colleen10

Hi everyone, I am a nursing student with 5 weeks to go before I graduate. I also work part time as an aide on a renal and abdominal surgical floor. I am also 4 weeks pregnant and need advice on how to stay safe on the job and at school. I don't go to my doctor for another month and really don't know what I should or shouldn't be doing at work. I work next week and plan on telling my employer about my pregnancy at that time, but am really clueless at the moment as to what types of patients I should avoid. Radiation and meds. like chemo are pretty obvious but are there weight lifting limits and what about infected patients? Back in October when I was at my doctor for an annual, he really only said to be sure to use standard precautions and be extra cautious about CMV in dialysis patients. Since I have told my preceptor and classmates about my pregnancy I am getting some conflicting information. My preceptor says that I should only avoid patients with Airborne precautions while a classmate of mine who is pregnant and due any moment said it's not worth hurting yourself just because of school and has completely avoided all patients on contact precautions all year. I don't want to be one of those "prima donna" pregnant nurses who avoids everything, I just want to be safe. I don't see a problem with contact precaution patients as long as you where you gown and gloves and handwash, is there something I'm missing here? Are there other dangers I have not considered? Whatever advice you have would be greatly appreciated. Thanks, Col

Hi everyone. Thanks for all of your responses. I don't just willy nilly call the doctor. I work with my preceptor on what I specifically need to ask the doctor, what information they will probably want from me and what order they will probably ask me to take. I never talk with the doctor alone, we have multiple phones on single lines and my preceptor will listen in to verify what I and the doctor are communicating but will not interject anything into the conversation unless I am not covering all of my bases. I had heard that some doctors can be real jerks but this guy was a complete a--. Just didn't know if I was completely missing something here.

Hi everyone, I am currently doing a summer externship at a large community hospital. I have one year of nursing school under my belt and will start my last year this fall. I have a "procedure" question regarding Dr.'s orders and who to call about them. I had a patient admitted c a wound infection to his inner thigh r/t a mass removed from his scrotum, member and inner thigh region. After his surgery he was d/c but 5 days later returned to the hospital because of wound infection. Byt the time I had him as a patient he was 7 days post op. Was passing some gas, voiding well but had not had a BM since before his operation. He was complaining of abd. pain and distention. I knew that doctors would be making rounds relatively soon and told him that I would keep an eye out for the doctor or resident to address this with them and that if he should see them when they come to check on him, that he should also bring it up to them at that time. He had allready tried colace for 2 days and an enema the day before which did not work for him. The patient requested a phos. soda because he had used those before and they worked very well for him. As the evening wore on I became busy with other patients and when I went to check on this particular patient later on, he said that the doctor had seen him and that he explained to the doctor that he wanted the phos. soda. I said I would check for new orders and see what the dr. wrote. I checked the chart and the doctor wrote an order for another enema. I explained this to the patient who refused the enema because he only wanted the soda. He was very adamant about this. I went to my preceptor who looked at the order and instructed me to page the doctor (who is not normally on our service) that wrote the order for the enema to see if we could d/c the enema and get the 30mL of phos soda. We did not know if there was a particular reason that the phys. did not write for it in the first place. I paiged the doctor who wrote the order, he was still in house. He was really sarcastic about being paged to order a phos. soda to clear this guys bowels and how he was a Chief, etc. etc. He did allow me to take a verbal for the phos. soda, so my patient was happy. I guess my question is, if I wasn't supposed to call this doctor that was in house and wrote the original order, who else should I call, one of his residents? And how are you supposed to know what level of phys. a doctor is if you don't normally work with them? I say if he didn't want to be called about a phos. soda, he should have listened to his patient better and written right the first time, but I'm just a student, perhaps this is a wrong ideology? My preceptor had no problem with me contacting this doctor directly to change his order. Another preceptor I had for a day a few weeks later and probably didn't know the whole story said she would never call a Chief for an enema/phos. soda. I wonder who she would have called then? Is there some sort of protocol in dealing with doc.'s?

