laurenD

English-Spanish/Spanish-English Medical Dictionary by Glenn T. Rogers They have it on Amazon and at Barnes and Noble. I have this book. Not only is it a dictionary, but in the back of it, there is 30-40 pages of assessment questions and intervention statements. That's the only part I ever use. It's awesome! Things like "Turn to your right/left", "I need to check your blood sugar", "I need to give you a medicine for your high blood pressure" (just off the top of my head). It has full systems assessments translated. Very very useful. I would consider it pocket size as well: thin and probably 5X7 dimensions. ~Lauren

I've always folded them in half to squeeze the air out. I don't imagine technique makes a difference a long as it's adequately compressed.

Remember ABCs...airway always comes first. If there's a plug and (s)he can't breath, suctioning on low vs high really isn't the issue. ~L

I had the same experience dutchgirl did. Dale Dubin's book is awesome. It should be required reading for nursing students IMO. ~Lauren

As bird2 said, its hard to answer that without knowing much about the bed sore itself. Does your facility have a wound care team? Many times it just comes down to frequent dressing checks/changes. You may try using a rectal bag to corral the poop (heh) and keep the wound dry...although the bags don't usually stick all that well, and if the patient is alert, the bags can be pretty embarrassing and uncomfortable. We use duoderms very frequently, and we reinforce the edges (esp the one that is next to the orifice) with tegaderms as needed. It probably wouldn't be a bad idea to use a protective barrier cream around the dressing to help prevent additional breakdown. The best thing to do though is to turn turn turn and check it often. Keep it clean and keep it dry!! It gets tedious, esp when you end up having to do it hourly. Ugh!! But it's the best thing that can be done. Pressure ulcers are a pain in the butt!! Literally!

I have also worked at St. Luke's/Texas Heart Institute and unfortunately my experience was not as good. To clarify...the things they do there are absolutely amazing. I would not feel more comfortable being treated anywhere else. In that respect, they live up to their reputation. Unfortunately, as an employee, I was not as impressed. There did not seem to be a lot of team spirit among the nurses in the units I worked on. I will refrain from being specific. St. Luke's/THI hires the best of the best...and even after hire, the nurses seem to remain very competitive. I was unable to work in that type of environment and chose to work elsewhere. Granted I only have experience in the two units I worked in (both critical care units) and I am sure there are other units in the facility where the nurses work well together. Just my two cents. ~Lauren

When I was pregnant, I wanted to do the cord-blood banking but didn't look into it until during my pregnancy. I don't know why I expected it to be inexpensive, but it was not. It cost around $1200-1500. I was really disappointed because we would not be able to afford it. I am saving though, so we can do it for my next pregnancy. I just hate to imagine what a guilt trip I would put on myself if I didn't do it and 10 or 20 or 30 years down the road could have really used it to save my life or my husband's or my child's or grandchild's life. Considering all the research being done now and the uses they are finding...imagine what will they be able to do with it in 25 years! ~Lauren

I believe the difference is in the background. NPs are nurses. PAs are not nurses, but have some other degree such as biology. I do not know the difference in the responsibilities, although I suppose I should. ~Lauren

Sorry if someone has mentioned this already... Of the rollover stories I've read, most of them seem to involve dad or a sibling rolling over the baby. I read a lot about co-sleeping when I was pregnant and was really excited about it. One of the 'rules' listed by Dr. Sears was not to put baby between mom and dad, but to put between mom and edge of bed (bordered by wall, or towels or co-sleeper crib). According to Dr. Sears, moms are naturally more aware of their bodies in relation to their babies and are much less likely than dad to roll over the baby. There are always exceptions of course. ~Lauren

I work nights in the ICU. I admitted a 42 y/o man who'd had a CVA and was DT'ing. He lived at home with his parents. While assessing him, I mentioned to him that we (myself and a female coworker) would be in and out of his room all night, messing around with assessments and vitals very often and that he was not likely to get very restful sleep this first night. Needless to say, I should have thought about my wording. 45 minutes later he says to me, ever so seriously (and right in front of his parents) "Aren't you girls gonna be messing around? I can watch, right?" OMG I about died. I looked at his parents who looked rather confused. I had to explain what I had meant by "messing around". I felt so heavily scrutinzed by his parents the rest of the night...but I got a thank you card from them a few weeks later. What a relief!

