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vampiregirl BSN, RN

Hospice

Content by vampiregirl

  1. vampiregirl

    Advice on comfortable shoes

    When I use the "search" bar in the upper right corner, I've found I have to scroll down to get to the AN threads - there are typically advertising sites on the top of the list. Lots of threads under the "Nurses" tab, then scroll down to the section on gear etc. My $0.02 on your question - I alternate between Danskos and Merrell. Sketchers with memory foam don't work for me. I've also found good socks make a HUGE difference. Good Luck!
  2. vampiregirl

    Summer 2017

    I'm looking forward to spending a week as a volunteer camp nurse this summer... at the summer camp that I worked at 20 years ago as kitchen staff. I know it will be completely different from those days (but it's a very different world today). I can't wait to see all the campers engaged in the activities they offer, I'm feeling all kinds of nostalgic after looking over the camp website and starting to gather stuff together that I will take... and camp is still a month away for me! How about everyone else planning to go to a camp this summer - what are you looking forward to?
  3. vampiregirl

    new RN/BSN - where to work for the most experience

    I gained very valuable experience working LTC. LTC's vary though - the one I worked in had lots of interventions (IV therapy/ maintenance, TPN, g-tubes, ortho patients, respiratory patients etc) in some units. Assessment and critical thinking skills were encouraged. It was a steep learning curve and hard work, but it gave me a great foundation of nursing skills.
  4. vampiregirl

    Isobar handover.. I can't get my head around

    Any report format is probably going to be awkward at first but becomes smoother with time. And then there are occasions where important details don't seem to nicely fit into any of the categories. The thing I try to remember is get the information organized in a concise manner with the pertinent info.
  5. vampiregirl

    What do I do if I'm struggling in the easy classes?

    Just a couple of thoughts... I struggled a bit with A&P, Chemistry and some of the other core courses when I took them. This material is very important to have as a foundation. It will come in useful in nursing. It's just dry and was pretty much unrelatable to anything at that point - just "stuff you have to learn". Take it one bite at a time. Figure out how you learn best. I found my nursing classes "easier" (not sure that's the perfect word), as I was more excited about the subject matter and could more easily see how it applied to my goal of being a nurse. I also came into nursing with a fire/ ems background. The theories of EMS and nursing are very different... it was a struggle for me to someone remember to use the nursing lens to view things. But trust me, EMS background can work to your advantage in nursing. Learning how to stay calm in an emergency, people skills, staying alert to your environment to ensure safety, etc. - those things aren't taught in school but are essential skills in patient care. Good luck! Nursing school wasn't any easy journey for me, but for me it was so worth it.
  6. vampiregirl

    CNA --> RN. Worth it?

    I went the same route, CNA to RN. For me, totally worth it! I guess I don't remember being bothered by the physical aspect of being a CNA, I will say I was in much better shape and a lot less fluffy when I was CNA than I am now. I'm also was lucky that my CNA instructor really reinforced the importance of proper body mechanics, so to this day I am very conscientious about that. Not that some days I'm not tired and achy, but I figure that is par for the job. I also enjoy caring for others, so this outweighs any physical discomfort I may experience. In fact, I think it has made me a better nurse. Not only am I competent and comfortable performing many of the same tasks I performed as a CNA (positioning, transfers, ADLs etc) but I often "sneak" in my nursing assessments during patient care. I think it also contributed to being able to build a better rapport w/ my CNA's when I worked at a SNF and allows me to assist the CNA's I currently work with in hospice. Having said all that though, you will have to figure out if this is what YOU want to do. Good luck in whatever you decide:)
  7. vampiregirl

    Best scrub jacket and tops

    Although my body structure is very different from yours, I have the same issue w/ scrub tops. My solution is to wear a knit shirt under it. I look for knit shirts with a fine gauge/ tight knit and a smooth/ narrow binding at the neckline (as opposed to the typical thicker necklines that are typical for t-shirts).
  8. vampiregirl

