marialsnd

It doesn't happen often that we have insulin drips, mostly because we are primarily an oncology floor, but I have had a patient with an insulin drip with 3-4 other patients who also might be getting blood or on a heparin drip.

I'm sure I sometimes sound cranky about getting admits from EOD staff without intending to. A big problem with transfers between units in our hospital is that the EOD staff work a different shift than the rest of the floors, except ICU. While they are trying to transfer patients out before the next shift comes on at 4 PM, we are just getting report on our patients at 3 PM so more often than not our admits occur right at our shift change before we even have a chance to meet our patients and get our feet under us. Again this comes down to administration. If we were all working the same shifts, or at least not having shifts change so close to each other, it would not be such a big issue.

That goes WHERE?!?!?!

Be a duck, Be a duck.....

PITA Pain in the orifice

1. If it's wet or sticky and not yours, wear gloves. 2. Air goes in and out, blood goes round and round, any deviance is a problem. 3. All bleeding stops, eventually. 4. Nursing school really does not prepare you for the reality of nursing. 5. You always need something when you're in a contact room.

YES!! The incontinent C-Diff missed my shoes.

Code Brown!

Another issue, at least with my BCBS health insurance policy is that they won't cover "obesity related" charges. I went for my annual physical and because it was coded wrong, they didn't cover any of the visit because it was obesity related. Insurance will cover dietitians and medications for all the diseases caused by obesity (at least in part), such as diabetes and high blood pressure, but will not pay for those same services for people trying to lose weight to prevent developing those diseases. Wouldn't it be cheaper in the long run for insurance companies to pay for prevention? Our local hospital has a medical weight loss program which includes both dietitians and personal trainers but the downside is that insurance won't cover the cost of it, even in part, because I don't have any of those diseases. However my mother who has several obesity related diseases was able to get the majority of the program paid for. It's a terrible catch-22 to be in; trying to lose weight to prevent disease, but health insurance won't help cover the cost while at the same time charging more for their policies.

At the facility I work at, all of our yearly tests and CPR are due to be done during our birthday month. It makes it easier to remember when to have things complete rather than keep track of a bunch of random dates. You could do something like that for yourself, even if you have to do some of those requirements before they're due, it would be easy to get everything done at once.

When I get my own port accessed or when I access a patient's port, I have them inhale and hold their breath. I feel like it helps to bring the port a little farther forward, plus it is a little more stabilized on the inside with the lungs expanded. As many have already posted, don't be timid when accessing. If you hit the side and slide off the edge, you can pull back slightly without the needle coming out and becoming locked so that you can slightly readjust the angle of insertion. If the port is slightly tipped, if you push on the opposite side it will help to bring the tipped side up (I know this from personal experience because my port is tipped and that is how I can feel all 3 bumps indicating placement and is how others are able to access it.

In my experience of having my port flushed, I definitely can taste the saline flushes but not the heparin flush. For the bed taste from the flush I either suck on wintergreen certs or chew gum, preferably cinnamon flavored. I didn't have luck with sour (such as lemon drops), but if it has a strong flavor, especially with a little bit of a bite to it, I don't notice the bad tasted.

We have a lot of falls on our inpatient oncology/renal dialysis unit as well. I've only been there 6 months, but we have yet to go a month without a fall, frequently we don't even get to double digits without a fall. We also do hourly rounding, and in fact about 95% of our patients have both bed checks and chair checks and use rounders/sitters as needed. One thing we all need to remember is using gait belts and lifts more often. It helps to get families on board and not try to transfer patients on their own.

