nurse96

At our facility we used to have a pt come from O.R. to the unit with and epidural already infusing. After a few mishaps (pt not being able to feel legs for a day) we are now starting them only when the pt begins to feel pain and can move the extremity. 99% of the pts I've cared for have out of control pain for the first couple hours until several other drugs (toradol, benadryl, zofran, phenergan...) are given and only then is the pca or the epidural effective. What do you do at your facility? Do you most of your immediate post operative pts have out of control pain?

When I went to school there, I had a pregnant friend who was advised to take a break, and another friend told she could not come back after having her gallbladder out d/t lifting restrictions. School is a busy time, why not get the schooling done and then the child, might be better in the long run, less financial struggling, spending more time with your child....

I've just finished reading The Protocal (April Christofferson) re: human cloning. Other books: Mutant by Perter Clement, and Terminal Mercy by Ed Stewart. I also really like Patterson, Cook, and Cornwell

Someone once told me if I had difficulty inserting a foley cath on a male to have him strain,usually goes right in.

Our facility actually has a pain control policy. I doubt any of the pts have read it, our the nurses would really be in trouble. The policy states the every pt has a right to be pain free! Whoever wrote this obviously has never had surgery or dealt with some of these physicians. I've had a pt with no pain have 3 different narcotics ordered and then a dying cancer pt have tylenol. How's that for right to be pain free? When some of the physicans are called d/t pain, they sometimes will make my blood boil by saying, I've given them all I'm going to given them, the pain is all in their head."

MRSA can be in bodily fluids, blood, wounds, or via respiratory. A healthy adult will not usually be affected by MRSA. But through Univeral Precautions; washing hands, gloves, gowns, and with resp., masks, I believe this to be inconsequential to nurses. MRSA pts that are immunocomprimised, older or very young, seem to be the ones who are most at risk, since the regular line of antibiotics may not work on them. The hospital I work at seems to have had a rash of MRSA Pts. Most of them aquired before admission to the hospital, but still it would be interesting to know how much of the population is carrying!

I bought a pair of Z-Coil shoes last year and have not one regret about the price. Most nurses I know easily spend that and more in shoes. A bonus with these shoes is in the spring. Not only can you adjust them, if you walk more on the inside or outside of your foot, but you can replace the springs for only $25/shoe. The shoes I have are leather and easily cleaned. I figure if they last me one more year, I've probably saved money in shoes. I work in a small hospital, and the nearest place to buy them is 2 hrs away, yet there are now approx 5 staff members wearing these shoes. Not only that, but the real kicker is they are a daily topic of talk, esp with pts and their families. If you do decide to possibly buy them, I would suggest walking around the place you are buying them from for atleast 1/2 hr, just to make sure they are the shoe for you. Also, if you buy them, I would have another pair of shoes atleast for the first 2 days of wear. I found I actually walk using different muscles in my legs, and had just a little soreness in the calves, but only for the first 2 days. I love my Z-Coils. :)

One day a man who had had a TURP called me into his room. He was concerned regarding the size of his testicles. I stated, "Don't worry, I've seen bigger", it was only after I left the room did I think about what I had said. Luckily I don't think the pt thought about it!

What I find usefull is first looking at what the lab levels have been and go from there.

We remove just about anything anymore, except we haven't started removing chest tubes,... yet! There's talk. :chuckle