There was an article about the Rapid Response Team idea in US World and News Report this past week. It's in the issue with the Top 50 Hospitals rankings.

Let me add... Having graduated school in the past year...here is the low-down on internships for new grads: Methodist, St. Luke's, Hermann, MD Anderson, Texas Children's, St. Joseph, and UTMB are the hospitals that I know have formal 12-22 week internships (depending on speciality). Competition is very high as the medical center hospitals only seem to take 10-15 applicants. St. Joseph took 23 this past June. Some of the outlying hospitals have internships as well, but most are informal. ~Lauren

I live in Houston. As the previous poster said, we have the Texas Medical Center which includes two Level I trauma centers (Hermann Memorial and Ben Taub) Methodist Hospital (which was listed in US World and News as a top 10 hospital in neurology, among other specialties), St. Luke's Episcopal Hospital/The Heart Institute at St. Luke's (#8 for cardiology according to US W&N and listed in top 50 for nephrology), Texas Children's Hospital (#2 for pediatrics) and University of Texas MD Anderson (#2 for cancer treatment, also listed for urology and gynecology). Also Park Plaza Hospital, Diagnostic Center, Texas Women's Hospital, Veteran's Hospital, and Shriner's Orthopedic Hospital. ALL of those hospitals make up the Texas Medical Center. Most of them are teaching hospitals so residents are there around the clock (yay!). In addition, we have St. Joseph's hospital (in the heart of downtown Houston) which is also a teaching hospital and where I work (I used to work at St. Luke's - a magnet hospital...but I am so much happier...and better paid at St. Joseph's - a non-magnet hospital). LBJ Hospital and Ben Taub hospital are our 2 county hospitals. I hear that benefits at these two are excellent. Of course, there are many community hospitals in the surrounding areas. I live in Clear Lake, south of Houston. Clear Lake Regional Medical center is up and coming. They have been accredited as a 'heart center'...the 2nd in Texas (St. Luke's is the 1st), and they are building a new 200 bed wing dedicated to cardiology due to open in 2007. In Galveston, you have University of Texas Medical Branch (UTMB) which is also a level I trauma center and a teaching hospital. Next door to UTMB is Shriner's Burn Center. This place is amazing!! It is totally funded by donations, and I don't believe the patients pay much (if anything) for their treatments. It's small, only like 50 beds, and treats severe burn victims from around the WORLD. I had an opportunity to tour it. They put the families in apartments on campus because the treatments are so thourough...so long. Also...having changed jobs within the past year...pay in the medical is comparable to pay at the outlying hospitals. In fact, many of the community hospitals pay more because working in the medical center is so much more attractive..."prestigious" or whatever reason. Parking in the medical center sucks. You park in a lot a few miles away and have to take the train in. Adds 15 minutes to your transit no matter how close you live. Unless you pay for a ridiculously expensive apartment within bike-riding distance. I live 20 miles south of downtown Houston. My drive time to work (at St. Joseph in downtown) is 30 minutes there in the evening and 20 minutes home in the morning...I work night shift. Wow. Sorry for ranting!! It's 0300 and I get a little crazy this late. Good luck on your job search! ~Lauren

Just a tidbit of trivia to remind us how important turning is in prevention of ulcers... The average person respositions him/herself every 7 minutes while asleep. I tried laying still, not even moving my arms/legs. I only made it 11 minutes before I decided I really really really wanted to adjust my position. It certainly makes 2 hours seem like a long time!!

I started as a new grad in the ICU 6 months ago. I posted a few tips in the New Grad forum not too long ago: 1) http://www.icufaqs.org 2) There is nothing that you can do to your pt that will kill him/her...except MEDS. Use your drug guide religiously, even for the drugs you use constantly. Check allergies, doses, routes, compatability, etc. Check your own MARs. 3) You will make mistakes and you will feel silly. Learn from it. The sillier you feel, the less likely you are to do it again. 4) Ask lots of questions!!! Good luck! ~Lauren