Jen,SN

"Can I help you?"(answering call bells) "How are you feeling" "How was your day/night?" "Can I get you anything else?" "Call me if you need anything." etc, etc, etc...

I don't know why, but I see it pretty frequently at work--to the point where it's almost expected in our post-dialysis pts. Maybe something to do with the massive moving and filtering of the blood sets off the inflammatory response? The cultures never come back positive....

Last week was one of the few times I actually went home from work feeling dirty. Lady on hospice with a massive wound infection--she had some kind of pouching system over the main wound, on her abdomen(surgical wound, open abdomen), a j-tube and g-tube that were draining, 3 ostomy bags being used for wound drainage, plus a colostomy and a foley. It took almost an hour to empty everything and get her cleaned up. Was wearing a mask smeared with peppermint spirits and still about gagged. Went home and immediately showered.

I work with dozens of nurses/nursing students who need some form of vision correction--I think as long as you can do an assessment without difficulty, and as long as you have enough depth perception to work with your hands(ie, give an injection, do IV's), you'll be fine. I have a severe astigmatism in one eye and very poor depth perception, and I do fine--there are some days where I have to pass off the trickier blood draws to others, but other than that I've never had a problem.

Thanks for all of the advice everyone. First off, a little more history: I'm currently a jr. nursing student, with 2 clinical days, 2 class days, and 3 work days each week--I work evenings(can't really change shifts, and whoever said that Id have less work to do on nights...well, instead of 8-12 pts I'd have about 18, so...) Yes, of course stress is a problem--isn't it for every person trying to do school and work? I'm trying to manage it as best as I can, and my headaches don't really seem to correlate with stress that much. My main triggers seem to be art. sweeteners, flashing lights, inc. blood flow to the head(bending over), dehydration, noise from microphones, getting startled out of bed, and my period. How does FMLA work? Do you just call in and say, "I'm taking a FMLA day?" I'm also looking into a temporary disability right now; by the MICAS profile I'm considered grade IV, seriously disabled. Also, disability pays...FMLA doesn't, right? And I am a starving student... My current treatment regimen is 30mg Nortryptaline QD(at night), 50mg Topomax BID, 150mg Zoloft QD(both for this and for my bipolar), and a prenatal vitamin that actually doesn't list magnesium. My rescue plan is Imitrex SQ ASAP, 2-3L of water, another shot in an hour if needed, and fioricet(which I believe is similar to the duridrin someone mentioned, it's asprin, caffiene, codiene, and barbituates) if I max out of imitrex. If that doesn't work, head into the ED for droperidol(which I don't like), valproate(which I've never had), or dilaudid(which, at the fear of sounding like a drug seeker, I do like). I love my job. I love what i do. I just can't handle these headaches, and I don't really know what to do the make sure I don't lose my job because of them...

I need some advice here.... Four months ago, I went to bed with a bit of a headache and woke up with a migraine that I can't get to go away. I've tried pretty much all of the different preventative medication classes; most cause such violent side effects that I can't take them(I'm taking antiseizure drugs now, but they aren't taking them away completely). I use the abortive drugs, but they are so expensive--$70 per dose, and I have no presciption coverage...my neurologist says the best he can do for me is to get me down to 2-3 headaches a month. The problem is that they don't just last for a few hours...they last anywhere from 3-10 days... I've had all the tests runL CT, MRI...there are some problems up there, swellings, strictures, etc...but nothing to be done about them. The advice I'm looking for is what to do about my job. In the past five weeks, I've called in once a week. I'm worried about getting fired. I'm good at my job, I love my job, Ive gotten awesome performance reviews...but I can only call in x amount of times before they fire me. I'm per diem, so I haven't got any sick time, vacation time, or PTO...what do I do?

The only time I can remember ever having a "VIP" patient was when the (now)former president of my college was admitted...she was put into one of our hospice rooms(which would creep me out a little bit, what with the plaque on the wall stating what it was and the patient having a terminal illness, but, hey, whatever.) The only especially annoying thing she did was insist that we fill her humidifier with our sterile water supply. Took about 6 bottles and depleted us for the night. Never mind the dressing changes or anything...

I've got nasty chronic migraines(to the point where I'm getting some pretty clear brain changes), and when I go in for them I'm so terrified of being labeled a drug seeker(esp. with the migraine dx...) that I don't think I've ever asked for more pain meds unless it was offered to me. Suffered a long time because of it, probably, but when I'm at that point I'm afraid of getting a nurse who's biased against pain meds and assumes that everyone asking for pain meds is an addict and trys to withhold the meds from them...

Hello, L&D nurses...I have my first OB clinical on Monday, and I have a few questions. 1. Is there any reason a pregnant woman(or her partner) couldn't check her own cervix at home, before they came into the hospital? I understand infection control issues, but what if they washed their hands/used sterile gloves/etc. In a low-risk birth, it seems like a good way to avoid unnecessary interventions and just the boredom of being in a hospital for that long. 2. How do you keep blood sugar up in laboring moms? The hospital I'm at places all moms on NPO x ice chips status...I'm thinking that after 12-15-24 hours of that, they'd be pretty hypoglycemic... Is that mainly prevented with IV dextrose, or am I missing something? 3. My book talks about water births, and how the baby doesn't start to breathe until its head is out of the water. As long as the cord remains intact, this is ok, right? The book says to get the head out of water ASAP, but it seems to me like it wouldn't be all that big of a rush as long as you don't cut the cord(I mean, obviously get them out of the water eventually, but theres enough time to deliver normally and ease them out, right?) Thanks!

that the first semester clinicals, where we had one patient, mild acuity, and no meds to give, could get really boring. After the initial assessment, vitals, and paperwork was done, we really didn't have much more to do. I'm anticipating this semester will be better

A few weeks ago, we had a pt. who'd been in for about 2 months(I'm a tech on a med-onc floor) with a variety of things--CHF, diabetic foot ulcer, etc. I had an awful night at work, and had been in her room putting her on the bedpan numerous times. When I went home, I was telling my fiance(fiancee?) about her, and I said, "Ya know, she's getting better, but I just don't see her leaving the hospital alive." The next morning she had an MI and died. About a year and a half ago, I was 5 weeks pregnant with my second pregnancy. I'd miscarried the first about a year before. We went out to the beach that night and while I was sitting on the sand, I could swear that the spirit of the first fetus was there. Was a little creeped out at first, but I got used to it and started talking to her, asking her to watch over the new pregnancy, keep him safe, etc. When I got home that night, I went to the bathroom and saw that I was spotting, and miscarried the next day. I still believe that the spirit of the first fetus came to take the second one with her.

Had a patient the other night go from a crit of 37 to 22 in 3 hours--not sure what the hgb was. Upper GI bleed. between vomiting and the NG tube, we got 1400 cc of blood out of her stomach before sending her to the unit. Last BP on the floor was 48/??. One of the other nurses saw her being RAN into the OR an hour after we sent her to the unit.

I can handle any body fluid: sputum, urine, poo, vomit, blood...but I cannot do sweat. Ugh! Changing sheets that are all soaked in sweat just makes me shiver. Oh, and dry skin that flakes off. I cared for a patient a few weeks ago who said that no one had taken off her TEDS in 9 days--when I peeled them off, this cloud of skin flakes went everywhere. I was certain I had inhaled them. Yuck.

Had one patient last night who was incredibly verbally abusive--ETOH withdrawl, just raging at us. At one point, he called us all 'f-ing whores." just looked at him and said, "I know you're frustrated and angry, but you may NOT use that type of language with us."