nursingnow

I use to work on a med/surg floor. I didn't work much though.. I was trying to balance being a stay at home (most of the time) mom and continue nursing, so I only worked 3-4 shifts a month. I never really got to know anyone on my floor, but most of them were clicky(sp?). I never felt like I was part of the team. I had 5 patients. It seemed the last few times I worked I had the craziest patients/days...when I'd ask for help I'd get the sigh and the supervisor asking me if the floor was too much for me!? Well....some days it was!! ugh. I eventually decided to let something go...and it couldn't be my kids! LOL I put hospital nursing on the back burner until I can be more committed to a schedule and floor so I can feel like part of the team and get to know people. My first med/surg job out of nursing school was awesome, so supportive, but I also worked full-time. I don't think I was ready to work prn...I was only a full-time nurse for 8 months and I got one day of orientation at the newer prn job. Needless to say, with working 3 days a month, I lost confidence in the skills and knowledge I did gain...traches, setting up pain pumps, NG tubes, even the process of giving blood since it only came up one time for me in almost 2 yrs working there. (I gave blood all the time previously...). I'm now a PRN school nurse and it works very well with my kids' school schedules. It's way less stress too..I can fill in and not feel like the new person every day. But I do long for that nitty gritty hospital nursing and experience. I feel like I never really got great solid start to my nursing career.... For now, I'm sticking with prn school nursing b/c it does allow me to be home with my kids every afternoon. Has anyone else had a similar experience? ...I know when I eventually leave school nursing, I'm going to have to return to a med/surg floor to regain my clinical skills before moving on to anything else, (possibly wound care nursing...). Has anyone else had a similar career experience? and returned to more acute nursing? I know I'll be starting all over again pretty much.. I wish there was a way to refresh skills or go to a clinical class periodically.. Thanks! Maybe I'm just venting.... :)

As a former Med/surg nurse I would frequently encounter patients angry with hospital policies and how Drs handled their diabetes care. Most Drs would have patients disable insulin pumps during hospital stay and have them on sliding/scale insulin doses, change the times of their doses to where they pretty much had to eat at certain times even if they weren't use to eating at that time. Or they would get meal boluses plus sliding scale and if the patient said it was too much or too little, I would listen and take the concern to the MD. They know their bodies better than me, and I'm not threatened by that in the least! :) I'm glad to see people take such an active role in their care.

Bear with me...I'm new to school nursing! I have a student who had lice...probably about 3 weeks ago (not sure..I didn't see the student, but heard about it after he returned to school). He was brought to the clinic late last week scratching away at his head. I saw nothing other than dry skin and a very slight discoloration (pink) around his right ear. My guess is that's where the infestation was previously. But he was scratching all over. So my question is how long does someone feel itchy after lice has been treated? He was brought back to clinic today, but I was not available to see him (long story). Teacher said she thinks she sees nits though. I'm sure he will be brought back to clinic tomorrow and I'll have a look then. Also, I've never seen lice up close and personal...Will I know it when I see it?? I've read that nits won't just fall off like dandruff does, but adult lice are hard to spot b/c they are fast and hide from light. I'm sure it's possible he could have a re infestation too.

His recess is in the afternoon. If he's low it's usually at his afternoon check. There are no specific orders for how to handle a pre-lunch low. I used my best nursing judgment at the time, but I still left the situation unsure...

Hi. Today, a student's pre-lunch BG was 59. Normally, we give 15g carb snack and recheck within 15 min. Since he was eating lunch, I didn't recheck until he finished lunch..about 25 minutes later. He ate a total of 61g carbs for lunch. His recheck BG was 256. It seemed counterproductive to give him insulin, but we normally cover carbs at lunch and BG over 200. He has a pump. I chose to give insulin since his BG did get so high. He got 3.4 units for his carbs, but I didn't use his 256 BG as part of his calculation. (Hope all that makes sense... ) Something just didn't feel right though.... He was due to be rechecked an hour and a half later before leaving school; his BG was 149 with no treatment necessary. But the lunch issue... ? How do you handle a pre-lunch low, then a really high re-check...? Thanks in advance.