MGM33

I am a nurse supervisor at a small hospital. Myself, my DON, Pharmacy and ER supervisor are trying to devise a policy regarding ER and OP ER visits in which the physician is ordering narcotic injectables. During our research we are getting many conflicting information. EMTALA will state one thing, the DEA another etc, STate board of nursing another. Our conflict stems from When a patient comes into ER with a Headache and we call the physician do they have to come in a do a medical exam or can the nurse do it take a phone order, tx the patient then send them on their way. Our hospital currently has may 'frequent flier' so to speak and we are revising our policies. EMTALA the way we are reading it states that a nurse cannot 'medically diognos a patient but can do a nursing assessment call the physician and recieve a verbal diognosis and orders and the physician never even see the patient.We are a small facility and do not have a inhouse ER doc all the time. What are your thoughts?

Can you explain team nursing. My facility was going to try it but then didn't. What is the role of the RN vs. LPN. Do they just split the patients with the RN overseeing the LPN's patients or do they each have roles for all the patients. Does this type of team nursing work well. My facility utilizes RN's and LPN's at this time but no team nursing. IF you are the RN you just have your load and have to attend all the picc and central line care/ivpushes etc. I was just curious how the team functions. Thanks.

I work in a rural hospital and my DON is an AD nurse. I am an AD nurse and am a OR/outreach supervisor. I really think it depends on the facility. IF you want to be a NP you will need a masters degree. I hope this helps.

I think that the risk for co-sleeping with an infant is the threat of rolling onto the infant during sleep not SIDs. Many small infants have died this way. That said. I have to admit my infant slept in his crib until the age of approx. 8-9 months. When he was old enough to sit up I and give me problems going back to sleep I consulted of all things my paster's wife. She have 6 children of her own. Her response was. She made her first child sleep in her own bed. This child was the child who clung to her legs with around others. THis child clung to her when it was time to go to sunday school class etc. When her other children came along she was tired and told her spouse I will put them to bed each night but when they wake up they can stay in our bed if that is what it takes so I can get some sleep myself. The result of this is her last five children all were outgoing, self assured never giving her the 'clinging' problems her first child did. Could this mean that the children who were allowed to stay with their parent felt assured in their love and not abandoned to room to be alone. Also I do not like to sleep alone so why would my child. Since my talk with my friend I have let my child come into my room when he wakes up in the night. I want him to feel I am there for him and he is not ever a burdon on me. I hope this helps. Marilee

I live in Kansas. I have given Methotrexate injections before on an outpatient basis. I have not actually given the chemo yet but have been told I will and I don't know the name, but I will find out. My boss is sending me to for a "shadow" day at a cancer center where our oncologist practices so I will be 'educated' on the medication. And no we do not have an oncology CNS or nurse Educator. And if you can believe it if the drug is not premixed I will most likely mix it myself. We mix most of our IV fluids and medications ourself. But we do have a pharmacy here M-F.

I am new to this site so please forgive any blunders I am a RN in a small hospital. I currently run a small OR and the Outpatient clinic. I have been recently asked to start giving chemotherapy agents. I have no experience in giving chemotherapy agents. My DON wants me to go to a Cancer Center and do a 1 day shadow program. In my state I am allowed by law to give chemotherapy without being certified if my education on the administration and medication is documented. But I am REALLY concerned about my liability and in essence my liscense. Would appreciate any feedback mgm33