ladylynx

Until you've had a chronic pain problem, please don't withhold meds because someone is sleeping. Sometimes exhaustion takes over, but when I have a migraine, I only wake up with a worse migraine if I had not taken anything. Pain meds do have side effects and believe it or not pain meds work in different ways affecting different receptors. For example, Morphine is considered the strongest, but it is not the most effective. Although you get the "high" (as nurses often call it) it does not take away all types of pain. It's like taking Tylenol for a toothache, when Ibuprofen works better. Work with Hospice and you will learn much about pain and what works by talking with the patients. I wish everyone would remember Anatomy and Physiology 101...pain and sleep are different parts of the brain.

I too exercise, don't smoke, drink alcohol rarely, don't eat pork, have decreased eating most meats and all that other good stuff, but after 17 years I can tell you that although I am not overweight, my blood pressure is significantly higher when at work, I have frequent migraines, I have back aches and more. I have co-workers that have been attacked violently or have contracted various diseases from being stuck by a needle. Of course, their are more physical risks. All you have to do is take a look at the Workman's Comp claims that are actually being approved. Those are just the one's that are even turned in. Lifting, turning, bending, and more...who do you call when everyone is tied up?

In another world maybe this would be true. But please, I advise all to speak with the Risk Management Department in their facility and go to a court session involving a health facility law suit. Yes we all can be held responsible and now that nurses are being named in law suits and not just hospitals (I have had the experience), even the charge nurse is held accountable for all those under them. The red line also means nothing when a med order or any order is missed...all can be held liable from the first day the order was written (had that experience too). These are the reasons new nurses are quitting. There used to not be "accountability", but now with increased knowledge and the "internet"...accountability is demanded and situations are not going unnoticed. As an LPN, I truly feel for the charge nurse, because unfortunately the nurse practice acts and the facility job descriptions clearly states the responsibility the charge nurses have. And we wonder why facilities don't have many volunteering to be the charge nurse (especially for $1.00 - $2.00/hour more).

Good for you...many need to follow suit. After 17 years of working the night shift, I see so many that don't realize that when they are sleep deprived, they are easily agitated and very unsafe. It's like the mentally ill person that says, "everybody else is crazy". So get some rest, call in if you haven't, because eventually your body will shut down anyway, if you don't heed now. The psych units and nursing homes are full of young to middle-aged nurses. Hardly anyone cares that you were a martyr. Be safe and take care of YOU

Not to scare anyone, but now it is shown that "as little as 0.5 mL of air in the left anterior descending coronary artery has been shown to lead to ventricular fibrillation", (http://www.emedicine.com/emerg/topic787.htm). I've also seen other literature in various hospitals. But to this situation, probably not because the pump will usually stop when alarming. To eleviate "air" in piggybacks you can always back prime prior to setting up pump. Those pumps that allow the machine to back prime are even better because it recognizes the primary calculations when back primed and then allows the rate to change when its time for the secondary.

If only this were true...I have often been labeled a rebel and been shunned, so I have learned to send letters to the entire chain of commands and be ready to quit. In general, people would not be able to do this (bad behavior) if the "higher chiefs" cared. There is a fine $, states HIPPA. If you only heard what those higher chiefs said and do at conferences and meetings.

You should also think about the fact that they too are sick. "Drug-seekers" (the word I really hate to use) have a history also. Many come in different forms and many started because of some kind of pain. But the stats from those in healthcare recognize the truly sick patient outweighs the amount of "drug-seekers". Giving pain meds, sleeping pills, and anti-anxiety drugs on time and as ordered often heals the sick person faster and will get the non-sick person discharged quicker. In regards to safety...if someone is in an unsafe situation give them the "complaint hotline" that is given to them upon admission (many forget they have at bedside). Sometimes this number is directly to Administration. Then there is always security. They often joke with me on how hard they work when I am their. Oh, well, "safety first" is what they say and I went to school to become a nurse not a security officer.

In one of the hospitals I worked in, C-Diff was rampant so we started reporting even the Dr.'s that did not follow protocol. I found that in most facilities I have worked in, the Infectious Disease departments are very serious about their jobs and often want to know (we often joke about them being anal). So they are a very good resource for reporting to, even anonymously. When C-Diff showed up with a new Mom, everyone got serious. If that doesn't work you always have the famous, "Ethics Compliance hotline".

