In_Chantress

Have you tried food with different textures or temp. I one a patient that was refusing to eat or drink... but when we offered him ice cream or popsicles, he ate it all and asked for more. Another patient refused anything, but would take ice chips... or anything that had salsa on it (she was hispanic).

OMG... I think we went to the same school.... I ,too, was deemed UNSAFE and failed during my 3rd semster, even though I was passing. After three hellish semesters of this evil program, I chose not to go back, but instead to take my LPN license and complete my RN online with Excelsior while working. It was the best decision I could have made. It took me 2 years to get my confidence back and my RN license.... but I would put my knowledge up against most anyone....especially those that completed the program I failed. This isn't the end, unless you chose to let them win!

Our DON has decided that a patient cannot give consent for any surgican procedure if they have been medicated for pain within FOUR hours prior to signing. So... if you come to our facility you will not have any opiates for pain four hours before signing your consent; regardless of the source of pain. Does this strike anyone else as barbaric? Doesn't pain impair the mind, sometimes more than any opiate might? Could denying a patient pain relief until after signing a consent be considered a form of coercion? What do you think??? T.:stone

Thanks to all who have responded... Theres has been a lot of great advice! First off, a little background... I'm a night charge/floor supervisor (which only means I hold the keys to the facility ;-) in a 22-bed VERY rural hospital. So yes, physicians are like cleanliness; that is, next to godliness here. Any direct confrontation with any physician will likely not come out well for me unless taken outside the facility. So this is my game plan... I've discussed the situation with the Chief of Staff, DON, and HR to make them aware that there have been issues with this particular surgeon. I've also observed this guy acts as if all women are idiots. As most men who are abusive to women, I don't think he'll have the courage to treat a MALE nurse the same. So while 2 nurses listen to the his orders, a male wil be the one initiate the call whenever possible. And finally, I'm keeping a log of all calls to the doctors in the middle of the night, to prove that our judgement is sound when we do call for orders and will also use it as a factual tool to document his idiocy in caring for his patients (i.e. no pain meds for a post surgical patient?) Thanks to all of you!

How do you deal with a surgeon who is angry when you call him in the middle of the night and just as angry when you don't... When he gives a telephone order, and then comes in the next day and denies that he ever said anything written in the order although he does sign off on it... won't even back up orders he wrote in the chart himself, calling you a "liar" until he's shown the page? FYI, this guy has made several big errors ( like complete transecting the bowel during a colonoscopy) causing us to already worry when we see that a post-surgical patient is one of his. How do you protect yourself and your license when dealing with such a weasel. HR says taping his telephone orders would be "too disruptive to the work process" and having two nurses listen to him on speaker phone and co-sign the order hasn't helped as he just says that both of us are idiots. Any and all advice will be appreciated!!

I've been a nurse for 2 years and this is the first time I've called in "sick" when in all honesty, I could have worked. Don't get me wrong, I had the flu on my days off and the first 2 of 3 shift, had post-viral syndrome. Went to the Doctor and felt much better on Day 3. But at our facility, the policy states that you can only call in 4 times a year, whether it's for 1 day or 10. Of course, they require a doctor's release if you're out for 3 or more... but I get so sick of other's calling in once a month or more and nothing ever being done about it. So yeah, this was my mental health day...lol;)

I've worked 6p-6a for 2 years now... and I think I've adjusted very well. However, it's transitioning back to the real world schedule that is causing problems. My DH thinks that I sleep too much... because when he's sleeping, I'm awake. Oh, we have about 8-10 hours together on my 3 days off and I reserve the day after my three shifts to catch up on sleep (especially since I'm on-call that night). What do I do? Here's another night I can't sleep, do I take caffeine or diet pills to stay awake... forcing myself into the daylight or is there a gentler way? The way I've been doing it up until now works for me but not him. All suggestions are welcome!

We had a pt w/the same issue. There are appliances that actually have a cone that fits into the stoma as well as around. This helped some, however we were never able to stop the leakage. Maalox applied to the skin around the appliance (not under) helped with the irritation by neutralizing the gastric acid and using peripads on top of the maalox absorbed the fluid before leaking any further than possible. Unfortunately, she passed away before we were successful in solving the problem. I hope you have better luck.

Why not call your former employer posing as a prospective employer. Ask all the "legitimate" questions you would expect them to answer and see for yourself how they answer. A little sneaky perhaps, but at least you'll know how to counteract what they might say. :-)

Using a gluestick, I put tinfoil over the glass. Not only is my bedroom dark as night, the tinfoil also reflects the heat... and it's CHEAP! ;-)

There are many different variations so the correct answer must correlate with the context of your class. However, one possibility is when writing nursing care plans; the outcomes must always be SMART: S Specific M Measurable A Attainable R Relevant T Time-bound For example, instead of writing “the patient will have little or no pain” as an outcome, it is SMART to phrase it like this: “The patient will report pain at 3 or less on a 0-10 scale within 1 hour after analgesic medication has been administered." T.

**sigh** Get used to waiting. Even after passing CPNE, it'll take 4-6 weeks just to update your status. And then another 10 days or more just to get a "Certification of Completion of Graduation Requirements" I DON'T even want to know how long after that I can actually "graduate". Oh well, I've nothing else to do. Each week I wait is costing me $300/week in lost wages $$Ka-Ching$$

:angryfire I passed CPNE on Feb. 18th. That was the last thing I had to do for graduation. When I finished the Info Literacy course in December, it took 5 days to update my status. Now it will take 4-6 WEEKS to do so. And nobody will tell me why there is that long of a delay.... not for graduation, I can deal with that... But just to update my status. In NM, we don't have to actually graduate to be eligible to board, just complete graduation requirements. However, I'm told it will take an additional 10 days AFTER my status is updated to get the certification form complete to send to the BON. With just that form and before taking the NCLEX, I'll get a $300/wk raise in pay from the hospital. I can't believe that after a 4 month wait to even take the CPNE, I'M STILL WAITING! :angryfire

I think the "fine print" state that the waiver is only good if your LPN program was NLNAC accredited. The program I graduated from was only accredited for their RN program. However, the LPN and RN program are the same curriculum... RN is just 2 semesters longer. But I still didn't get the waiver.

Using the pharmacy/instructor formula, you would actually infuse 280.5 ml in the hour and a half the IVPB was hanging. Hope you have an adequate amount of flush and a patient who is not on fluid restriction. T.