analee23

I think I have only worried about insurance once in my entire career with a little girl that had just come from another country and was diagnosed with a brain tumor. Luckily she came to a not-for-profit hospital that has something called "charity care" covering her costs until she can get coverage (which social work was there to help the family with). I absolutely love my job... we are a team that runs like a well-oiled machine helping each other out. There are times when I get frustrated with rude families, drug-seeking patients, and the like. But for the most part, it's great! I'd say the worst part is having to take care of abuse cases.. and just the emotions involved. I just couldn't imagine ever hurting an innocent baby and it floors me what people will do to these tiny ones. Had a really bad one recently, so I guess it's fresh on my mind.

Here are links to each of the nursing programs at the two Universities you mentioned: http://www.pace.edu/academic_psearch/display_program.cfm?School=NUR&Cred=BS&Maj=RN4&Location=PLV http://www.mountsaintvincent.edu/nursing/ It looks like Mt. Saint Vincent has an open house, that may help to clarify some questions. Hope that helps, Analee

Thanks everyone! I wasn't sure if the government would give me a visa, but I had a feeling that that was the case. I haven't gotten many details yet, so I was a bit worried that the visa thing wouldn't work out. It sure will be an adventure, if nothing else!

Hi everyone! My husband just recently got a job in Alice Springs with the US government. We will be moving in November, so I've got a bit of time. I contacted the NT board of nursing and they sent me a big packet to fill out. My question is that it says I must have a visa before I can fill out the packet to get a job. Am I looking into this too soon? I've looked into the hospital in Alice Springs (I'm a pediatric ED nurse currently and have NO adult experience) and their pediatric department is hiring nurses and will ONLY accept an application if one already has their NT license.... so basically, I'm stuck, how do I get a visa without the hospital sponsoring me? Any advice would be much appreciated. And yes, I know there's nothing in Alice Springs and that we're crazy to move there, alas, it's a good job for the hubby. -Analee

My husband just got me an Under Armour watch that does both digital and has hands like a traditional watch. I just looked it up so I can post a link and it is quite pricey, but I LOVE it. It has withstood nastiness in the ER and I've never had trouble with it. Plus, it tells me what day of the week it is, which can get confusing at times! http://www.underarmour.com/shop/womens/accessories/pid8797216-Women-s-UA-Coach/8797216-675

I would confront her if I were you, in a very nice way. Just let her know how her comments made you feel and so forth and document EVERYTHING. Document what was said, what date, etc. If everyone has had to deal with her, the manager must be somewhat aware of the problem. Documenting her behavior can help you out as it will show that the problem is ongoing and not improving despite your efforts. You should copy your documentation and give it to your manager if the behavior continues. This will show her that your coworkers behavior is a major problem. By doing so, it may help in either her termination or one-on-one counseling with the manager to improve her behavior. I had to do something similar with a tech that was being very verbally abusive to me, he has since changed his ways. He still works on the unit, but is now a pleasant person to work with. Hope that helps!

Hey! I figured I'd answer the rest of your questions. The two offices I worked in, we weighed the babies naked, no diaper. I haven't seen weighing WITH diapers except in hospitals where we are more concerned about medication dosing than measuring weight gain. With adolescent physicals, parents stay in the room with the patient until the doctor is ready to do breast/testicular exams. These are done on the older adolescents. I have even seen a few doctors do pelvic exams on sexually active adolescent females. If this is done by a male doctor, a female nurse or medical assistant must be present during the exam. And STOP worrying about them being stupid questions! When you're new to a field, it's totally natural to have a lot of questions. No one would think that your curiosity because you're stupid. I LIKE it when the students I'm working with have a lot of questions, lets me know that they're thinking and not just going through the motions.

I've worked in two different pediatric offices, so I don't have a whole lot of experience with this, but the scenario was the same in each of these offices. For younger children, say younger than 12 or so, they stayed in their street clothes. Once the kids were older and starting puberty and so forth, they were changed into a gown with a sheet to cover their legs. I know not all pediatric offices have their kids change, it just makes it a little easier in some ways for the doctor to examine the patient. I'm sure there are doctors out there that don't do this.

I'm not saying bounce-backs are bad... I'm saying that we should try and meet needs so that they aren't forced to bounce back over and OVER for the same complaint that should have been met on their first visit, or from misunderstanding of discharge instructions. I want to make sure these patients get what they're looking for and clearly understand their instructions. A mother comes to mind who came in on 4-5 separate occasions for a child that had nothing more than a bad cold, kid was fine, eating great, but she couldn't figure out why the kid still was sick. It was clearly a lack of teaching and understanding. OR, the kid that slips through the cracks and comes back barely alive because no one followed up properly or explained what they should return for. THIS is why I am doing this, I want to help these families. It's not a frustration thing. Just wanted to make that very clear. I often am not quite as eloquent as I like and say things that get misconstrued pretty easily. It's a curse, really. sorry for the misunderstanding. yes, we have used something similar to press-ganey and our scores are generally pretty high. It isn't press-ganey, it's something else, but very similar.

