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Critical Care, formerly Oncology

Change is good!

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DVorahRN has 15 years experience as a BSN, RN and specializes in Critical Care, formerly Oncology.

I was an oncology nurse for more than 10 years with a focus on pain management. In 2017, I switched to Medical ICU and still feel like there is so much more to learn. I still think that Hospice is where I’d really like to work.

DVorahRN's Latest Activity

  1. I have an obese female pt on BiPAP for COPD exacerbation who needs a Foley catheter placed. She cannot tolerate supine or lithotomy position, or lateral position. Has anyone else faced this circumstance? The only thing I can think of to try is reverse Trendelenburg to keep her breathing comfortable, and raising the bed up off the floor so I can see what I'm doing. Suggestions?
  2. DVorahRN

    Running vassopressers separately?

    On my unit we run compatible gtts together frequently. Waiting for another line when someone needs vasopressors could result in a very poor outcome. Obviously, it’s best if you can have a triple lumen central line, but use what you have to save their life.
  3. DVorahRN

    Boise, ID

    Anyone have recommendations about the best (or worst) hospice agencies in the Boise, ID region? Looking to change from hospital nursing, but don’t want to get hooked up with a poor employer. Thanks!
  4. DVorahRN

    Am I too old to become an RN??

    I was 38 when I went to nursing school, and while I was in the older half of my cohort, I was far from oldest. One of my classmates was using Social Security retirement benefits to pay tuition! And as has been said many times before, how old will you be in two years if you don't go to nursing school? Go for it! Don't be a slave to the calendar.
  5. DVorahRN

    Bedpan? Why not a Poise pad?

    We jury-rigged a better female urinal by attaching an ambu bag mask to a urinal. The squishy edges of the mask held it in place well so we didn't have any leakage.
  6. DVorahRN

    Nursing shoes that aren't clogs

    I have two pairs of Keens and two pairs of Pearl Izumi running shoes. They are all really comfortable and I alternate which ones I wear. There are several shoe stores in my town that actually give health care workers a discount -- don't forget to ask!
  7. DVorahRN

    SCRUBS (Mailorder)

    I like Allheart.com and Tafford.
  8. DVorahRN

    Best most comfy and durable scrub pants

    I like White Swan. I also frequently get scrubs by Allheart.
  9. Our facility introduced the concept of Bedside Shift ReportSM as proposed by the Studer Group a few years ago. Frankly, I think they did a poor job of introducing it and an even worse job of training us (yes, scripts and role play feel silly, but it does give you a starting point -- something my hospital skipped over completely). My unit has really had a difficult time with implementing this process as we find it takes far more time to give report this way, and off-going shift RNs are inevitably leaving late. One of the challenges is that the patient decides that "as long as you are here" they need to go to the bathroom, get pain medicine, get nausea medicine, get a warm blanket, get ice water/coffee/food, etc. Obviously some of these needs can easily be met by ancillary staff, however, since there are 2 RNs at bedside, the RNs have to do it right then. This eats into the time available for report on the remaining patients. And if you are giving report to/getting report from multiple nurses, an awful lot of time can pass. Our unit management is really cracking down on us to do it every patient, every shift, and it is causing a lot of push-back and stress. Has anyone who is using this program found a way for it to work smoothly, without making shift report last forever?