surreal

anyone have a patient who has committed suicide before noticing s/s that this was going to occur? stuggling with grief, open for any comments on the topic.

anyone have a patient who has committed suicide before noticing s/s that this was going to occur? stuggling with grief, open for any comments on the topic.

check out the link I posted in the previous posting. it will allow you to look up a plastic surgeon to see if he is certified or not. if he is not certified than my advice is to get a second opinion and a second doctor. there are many doctors out there, this is not the only person that can help you. that website specifically says that you should not have someone do plastic surgery on you that is not board certified. and make sure they are certified in plastic surgery, not just surgery. not just any person can do this type of surgery, even if they watched it a thousand times, its not the same. if you know this person is not certified i dont personally see any reason why you need to go see him and question him about it. if hes not certified who cares what his excuse is. you are more important then risking this type of surgery with someone who is not even certified to do it. please seek advice from a different doctor. perhaps start by looking up surgeons who ARE certified first. please dont feel worried about being tactful to this person. you should feel no remorse over not letting him perform surgery on your face. i have had some doctors in the past try to make you feel guilty or pressure you into surgery. etc. as if they are car sales men. if they are that good of a surgeon they shouldnt have to pressure you into coming back , etc. please think this through and dont feel like you owe that person anything. you dont even owe him an excuse, if you want to cancel with him you dont need to call, if you want to call- all you need to say is "im calling to cancel my appt, thankyou, goodbye" if they pressure you to say more, tell them it is a personal issue and you dont think its any of their business. that should get the point across. these people are so into pressuring young people your age, makes me mad. good luck

work at a facility where this isnt happening? i dont know where that is.. but all the LTC places i have been to are like what you describe. its sad. as a nursing student i was only given one patient and they got a ton of care and some people dramatically improved (mood-depression) after getting one person to care for them 5 hours a day.. but sadly its unrealistic.. i wish you the best. i love the geriatic patients, but alot of people dont like it because of how you have to treat them in most places (rush rush). i think its a system problem...

i know this is something you probably dont want to hear.. but you really should consider not working. the rationale behind that is... i have seen a handful of my classmates have to drop out of school because they dont put nursing school as a top priotrity and burn out because they are trying to do too much at once. i cant talk.. i still work, but dramatically less than before nursing school. i work only a few times a month for my old job and then i got a job at school working for the nursing dept. which would be awesome if you could do that (some people arent eligible though). its called "work study" and basically a grant you get and work for during the quarter when you have time. i think that when you go from the transition from pre-req to nursing school its easy to forget that now you are taking the classes that will make you a nurse. people also forget its only 2 school years of your life and if you over work yourself and fail nursing school you will have wasted all those years of prerequisites and all that money you have put into your education. when you are a nurse you will be able to pay back debt you may have from not working. your family will benefit and your family is not something you can pay back when you are finished with school. please trust me when i tell you it wont be good if you keep working fri. sat. and sun. if your school work and patient's care doesnt pay for you being too busy your husband and children will. i am super poor but loans can be paid back. atleast you wont go crazy in the process... or atleast not as crazy.. hahah... i am almost done with my 1st year of nursing school, have about one more week left... and thats my advice for now.. if you have to take one thing out of your schedule i would recommend the job... husband, kids, and your future career should be your priority. PS when you get into nursing school dont stress out if you dont get all 4.0's . its okay to get grades that are just "passing" once in a while. you will still become a nurse, you will just know what you need to study more in the future.

oh no my instructor just went over this the other day and i can barely remember a thing! hahah he talked about how from 90-100% the curve doesn't decrease (its flat), but as soon as you start getting down past 90% it rapidly decreases... and is why sao2 from 90-100 is WNL but as soon as you begin to drop down under 90 it gets more serious.... for example a drop from 95 to 92 wouldnt be nearly as dramatic as a drop from 90 to 87. the differences are the same and they are small but once under 90% those small differences in sao2 reflect large changes in the pao2. geesh i need to review this one too!! hahahah.. good luck!

