Bicycleboy

I ask because I am curious. I had an 84 year old pt who had recent knee surgery to reattach her left patella. She is progressing very well but the problem is a open blister on the the right heel that is causing her tremendous pain. She indicates that it hurts more then the knee injury ever did. She does not take anything stronger than APAP and is not able to take any opiates. She is also a diet controlled diabetic. My concern is that if she ambulates any less that she does now that she will stop progressing in her recovery. I was thinking that xylocaine gel applied to the blister would help numb the pain for her so she could continue to ambulate. The thing is that I don't like to mess with diabetics and their feet and am not willing to experiment with something I know very little about. She has decent circulation to her feet, palpable pedal pulses, good cap refill and sensation and no history of neuropathy. I am also thinking that if it does work that numbing the pain too much will prevent the blister from healing because the pt will be walking more. Right now she does not walk too much, just to the bathroom and such. Yes the doctor will know as soon as he decides to visit the floor so I am not looking for a prescription from allnurses, I am just wondering what your thoughts are on using xylocaine gel in this instance and if anyone can offer any insight.

I have never been laughed at for saying that I am a nurse. Most people admire me for being a decently paid professional in a community where most a very poor and don't have jobs. Of course I am pretty rough looking myself, when I am not at work, so they usually laugh at me because I am so ugly and weird looking. Even so I have a saying that goes "I would rather people laugh at me than yell at me." If me being a nurse makes them laugh then I know that I have made them feel good. All the drugs in my cart, even the locked drawer, are useless at making people feel better compared to what laughter can do.

I have had only positive experiences as a male nurse, I recently graduated about 6 months ago and have been working ever since. If we are over bedded and there is not enough staff everybody floods the manager with grievances, which is quite often. The medicine floor is the most unpopular one to work on an few nurses want to work there. I love it, for me every shift is a party. It is rare that someone misses a lunch, if you do you will suffer the wrath of the floor, in most cases you will be hounded by your co-workers until you get sick of it and go for lunch. Every time one makes a move on the floor there is a co-worker asking if they can help you, if they are not engaged themselves. If you ask for help quite often you are overwhelmed with any and most of all your available co-workers running to help you. One time I asked for a hand to boost a patient in bed, I only needed one other person, and 3 came into the room at the same time to help. If you need to start an IV and happen to mention it out loud, as soon as you turn around your supplies will be ready for you, and you lines primed. Of course when everybody is overwhelmed this does not happen because everybody is fighting to keep from drowning, but as soon as someone is free they will jump in to help somewhere else. I am lucky in that no one seems to care that I am a male, and the only male RN that works in medicine, the rest are RPN's, who in my opinion are as capable, and many times they are more capable than many RN's. The only time that I am reminded that I am male is when the nurses talk about relationships, home decorating, menstrual cycles, children and their lazy husbands. I just grunt and in my best caveman voice say me man you woman, I hungry, make me sandwich woman. Of course they all laugh because they know I am joking. Of course I have to take a lot of ribbing from them being a man, but I know they are just joking with me. I do like it when there are other males on the floor, even from other departments then I get to talk about manly things like knives, guns, meat, beer, and football. Even the gay male staff are quite manly and usually want to talk about hunting and their gun collections and how big and fast their cars are. Of course the conversation always turns to beer in most cases.

4.0 for the entire 3.5 years I have been in school. The last semester was the only time that someone has had higher grades than me.

You have your RN licensee as well as a member and testicles, and it is considered normal to have facial hair. You probably have a deeper voice too.

