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Rosalie Blythe BSN, RN

General Surgery, Endoscopy/Gastroenterology, PACU
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Rosalie Blythe has 2 years experience as a BSN, RN and specializes in General Surgery, Endoscopy/Gastroenterology, PACU.

Rosalie Blythe's Latest Activity

  1. Rosalie Blythe

    Boyfriend wants me to stay away

    Finally somebody who actually addressed OP's concern in a helpful, non-judgmental and friendly way. I also have also a similar situation as OP and I found your comment honest and useful. Thank you so much @FullGlass Exactly my point, thank you @AffsiRN for speaking up for OP. In fact, none of us deserve to have any sarcasm, insult, rude and demeaning comments from anybody in any circumstance. Being a more senior and experienced nurse does not make you more superior nor give you the privilege to be mean and disrespectful.
  2. Rosalie Blythe

    Boyfriend wants me to stay away

    I agree with you. Again, I respected any nurses’ opinions and comments here but my bottom line is mutual respect. We all know nowsday that practicing social distance is one effective way to flatten out the curve. However, it is absolutely unnecessary to be sarcastic and offensive.
  3. Rosalie Blythe

    Boyfriend wants me to stay away

    I don't know why you keep thinking OP doesn't want to practice social distance. She is in fact practicing social distance. She has already clarified that she originally wanted to see her bf in his house from a distance from her car. She was just wondering how this type of compromised method of physically seeing each other is defined as not practicing social distance. So please stop targeting on her for not practicing social distance. Please read exactly what were her main initial problems with her boyfriend (which is the fact that he showed minimal effort to make up the time they lost physically) and then respond. I have read enough of your rude and mean comments in this thread. If you don't have any constructive criticisms and advices to provide her other than keep blacklashing her and accusing her to do the things she has never done, then keep your negativity and sarcasm yourself. I agree with others that while OP and everyone else need to take criticisms in a public forum, your continuous demeaning comments are simply irrelevant and unhelpful.
  4. I used to work in LTC and acute care of the elderly (ACE) when I was a student. Unfortunately, I can tell you that PU is especially common in the geriatric populations - PU is probably the top 5 imo. In the LTC that I worked, the day shift and evening shift nurses would complete a thorough weekly skin assessment on 2-3 patients per his/her shift, mostly checking for possible impaired skin integrity and new PU. For existing PU, BID dressings is usually ordered. And PSWs are supposed to reposition the patient q 2 hours as recommended (but do they actually do that? questionable). I personally do not think its quite effective because especially my floor, 1/4 of the patient is total care and required a lot of time from both the nurse and the PSW. It's also especially challenging to do skin assessment who are confused (half of the residents on my floor has Alzheimer) and do not want to be touched or they will be physically aggressive towards you. I wish they can have a special wound nurse to conduct those skin assessment on a set schedule. In hospital and some LTC, they sometimes can put high risk patients (usually the one with high immobility) in an air mattress to prevent PU but again, resources are limited and these mattress are expensive. In my opinion, half of the residents on my floor should be on it but in real life only a few residents are using one The director of care, my boss, is the one ordering supplies. In the nursing home I work in, I am the other RN after my boss. On weekends when my boss is away, I am the nursing manager supervising the RPNs who are working on a less heavy floors. I personally am very involved in advocating for the right wound supplies to be ordered, even though I know lack of funding is always an issue especially for LTC. I believe that only the right and correct dressing supplies can help with the healing process of a PU especially for the geriatric. I had found myself staying after work several times to email my boss about what supplies were short and asked her to restock them. I usually emphasized on ordering different size of "3M Tegaderm High Performance Foam Adhesive Dressings". They come in different shape like square, oval and heel/elbow design. I personally used a lot of the heel/elbow one and I always make sure I have them stocked up in my dressing cart. I also like the square one because I can cut them into smaller piece and secure it with either opsite or medipore (depending on the condition of the surrounding skin area of the wound) and use the remaining on the other patients (which is not recommend but due to lack of funding and resource, you have to work with what you have) I know that in some hospital setting, if new PU is found in any patients, an incident report must fill out...not so much in LTC. But if a new PU is found in the residents, there is advanced directive/protocol to follow what type of dressings to apply...unless the PU is at a very late stage, then we have to call the M.D. for further instruction. However, for any type of PU, as a nurse I would record the new PU the Dr's book (a book that the Dr will read when he/she comes to see the resident once a week, it records all the concerns any nurse might have / family concerns that the family members want the Dr to address). On top of that, I would also complete a wound assessment charting and let the next shift nurse know this new PU. I will also write it on the today's worksheet; We have a worksheet with all the patient's name on it; its a sheet to record any new changes for the resident in any given shift you work. I know that for any new wound being reported, family members of the resident must be notify too. I never got into trouble with PU *touch wood* so I cannot help you with the rest of the questions you have. Hope it helps.
  5. Rosalie Blythe

    CONCEPT MAP QUESTIONS

    Oh man, not again those concept map assignment from nursing school. Nope, the patient is still Ms Caren Walker in this case. Her daughter Ellen is her caretaker. I understand what you mean though, but since your project is focusing on patient with Alzheimer's disease and given with your case scenario, I think you are heading to the right path; caregiver role strain. It seems like the daughter is having difficulty taking care of her mother, who is going into the late stage of the disease. I guess you can focus on education, social works and maybe connecting resources like asking her to consider to place her mother in an assisted living nursing home. Something likes that
  6. Rosalie Blythe

    Care Plan for IV infiltration help please!!

