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Aniroc

Aniroc

Orthopedics
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Aniroc has 4 years experience and specializes in Orthopedics.

CRNE Certified as of June 09, with specialties in high acuity and pediatrics. Currently working in a busy Orthopedic unit and consider taking my Masters in Nursing.

Aniroc's Latest Activity

  1. I really appreciate these comments and suggests as I too am considering a Masters with a thesis component but have been having problems trying to narrow down the process. Thanks so much!
  2. Aniroc

    The flu shot making people sick

    On topic, but a bit off topic. While in nursing school I worked for a well known agency as a flu clinic nurse. I went to businesses that offered to pay for their employees immunization. When at a large telecom company, I was paired up with another nurse. During the lolls, we'd talk and I found out that she was really into holistic medications and treatments and didn't "believe" in vaccinations and would never get one herself. Here we were, shooting people up with a product she was adamant against. I asked her if it was ethical for her to be giving immunizations given her position. Her response was that she needed the money and it was an easy job. Honestly, I believe that given a choice the majority of people would and generally do get vaccinated. Though if they decide not to, I uphold their right to refuse but I still give all the information, benefit, consequences etc. But this woman? I could hardly stand to work next to her after I found this out. In fact I called the agency and asked not to be placed with her again. They asked me why and all I could say was they needed to ask her opinion on immunization and vaccination and that I was ethically torn working with her.
  3. Aniroc

    Just something good

    Its a great feeling to have all your hard work recognized. I really appreciate it when managers take time to give their staff feedback. It helps us associate with them, as managers and not just that person in the office, but it also encourages us to continue what you're doing! Awesome job!
  4. Aniroc

    Need to vent.....dont understand why people are so nasty

    You don't need any advice...just some kudos! You did a fabulous job. Considering the environment you work in, the information you were provided by the aunt, the policies and procedures set in place at your school you did exactly what was expected of you. People will try to push you around, no matter what area of nursing you work in. You have a responsibility to protect the other students as well as the faculty from getting ill - evident by the principal supporting your position. Pat yourself on the back knowing you did your job and did it well.
  5. I am currently working on a busy medical/ortho/uro/gyne unit and now considering taking my Masters and or specializing. One of the areas that doesn't get a lot of attention, and one that I find fascinating is Nurse Continence advisor. I don't think its a well known area because many individuals are ashamed of discussing their urinary or fecal incontinence. Its a problem that isn't limited to geriatrics, anyone at any age can become incontinent. Being involved in this specialty has significant impact on a persons social life and overall quality of life. A nurse continence advisor works with physiotherapists, urologists, gynaecologists, generalists and performs assessments, urodynamic testing, various non-surgical interventions and works in a variety of environments from clinics to hospitals to LTC facilities. Good luck in your research and do search the nooks and crannies of nursing as there are definitely some interesting and not well known fields that should be explored.
  6. Aniroc

    Teaching as a new grad?

    I have only been nursing for 4 years and eventually I would like to teach. I really enjoy preceptoring students and working with the nursing students when they're on my unit. But I wouldn't even consider pursuing a teaching career with less than 5 years experience. Theoretical knowledge is one thing but the practical knowledge and know how is where you pull it all together. I would feel highly uncomfortable working with her and her clinical group. Perhaps you can ask her how and why she got into teaching so soon after graduating. Perhaps she'll be able to share some insights or additional knowledge you weren't privy to before.
  7. Aniroc

    At the end of my rope...hate nursing.

    There has been some wonderful advice in response to your post. I hear your pain and feel it as I too was burnt out by the time I finished nursing school. In fact I didn't write my exam until one year later as I was depressed and anxious and didn't believe I could be a nurse...at least a good nurse. I had nothing to substantiate my feelings but eventually I came around to writing my exam and getting my first real nursing job. It was hard and challenging and I went through ups and downs. Eventually you get to a point where you realize "wow. I actually make a difference ...or I saved that person by recognizing they were crashing...or I am really good at doing this, but I suck at that etc." It will get....easier. Hang in there. It will take some time to figure out where you want to work. Nursing is prestigious, don't think otherwise. There are many wonderful things to explore in the nursing and not all are hospital or LTC related. Your formal education will soon be over and then the real learning begins. Give yourself a break and don't be too hard on yourself for feeling like you do. Find the one thing you love about nursing and when you need it, take a deep breath and remember what that one thing is. You can do it. You've proved yourself by accomplishing this much already!
  8. Aniroc