I was at a diabetes conference the other day where Dr. Geremi Bolli was speaking and there were some interesting ideas about DM2 and insulin. The information went like this: Start someone on insulin and metformin as soon as the are Dx'ed with DM2. The reason being is that the insulin allows the beta cells to rest and the metformin reduces the amount of glucose released from the liver, as well as increasing insulin sensitivity. This reduces the gluco-toxicity on the beta cells. Research has shown that DM2 goes into remission after intense therapy and stays that way for a year on a majority of cases. Sulfonylureas make the problem worse by overworking the pancreas leading to cellular apoptosis sooner than if they were not used. Early treatment can induce remission but the remission does not last as long as insulin therapy. Another part of the message was to avoid premixes and NPH. Studies of radiolabeled NPH have shown that the variability in absorption ranged from 30% to 100% because of its insolubility. The premixes also fail to have the peak of rapid acting insulins, in effect they can cause more inter-prandial hypo events.

I just thought that I would share this. I am doing my preceptorship at the local diabetes clinic and I was telling my preceptor that I would like to have type 1 diabetes for a week to see what it is like. So she is arranging it for me. She is going to set me up with a pen and some saline in place of real insulin and a glucometer. I have to see the dietitian next week so I can plan a diet for the week. I will have to inject myself 4 times a day and take my blood sugar 6 times a day for a week. I only have one kidney so tight glucose control is really important thats why I am doing the MDI. I don't know why I am exited about this but I think it will be a real eye opener. My preceptor tried it and she said she was only able to keep it up for 2 days.

I am a 4th year BSN student and I used to work in mobile hydraulics.

Spending as much time as possible in the woods with sharp objects, mainly knives axes and saws.

By saying "I do not mean this facetiously" makes it more the like. You assume what my values are when I did not mention them. I would not invest this much time on my studies to be a volunteer nurse. I am definitely in it for the money among other things, and I have no problem pushing a med cart around because it will eventually get me what I want. Eventually a med cart will be a foreign object to me, but I don't mind taking a ride on it to get to where I want to go. Another assumption. How would you know how much I have invested? Is it not possible to work in health care and not have to be a nurse as a minimum requirement? Working in the illness care is definitely what I intend to do as a nurse. But being a nurse is only a small part of what I plan to do. Nursing is a vehicle to get me where I want to go. That being said I will always be a nurse no matter what other professions nursing allows me to pursue I see a pattern here, is this what happened to you? My nursing tuition and books are free, and I even get a bit of extra money to spend on indiscretions. The best part is that if you live anywhere near me you are paying for my tuition and books, and will continue to for the next little while. It pays to consider my wife and I the number one priority. Consider looking at things through another lens, it may reduce the need to assume so much. Is the minimum requirement to work in health care a nursing degree? Or is it possible I can be on the inside and not have to be a nurse?

I must say that I understand why the brainwashing occurs. If we did not have a common knowledge base, and certain ways of doing and learning, things would be too chaotic. Nobody would now what the other was doing. I have found nursing school to be the hardest thing I have ever done, it also has been the most rewarding. For all the brainwashing that goes on there is a lot education that has also taught me to question what I am learning and to think about it, and not just perform by rote. I understand what you are sating Mike. I don't have the solution, but there is a way to make things better. You said med passes and dressing changes are a part of it, and I can't agree with you more. IMO for you, me and other nurses of all types it is not entirely about the money. For the hospital system it is about the money. If it were not there would be none of the mega industries surrounding it as well as the hospitals themselves. I don't think nurses in general are greedy and don't care, but many of them are part of the system whether they like it or not.

I I can see how you might be concerned. A large part of nursing school is brainwashing. You do learn a lot of stuff, but the more you learn the more you see that the health care world does not really serve the patient. It is more about serving the people who are in it. If you don't like the idea of pushing drugs you don't have to. There are areas of nursing that are removed from the hospital and the bio-medical model, which are focused only on sicknesses. You could work in the community using a socio-environmental model which promotes health of the person by trying to improve factors that contribute to health, instead of blaming the victim and only focusing on illness. Take a look at a population health promotion model. It looks at inter-sectoral collaboration and the determinants of health, as well as other factors that contribute to well being of the individual, and the environment that they live in. As a nurse you do many things that will help improve health that have nothing to do with pushing drugs. There is a way to change but you need know what it is like on the inside. You may start out in a hospital with the best intent to help people, but in the end hospitals are a business and would not exist if people were not sick. In this way it is in their best interest to have a bio medical approach that is only concerned with illness as the focus. If it were not this way, there would be a lot of hospital corporations out of business, and many more nurses working with the community to make the places where people work live and play much more conducive to health.