    ummmmm from what I remember, we usually use warm compress if we cannot locate a patient's vein; and we use cold compress for like bruises at the IV site (like for some people, when you removed the IV, they can get some bruises). I am not sure in this case but I would just put elevate the hand to relieve edema. I did some research and it said " Check your institution’s policy regarding which type of compress (warm or cold) should be applied. Generally speaking, if the infiltration solution was isotonic, a warm compress is used to alleviate discomfort and help absorb the infiltration by increasing circulation to the affected area. However, sloughing can occur from the application of a warm compress to an area infiltrated with certain medications such as potassium chloride. In certain situations, a cold compress is recommended." https://www.RN.com/nursing-news/know-the-difference-infiltration-vs-extravasation/ Other websites that I have read also stated that the type of compress is depending on the type of fluid being infused, like you have stated. When I worked at general surgery, most patients are either on 0.9% NS or Lactated Ringer so we would usually applied warm, as NS and LR are both isotonic solution. The other website has stated that use warm compress "Warm compresses, NOT HOT, for normal or high Warm compresses, NOT HOT, for normal or high pH/alkaline solution (ex: D5W) pH/alkaline solution (ex: D5W)  Cold compresses for low pH/acidic solutions ( ex: Cold compresses for low pH/acidic solutions ( ex: vanco )" from https://www.mghpcs.org/EED_Portal/Documents/Central_Lines/CL_Module9.pdf I am also curious of the answer, maybe you should ask your professor. But I think what you have said is also correct.
  7. Rosalie Blythe

    Boyfriend wants me to stay away

    I want to clarify before others start commenting. I understand the risks and I have been practicing social distance and self-isolate myself at home but for my boyfriend's parents to state bluntly that I am not welcome in their house anymore because I am a hospital nurse...well, clearly they don't want their son to have a nurse girlfriend. It is the stigmatization of me being in healthcare from his parents that really hurts me. I haven't tried or thought to go to my boyfriend's house ever since this pandemic has officially been declared by WHO and the government. However, I will be uninterested to go to my boyfriend's house and see his parents again even after this pandemic. As for my boyfriend, yes he is right about the social distance, but my problem with him is the same with OP, he did not show any support and love for me other than practicing social distance, which is why I am heartbroken and in tears...not because we are no longer seeing each other, but the minimal effort that he is putting in to make up for that. We were a quite loving couple and had no problem prior to this pandemic. I just couldn't help but to question if he is just one of those people who usually show true colors when their lives are put on the line against others. I am yet to find out.
  8. Rosalie Blythe

    Boyfriend wants me to stay away

    I personally want to thank you @TriciaJ and @Wuzzie. Your comments are very helpful in OP's situation and my situation. If OP is looking for their advices, read what they have said. You two gives helpful, honest advices and shows empathy, which is what we need in this discussion (and nursing)
  9. Rosalie Blythe

    Boyfriend wants me to stay away

    That’s so true. Thats my augment too. Although I personally believe that by default being committed in a serious relationship implied that both sides should stand by each other in sickness and in health...or if not, whats the point? By the way, Honestly, I agree that OP do not need any rude, unfriendly and unconstructive comments. Nice come back and I am glad you stand up for yourself and your belief.
  10. Rosalie Blythe

    Care Plan for IV infiltration help please!!

    Yep, and also risk of infection. Those are the main one Ummm, I want you to look up the signs of pneumonia and sepsis.
  11. Rosalie Blythe

    Care Plan for IV infiltration help please!!

    I will say these are minors problems. Focus on the priority of the problems first.
  12. You can observe that too with patients who are fresh post-op day 1 from abdominal surgery; they are less likely to take a deep breathe because of post-op pain. Thats why pain management is important for any post-op patient (your other post )
  13. Rosalie Blythe

    Care Plan for IV infiltration help please!!

    Of course it can, imagine a patient who can sit up on his/her own and breathe normally versus a patient who guard/shield his/her abdominal wound and unwilling to breathe normally because of the pain Ummm...I personally don't think it can decrease cardiac output. Other commenters can correct me If I am wrong. I talked about your case study with my colleague...she also wants you to be focus on What can risk of infection lead to? There could be serious complication to that; even though the given vital signs are not very suggesting it, but one of the vital signs did meet the criteria. On the other hand, I want you to know that; for any type of surgery, and especially for abdominal surgery, the patient is first placed on clear fluid diet, and then NPO before the surgery. So mentioning I & O is critical. In this case, the vital didn't show that the patient is dehydrated (VS will be hypotension and tachycardia) but I want to keep in mind that other patients can have fluid deficit; especially after surgery because we expect moderate amount of blood loss from any type of surgery.
  14. Rosalie Blythe

    Care Plan for IV infiltration help please!!

    This is true (and I am glad you did you research), which is why its important to teach our post-op patients deep breathing and coughing technique (this can be one of the interventions) but if the abdominal pain is not managed properly, the patient will less likely to practice DB&C. And we all know if too much mucus sitting in the lungs of a patient with wounds who is not breathing effectively, It can turn into ....? You are on the right track...remember...we look at the patient as a whole, dont focus on just one thing.
  15. Rosalie Blythe

    Care Plan for IV infiltration help please!!

    Think again why the patient will have ineffective airway clearance. It has nothing to do with the anesthetic. When patient has a wound in their abdomen, and especially in post-op day 1-2, he/she is usually bed resting...what would the breathing pattern like? Shallow or deep?
  16. Rosalie Blythe

    Care Plan for IV infiltration help please!!

    OP can refer to this post for care plan help to get started at least
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