Jenny P

After 34 years in critical care; I never went to work without my own favorite med book, my stethescope, scissors, 2 hemostats, a penlight, my own 2 pens, and a critical care pocket reference book that I added my own paper to so I could add my own little "perls" to: I would add certain MD's odd little quirks (ie: if one surgeon liked some different lab test done that others didn't); hosp. and MD telephone numbers for emergencies; and if there were certain tests that were difficult to remember how to do them. In other words, my extra pages of perls were the things I didn't use often but if I needed to use them I could find those things STAT.

Zee, when is the test? I'm too lazy today to read back. I think you will do okay if you remember to use your head. Sunnybrook had some excellent advise.

Congratulations HealingtouchRN; I have never heard of this exam before. How does it compare to the CCRN exam?

There really is too much info missing here for me to give you much help. Why they wouldn't have inserted a SG cath when they put in the IABP is beyond me; did he arrest in the cath lab? What was your MAP; what was the augmented diastolic pressure; was the pt. making urine? Thank goodness some people live in spite of what we do or don't do, huh?

We don't use Levo that often; vasopressin or Neo would be our drug of choice for the BP. Primacor (milrinone) would have been a good choice, I think. What was the MAP?

ACOG= ? American College of Gynecology? If so, no, your hospital is NOT following their guidelines (try checking their website and see if they can tell you their guidelines).

I've cared for patients (back 30+ years ago) that were debilitated and poor who had had maggots in wounds when I went to change dressings. The first time was terrible, but then after that it wasn't so bad because I knew that they would be clean wounds. I just always felt like I needed to bathe in Kwell and chlorhexadene or lye soap afterwards! I remember in particular (this was the first time I saw maggots) some old bachelor brothers who had been on a drinking binge after finding money while ripping down a building: one had died of alcohol intoxication and they were found at the same time a few days later. We gloved and gowned before touching the survivor; undressed and put him in a tub, then found he was wearing another pair of long johns that his body hair had grown through! He had a "bed" sore on his hip where he'd been found lying; this was badly infested with maggots. It was very clean! I nearly lost it when I realized what the creepy crawly things were; but the wounds were some of the cleanest ones I've ever seen. (this was back in 1967 when I was a student; I doubt if I will ever forget that smell! And I still get the willys when I think about it!). Aren't you glad I shared this with you?

I used to teach heart sounds at different points of my life. This used to be called a "flow murmur of pregnancy" and Kimmicoobug did a nice job of explaining the cause of it. It is labeled as an "innocent" murmur because there is no pathological reason or effect to (or from) it. It will resolve during the immediate post partum period. I don't know if it is still referred to by that name, but I suggest you Google it and see. (I just did that and found 2 good atricles on it). As far heart murmurs in teens, these can either be innocent or worrisome; it all depends on what is the timing, how loud, systolic or diastolic, and are there other symptoms that the MD is concerned about? Make sure your cousin is seeing a good cardiologist! That is about all I can tell you on such a general question. Sorry.

Oh, come on, Mel! There were many times even us oldsters could post and not get a response. I have been here for 3 years and in that time, there were many posts I made and not get a response to a post. When you meet someone online and share some similar ideas and experiences; you start thinking of them as a friend and you may be more likely to respond to their posts than someone you DON'T know or who hasn't posted in the same threads you are interested in. The way you have stated what happened here is mean and another snide comment at the group who left here. Many of them were fed up with the hipocrasy they saw here; several were banned for speaking out about it. They left for "more exclusive venues?" No, they left to be among friends who wouldn't stab them in the back. You are so right about the "out with the old, in with the new" though, so many of the more senior members here no longer feel welcome.

Soundslikesirens, I remember you from long ago. haven't seen you here for years; now I know why. I have nothing to add to your thread except take care of yourself and never argue with your ex in front of (or through) the kids. Please don't give him the power to control your life or attitude; you are able to move on and build a better life for yourself. Don't let him control how you feel; I can't help you much but I do strongly recommend counselling when you need to sort things out. I'm not sure if your lawyer was very helpful (I know nothing about Ky laws); but maybe you should go lawyer shopping if that is what you think.

I lurked for a long time before I joined. Sometimes I just want to read, I don't always agree with other posters; sometimes it's important to put in my 2 cents; many times it isn't. I've been here a long time; lately the climate has changed and I don't feel like talking as much anymore.

My hospital no longer calls them "incident reports;" they are now titled "safety forms" and are referred to as "Sentinel Events." These forms do not go in the chart either; nor are they referred to in the chart. We have supposedly switched to "blameless reporting," where all facts are stated clearly and concisely and anything that may have led to the incident is recorded there, including any department that may have added to the problem. These forms are then studyed by the Safety Committee who then try to correct what failures in the system caused the specific incidents. The person filling out the form is not considered the "guilty" party either; which really helps to make sure the forms are filled out and all incidents are reported so problems can be corrected in a timely manner.

You graduated with a BS in Nursing in 1996; it is now 2003; 7 years later. I think you need to contact your BON in your state and ask them for their advice. Seven years without taking the NCLEX is a long time; and nursing is not a static profession: there have been many, many changes in meds, treatments, and medical breakthroughs during that time. That is just concerning the time issue. Then there is the abuse issue. These are 2 separtate issues and only your BON is capable of giving you the advice you seek; each BON has different procedures and rules and it would be impossible for any of us to help you without knowing your state's Nurse Practce Act. Your profile is totally blank at this time, so we can't tell what state you are in. Sorry, but I don't think we can really give you the advice you are asking for. Good luck, though!

Congratulations Nancy on finding the perfect job for you. I am a strong believer that when one door closes another one opens. We just have to be open to the possibilities. And I will keep your MIL in my prayers for now.

Oramar, I was listening to the BBC this past week and heard where China has really taken the bull by the horns as far as isolating and containing anyone with possible SARS symptoms. From what I have read and heard in the media, China's main problem with containment of SARS is their weakened infrastructure: the broken plumbing/waste pipes in the one residential block in Hong Kong seemed to spread SARS faster than anyone expected and there is a concern that these problems may occur again in other areas if the virus should return this fall and winter (following the usual flu season pattern). A local private college made their exchange students return home early this week instead of finishing out their terms in Asia. The students told how they found that the Chinese and Japanese were extremely thorough in scanning and screening travellers (doing temp scans of everyone, questionaires re: recent contact with anyone with cold or flu sx,. etc.); but as these students came farther into the "civilized" western world, they felt there was no screening going on for any protection of the public. The number of new SARS cases in China is about half this past week of what it was the week before. I think China is doing a good job so far; but the real test is going to be next winter flu season-- all over the world.