    AED Recommendations

    Even if your local EMS can't offer you a discount and/or grants, finding out what defib units they use is helpful. It saves time and makes a smoother transition if the pads are compatible and all it takes is switching connectors.
  9. vampiregirl

    The Nurse at the Bedside

    Beautiful article! When I chose to leave a management position for a clinical/ bedside position in hospice many of my friends/ co-workers thought I was nuts. Best career choice I ever made. I don't see myself venturing back into management - it's not where my heart is.
  10. vampiregirl

    Nurse Face Her Fears To Help Patient

    Cases like "Peter" are sometimes where we have the chance to make the greatest impact with an individual patient:) And as the greatest reminder of what nursing is truly about. I hope the director was able to find a primary case manager RN who is able to appreciate him as much as you were! I'll never forget the day that one of my most challenging patients in my career told me that myself and a social worker for my agency were the first 2 "medical people" who he ever felt like listened to him and cared about him. That moment will forever stick with me.
  11. vampiregirl

    Macy catheters - Anyone using them?

    Read a recent journal article about Macy catheters for end of life medication information and was intrigued. Was curious if anyone has used them and if so, what are your thoughts about them? About the Macy Catheterâ„¢ | hospi
  12. vampiregirl

    Most efficient, easy way to stay UTD on new medicine?!

    One of the ways I learn about new meds is to look up any new meds I encounter. Usually with a drug handbook/ online resource initially but I often jot down the med name and check out more in depth resources later off the clock - with new meds manufacturer's websites are great sources of info. Also, see if through your employer you have a way to access professional journal articles online through a scholarly search engine. Check with colleague education if you're unaware of how to do this. I also learn tons from reading general nursing magazines (Nursing 2017 and Nursing made Incredibly Easy are two but there are more) - both related to meds and EBP. Professional associations are also a great source of info - both in print resources and online. I'm in a different specialty, but I'm betting there is at least one medical/ surgical nursing association. It's great that you're interested in learning about new meds and EBP - this is a great way to improve patient care. Also learn the process at your work to recommend reevaluation of policies/ procedures to implement EBP. At my work place, this is nurse driven:) Good luck!
  13. vampiregirl

    Does "BSN preferred" mean "ADNs need not apply"?

    One thing to keep in mind, some places may require you to complete your BSN within a specified time frame. Where I work, it's 5 years. However, we have tuition reimbursement for a large chunk of it and scheduling around my classes was never a problem. So it's been a win-win situation for me.
  14. vampiregirl

    Will nursing wreck my hands?

    Thick cotton socks on your hands also work great! As much as I love to use yummy smelling lotions at home, I've found that high quality lotions with no added scent or colors tend to work best for me. I also use non-antibacterial soap at home. Caring for your hands/ cuticles in health care is so important. If you don't care for them, it puts you at increased infection risk as non-intact skin is a portal for germs/ bacteria/ fungus to enter. Burts bees is my current favorite cuticle treatment, but there are several other options out there. I tend to rotate "favorites":) Sometimes it has to do with which good quality product is on sale when I am running low!
  15. vampiregirl

    AHA CPR Instructors

    I teach through my fire dept so I have a limited amount of equipment available for smaller classes. Large classes require reserving/ renting equipment from other sources. I too have been trying to figure out how to best handle the "last minute/ emergency" certifications. My first thought is typically that your lack of planning is not my emergency:) But sometimes people do have legit circumstances come up that they need a cert fairly quickly and for me, the public relations aspect can also play in. Typically I cave and accommodate them IF I can. Several "last minute" students have made donations to our fire dept in addition to course fees, which then I put towards equipment. I teach as volunteer though, so overhead is very low (cost of cards, disposable supplies for classes and cleaning). In turn, we have very reasonable rates. We also have a few corporate contracts outside our fire dept service area that our rates are competitive with other area providers.
  16. Have you explored the "articles" tab at the top of the page, just under the golden "allnurses" banner? There was a recent contest with lots of submissions about study tips/ plans - lots of great ideas there in the different articles. Good luck! Establishing good study habits early is so important, but it does take some time and experimentation to figure out what works best for each individual:)
  17. vampiregirl

    Stressing out about my TB skin Test...

