MikeRN1

I never really had a problem with last names on badges until a cooworker did have a problem. A paramedic who was picking up a patient read her name badge and called her at home numerous times to ask her out and even showing up at her house. She ended the problem with a restraining order and changing her phone number. I personally haven't had any problems but I do cringe everytime I here a patient read someone's nametag. My last name is covered for this reason. Mike

but thats probably because its late here and I've been working too much overtime. Usually for fistulas we don't use a vac for the reasons you mention (excessive drainage, leaks, multiple changing, etc.). We use an ostomy appliance which seems to handle the drainage better and reduces skin irritation. But if that is not an option, here are a few things I've seen and used. #1 stoma paste around the fistula, this seems to keep a seal better. #2 Duoderm on the healthy skin around the fistula, this decreases skin irritation and also keeps a seal better. And last but not least #3, Your KCI rep, KCI has either introduced or plans to introduce a bigger canister and you would honestly be suprised what reps keep in the trunks of their cars, they may just have one. Lemme know if this helped at all. Mike

Actually, silver is supposed to be the new "buzzword" in wound care. It has been used on wounds forever but is making a comeback like many other "old" treatments (maggots, leeches, honey, etc). From what I can find, silver has a bacteriostatic, not bacteriocidal, property. The new V.A.C. silver impregnated foam should be out next year from what I hear. Hope this helps. Mike

We give reglan IV often in our abdominal post op patients, either 10mg q6hr around the clock or q6hr prn. We use it for nausea and I've been told by some surgeon's that they use it because it promotes gastric emptying.

was in my first day of OB clinical. I walked in and my patient was an ex-girlfiend that had gotten married and I didn't recognize the name. Actually I don't think she had as much of a problem with me taking care of her as did her husband. Fortunately, my instructor (who was also a male) was very understanding about the situation and changed my assignment. All in all, my entire OB clinical was not a fun experience because everytime I went into a room to do anything, I had to have my instructor and a fellow female student with me. Other than those eight weeks, I've never really had a problem with a patient.

[i work in PA in a teaching facility on a monitored surgical/neuro-trauma floor. It's actually a dumping ground. We handle all the monitored surgical patients which range from gyne to ortho, any monitored trauma and neuro trauma pts, tele overflow, ICU stepdown, peritoneal and hemo patients, and ENT patients. We also are a vent floor. This keeps us on our toes, but we do get to utilize all of our skills. Staffing is adequate, but we generally have little backup to cover call offs, vacations, etc. It is a 20 bed unit, on daylight there are 4 RNs, 2 LPNs, 2 CNAs, and a secretary, no charge. On nights, there are 3 RN's and a CNA. Mike

I've worked Per Diem and agency. Agency nursing gives you a greater amount of freedom. The pay was comparable, but Per Diem required so many hours a schedule and so many of those were off shifts and weekends. The only good thing I could say about Per Diem is that they usually give you a longer orientation period. Hope this helped a bit.