Due to moving around for clinicals and "stress" you might loose many stethoscopes. I suggest trying those least expensive ones first and maybe as a graduation gift to yourself by yourself a Littmann. I still carry a colorful least expensive one and when someone borrows it they comment on the clarity. Somethings are still overrated. Also when in the hospital you can try a few for yourself.

For some reason many of us seem to forget about a "law" that exists outside the workplace. If someone hit you outside of home, criminal charges would be filed immediately. You might want to seek the advice of a legal representative, including risk management. To many nurses are on disability due to workplace violence by patients. Many facilities are teaching self defense...if it is you vs. the patient...run and get security and/or police help. If the family is refusing, then they should be sued for damages. We still live in America, abuse is never acceptable. Peace and love...nothing less! Cathy

I see I am not the only one. I just left December 2004, after visiting Georgia during one of the hurricanes passing through Florida...I decided to leave. My next choice would have been Nashville, TN. I am much happier although even Georgia is in a class by itself, but at least it is overflowing with opportunity. I lived in Orlando for 3 years and St. Cloud for 1 year. After 1 year in a house in St. Cloud I sold my house with a profit of $27,000 (after paying both Realtors). I too found central Florida rediculously "overpriced and underpaid" and my children hated it also. Even having to pay for those crazy toll roads was draining our pockets. I realize this does not answer your question, but even 3 other ladies moved here right after I did and I hear more from the Orlando Hospital where I worked and are moving out of Florida. Just remember the stress of unhappiness is never good for oneself or the family. There are too many of us nurses in the Psych Units already. Good luck.

I thought someone would mention K-Swiss (the thicker soles). A few years ago, a nurse that had many problems with her feet mentioned that her Orthopeodic (sorry if it's spelled wrong) Doctor referred her to an expensive orthopeodic shoe (I can't remember what kind) or K-Swiss ($50-60) and she chose K-Swiss. So I decided to try it and now 4 years later that is still all I will buy...NO PAIN! I always work 12 hour shifts 4-6 per week...NO PAIN Also my fiance has neuropathy and that is all he will wear...NO PAIN!

Although this is an older post, I must have input because I am still not sure of the rationale. For the past year or so, Dr's, Pharmacist's and other nurses often get upset when Vancomycin is being held after the "random" troughs. Now, most places there are no "Peaks" required or ordered anymore (thank goodness for the records in the attorney's hands). As for the "times" to draw, I have learned from working in various hospitals, that the most important answers you can get regarding peak and trough times, as well as how to flush an type of intravenous lines, etc. is all in the "Policy's and Procedure Manual". It doesn't matter what another nurse tells you, even though P & P are considered as guidelines (if an attorney asks you). Like "laws", these can be changed, but it keeps a little more consistency in place.

My title is based on an answer given by a 100 year old when I asked her how did she get to be 100 years old. But back to the question...there apparently is in various literature, including the physicians and the nursing drug books that talk about deep subcutaneous. Here is one reference I found online http://www.medicinenet.com/cyanocobalamin-injection/article.htm In the past, I have had to give it subcutaneous before, but did not quite no the reason since when I too looked it up years ago, the references stated that it could be done.

I do agree that most agencies will not hire new graduates, but after as little as 6 months, I have worked with those that are working through agencies, as well as having travel nurses who are in charge that have worked less than a year. My point was that working at a level lower than your expected license often gets you in the door. Besides the local papers, which are available on the internet and the official city sites are available and usually show the median incomes of various occupations. This also allows you to see the cost of living and whether are not they have a state tax or not. You can also get a rating of the various schools in neighborhoods.

I've never worked at a hospital thus far that Dilaudid was not in stock. Out of 15 years I have only seen 1 reaction from Vancomycin that required a medication atagonist. With C-Diff on the rise, we are using Vancomycin like it is the new Penicillin.