    The reference to the site being 2 inches away from the previous site was likely a reference to when the administration of the tuberculin does not yield an adequate wheal and must be redone. It's not a problem for the 2nd step to be done on the same arm as the initial step. Here's a link to some info: https://www.cdc.gov/tb/publications/posters/images/mantoux_wallchart.pdf
  18. vampiregirl

    AHA CPR Instructors

    There is always the chance that the TC you worked with has been on vacation/ leave or another individual has been assigned that role. Also, I'm aligned with a small hospital and my TC is always crazy busy with many responsibilities in addition to being a TC, it took me a while to figure out delayed responses were nothing personal just not enough hours in the day. Maybe consider calling the hospital and requesting to be connected to her dept and try making contact that way. There may be an admin asst who can provide you with assistance or direction. My cards always get sent out quickly because the admin asst does those, not the TC. Also, in regards to your questions about bloodborne pathogens, have you checked the AHA instructor website - there's lots of good info there. Good luck in you venture!
  19. vampiregirl

    Renewal rate for Nursing Central app

    I've found several free and low cost apps that have the same info from reliable sources instead of paying the cost of nursing central.
  20. vampiregirl

    do any home hospices provide linens 4 hospital beds

    We provide pull-ups, briefs and disposable chux for our patients. No wipes or personal care products but we do provide barrier cream. As for linens, we have a limited supply available for patients with limited financial resources if we place a hospital bed but only provide 1 set (unless extremely extenuating circumstances). Those are purchased by a foundation associated with our sponsoring hospital from what I understand. Since the latest recommendation is 100% cotton for safety if oxygen in use, some families don't have 100% cotton sheets already. It's interesting for me to learn about how other hospices address things.
  21. I did what the previous posters recommended. I am an Excelsior grad who took all my classes except the nursing classes through my local community college. They had online options for many of the classes I needed. You may want to check with Excelsior to make sure they will transfer before signing up though.
  22. vampiregirl

    Distat. What Would You Do?

    Would an order for intrantranasal midazolam be an option? I've seen studies that have shown this to be as or more effective than distat, plus the method of administration is more "socially acceptable" compared to rectal administration.
  23. vampiregirl

    Dual Head Stethoscope?

    I so had the mentality of not needing to be able to hear/identify S3, S4... until I attended a CHF inservice at the nursing home I worked for at the time and learned why I needed to be able to identify especially an S3. Also, the bell can be handy in the assessment of peds. See if you have some friends who have stethoscopes already so you can see which dual head stethoscope you like and is comfortable for you. There is a lot of variation between stethoscopes, even within the same price range - and personal preference definitely is also a consideration.
  24. vampiregirl

    Punished for NP decision

    During my time in SNF management, I became familiar with state regulations regarding psychotropic meds. I'm guessing these vary from state to state. Often the issue isn't that a med isn't inappropriate for the patient, it's that there is lack of documentation to substantiate it's use. The facility I worked at had a process in place that included requirements of documentation of notification to the POA of any med changes, a way of communicating psychotropic med changes to the appropriate members of management and a review process in place to observe for effectiveness and/or side effects of any med changes. There was also a monthly meeting that included representatives from the psych provider group and the pharmacist to review every patient on psychotropic medication. Was this a pain to complete all the required steps and documentation? Yep. Did it serve to protect the patient and the staff? Yep. If the opportunity arises, maybe consider initiating a conversation with your manager about reviewing the current process. It also could be the patient happened to have a decline in condition concurrent to the medication increase. Sometimes family is not in a place to accept decline in condition and react aggressively without consideration of the patient's wishes and/or directives in place.
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