I start my BSN program next Monday and I am ordering a Littmann stethoscope. My Mom is a nurse and when I was talking to her about equipment, her only recommendation was that I should get a stethoscope that has a single tube rather than a double tube. Our NSA has Littmanns for sale. I found a website, Stethoscope Sale - 3M Littmann Stethoscopes where I am ordering my stethoscope from. Not only are they a little cheaper, but they also offer free laser engraving to help avoid losing a huge investment. (I don't have any affiliation with the medisave website, I'm just impressed with their prices and services offered). I'm a former EMT so I have acquired the rest of the my required equipment over the last 20 years, but if you're looking for quality and something that will stand up over time, I've found that spending a little extra money on individual pieces over the kits is a better financial move in the long run. Good luck with your program!!

Thanks for the input. That's kind of the way I am too. I don't have a choice about purchasing the e-book. If I choose to purchase the printed version of the books, we still automatically get the e-book access. It costs more and is what I did this semester. I'll see how much I actually use each book type. I did look at the e-book access we have and it's better than any I've used so far, but I'm reserving judgement.

I am starting my first semester of my BSN program on the 20th of this month. Over the summer, my school did a lot of revamping of the nursing school and one of the major changes was a change to our textbooks. This is the first semester that they have started to require each semester (5 total) to purchase a different bundle of books, which don't actually cover all the required courses for the semester. Each bundle has the option of purchasing just the e-books or the printed material in addition to the e-books. For first semester students this was a difference between $320 and $530 just for the bundle. I am an older student (just turned 40 this summer) and so although I have used a few e-books in other classes finishing my pre-reqs, I have spent FAR more time in my educational career with printed material in front of me. Since this is new to my school, no one is really sure how this will all work. Do any of you have any experience with your schools requiring e-books and online material for your classes? How do you think it compares to to using printed materials? Have you found a benefit to having the printed material in addition to the e-books and online materials?

I hated to give up my EMT-B license when I came back to school to get my BSN because I know that I will never go through the training to get it back. Here in ND, if an RN works on an ambulance service, they are operating under their own medical license rather than the license of the medical director, which means that there aren't many nurses working on ambulance services unless they are separately licensed as an EMT. When I took my EMT course 15 years ago, I had 3 nurses in my course, 2 of whom were struggling with the material. Not so much because of the material covered, but because each license has different levels of skills that are allowed. An RN working as an EMT on a BLS ambulance service is not allowed to start IVs or push drugs that they would be allowed to administer in a hospital setting. I agree with several of the posts that you really can't compare the 2. Even though I spent 15+ years working on ambulance services and earning advanced skill certifications and being an EMS Instructor at the state level, does NOT mean that nursing school or finding a job after graduation will be any easier for me than any other nurse.

Depends on your instructor. I actually got an email a few weeks ago from an instructors encouraging us to start reading now. As was posted before, check with your school's bookstore. They should have the books required for each course. I know what books I need and what they will cost, but I have to wait until the bookstore opens up Financial Aid charging on August 1 so that I can afford to buy my books.

I just turned 40 and am starting my BSN courses in a few weeks. It's definitely different being back in school at my age, but I find that except for being "Mom" to some of my classmates, they treat just like any other student in class. I feel like my life experiences, especially my 15+ years in EMS will benefit me in school. There's something to be said for being an older student who because of experiences in life is going to nursing school vs. someone younger who may have a glamorized view of what is actually involved in a nursing career. I know that some of my upcoming classmates have never actually worked in healthcare except for the time they spent in their CNA courses, which are an admission requirement.

I have a classmate that is starting nursing school with me in a few weeks. We have actually taken several courses together and study well together. We planned which sections of courses to take so that we can study together. Last semester we took the same class from different instructors and they were so different that we weren't able to study together and neither of us did as well as we would have liked. We both seem to catch different things out of the lectures and when we put them together, we seem to do best. When we try to add anyone different to the group, as someone else stated, the dynamics change and we don't do as well as when it's just the two of us. Find what works best for you and stick with it.

I can tell you that as a former EMT, if there was no signed order in front of me, I was legally obligated to perform all measures possible to save that patient, no matter what I was told. Just being told that there is a DNR, doesn't mean anything without that document. First responders do not know what the family dynamics are and whether or not there is a dispute over care.