jdub6

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All Content by jdub6

  1. jdub6

    Thinking of quitting after orientation

    jdub6 replied to Anonymousnurse's topic in Geriatric, LTC

    if this is rehab or skilled nursing and there is no lpn then that is way beyond the norm for staffing. For LTC with stable patients its still a lot but potentially do-able on nights depending on...
  2. jdub6

    advise needed

    jdub6 replied to pedsorbust's topic in HIPAA Challenges

    Had this nurse requested to opt out of the hospital directory? if so then you have a big problem. If not, then the actions you described do not actually violate US law. The fact that a particular...
  3. jdub6

    Anyone seen an MI from septic shock?

    jdub6 replied to Lev's topic in Emergency

    I haven't but certainly have seen varying degrees of ST depression with much much lower trop (say .03 to 1.5) that was ultimately resolved and attributed to the stress of the infection along with the...
  4. jdub6

    Unique withdrawal of care

    jdub6 replied to johosa12's topic in Critical Care

    I didn't see this while working icu but have had multiple hospice patients in this situation. Some examples: several cardiac patients on milrinone/pressors/lvads that were to be discontinued; a...
  5. jdub6

    Swallowing PO meds with NGT

    jdub6 replied to dvill2305's topic in Critical Care

    I've seen this in both peds and adult pts-think of the cancer patients who have home ng tubes for semi long periods of time due to weight loss. I have never heard of someone in that type of situation...
  6. jdub6

    Hospital & The Drug Screen: I thought they had to wait?

    jdub6 replied to cassimoo's topic in General Nursing

    Not saying this applies to the OP however this misconception has been stated more than once in this thread. As a matter of fact there are studies showing that people on long term narcotics like...
  7. jdub6

    ED nurses: What can a volunteer do to make your life easier?

    jdub6 replied to petali's topic in Emergency

    Help direct visitor traffic by answering some of the "where is the closest vending machine? " and "how do i get to the pharmacy/ icu/out to smoke from here? " and even "where is the waiting room? "...
  8. jdub6

    License info being sold

    jdub6 replied to #wontgiveup's topic in General Nursing

    Sure that one site only lists your name, license # and town. However, with your name and town one could typically find your address, phone # etc, which is typically public info. And with that...
  9. jdub6

    Hipaa question help

    jdub6 replied to Foxlern's topic in HIPAA Challenges

    Saying you saw or assisted with xx procedure or condition, with no other info, is not a HIPAA violation. My usual test for things like this is, if I were the patient and I overheard this...
  10. jdub6

    Patient death

    jdub6 replied to aspiringrn1987's topic in Geriatric, LTC

    Although it is certainly very possible that the leg swelling was due to clots, it is not the only explanation. Pt could have had afib or could have developed dvt and thrown the clot very quickly....
  11. jdub6

    Do males ever get to work in hospice?

    jdub6 replied to northmississippi's topic in Hospice, Palliative

    Definitely. They are great and many are well liked by pts/familes and great assets to the team. Note that in inpatient and continuous home care settings, where staff does a lot more hands on care,...
  12. jdub6

    Clinical Judgement Call...Not sure if I did the right thing

    jdub6 replied to AvaRose's topic in General Nursing

    You do know this is ltc we are discussing right? Not LTAC. The majority of LTC short term residents are admitted for rehab after a hospital stay. Long term residents are essentially custodial care...
  13. jdub6

    Ddavp with DI peds

    jdub6 replied to Pednursealoha's topic in Patient Medications

    Your way is the only way that makes sense. If the MD wanted it to be based on amount of urine per void the order would say "if voids over xx amount" or "over xx amount per void"...unless this nurse...
  14. jdub6

    omg...fish oil!

    jdub6 replied to beckster_01's topic in Patient Medications

    Well, in a pinch I have seen people give Colace capsules and Tesselon Pearles down feeding tubes by using a large needle to withdraw the liquid inside the capsule into a syringe and then either...
  15. jdub6

    Last days of life

    jdub6 replied to freckles23's topic in General Nursing

    I was going to mention something very similar but it looks like others have beat me to it! It's amazing how, despite working with very sick patients, we sometimes really don't realize when someone is...
  16. jdub6

    No dnr

    jdub6 replied to aphillipi's topic in Hospice, Palliative

    I am not going to respond to this whole post for many reasons. But for the clinical staff out there wondering about the legality of "required" DNRs i think this brings up a good point. As far as i...
  17. jdub6

    No dnr

    jdub6 replied to aphillipi's topic in Hospice, Palliative

    There is a difference between requiring pts to sign a DNR (illegal as far as i know) and requiring staff to provide an intervention like CPR. Some hospices have policies that pts may be full code...
  18. jdub6

    Reason for IV fluids

    jdub6 replied to Matt8700's topic in Emergency

    This drives me up the wall. A large majority of people who get fluids have no indication at all. One could certainly argue that many patients should have a lock placed, preferably with labs, but...
  19. jdub6

    How is like working in an SNF?

    jdub6 replied to Life22feb's topic in Geriatric, LTC

    A note on cheat sheets- TheCommuter posted great tips on what you may want to include. I personally preferred to use a census list rather than a task list. Depending on how mobile your residents are...
  20. jdub6

    Is this true?

    jdub6 replied to OyWithThePoodles's topic in Infusion, Intravenous

    So, with that said-and this is a serious question-where do you place your PIVs then? I'm assuming as an IV therapist you see plenty of pts with less than ideal veins. So take those same pts and now...
  21. jdub6

    What happens if IV med does not finish on time?

    jdub6 replied to umharhar's topic in Infusion, Intravenous

    In some areas (including mine) the infusion company will send a nurse to do pt teaching as well as manage the IV (restart PIV when needed, dressing changes on PICC etc). The OP could be a home...
  22. jdub6

    G/j tube spray

    jdub6 replied to Rnbc1234's topic in Developmental Disabilities

    This thread will probably be closed as per the terms of service we cannot offer medical advice. If you were exposed to body fluid at work you should seek medical advice and follow the exposure plan/...
  23. jdub6

    When is the right time to job hunt?

    jdub6 replied to gnurse2089's topic in Nurses Recovery

    One other thought, because you mentioned the medical community there is "small". You may want to talk to others in your program (at nurses meetings or wherever or even ask your case manager) and find...
  24. jdub6

    FirstLab

    jdub6 replied to GreenFeather's topic in Nurses Recovery

    I believe FirstLab uses Quest labs. Quest processes the specimens and around here most of the collection sites are Quest but there are a few other places on the list that will collect and send to...
  25. jdub6

    Am I overthinking this?

    jdub6 replied to rdsxfnrn's topic in Geriatric, LTC

    I don't have that much ltc experience and will leave the bulk of your questions to others. I can say that an ltc med pass will get MUCH faster as you get to know the pts-esp if this is true ltc...