Melina

This case didn't even involve a central line or drawing blood for lab tests, and no medical professionals were found to be culpable.

If you want to try out a Prophecy test, Mightynurse.com offers access to a free exam. You can take any of the competencies. Melina

This is already being implemented as part of the APRN Consensus model. The move is to a population-focus instead of setting-focus. For instance, the acute/critical care CNS program I am in is now an adult-gero CNS program, and we are expected to manage that population from wellness to critical care.

I love this thread! The LTACH where I work has a lot of the issues you all speak of. I am planning on taking on this issue for my master's comps. I was inspired by the reports by the ACCN (Relevant Research) about reducing medical errors by speaking up when another professional is acting inappropriately or dangerously.

I was wondering the same thing on my last shift! It wasn't covered in our policy, so I looked it up. Depending on the manufacturer, some end caps do not require clamping to function. Clamping between uses is recommended, though, because the end caps could loosen, making patients vulnerable to air embolism,etc. http://www.carefusion.com/pdf/Infusion/clinical_documentation/white_papers/Clamping_WP_MX2923.pdf

Have you tried Cymed? They have a novel, appliance that adheres to the skin with a tegaderm-type material. Because it is so thin, stool cant easily leak underneath. You can see them at http://www.cymedostomy.com/what.html. The company is very generous with samples. The ulcer can be protected with Arglaes powder. Brush off excess with dry gauze before attaching appliance.

I found this: ECMOjo Simulator and Trainer - Home by searching "ECMO simulator." Not sure if it is the one you are looking for, but it's kinda cool.

There are many anti-chafing lotions on the market. I've never tried the lanacane brand, but a lot of althetes use Bodyglide. There is also a product called Luvees (http://www.luvees.com) that might be worth trying. Good luck.

A calf BP can be significantly higher due to calcification of the lower extremity arteries. We see this all the time when taking ABIs for wound assessment. I would be hesitant to to use this to take a patient off pressors. I'm interested as well to hear why there was no a-line.

I'm currently enrolled in University of Cincinnati's online CNS program, but I am transferring to CU Denver this Fall. Nice to connect with you all.

Have you tried switching brands? Cymed makes an excellent product that uses a transparent film instead of a hydrocolloid wafer. I've used it with great success on several occasions.

I have worked intake, and I can tell you that we would often not get d/c notices until after 5pm the evening of discharge, especially on the weekend. There would be know way to let you know by Friday. As for whether you get paid for cancelled shifts, that would depend on your contract with the agency.

As long as the infection is being treated a wound vac is appropriate. Silver foam seems more reasonable than sterile technique. You can always call and ask the doc for his or her rationale. Melina

No caseload? How many nurses will see a single pt? I've never heard of this either. Is there any issue with continuity of care? Mel

I chart vitals and make notes of anything exceptional with a pen (a fine tipped TUL gel pen, in fact) in the pt's home then bubble everything after the visit, usually in my car before I leave for the next pt. That's where I write a visit note as well. It was tedious at first, and it's really tedious now that computer charting is on the horizon, but I wouldn't call it doing everything twice.