Oh, no, no, no is this just for satisfaction. I'm looking at improving patient care. I want these people to get what they need so they don't bounce back time after time after time. :) Now THAT'S something I'd volunteer for! Well, that and catch those patients that really shouldn't have gone home and need to come back.... NOW. thanks for the response though!

Hello! OK, so I've been out of work for almost 2 months now because I had foot surgery and want something to do work related, so I offered to do some research, etc, for the unit. I work in a Pediatric Emergency Department that has been open for about 2 years now. I am looking at developing a questionnaire for follow-up phone calls made by the nurses on the unit. This is NOT for numbers... this is for patient satisfaction, making sure they get the care they need. Well, my questions are: Do you do telephone follow-up in your unit? Is this useful? What types of questions? And what institution so that I can maybe call and speak to your PCD or somethin? I'm not sure which direction I'm going or even what types of questions to ask. I think it should be a mix of clinical and patient satisfaction to make sure the patient is doing OK and that they were happy with their visit all at the same time! Any help would be GREATLY appreciated. thanks for your time! Analee

I really had to stop to get some groceries as the DH was coming home the next day and there was nothing edible in the house. Stopped at the grocery store, wandered aimlessly throwing random things I thought he might like into the cart. Got to the line and for some reason still had my ID badge on. So, I was going to pay for my random purchases and kept trying to swipe my time clock badge in the card reader! I was getting so frustrated, FINALLY the teller asked if I had a debit card... then I realized what I was doing. I'm sure she was trying not to laugh. Oh well.

WHOLE family, grandparents, parents, aunts, uncles come RUNNING down the hallway carrying 6 month old baby... frantically come to triage window and state, "the baby hasn't smiled in an hour and he is ALWAYS smiling." Very hard to keep a straight face for that one! 20 something man comes in with chief complaint, "A tick bit me on my butt and I pulled it out but I think I might have lyme dz. No signs or symptoms but a "friend" that was in "medical school" told him he should go to the ER at 2am to "make sure". Kid got bit by a snake, mom CAUGHT said snake and proceeded to show it to the triage nurse. Small garden snake quickly escaped and slithered all over the ER before security managed to catch it! THAT was an exciting night. And, child comes in after being bitten by a baby skunk. When asked about said skunk mom states, "it was so cute and so trusting of people, we just loved playing with it!" That's right, mom played with it too. Skunk died of rabies (imagine that) and now mom and child need rabies vaccines! UGH, why WHY would you play with a wild animal that was just "so trusting of people!"

In my pediatric ER it's PALS and ENPC. We are not required to have ACLS, although many of the nurses do. The reasoning behind not having ACLS is that we are a trauma hospital, our ER is attached to the adult ER, and children 16 and up are considered adult traumas, so the adult nurses take care of them. Adult nurses care for these teenagers ONLY if they are a trauma (meet the guidelines)... otherwise we get them in our ER. Hope that helps.

You'll do great! I love being an ER nurse! Just remember: The ER works very differently from the floor. In the ER we like to keep em movin... figure out the problem and then Discharge, Admit, or Transfer! It can be quite hectic, and even a nurse with tons of experience needs to get used to the difference in flow... so just take a deep breath and know that it may take a little while to get the hang of things. Good luck! It's definitely an exciting, fun job! Analee

I thought I'd add a few... I'm quite a klutz myself, so have quite a few... here's a couple. When I was in nursing school we had one day that we could go and watch surgical procedures. This was quite cool because I had been caring for a patient with a brain tumor that was going to the OR. Very neat. So I'm standing there watching the neurosurgeon carefully dissect down, he's standing there with bone-saw in hand ready to cut into the skull, it's literally buzzing in his hand and my legs were getting a little tired from standing in one place, decided to move a little bit and tripped over the cord that went to the light mounted on his head, unplugging it, the surgeon says, "Uhh, LIGHT please!" I was so embarrassed, but luckily he wasn't sawing at that point! Another more recent one, I was taking care of a critical patient in the ED, taking patient to cat scan. Patient is intubated and on a vent, so we were bagging on the way to CT. So we get done with CT, hook pt. back up to O2 under the bed and everything, get him all packaged up and start on our way back to ED... his sats slowly start to drop and then PLUNGE! I'm freaked, but luckily have a second nurse, start running down the hallway with pt to make it back to room, loose BOTH of my shoes, causing me to slide into wall thus causing my body to crash into the wall, luckily just kinda graze the wall with the stretcher... but there's suddenly blood everywhere... I sheered off the IV tubing, not sure how I did it, but I'm freaked, we rush the kid back... I now have wet socks from IV fluid and blood, get him all hooked up... turns out I forgot to turn the O2 tank on.... yah, not my finest moment, but he was OK.... luckily! My co-worker that went to CT with me was not impressed, but nice enough to get my shoes and a pair of hospital footies... I now carry a spare pair of socks to work... I'm THAT special!