    Supra Pubic Catheter Question

    Well, patients who have chronic retention or other urological issues that prevent them from long term catheterization often receive SPCs as a way to manage urinary retention. Therefore if after the catheter has been changed and the patient is still leaking or having retention issues, something else must be happening. First thing I'd look at is the stoma. What is its character. Does the peristomal skin look healthy or inflamed, is there tracking, fistulas or hyperplasia. Did they use a new type of catheter that the patient may be allergic to causing inflammation around the site leading to leakage? Some patients are sensitive to latex and need silicone catheters. You may need to check the balloon positioning of the catheter as it may not have been inserted fully into the bladder space preventing proper drainage. If you believe the catheter is in correct position can it be gently flushed with easy return? And lastly, if the patient does have a confirmed UTI what antibiotics are they being prescribed and are they taking them correctly. Its hard to say wether or not this patient will have retention as it depends on numerous conditions. If all else fails, this patient needs to be reassessed by their urologist as chronic leakage and or retention worsens their quality of life. Hope this helps.
  9. Aniroc

    Continence Nurse

    Here in the Wound/Ostomy/Continence Nursing forum there is plenty of discussion around wound and ostomy are yet there seems to be very little discussion on Continence nurse. This is an area of nursing that I think has been somewhat left out of the discussion. I am considering obtaining my Masters in Nursing, specializing in Urology and Continence. Do any of you WOCN nurses specifically work in the area of Urology and Continence? If not, how much of your practice is dedicated to continence issues? Could you share some of your "ah ha" experiences working with incontinence (be it fecal or urinary) and what it means to you to work in this field? Looking forward to reading your responses.
  10. Aniroc

    Incontinent ON PURPOSE

    WHen I have patients that act like this...and I'm talking about those that have the mental and physical capabilities to toilet themselves and mobilize to the washroom or can ask for help etc... I first tell them how unacceptable their actions are and that I have more critical things to do then clean up someone who should know better. They're wasting my time when I can be helping Mrs. Smith over there use her new knee replacement. They wouldn't do this at home in their own bed so I insist that they do what they'd have to do at home. First I get them to the washroom and make them wash themselves or shower if possible. An attends is put on if one wasn't previously. As they're doing that...I pull out new sheets and have them waiting. I make the patient assist me in making their bed. I specifically have them take off the wet sheets and put them in the hamper. I make them cavi-wipe the mattress and I do the same on the other side. I have them help me make the bed. I actively involve them in dealing with the consequence of relieving themselves on purpose - i.e. getting out of bed, actively cleaning themselves and being hygienic, making the bed and reminding them every hour on the hour while i am on shift that they must use the washroom to prevent an accident as it is their responsibility to keep them and their environment clean for their safety and others. I never threaten the use of a foley (cause some of them want that as a reason to stay in bed), and I talk candidly about real urinary incontinence, the health consequences of incontinence as well as social shame and isolation that goes along with real incontinence that such actions often result in people going to nursing homes which isn't always the best choice. Give clear expectations, define consequences and more so follow through and document in the nursing notes and in the care plan.
  11. Aniroc

    Clogged 3 way foley with CBI?

    I agree that it was a partial obstruction by a clot. If all else fails I also deflate the balloon very carefully and readjust to ensure that a clot isn't caught around the cuff and not obstructing the catheter. Then, I would go back to the urine port and flush direct with hopes of flowback or drawing in of any clot. Also, prior to any irrigation, I make the patient move around ALOT sometimes their own body movements can dislodge a clot in the right way to allow everything to flow.
  12. Aniroc

    continuous bladder irrigation

    Since no one has answered this question I'll give it a go. I work on a busy surgical unit and have a lot of urological patients who require continuous bladder irrigations post TUPR or TUR or if they come in with hematuria. Your first clue about when to irrigate is in the word "continuous" Essentially, this means that irrigation fluid is constantly streaming into the bladder and exiting via the catheter at a constant flowing rate. You control the rate of the irrigation with the flow-meter wheel until there is a continual flow that flushes blood clots and sangueous drainage along with urine without causing a blockage which would then require manual irrigation (and can require some real strong muscle strength!). Generally the surgeon will order "Run until CBI clear". But what does "clear" look like? After most uro procedures the output is sanguenous with some blood clots present in the returns. Some nurses believe that once the clots have finished passing - that means "clear" even though the output may still be quite red with some residual tissue or sediment still occasionally passing. Other nurses like the outflow to be at least cranberry to light pink without clots or sediments, in order for it to be "clear". I am somewhere in between. I generally start reducing the rate of flow once the blood clots have cleared until a nice cranberry colour is obtained. I then reduce further over night to watch the output and drainage quality. I have them mobilize in the morning to watch first passing to see if its too sang or if more clots appear or if its clear. If in MY the drainage is "clear" and the patient is comfortable, I then call the surgeon if they haven't come in to assess their patients to get an order to clamp and d/c the cbi and put to straight drain. I hope this helps!
  13. Aniroc

