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New Grad PDN
Here are a few hints: Baclofen pills dissolve almost instantly – no crushing needed. The senna pill is hard to crush. It helps to split the pill first, before you crush it. The crushed Vitamin D doesn't mix into water very well. If he takes calcium, crush the vitamin D pill and mix it into the calcium before putting it in the feeding tube. The easiest way to clean under the trach in the morning is to put on gloves, take a 4x4, pour a little of the trach care vinegar solution (or whatever solution you use for trach care) onto the 4x4 "legs" and use that to clean the stuff off his skin. Do this before you use Q-tips to clean around the trach. To slide him up in bed in his bedroom, put a slippery satin-like sheet under the cloth drawsheet. He slides up fairly well. But do remove that sheet when you're done, or he will slide right back down. Know where all the emergency equipment is. (O2, AMBU, suction, etc.) Know where the Go-Bag is and be sure it's stocked. Know where the vent manual and "cheat sheet" are kept. Know how to trouble-shoot the alarms. Especially when starting with a new client, I write out a little schedule. On a sheet of paper, I write in the times (hours). Next to each hour, I note any meds that need to be given. Depending on the client, I either write out the individual meds or I simply write "med". I add in any scheduled therapies, feedings, etc. (Yeah, time management was my biggest challenge when I worked in the hospital!)
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What does a shadow interview entail?
Lots of good advice here. https://www.indeed.com/career-advice/search?q=job+shadow
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Need pediatric GJtube expert advice
Do the meds go in the G or the J? I would expect most to go in the J. The G is venting air; does it need to be drained? What are the physician orders?
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Crusty Old Bats
Someone mentioned Maalox and heat lamp for decubes. How about pouring a packet of sugar into the dressing over a decube? It worked. Ventilators (Baby Byrd, LP-6, HP-50) Nitro Paste, Lidocaine, Quinidine, Nitro 1/150 grain and 1/200 grain. And ASA grain 10 to dissolve under the tongue. My mom – also a nurse – talked about working as a student in Central Processing. They would blow into the gloves to make sure there were no holes, then carefully fold them, wrap them, and sterilize them in the autoclave.
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Crusty Old Bats
You are so right. This is where the moral injury happens for nurses: being unable to do more than simply keeping your patient safe. On the other hand, it was horrifying to see your husband needing the help and not getting it. My heart goes out to you. I'm glad that you were able to help him.
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When You Live With a Nurse
I laughed and laughed! I don't know how to embed this, but you can just click on it. https://www.facebook.com/watch/?v=1723688564709266
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Is there a place for slower nurses?
Have you tried private duty nursing, homecare? I work through an agency, and I do a full or partial shift in one home, usually a 6-, 10-, or 12-hour shift. I can choose how long of a shift to accept. And I don't jump from one client to another. I have been with my current client for about 10 years, although I did alternate with a second client at first. (I've been doing private duty since about 1985.) Time management was my biggest problem back when I did hospital work. I was easily distracted, going from one problem to the next, barely getting my work done and feeling like I wasn't able to give truly good care. Agency work doesn't pay as well, but it pays enough. And I enjoy my job.
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Full Moon
If you think bad things will happen during a full moon, can the patients sense this? It may truly be happening, but not because of the moon.
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LPN - Medicaid PDN
I wonder if you could join different patient support groups, like the National MS Society or the ALS forum. You could probably network within these groups.
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LPN - Medicaid PDN
The need is immense where I live, too. We cannot get enough nurses to cover the hours needed. Some parents even pay privately for nursing help. Expen$I've! These parents would love to have you. My concern about doing private duty home care without an agency is the need to be sure you have physician orders to protect you legally.
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Patients Filming You
In private duty home nursing, it is not unusual to have a nursery video monitor trained on the child. In some case, an actual closed circuit camara is mounted on the wall. This is so the parents can keep an eye on their child - especially when their child is alone and cannot call for help. So, naturally, the nurse is on video, too. In a private home, I'm OK with this. In a hospital, it's not OK.
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Home Care
Wow. I don't know what happened to my reply, but I was able to copy & paste just what I wrote. Here it is: I would ask permission from the parents to organize the supplies. Nurses know how to do this, and this is part of what we do. You should keep your shoes on; this is policy in my agency. Your agency can provide you with shoe covers if the family wants no shoes. Your agency should provide you with paper towels, gloves, hand soap, and hand sanitizer. I would clean off enough countertop by the sink to put the cleaned syringes and containers. Are these kept in the kitchen or in his room? Like you, I would not work where a bathroom has no door.
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Don't use Google to look up medical information. Try these sites.
When nonmedical people use Google to look up medical information, they might find a good website. It's just as likely that they will hit on a site that has misleading or even false information. These are some of the sites that I use. I find webMD to be very basic, lacking in detail, but easy to understand. I find MedlinePlus to be detailed and easy to use. My favorite is the Merch Manual, but that is probably too in-depth for the average Joe. What websites would you add to this list? https://www.nih.gov/ https://rarediseases.info.nih.gov/ https://medlineplus.gov/ http://mayoclinic.edu/ https://www.hopkinsmedicine.org https://www.webmd.com/ https://www.merckmanuals.com/professional
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A face book funny
I found this on face book. Is there a problem if I copy & paste as long as I show who wrote it? Mark ChewieHumor Jokes Nostalgia & Funny Memes Mark Chewie · · Johnnys wife, Judy, had been after him for several weeks to varnish the wooden seat on there toilet. Finally, he got around to doing it while Judy was out. After finishing, he left to take care of another matter before she returned. She came home and undressed to take a shower. Before getting in the shower, she sat on the toilet. As she tried to stand up, she realized that the not-quite-dry epoxy paint had glued her to the toilet seat. About that time, Johnny got home and realized her predicament. They both pushed and pulled without any success whatsoever. Finally, in desperation, Johnny undid the toilet seat bolts. Judy wrapped a sheet around herself and he drove her to the hospital emergency room. The ER Doctor got her into a position where he could study how to free her (Try to get a mental picture of this.) Judy tried to lighten the embarrassment of it all by saying, "Well, Doctor, I'll bet you've never seen anything like this before." The Doctor replied, "Actually, I've seen lots of them I just have never seen one mounted and framed."
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LPN - Medicaid PDN
You are looking to do private duty nursing without going through an agency, right? Do you work directly with the client's physician?