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suzem

suzem

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suzem's Latest Activity

  1. Hello everyone, I am a senior in nursing school and am working on a community health project. I am seeking a school nurse to answer a few questions that to write a paper on the subject of school nursing. I would so greatly appreciate it if anyone would be so inclined to indulge on the subject of school nursing. The project requires interview answers to the following six questions: What are the unique aspects of this area of practice? What are the main job functions of this nursing practice? Who are the populations served by this practice area, and what is the scope of the challenges/opportunities? Describe the larger picture: What are the contexts for this practice area? Who are the members of the "team" that makes this practice possible? Why do we need this practice area of nursing? What are important agencies of the federal, state and local levels that affect this practice area?
  2. I desperately need an interview with a nurse working in the corrections field. It's for my Bachelor's program. I don't see attempting to contact a prison or jail being succesfull, (I know I don't have time to talk on the phone when I'm working) If anyone is able to help a desperate student nurse out, I would be so happy if you would answer the following six questions: What are the unique aspects of this area of practice? What are the main job functions of this nursing practice? Who are the populations served by this practice area, and what is the scope of the challenges/opportunities? Describe the larger picture: What are the contexts for this practice area? Who are the members of the "team" that makes this practice possible? Why do we need this practice area of nursing? What are important agencies of the federal, state and local levels that affect this practice area?
  3. Hi all, I am a new nurse in orientation on a med/surg unit. I had a scenario the other day where the nursing educator was upset with me for not doing assessment systematically. I had a patient with a BP 170/107. I wanted to give her four morning BP meds to see if I could get it down before contacting the Doc. All of her meds were crushed and she had some dysphagia, so it took me a long time and I was behind on the rest of my morning assessments. Background: Patient was 89 yo female, comfort measures, with intracerebral hemorrhage, BPs were trending high, but not that high... The educator stated I have to do assessment, chart, assessment, chart, then take care of that issue after all assessments and charting are complete. I just wanted someone else's feedback, I don't know if I did the right thing. :heartbeat
  4. suzem

    Transitioning from LTC to Acute

    Anyone out there have any words of wisdom that has transferred from LTC setting to an acute care? I am moving from an inner-city LTC facility, 150 beds, 40-50 on 1, ROUGH faculty and staff, very hostile environment, questionable quality of care at times, left me with a lot of stress and anxiety about the residents and their well-being. New environment is a tiny rural hospital, not sure how many beds, but definitely cozy looking from what I can see, only 4 ICU beds for sure, Med-Surg is bigger. The transition is making me a little shaky:eek: if you know what I mean. Just looking for any useful advice.
  5. suzem

    RN working as CNA2

    I have primarily seen that stated on job postings for Oregon Health and Science University.
  6. suzem

    RN working as CNA2

    Hi all, I am an ADN, currently working in a LTC setting (skilled unit). I am returning to school in the fall to pursue my Bachelor's degree. In the meantime I am considering taking a job as a CNA2 in the hospital setting so that I can get some hospital experience, as my goal is to work in acute care. Oregon has a severe nursing job shortage for inexperienced nurses, and I am skeptical that even with a Bachelor's degree that I will be able to find a job in acute care. I have been looking at the local hospital job listings, and some say that they will consider CNA2 experience in a hospital setting as a requisite for some jobs. NO one is accepting LTC experience as valid work experience that I have seen. My dilemma is that I feel that if I stay in my current position, I will get more relevant nursing experience, and I am afraid that working as a CNA2, I will lose my nursing skills. At least now I am doing assessments, medication administration, some IVs, some wound care, etc. Any advice would be greatly appreciated!!!
  7. suzem

    New RN - Wants to know when to wake up the doc

    Thank you so much for this advice, I am excited to start a journal my next day worked.
  8. I had a situation the other night while working a NOC shift, I had a client c/o CP. After evaluating her situation I administered a SL Nitro per prn orders, performed proper monitoring for BP and pulse at 5 minute intervals. CP was relieved with 1 nitro, O/C MD notified. The O/C was so furious that I had woken him up to notify of CP relieved with one nitro that I could have envisioned steam coming out of his ears. I was referred to as incompetent for not knowing the difference between an emergency and routine care, and I was questioned as to whether I was even old enough to practice nursing (I'm 33). He told me he was not speaking to me anymore because he could not consider me a professional. This MD is generally quite abusive, however I just wanted to get a second opinion on what you would do in the same situation. I had worked with this client previously, she did not have any nitro signed out in the MAR, so I felt this was a somewhat unusual situation for her. Do you normally call the MD if someone has a prn Nitro order?
  9. suzem

    New RN - Wants to know when to wake up the doc

    Out since June, 8 months, started working 2 months after graduation, had 3 days of orientation.
  10. suzem

    New RN - Wants to know when to wake up the doc

    This patient was immobile prior to being hospitalized. She is totally bed bound.
  11. suzem

    GI surgery and PE?

    I was wondering if GI surgeries pose any risk for pulmonary embolism? I wouldn't think so because PEs come from a LE clot, but the mere immobility that it causes could pose a risk I suppose... just curious.
  12. I am a new RN with limited experience. Out of desperation in this job market, I had to take a job in a LTC facility / rehab where I am all alone at night with 30 residents to care for, 3/4 of these are skilled! I am having so much trouble deciding when to call the on-call doctor at night when the situation is questionable, not an emergency situation. I will give an example... PT is a few days to a week post-op. She has returned to the facility s/p open cholecystectomy. Her current problems include widespread edema (she has history of +1 edema to lower extremities, now she has +2 edema to BLLEs, +1 to arms, hands, and face.) VS are all stable except her O2 sats, which have been 88% RA, 92% 2L NC throughout the evening shift. Lungs are CTA, resident alert and oriented, little fatigued. C/O slight SOB when on RA. Resident states she really does not want to return to the hospital. On my shift, while resident is asleep, her O2 sats are 84% on RA, 88-91% 2L O2. No other abnormals except for the edema and some slight upper respiratory congestion, presents with weak, moist, occasionally productive cough. Lungs remain CTA. Resident is not taking any additional pain medication. Evening shift was unconcerned about her present condition, I was unsure if there was any correspondence with the MD, except that the records from the hospital were faxed over upon her readmit. On-call doctor has history of not ordering anything at night, unless there is an emergency he will give order to send resident out to hospital. What I did: Monitored the resident frequently throughout the night, assessing her orientation status and lungs several times, turned O2 up to 4L to keep her sats at 90-91%. This is one of the many questionable situations that I face working NOC shift. I hate this because during the day you can contact the doctor for this and that, and you can get a hold of the doctor that is familiar with the resident. What else could I have done? I didn't want to send the resident out to the hospital, and she kept reassuring me that she was fine and didn't see why I would consider sending her out. I guess I could have gotten an order for a nebulizer treatment or something? Just want to know what any experienced nurses would typically do in this situation///:nurse: BTW, the day shift nurse stated that there was no reason to wake the doctor for this situation, that the PCP had followed the client at the hospital and was aware of her current status, but how was I to know that?