I know this is a bit off topic, but thought I'd share. I am currently self-administering Lovenox SQ for prophylactic treatment for DVTs (I had foot surgery and have a clotting disorder). Well, when I first went to give myself the shot it burned like CRAZY. I asked my mom about this (she has rheumatoid arthritis and gives herself shots all the time... enbrel I believe) she said that you should warm the syringe in your hand for about 10 minutes prior to administration and inject VERY slowly to avoid the burning sensation. This works like a charm for SQ injections... including lidocain/xylocaine. My mom always says that the dentist does the "painless shots" before procedures and that she got the technique from him. Gotta say, I'll remember that in the future when administering SQ shots!! For IM, I jiggle the muscle a little with my hand right before giving the shot... seems to help with pain as it forces the person to relax the muscle. I'll need to try the slap technique, haven't heard that one before!

Femur fractures can be tough for kids. Before surgical intervention, these kids are often put in traction. When kids are in traction, it can be hard to keep them in the right position so that the weighted traction will be doing the right job. One thing I used to do with these kiddos is to make it a game. Make a line on the sheet and say, now you have to stay above this line and offer a lil prize (I carry small toys and stickers in my pockets) if they are able to do it! Works some of the time for certain age groups. Good pain control is also quite nice BUT, hey... there ya be. Hope that's helpful! Analee

I work in a Peds ED and we are encouraged to dress up. But, as many of you have said, it must be easily removed in case of a bad code. Last year I dressed up as an angel with giant wings and a halo. The kids loved it and it was very easy for me to remove. Another nurse was a pumpkin with suit and all. She could easily slip the suit off in case of a code. We had a good time and the kids from the children's hospital had fun "trick or treating" with us!

Thanks Daytonite for the tip! I have had veins blow after pulling out a clot like you said. It's usually when the peds floor is full and we're holding them for a few extra hours. But maybe I'll try your technique now and save them for a little longer! Again, THANKS, good info and very useful! Analee

I work in a pediatric ED and it is common practice to place saline locks. The rationale is, if the doc wants blood work... why not put an IV in to save the child from more trauma?? If the vein blows and we're able to get all of the blood work, we often will wait to see before sticking the kid again. It's kinda nice to be able to draw blood, wait for results... results show possible bacteremia and being able to administer an IV antibiotic without having to stick a kid again! We do have problems with clotted off lines once in awhile as we use saline locks as well. This usually occurs with a transfer from another facility (we're a level 1 trauma center). I just unhook the IV tubing or whatever may be attached to the hub, use a BLUNT TIP needle with syringe to pull the clot out and then flush the line. 75% of the time this works and saves the kid from extra trauma. If it doesn't flush easily after pulling a clot out, I never force it, just pull the line and re-stick. Having the parents watch you carefully try and pull a clot out always helps them realize that you're doing everything you can to save their child from extra trauma as well. Hope this helps! Analee

We use IOs frequently in my pediatric ED during code situations. The thing that bugs me about them is that it is pretty dang easy to dislodge them! Often when the medics place them, by the time they get to us, they've infiltrated. The MAIN thing to remember is that you have to push the drugs and fluid a little slower than you would with IVs. Still works quickly, just gotta be a little more gentle! Also, takes a bit of umph to place, but once you're in, you'll know it! Not my favorite way to administer meds, but works just the same!

The school I went to had a pretty high pass rate, but wasn't easy to get into. My class started with 50 students and when we graduated there were still 46 there. I think 2 of the 4 students failed the first med-surg class (med-surg 1). 1 failed the Critical Care class and 1 failed L&D (I think, can't remember). Anyhoo, the reason my school has such a high pass rate is that it isn't the easiest to get into. With no wait list, you have to have very good grades... The interview process also requires letters of recommendation and a written, timed, exam... So, maybe that's why the pass rate is higher. Not sure, but there ya be!

I work pediatrics and would NEVER EVER want to work anywhere else. I did a lot of pediatric-oriented things during nursing school to ensure that I'd be able to do kiddos right out of nursing school. It was well worth it! Currently I work in a Pediatric ED, a great great place to work in my book! Best of luck... and yes, there are people that love their jobs in nursing. I certainly do! But we do ALL have rough days, and that's what we tend to focus on on this website... mostly because we need advice/commiseration/etc. for our bad days. But, our good days give us a smile and help us sleep well knowing we made a difference in someone's life. Best of luck on finding your niche! Analee P.S. Just re-read your post and would like to add that I knew I wanted to work peds because I love to play! Kids are so playful and say the funniest things. It is hard having to do painful procedures, but knowing you're helping them out is great.

I know this is random and may be a bit :offtopic: But, just thought I'd share. The other day we had two kiddos come into my ER (about 2 hrs. apart) with foreskin entrapment in the mesh lining of their swimming suits! It was a bit odd, and scared the little boys, but I must say, both did very well with it. Never thought that could happen, but there it be! Both kiddos said it didn't hurt unless someone touched the entraped part of their foreskin. Just a lil bit odd... not saying they should be circ'd, just saying a lil weird that that could happen.