    A Guide to Nursing Specialties

    What a great visual aid for those choosing a specialty. Still doesn't make it easier to choose which pathway though!
  14. Aniroc

    The flu shot making people sick

    Actually, when you get a vaccine you body IS being tested. Vaccines, most of them except for live vaccines, contain small parts of the dead enemy. Its enough to activate your immune system to recognize the intruder and start making antibodies against that foreign body. Besides that, your body is tested everyday agains the heaps of other common viruses and bacteria that we come in contact with. While there is some guess work with which influenza virus they make vaccines for, its based on pattens seen in the rest of the world the year previous. They can detect its type and travel pattern hence make the appropriate and most common influenza vaccine. ITs not a shot in the dark but a very educated guess (though still a guess).
  15. Aniroc

    focus charting

    NYBaby, thanks for your response to this thread. I've been nursing for a year now and lately, I'm on the path to burnout. I'm on "holidays" at the moment getting refreshed before I go back to work and I really want to try and cut down on all the "extra" charting I do. In nursing school I was taught narrative but its hard to change. The fact of the matter is I have to. Flowsheets, focus charting (which my hospital does promote) and no-nonsense documentation is an way for me to become more efficient with my time. You're response was just the wake up call I needed. Thanks.
  16. Aniroc

    Frustration Rant

    I am all for teamwork. In fact I believe that without teamwork its makes my job as a nurse very difficult. As part of a team, sometimes we have to do things we don't want to; such as taking on extra patients when there are sick calls and being the "in-charge" during nights or for the last few hours of the day. I hate having that extra responsibilty (I am a new(ish) nurse with less than a year of working experience) but I do so for the sake of sharing the workload and working as a team. Last night we were extremely busy, so busy that I and several other nurses couldnt even take a break. Two of our patients were going sour and the call bells rung all night for the usual things like toileting, analgesics etc. As the pcc last night I was in charge of the unit and staffing for the day shift. It so happened that we needed to get a constant for our extremely demented and potentialy violent patient, a replacement LPN for a sick call and the regular PCC on days was sick but not replaced. As of 5am this morning, I had no one not even a single staff member on overtime to be fully staffed. To top it off, one of our LPNs needed to be off the floor from 11-2 but would at least be returning. Without our regular PCC, I needed to have someone in charge of coordinating patient care. We have a clinican who used to be a PCC until just recently and due to circumstances on the floor I thought it was more than appropriate to ask her to take on that role for the duration of her shift. However when our clinican came onto the floor she flat our refused to be the PCC citing "management" as her reason that some else had to do it. I asked her to explain further, and all I got was a head shake and "No, I will not be the PCC it has to be one of the RNs. Thats per management". I am nearly agaste. This is the same nurse who told me the day prior how important team work was. Now I feel as if I and the rest of my team mates have been slapped in the face for our naivity. We needed a PCC today more than we need a clinician. I needed her to step up to the plate like the rest of us have to. In the end I had to pull an RN off the floor instead and further the load of each remaining nurse for a total of either 6 or 7 patients. Our standard ratio is 4:1 for acute medicine. It just boils my blood that while the rest of us are expected to make consessions to provide care for our patients, those in more "elite" positions, such as that of the clinican, are exempt. It doesn't say in my job description that I have to be "in charge" but I do it even if I don't want to. This episode has made me loose respect for this nurse. I know that the PCC I chose to be in charge will still help out the rest of the floor nurses, which will be much appreciated because she a senior nurse who will be leaving for the ICU soon. And while she is helping out one of our sick patients, the clinican can continue to make sure that our fluid balance sheets are done correctly, that we've updated our care plans and reading through charts while the rest of the "team" is being run off their feet. Thanks for letting me rant my frustration.