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home health, neuro, palliative care
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Melina specializes in home health, neuro, palliative care.

Melina's Latest Activity

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

    Sweating The Small Stuff

    My thoughts exactly! While no one is perfect, the lack of accountability demonstrated by your post was concerning.
  3. Melina

    UCH Pharm and Tele new hire exam

    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
  4. Melina

    Family/Individual across the Lifespan CNS?

    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.
  5. Melina

    nursing dilemmas

    Do you have a nursing research department at your university? The RAs can be really helpful. I would contact the author of the tool directly if it isn't publicly available.
  6. Melina

    Nurses Talk To Nurses. Doctors Talk To Doctors

    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.
  7. Melina

    To clamp or not to clamp

    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
  8. Melina

    Please help with a difficult ostomy

    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.
  9. Melina

    ECHMO game?

    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.
  10. Melina


    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.
  11. Brainstorming: Always ask what you can do to help another nurse if you aren't busy. Never ignore an alarm, even if it's not your patient. Make sure all your lines are in order and labeled. Clean up after yourself and your patient for the next shift (they are your colleagues too). Clean up after your teammates if they are slammed. Ask lots of questions, and listen to the answers. Take time to learn everything you can about your job and your patient so you build trust in your autonomy. Have a good attitude; it's infectious! One more, don't take anything personally! If another nurse, therapist, MD or family member is short with you, assume it is because s/he is under stress. Watch for ways you can help out (sometimes helping out is leaving the person alone for awhile). Good luck!
  12. Melina

    BP arm VS calf while running pressors

    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.
  13. Melina

    Calling all current cns students

    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.
  14. Melina

    Please help pt with leaking colostomy

    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.
  15. 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.
  16. Melina

    Wound Vac Tips and MRSA sterile dressing

    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