sounds like you have the pertinent info for a diagnosis of alteration in comfort r/t pain. i wouldnt say that 37.2 is a fever, but like you said.. i would check the clients norm to see if maybe this is a bit high for her. if she had a fever and was 2 days after the appy i would seriously question an infection. You asked if pain could cause an elevated temp and i would say yes. im sure you have learned about prostaglandins in anatomy... they are chemicals, similar to hormones that stimulate neural receptors in the body for pain.. that, in this case most likely is coming from tissue damage related to the surgery. prostaglandins that are released can trigger physiological changes like increased temp and dilation of blood vessels. drugs like asprin are taken to decrease pain and temp because they block a certain enzyme in the body that is needed to create the postaglandins. but prostaglandins also help the stomach lining resist gastric acid so that is why you may realize that asprin can cause stomach irritation and bleeding in some people, especially with long term use.

always follow your gut instincts and remember that you are your best advocate, so dont feel bad about worrying or asking questions, because you are the one that is affected by this surgery. deffinitely bring up any concerns you have about this doctor, and if you dont feel comfortable asking him perhaps you can bring it up with your regular plastic surgeon. since this is an elective surgery you should not feel rushed into making a decision, this does not sound like you need emergency surgery, so make sure you feel comfortable with who will be your surgeon before you do anything. but also remember that with any surgery there will be some degree of anxiety and worrying and this is normal . if your new surgeon makes you feel bad about asking him about his certification than dont feel like you need to remain his patient. furthermore, please look into this website i found for you. http://www.implantforum.com/doc-research.html here is an example of what they say about plastic surgery and board certification: when considering a body contouring procedure, such as lipo, tummy tuck or breast surgery, you want a plastic surgeon that is certified by the american board of plastic surgery (abps). if you are contemplating facial plastic surgery only, you can consider a abps board certified plastic surgeon or a otolaryngologist (also known as ent, ear nose & throat specialist) certified by the american board of otolaryngology as they are qualified to perform cosmetic procedures of the face. please do not allow an ent or any non-abps certified doctor to perform any procedure below the neck! do not let a surgeon's office tell you the doctor just moved from another state and they waiting for transfer of their certification. certification is a federal exam and is good in any state. "

Thanks guys, I thought so. I watched this happen during one of my last clinicals. Our teachers tell us one thing and the nurses we work with tell us another. In this situation the instructors were right. if it were me I would have wanted to get a new hat and then used the sterile tongue blade. However it was interesting to know I could also pour it into the cup, as long as there is a new hat being poured from. This stool wasn't really stool.. it was gel consistency bright red bloody "stool" from a person found to have ischemic coliits after colonoscopy, the stool count came back with many WBC, gram pos and neg rods and some positive cocci as well. Was interesting to find this is a common disorder of large intestine, seen in younger people with oral contraceptive use. This patient was older but taking the oral contra. to prevent some complications she previously had with ruptured blood vessels in the uterus, pt also had regular low b/p of around 90/50 which increases the risk, because interference/decrease of blood flow to colon. Anyway, thanks for the advice and laughs, stool is a pretty good topic for a 1st time posting... if you're a nursing student at least. I don't think the stool sample was contaminated this time, however good to be mindful about collecting such things.. wouldn't want to interfere with tests that could help determine care our patients receive. Thanks!

Here is a question, please let me know your thoughts about this: When taking a stool sample out of a plastic "hat" that was placed in the toilet in preparation for a specimen leukocyte c diff and culture testing would you scoop it out with a sterile wooden tongue blade and place in the stool specimen cup, or tip the hat to pour the stool into the cup? I thought that using as sterile of a technique as possible (tongue blade) would be beneficial to prevent contaminating the stool with microbes that may be accidentally poured into the specimen cup if if done by pouring. In this particular case the hat had been used before, rinsed out of course before using again, but I'm sure there were micro-substances in the hat that, if poured into a specimen cup, may potentially change the results? What do you think? Thanks! Almost done with my 1st year of nursing school, one week left!