I think a lot of the thoughts that you and your co-workers are valid ones. I once worked in an office with a woman who kept her pregnancy secret, didn't tell a soul, not even her boss. One day she just doesn't show up for work and didn't return for several weeks. Turns out she was pregnant, hid it, had the baby and gave it up for adoption because she was married and the child was not her husbands. They were a nice, average, middle class family too. Appeared to outsiders to be a nice 30 year old down to earth lady til this all happened. I also went to high school with a girl who hid her pregnancy from everyone in her entire family until she went into labor. That was easier to understand since she had recently graduated high school and was in college when she got pregnant.

Hi everyone, I am almost done with a online summer class on Nursing Professionalism and Ethics. I need to conduct on online interview with a Case or Risk Manager for my class. If you would be willing to help a student out, please feel to respond to this post or PM me. Below are the types of questions that I am interested in hearing your responses. Thank you for any help any of you would like to provide. Col 1. What is your previous education experience(s) and do you hold any special training/certifications? 2. Previous work experience? 3. What is a typical work day like for you? Do you meet with clients at their home, place of work and/or hospital/clinic? What types of issues do your clients have or experience, typically? 4. What do you feel your role is in delivering healthcare to your clients? 5. What do you like most about your job? 6. What do you like least about your job? 7. I imagine that you spend a lot time dealing with a pretty big system of insurance companies, doctors and your clients places of employment. What would you change about your job and the health care delivery system that you work in? On the other hand, what do you think "works" in the system and enables you to deliver quality healthcare to your patients?

Hi there, I am half way through my student nurse career and am taking a summer internet based class on nursing ethics and professionalism. I have an assignment in which I need to conduct an interview with a case manager via the internet. I am just looking for very basic info. such as your background, education and function where you work. If you would be interested in helping a student out please PM me. This interview can be conducted via email and can be completely confidential if you choose. Thank you for any assistance you can provide, Col

Hi Leslie, You must live in the North East with me and have nothing to do but spend time on the computer since the weather is so hot, humid and rainy. Thanks for the help. I checked out the page and can tell that the one about the air bubbles in the nail causing white spots is what I had when I was filing my nails too much and pushing back my cuticles. I stopped that and the problem went away. I guess what seems to fit most is the Onycholysis, but my fingers don't look as bad as the pictures. I am going to do a search on the term onycholysis because I think I saw something about it being associated with contact dermatitis.

Hi Clara, Don't want to speculate too much but the information you have from tests could be any number of different things. Looks like your values are normal except for your TSH which is a bit high. If you do not have any sypmtoms of a Thyroid Disorder such as Hypo or Hyper- Thyroidism then you could have nodules on your Thyroid which can be quite common and not indicative of a major disease. I know it's hard but try not to worry too much until you get to the Doctor's. A friend of mine had Thyroid nodules which needed to be biopsied. She had no sypmtoms and they were palpated during a typical doctors examination. She had to have a ultra sound and then a biopsy and they turned out to be nothing but an over growth. Depending on what you have, I'm quite sure you can most certainly continue your plan of going into nursing. You have the rest of the summer to figure out what is wrong and if you do have Hyper or Hypo-thyroidism, time to get it under control. Good luck and I wish you the best.

No, my hair and the rest of me is normal. No more hair loss than what I usually have with brushing and drying. My hair doesn't appear brittle or dry. No weird rashes and nothing wrong with my toe nails either. The rest of me is absolutely normal except for these 4 fingers. I don't take any meds. except some Nasacort every now and then for allergies which I have been taking for years and I take a multi-vitamin at hs. I've been taking that for at least 6 months. The only problems I had with my fingernails was that they were brittle for a while and for a month or so I had those white dots on them, I think their called Mee's lines. That was many months ago though.