In Florida, they basically did away with Demerol. There was literature passed around and for the central Florida area, the only exceptions were in PACU and OR. They posted charts that gave alternatives and comparable dosages. What I found most interesting is that Dilaudid 2mg is equal to Morphine 10mg. Now that I am in Georgia, they are scared to give Morphine 4 mg, or even Dilaudid at all. Among many other issues, they were clueless to the debate on Demerol (4 of the hospitals thus far). Coming from Tennessee, I found that the days of giving Demerol 100mg every 4 hours, Dilaudid 2mg every 4 hours, and Morphine 5-10mg, we got the patients up and out faster. Making sure we weaned them by the night before discharge. Peace and love...nothing less! The Lady

the excelsior college has a network where you can talk with people in your area that have gone through or going through. https://www.excelsior.edu/portal/page?_pageid=57,1&_dad=portal&_schema=portal i hope this is a start. take care. peace and love...nothing less! the lady

I have 3 and now they are 14, 12, and 10. When I schedule myself, I always make sure I only work a max of 2 days in a row with always a min of 2 days off. The kids hardly miss me, especially since I work at night. You will find that every 2-3 weeks you will have 5 days off. Quality time is the key for children. Take care. Peace and love...nothing less!

For all of those out there, check out http://fastweb.monster.com/index.ptml You would be surprised at what you qualify for. All colleges provide this info and more. Take care. Peace and love...nothing less!

You might want to check for yourself. For instance, the local paper is a good way to start. You can call and ask, if they are hesitant, just tell them you are checking as a student. Go in and talk to some of the local facilities that might interest you. I often use http://www.careerbuilder.com/ as resource for jobs available in any state, some of the employers will list salary ranges, especially medical temp agencies. If you see their ranges, then you can take off anywhere from $5 to as high as $10 off for full time pay. Sometimes the agency is a way to start trying out facilities, even as a LPN/LVN, RN, or even CNA. They now have made it easier to work for the employer where you are "agency", instead of having to buy out a contract. I hope this is a start. Take care. Peace and love...nothing less! Name of agency deleted. Against the TOS of this website for advertising.

I don't know specifically about TX, but I do know from other nurses in various states they all take their time. You can go to that state's website and they give you an estimate of the time it takes. http://www.bne.state.tx.us/ I hope this helps. Take care. Peace and love...nothing less!The Lady

The syringe is simply a subcutaneous syringe...usually tuberculin. You might want to refresh yourself on the meaning of subcutaneous. No other technique than what is required for insulin injections. Hope that helps. Take care. Peace and love...nothing less! The Lady

I must say after just going through a mock Joint Commission survey while passing medications (passing), I feel that my experience of working for various agencies over the past 15 years has allowed me to see things like this incident and far worse. Whether a new nurse or and old nurse, mistakes are made. I still get the evil eye when I: (1) refuse to take a syringre, filled by someone else, and inject a patient, (2) check the Pyxis info on when the med was taken out vs. the MAR, (3) remove meds from the Pyxis and immediately going to the patient and then coming back to remove meds for the next patient, (4) check the Ativan vials to make sure the top has not been previously removed, (5) check for the viscosity of the Ativan, (6) will not change an IV bag for someone without varifying the MAR and asking the nurse, (7) take the written MAR in the room with me, (8) open the meds in front of the patient, (9) make sure the patient knows why they are getting such meds...I could go on and on. Take time and observe around you, these practices are ignored at an alarming rate. You would be surprised how your co-workers are completing their tasks faster than you. Lastly, to your incident, suspension...of course not! But there should be an inservice regarding policies and statistics reviewed on adverse effects on patients for such actions without naming the persons at that hospital involved. I have also learned a lesson a few times...when the floor is short staffed, don't cut corners for yourself or anyone else. Let the companies justify why meds were late, patients fell, and others just unhappy with the lack of staff. Remember they don't put up a street light at a crossroad until so many accidents happen. Take care. Peace and love...nothing less! The Lady

My heart goes out to you...I have seen this done so many times. I have tried to encourage my colleagues to attempt to converse with the patient, even if you think they don't understand. Even with an order, in the case of someone like yourself, I would call the family member closest to the patient and see if they can talk to them on the phone or just come in. Many families are greatful, because they were greatful for the little sleep they did get or they were up worrying anyway and wanted to be called if something was wrong. When it's a loved one, there is no such thing as too early or too late. We have to sometimes compare patients to children in daycare. Also on the medical standpoint, many patients have died in restraints, so we must take this seriously. I wonder if any of you have seen the "veil beds" return. As humiliating as they looked, they were safe.