Hello. I am a 3rd year BSN student with a bit more than 3 semesters left until I am unleashed on the hospital population. I have already got an offer from a hospital looking to guarantee me a job before I even graduate. One has even offered to start paying my tuition before I finish school. I am going to move to Northern Ontario when I graduate so naturally I have been looking at hospitals in that area. My love of the outdoors goes along with the environment, and my wife is very exited to have the chance to live up north. I like very cold weather and she hates the heat. So, as well as hospitals offering incentives, the Ontario government is also offering incentives for nurses who move to areas that are in need of nurses, like areas such as Northern Ontario. In some cases it looks like I will be able to pay off 30K worth of tuition in less than 2 years and not have to take one penny out of my pocket. Incentives are nice but I don't want to loose my license because of lack of support or training. A bit about myself: I am a married 35 year old male. I excel in all aspects of nursing school. My wife has a neurological disorder and her drugs costs are well over 1K/month, so full time benefits and a drug plan are needed. I am looking to start out in the hospital and then after I gain some experience I wish to get an advanced degree and work in the community. It is also very important to me that I get to work with native/first nations people because I hope to move up to the Northwest Territories and eventually do outpost nursing. I have a plan to have my PhD by the time I am 60. Of course that is all in the future and my main concern is to get through NS in one piece. I have no children and will not be having any children. I am looking for questions to ask prospective employers. So far, from searching this site I have found the following information on questions that I should ask prospective employers: 1. What area of consolidation would be beneficial to a new grad to have in order to get a job in your hospital? 2. What type of pt's do you care for? 3. Who can I call when clinical concerns and questions arise? 4. How long is my orientation? 5. What would a new grad get paid? 6. What are the benefits? 7. What insentives do you offer? 8. Will the work be full time? What are some other questions should I ask so I can make an informed choice. Thank you.

I quit about 7 years ago. I had become an expert at quitting, I had done it so many times. What worked for me was telling myself, and believing, that I was not a smoker, therfore there was no need to smoke. I also picked a bad time to quit. It was during a camping trip with the boys where we spend most of of the time drinking. For some strage reason it worked. When I think about it, it should not have worked, but it did. The real funny thing is, that I went to my Dr. to get a prescription for zyban, but never ended up filling it.

I am going to school in Ontario, and I have been told by my teachers that to become an RN in Canada you need to get your BScN. Present RN's do not need to upgrade if they do not already have thier BScN.

I also found patho easy. My teacher did not know her stuff at all but that was of no consequence for me. I am very analytical especially when it comes to stuff like patho. I would make sure to read very slow, and after each paragraph I would reflect on what I just read, and how it relates to the body and nursing. As the course would go on I would key in on things that I felt I would be tested on, and when I re-read the text I would relate this to the reflections I had made earlier to re-enforce what I had learned. I am not a notes person at all, that is I do not study by reading notes. I take notes to cement information in place, and somtimes while I am studying I will make notes to break the monotony of reading. For me notes are to be written but not read. Of course there are exceptions to this, like when the teacher dwells on something for longer than I feel is normal; to me this means that the info is probably going to be on the test. In such circumstances I will refer back to my notes to give direction to my focus. I also remeber stories much better than individual facts. Make a story up about patho that relates to something you enjoy. If you know people with the patho that you are studying, try to relate it to them and how it affects thier life. When you are dealing with individuals that have the patho that you may be studying, relate it to the whole person, and why it affects that person in that way. Many people are different in the way that the disease manifests, but kidney failure is kidney failure no matter how the individual is outwardly affected.

May I also have a copy please. Thank you.

