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Krazziekid78

Krazziekid78

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Krazziekid78's Latest Activity

  1. Krazziekid78

    Chafing

    I had to reply to this old post because after working 4 13-14 hours shifts on a short-staffed rehab unit (knowing I had 2 more shifts to go), my thighs were a hot mess. By the end of my 4th shift, I could barely walk. I had two open sores on my thighs.... One sore was BLEEDING. I searched the net for something to help, as I was on the verge of crying... Or calling in the next day. Lol. Here is what I did. I took ibuprofen, applied hydrocortisone cream, and iced my thighs that night. Next morning, I took a different route and applied corn starch and wore a pair of spandex shorts. And I survived with minimal pain the next couple of shift (walking approximately 5 miles per shift caring for 26 people..when I typically only care of 13 😵). Good luck desperate thigh chafing nurses!
  2. Krazziekid78

    CRAZY / GROSS / NASTY

    Wow. Too many stories and I've only been an RN for 8 months! all time favorite.... Upon completing a very thorough skin assessment on a 450 lb woman that was just admitted, I noticed an AWEFUL smell. Lifted her one of her multiple abd folds,found a spoon that was pretty much embedded in her skin. NASTY infection. Lots of pus. Almost made me gag... that and the time I forgot to clamp the tubing to a g-tube when giving meds and nice pretty GI juice splattered on my lip
  3. Krazziekid78

    COPDer de-satting? What do you do?

    Baseline is 88-92%. SOB resolves after resting in upright position. BP was 140s/90s. HR was in 95-100 (usually runs tachy). Respirations were about 25. These vitals are typically baseline for patient. Respirations were elevated above baseline (usually 18-20). And no- we don't have the ability to check a quick ekg i might add add that patient has been de-satting frequently with therapy only ambulating short distances. Today was the first time he dropped into the 60s
  4. Krazziekid78

    COPDer de-satting? What do you do?

    I'm throwing out a scenario. Please tell me what you would do (especially regarding oxygen therapy...how much to give and through what device) Patient with COPD is found with oxygen saturation of 62% after working with therapy. Lungs have fine crackles in bilat lower lobes, c/o feeling light headed and SOB. Cyanosis to lips. Currently on 4 L (baseline for patient) on a NC. Patient placed in high fowler position and encouraged to cough and deep breathe. Oxygen saturation raises to 70%. Ordered PRN duoneb (q4h) was given 1 hour ago. Increased oxygen, and sats sit in mid 70s at 6L. Do you go to a non-breather or face max at a high rate of oxygen per lpm and risk hypercapnia? Or do you focus more on getting their o2 up? Note- I am in a small rehab facility with no RT or rapid response team.
  5. Krazziekid78

    Oxygen administration with COPD patients

    Wow okay. Should have been more specific. We OBVIOUSLY tried to titrate through the NC, once we hit 6 Ls and patient was sill in the 70s, we started the non-rebreather on 10 lpm, when his sats finally started to rise. Once he was stable and non-symptomatic at 89-90%, we put him back on a NC and brought him back down to his usual and ordered 4 lpm. He was only hooked up to the non rebreather at 10 for about 5 minutes. Just was scary and wanted info on how to manage de-satting COPD patients when you don't have the luxury of a RT or rapid response team. We are a very small facility and when stuff gets rough, we send them out to ER.
  6. Krazziekid78

    Social Life Concerns

    I actually just shared that article on my Facebook this morning. Too funny. I graduated with my BSN in August and have been working as a rehab nurse since January. This article is spot on as it totally shares a lot of the struggles nurses face. I really have found that the best way to have a life is to learn to say no. It's so easy to agree to pick up shifts, but you have to take time off to let yourself re cooperate. Those 12 hour shifts you put in are tiring and demanding- and putting in more than 3 can be rough (don't ever work 5 12s in a row bty). You need those extra days to recover and have YOU time. The key is finding a balance. Nursing is such a heart-wrenching job that sometimes it's hard not to bring your work home with you. But with more practice , it will get easier.
  7. Krazziekid78

    Oxygen administration with COPD patients

    Thank you for your reply. This answered my question. Rather than focusing on a amount of oxygen being delivered, it's best to titrate to the 88-92%. I was just shocked at the amount of COPDers receiving up to 8-10 LPM, none the rest on a rehab floor! í ½í¸± I had always heard it was unsafe for COPDers to be more on 3 L. But you gotta do what you gotta do to keep their sats up
  8. Krazziekid78

    Oxygen administration with COPD patients

    I'm a new grad working in a rehab facility. We get a lot of patients with COPD who seem to always de-sat. Nursing school pounded it into my brain to be very cautious about administering too much oxygen to ensure patients don't lose their drive to breathe. However, I have seen so many COPDers and up to 10 L of oxygen! I had a gentleman's sats drop to the low 60s today after therapy. The nurse I was working with turned his oxygen up to 10 on a non rebreather, sats improved, then we titrated him back down. My question is- what is the best way to get a patients sats back up when they have COPD? Does the oxygen LPM really matter? Or is it mostly a focus on the o2 sats, making sure they don't climb above 93%? Is it that common to see COPDers on more than the recommended 3lpm?
  9. I'm a new nurse on a med-surg floor. I had a lovely patient who had really been through the ringer that I cared for for 10 shifts. When I was saying my goodbye, she got teary eyed, thanking me for my care. She then said "perhaps I could call you sometime to stay in touch"... Rather than saying what I should have, I got flustered and said, "oh, just call the hospital". I didn't tell her to call the unit or anything. I just slipped and said that. Urghh. I'm afraid I'll get into trouble if she calls the unit saying I said she could call me =\ any advice? Is this something I could get into trouble for? How do you guys politely turn down a future communication? Thanks!
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