first reading the label. Another nurse I know hung a bag of NS for irrigation as an IV of NS. The bag was clearly labelled by the manufacturer in red print on the bag instead of black print, and she said she wondered why it was red, but never bothered to check. There were no ill-effects to the patient. A frequent med error made by the patient is to over use Timoptic drops. Timoptic (Isoptin) is the sam drug as verapamil and over use will cause heart block. I can't even begin to say how often I have seen patients needing temporary pacemakers to deal with this self administered drug error.

My husband is a farmer, artist, computer programmer, web site designer, all at the same time. He also makes all the family meals at home. I dare not complain about who works the hardest. :chuckle :chuckle

In a normal situation apical and radial pulse equal each other. The apical and radial pulse is best taken by two people, one on the pulse and one on the stethesope. You both start at the same time and finish at the same time and should come up with the same number. When there are more apical than radial beats, there is the presence of some form of ectopy that is not a strong enough beat to be felt radially, and so does not perfuse the body. This is not good. Like a two to one ratio. 70 apical, 35 radial is not conducive with life and needs emergency intervention. It is very likely a ventricular bigeminal rythym. Sometmes atrial fib has some weaker impulses that do not perfuse the body well either. Always as your patient how he feels, and see how he looks. This is a huge part of your assessment, then utilize your vital signs assessment in combination with this. Hope this helps

Angela There is no way I can answer all the questions you ask. If this was my Home Health patient and she was on the meds as stated by you, I would assess the following. Edema: how are the lungs? any rales? if so, notify the MD. if not, recommend a lo Na diet and elevate FOB and LE's while pt in the chair. Encourage ambulation. How are the electrolytes and renal function. was lasix D/C due to labs. It is not necessary to treat dependent edema with diuretics. How about some TED stockings? BP: Ask the MD what parameters of BP he/she wishes to be made aware of. I would certainly report anything above 160/100, regardless of what the given parameters are. How does the patient look, and how does she say she feels? Fatigue/tiredness: One of the side effects of metoprolol is tiredness. Also please remember the patient's age and amount of edema. And maybe she isn't very comfortable in bed and is not sleeping well at night, so naps a lot during the day. Maybe she is a bit depressed due to her physcal limitations and that is why she is sleeping a lot. Sometimes the answers are very simple. I would never recommend what meds a patient should or should not be taking as that would be practicing medicine, and I am not licensed to do so. By all means ask the MD the rationale of the treatment plan. Ask the MD why certain meds have been D/C and others continued. And ask for that referral to the cardiologist if you are at all in doubt about this MD's ability to meet all your mother's complicated needs.

Sounds delicious! Who needs a cold?! Lets party!

Our pharmacy has a KOP system that will label each med seperately with bubble pack cards, regardless of cost. The problem is the BON says each inmate must keep his meds in his own locked box, to which only he has the key. Ya, right, like D.O.C. is going to allow the inmate to have a locked box that D.O.C. is locked out of. Not in our wildest dreams! We used to have KOP for lotsa stuff, until the BON made this demand. Now the only things they can self carry is topicals and rescue inhalers.....much against the BON directive though, I might add

Don't believe everything you hear. Go to the top administration to check this one out, and get the directive not to count in writing. Keep a copy of this directive at home as well as at work. There are times when administration makes a decision to change something and it is not in writing. Then whe the s*** starts to hit the fan they could deny ever having given that directive, if it is not in writing. It is absolutely possible that someone who wants to divert some controlled substances has started the "don't need to count" rumour. I urge you to check this one out. It certainly doesn't sound right to me. Controlled substances are Federally mandated.

Angela There is never anything wrong about questioning the doctor's rationale in the treatment provided, however it is the doctor that is examining your mother, not us nurses. Generally the patient is tried on a medication regimen for a period of time and the response to the new meds is assessed at the next scheduled visit. However, if your mother appears to be deteriorating in any way, the next MD visit should be sooner than originally scheduled. It is very difficult to second guess when the patient is not present to be examined. If you are concerned about lack of response to treatment or deterioration, by all means, bring her back to the MD and get a referral to a cardiologist. Hope this helps

Alcohol to actually clean the skin first. You'd be surprised at how dirty that alcohol pad looks after you clean the skin. Betadine to disinfect the skin...allow to dry, then do the venipuncture. I was always told to follow ABC alcohol, betadine, cover the site when done.

There are so many RN positions available in Vermont. The Vermont RN license is fairly inexpensive. I am not positive, but I think it is around $80 every 2 years. There are jobs galore in the city and rural areas. Vt nurses make about $25 to $35/hour depending on the need in the area. Good luck. You can PM me if you want more detailed info. Pat

:chuckle Just have to ask, how did you get pregnant with bronchitis and an ear infection?. On a more serious note, I always use ecchinachae at the onset of a cold. Boosts the immune system and the cold is gone almost before I know it. I take it every 2 hours while awake. Works wonders.