Up here in the great white north the only way you will become and RN is to get your BScN, so there is not need to worry about which degree to get.

Why not stick it out then get an advanced degree. How about flight nursing or working in the military

It seems that there is so much you can do as a nurse, if one part is terrible go and do something else. I see nursing as my ticket to reach my full potential, there are so many different directions one can go as a nurse, and almost all of them are up.

i thank you for your information, i appreciate that you took the time to give my your honest opinion. you don't have to excuse yourself for busting up anything, although you should for calling me a kid, honey. the point i was trying to make was that all of my previous instructors would not point anything out to me good or bad. they would just say that i was doing a good job and nothing else. i don't mind having my faults pointed out, especially when i can use it for a place to start improving. what i can't stand is people not caring enough and then just saying that say that i am doing a good job. yeah she may not be perfect, but i am glad to hear criticism for once, and not just that i am doing a good job. my wife agreed with my teacher, she thinks i am very disorganised. i know it is because my mind is always running so fast all the time, and my body wants to follow. again thank you for your time and i will check out the links that you gave me.

For me nursing school is not that hard, it requires a lot of work but I have no problem being at the top of my class. This is very nice, but I know that this means nothing when it comes to being a nurse in the real world. I am almost half way through an 8-semester degree of an RN course, but I find that my skills are lacking. I know what to do, when I should be doing it, and why, but when it comes to application I am lacking. I know I am a novice and will not have the skill and experience of the people training me, but for what I know I should be better at the practice part of nursing. Today I was with a new instructor that previous students have dreaded. She is always rushing you, and extremely direct, there is no beating around the bush, and she does not seem to care if she hurts your feelings. My previous instructors were very understanding and knowledgeable, and made you think before you talked, and they never criticised me or made me feel that I could not do the work. When the previous instructors evaluated me I was always the stellar student in the group. Today with the new instructor I had my weaknesses affirmed, it upset me; my feelings were definitely hurt. The fact is I learned more in one day about myself as a beginning nurse than I have learned in the many hours of this programme that have preceded. And I am eternally grateful to my new instructor. In private I asked her how was the best way I could improve. Flat out she called me a "scatterbrain". This was the best feedback I have ever received. She said I was disorganised. She continued to say that she thought that I was doing good but I need to work on my organisation, as well, I have an enormous load with 2 surgical patients as it is. What happens in the real world if I am not organised with 5-8 pt's. I don't think I could know a person like my present instructor on a personal level. On a teacher student level I think it is what I need, someone who will point out ways I can become a successful professional, and not be afraid, or not willing to pay attention to what I do so that only good things are mentioned. So I have the skills and the know-how to eventually be very good at what I do, but I am disorganised. I think I can attribute this to my focus. My mind is constantly running at very high speeds, this is good at certain times but I think it is part of what is causing my lack of focus in the clinical setting. I know everyone is different, but how do you channel the enormous energy that runs a mind at hyper speed into a slower focus that plans and reasons out that plan to benefit everyone involved in the clinical experience? I feel if I can have more control over this aspect I will improve in many ways.

I work in LTC. The management complains that we, (the nursing students that they hired for summer work) use too many gloves. Many of the full time staff have been there for a long time and the only time they use gloves are when they are dealing with someone who has c-diff. We are always having UTI outbreaks. For the record I always have my scrub pockets filled with gloves, and always carry around alcohol sanitiser. I guess the reason that the nursing students that work there always wear gloves is because all through school we have had sanitation pounded into our heads, as well as the fact that nurses and PSW's are the best ways to pass around infections in any agency.

Where I work it is rare that the PSW's even put on gloves, and mangment discourages the use of gloves.

When I worked in retail we would get profit sharing and defered profit sharing, it turned out to be between 5-8K, you would usually take home about half of that. After working there for 11 years, I quit to go to nursing school, I had 15k in the deffered account. The nice thing was that we would get the bonus at tax time, so you would get you profit sharing and tax return at the same time.