Hi everyone, I am writing because I have a bit of a problem. I have noticed the past few weeks that my finger nails seem to be lifting from the nail plate and I have no idea why. I am a healthy 29 year old with an unremarkable medical history. When I look at some of my nails I can see that it has lifted from the nail plate down to various points. It is most prominent on both of my pinky fingers where it's lifted about 1/4 of the way down the nail, then there is some on the next finger next to my pinky. I don't really see any on my middle, pointer or thumbs. They don't hurt, there's no redness, irritation, discoloration, etc. as you might expect with a fungal infection. To the best of my knowledge I haven't banged them up. They look perfectly normal except for the pulling away. They aren't pulled away so much that they are actually loose, but I can tell because the area is lighter, you can see that the line where your nail over hangs the plate is way back now. Does anyone have any ideas as to what could be the cause? I am going to call my doctor but I want to go in with some ideas. The only thing I can think of is some sort of nutrient deficit or a contact dermatitis. I started working at a hospital on an externship a few weeks ago and thought maybe it is some sort of reaction to the gloves or anti-bacterial soap we use. Could it be a Latex allergy? I've checked the internet but haven't seen any information on Latex causing this type of reaction. Could the soap be drying out the area underneath my nails? My hands don't appear to be dry. I used to constantly wear nail polish and stopped a few weeks ago when I started my externship. I know I didn't have this problem when I was wearing nail polish. I had very brittle nails for a while which I attributed to the nail polish, when I quit wearing it, the brittleness went away, but now this is starting. Any leads you guys have would be appreciated.

I just wanted to say that this whole situation is rediculous and if I were you I would have found a new doctor as well. To pay so you can come in and they can fix THEIR mistake is outrageous. In fact, I'm so spiteful that I probably would cancel the check that I wrote to them for the first appt. They obviously didn't do it right, why should you have to pay for it? I read an article that more doctors offices want to be treated like "businesses", ie. if you cancel an appt or don't show you still get charged for the appt. Well, then, if they want to be treated like a business they should start acting like one, providing quality service and information for a cost, and if they don't do it right, don't get paid.

Hi Violet, I am starting an externship program in 2 weeks and was just ordering myself scrubs online since we are allowed to wear what ever type of scrubs we would like to. I checked out AllHeart.com and ordered two sets from them. If you do a search for "Barco" the maker of this particular set you will come up with a section on scrub sets they make, it is a flair legged scrub pant with nice big pockets (I have a pair I wear for clinical and I love them) and also a very basic matching scrub top. The set is around $22-23 dollars and they also sell the "Riverwashed" material that is so nice and soft. They have many different colors so I hope one of them falls into the "Blueberry or Periwinkle color" that you are looking for. I'm just mentioning this particular set because I thought the price was decent for both a top and pants and I own 2 pairs of the pants and have found them very comfortable. The have a drawstring front but a little bit of elastic in the back. Plus the big pockets make them nice too. I have heard some people on this board say that they had problems ordering with Allheart such as the item was delivered really late or they didn't have it/not in stock, etc. but when I ordered my pants and steth. from them before clinicals started I didn't have any problems with them. It may depend on the actual supplier of the item, in this case Barco, and not actually Allheart. I also checked out Life Uniforms website and they have a huge selection but are a bit pricier. I have located a store in my area and am going to take a drive out there one of these weekends to see what they sell in the store.

I live in Pittsburgh, PA and can say that yes, my state has been loosing OB/GYN's to sky rocketing insurance and malpractice verdicts. It can take 6 months to get in to see an OB/GYN if you are not a previous client and even if you have an emergency. A co-worker of mine had to wait 5 months to get in to see an OB/GYN for endometriosis. Other doctor's offices told her she could end up waiting as long as 8 months. While she waited she spent a lot of money and time in the ER. Her first OB/GYN left the state due to insurance costs. It takes me 3 months to get a "check up" appt. with my OB/GYN of many years, I think I could get in in relatively quickly though if I had an emergency. A few years ago a local hospital closed down it's midwifery service. Luckily, with much gusto and public out cry they were able to open up their own practice outside of the hospital. I agree with Dawn Gloves. Seems we spend a lot of time, money and public education on female health issues and disease prevention like breast cancer screening and STD's in the young at risk population but when the doctors aren't there to see the patient's what more can you do?

During my L&D rotation the patients pushed in their birthing rooms with just the nurse present. When the nurse felt it was close to the actual birth they would call in the doctor and tech and other nurses. The doctor really only showed up to catch the baby and placenta and stitch mom up if need be. The nurses were the ones who took the babe over to the isolette for APGAR scoring, drying off, warming up and physical assessment. Doctor didn't even look at the baby aside from when he delivered it.

IamRN, Thank you for your post. As a student nurse I had never thought about what you said regarding picking narcs. up (or anything for that matter) from the pharm. and people being wise to the nurse or tech carrying it.