michlynn

TEDS for sure. Transporting immobile patients down to CT/Xray/MRI in the middle of the nights with multiple lines. And filling out the white board, I don't know why it annoys me so much! Probably because it's so menial and you get written up if it's not done. So dumb.

If you google "handoff reports" or "nursing assessment sheets" you can usually find a good one to go off of. I always include a brief h&p, current vitals/lab work and then I go through every system - neuro, heent, cardio/vascular, respiratory, GI/GU, skin, IV access, current running fluids/medications and then what the plan is for future care.

I almost never have to do any math, most electronic med administering programs will do it for you when you scan the med (always good to double check the dose of course!). I've never had to figure out a drip rate EVER, even if you don't have a pump for basic IV fluids they make tubing now with a gtt factor dial. The only basic formula I ever still use is the "what you need divided by what you have multiplied by the volume." Most IV pumps have meds pre-programmed with dosages so you type in the pt's wt and it calculates for you. Drugs like heparin come with a dosage chart based off of wt and lab work but it's just adding and subtracting, sometimes bolusing, nothing too crazy. Clearly this is going to be different depending on where you work, some places still paper chart - including med administration, but most hospitals are converting to computer administration.

Causing harm and causing some pain are 2 totally different things. There could've been trauma during the insertion of the foley which can cause a painful removal and possibly some blood. Just wait until you rip all of the tele leads off of a hairy man's chest

Oh, gotcha. Read it wrong.

HH patients have already been evaluated and are already in a "system" per say. I don't think there's much of a screening process for the mobile infusions. And I wasn't aware the infusion centers were by appointment, thought you could just walk in! Guess an appointment would make more sense LOL.

They have stuff like this in Cali, not mobile, but infusion centers for people wanting a little extra hydration or vitamins or whatever. I don't really think I'd ever pay $650 for a bag of fluids no matter how hungover I was And I don't think I would ever be willing to show up at some random person's house and start an IV on them. Lord only knows the things that could happen... yikes!

I agree, I think it was kind of an odd suggestion.

Has anyone ever transitioned to peds from caring for adults while traveling? Is this even possible? My recruiter asked me about doing peds the other day and I never really thought about it because I didn't think you could. Any thoughts?

I hate it and I feel very strongly that it's a violation of HIPAA when pt's share a room. It's not appropriate to be going over one pt's entire medical history/current admission when the neighbor can hear everything. I do however think it's appropriate to first get report and then go eyeball everyone with the previous shift just to make sure everything is in order.

I like Estee Lauder double wear foundation for 12 hour shifts with bare minerals bronzer to finish. I used to use Smashbox mattifying BB cream but it barely lasted me 6 hours. I don't wear mascara to work, sometimes it can irritate my eyes so I just don't bother. I also like to keep clean n clear oil blotting sheets on hand, those are my fav!

OMG! That's terrifying!

I should have worded it better... I blame it on asking this at the end of a 12 hour night shift. "psych diagnoses" is what I was going for, I realize how ignorant it sounded. Thanks for your response.

Thank you for sharing! I was really just curious because there seemed to be a correlation but I haven't seen enough of it to know enough about it. I didn't mean for this post to be offensive in any way. I've done a little research on it but have never spoken to another individual who has it or experienced what it's like other than what I've seen from a patient's perspective.

Just out of curiosity, has anyone ever taken care of POTS patients (postural othorstatic tachycardia syndrome) and notice a trend in psych issues as well? All POTS pts have been young, female, new moms and have multiple psych problems. Just curious if anyone else has experienced this?

My favorite are the clueless ER residents that show up to codes or rrt's and have no clue how to run through ACLS. Ex. Pt is in vtach (awake and alert), we've already hung amio bolus and started a gtt. Resident walks in... "how about we start a cardizem gtt?" Me: "Or how about that amio gtt that's already hanging?"

There isn't one And yes, competency was the word I was searching for. I think I was laughing too hard to focus.

I guess those yearly mandatory blood born pathogen quizzes are good for something Does OP think bipap will be required post needle stick??

I'm a little confused as to why the Bipap was brought up? Is there something we should know about needle sticks and a breathing machine? Not trying to be rude but this post is throwing me for a loop... Even if you sliced your hand open with the scalpel you just used to cut into a patient with HIV/Hep C there's a less than 2% chance you will contract either of those.

Thanks for your input as always, Ned! I think I probably would feel a little guilty hurting union nurses because it would be nice if all states were union.

I work with AMN and have no complaints thus far. I think it depends on your recruiter and your relationship with them. There's going to be positives and negatives about every company.

For anyone who has done crisis/strike travel, which agencies do you use? Do you like it? What are the working conditions like? I've recently become interested in doing something like this in between assignments. Thanks for the info!

Yes, most hospitals stock 0.5mg vials as well.

Like other posters have mentioned, you're not going to fix this patient during your 12 hour shift. If this person is actually a "drug seeker" then they are going to need more long term treatment and that isn't going to be up to you either. Yes, it is annoying when those "frequent flyers" come in and docs continually give into them but there's really not much you can do about it unless the pt is unstable. It used to make me upset too but now I just look at it like any other scheduled med. If they're due for it and they are clinically stable then I'm just going to give it without argument. I do enjoy the option of the functional pain scale though, so if you're chatting on your phone, laughing, eating and joking with me but then say your pain is a 10.... I don't think so... your functional pain scale says you're a 2.

Definitely sinus tach.