StacieRN

Do you read it back to him? That usually causes them to realize how inappropriate they're being.

Or: Ok, I charge an extra $10.00 an hour for maid service - CASH and in advance!

Female here. I had some adhesions due to radiation and was given Flomax to try to increase output - I was down to a dribble. Didn't work for me though. I had to be cathed and keep a cath while the adhesion area healed.

Love it. Very enticing. I appreciate how hard you work to get the medical details right. I really hate when I'm reading a book and wrong information jars me out of the story. Kudos!

Very nice imagery. A few things though: A newly trached pt has to be taught to speak. And they can't speak while hooked to the ventilator. For speech to happen, air must move over the vocal cords. While connected to the vent, air exits before that happens. The vent will be unhooked (after a breathing trial) and the end of the trach tube will be capped or the pt will be taught to cover the end of the tube with a finger when speaking. Next: if this patient has been in a coma long enough to be trached, she will NOT have restraints on. They would be unnecessary. She was comatose - i.e. not trying to pull tubes out. So upon awakening she would probably reach up and pull the vent tubing away from the trach in confusion. Thus setting off the vent alarms and bringing your nurse running to reattach it. I do agree that the nurse would do pupil checks almost immediately after re-attaching the vent (usually while updating the pt on her condition).

A TLSO (thoracic lumbar sacral orthotic) brace should be worn whenever pt is upright. Pt should logroll from side to side as brace is placed and fastened. Only then should pt be allowed to raise from being flat. Once in the brace, the pt may sit, stand and walk. The brace is custom made and fitted and should not be adjusted. If the pt is uncomfortable, have the orthotic specialist come out for a re-fitting. A shirt should be worn under the brace to protect skin integrity. The brace should only be taken off to sleep and should be wiped down after each wearing to prevent bacterial growth and smell (using mild soap and water or alcohol). The pt will usually have to roll to the side of the bed and put their legs off then push up with one arm to rise from the bed. When sitting, the brace should not be pushed up by the thighs, but remain in place. Ask for a re-fitting if that happens. It IS possible to move so as to twist/turn the spine while wearing the brace. The patient should be reminded to avoid doing this. Depending on severity of injury and pt's healing, the brace is usually worn 8-12 weeks.

Additionally: Depending on policy at your facility, pt may need to be on bottled water only. If that is the case - no ice (ice machines possible source of bacteria.) Limit sticks. Make sure pt has soft toothbrush or switch to toothettes. No straws (may cause gums to bleed and introduce bacteria.) No alcohol based mouthwashes. Absolutely no children around. If antibiotics are ordered on a neutropenic pt, always consider these orders STAT. No visitors (or staff members) that have had a live vaccine in the last month. No tampons. And no blue cheese dressing (it contains live mold).

But, of course, according to the National Quality Forum, falls are never events. I tell you, if anyone figures out how to keep all of these health care monitoring agencies happy with their wildly differing agendas....that person can count on an immediate nomination for sainthood (having performed a miracle of the highest order).

I agree with sending the patient to the hospital and then not accepting her back. If your facility director will not agree to this, I would have her notify the family that they must provide home health aides around the clock who will be responsible for the patient's toileting needs as your staff are not trained to do this and it is outside of their job description. I would have them sign a statement saying that they had been notified of this and after 48 hours you would no longer see to her toileting needs. At the same time, I would give a 30 day move out notice. Hopefully these provisions would get the family off their duffs and make them take care of this.

My grandmother's cure all is Vaseline. If you have an arthritic limb or sprained joint. She spreads .the pain away within an hour. By the way, the only food that doesn't spoil is honey. There have been pottery jars of honey found in the pyramids that are perfectly fine (well, a little crystalized). My grandfather raised pigs. The local grocery store would give him all their spoiled meats and produce for the pigs. If he thought it wasn't quite spoiled yet, he'd bring it home and my grandmother would cut of the bad bits and cook it up. Then the leftovers would stay out until supper and they'd eat them then. I guess their stomachs were made of cast iron, because it never bothered them.

Unless they give you a PAID lunch, they cannot legally prevent you from leaving during lunch. They CAN require you to clock in and out to make sure you're getting back to the facility in time. I used to work nights. (also no cafeteria) We'd get together and decide what we wanted to eat and one person would go out to pick it up.

Stomach acid will take care of most anything picked up from a surface that is not obviously dirty (if the oral and esophageal lining is intact). So, yaeh, I'd have done the same - and have.

Honestly, I feel that being a nurse made me a better patient not the other way around. Knowing what the nurses were going through helped me understand when things didn't go exactly easy or quick.

Agreed. If management really wants good customer service, They should hire staff specifically to address these needs (wants). We really have our hands full NURSING. When DID it become our job to tend to housekeeping, dietary, clerical, social work, television repair, etc anyway? Not to mention becoming our patient's social secretary and visitor traffic monitor/director? Because it was never covered in school, on the Board exam or in my job description.

I don't know. I'm off work now because of cancer. I'm in remission now and hope to be well enough to return to work soon. I'm paying close to $400.00 a month for COBRA. Everyone keeps telling me to just apply for Medicaid. Also, have been on me to apply for SSI disability. I'm not permanently disabled. I think it would be an abuse of the system and no one gets that. So my family keep telling me THEY"RE tired of worrying about my financial situation and I should apply for benefits. SIGH!

Just a few things. I do believe in charity. I mention in my post that I give to needy programs. I just think I should be allowed to have the right to choose which charities. I think the deserving poor, aged, children and invalids should be taken care of. But not by the government. That's not their place and they don't do it well. As a Christan, I think the we, the people, should take over that responsibility on a local level. People should take care of their families and neighbors. People should be responsible and take care of their elderly relatives, help out their neighbors and fellow church members. By the way, in my family, this is how it is done. None of my grandparents, or great-grandparents died in a nursing home. I'll be dead before I allow my parents to go into one. I am a single mom (as I mentioned). My family helped me care for my son and shared out babysitting. I am a grandmother now of a beautiful 3 week old baby girl. I will be sitting with her when her mom returns to work. When my cancer was newly diagnosed. My sister quit a nursing job four states away and moved home to take care of me while I needed it. As far as having the right to life, liberty and pursuit of happiness but not the means, welfare programs are not the only way to fix this (or the best way in my opinion). I think that the minimum wage should be increased and that the government should rein in inflation. If our taxes were lower, then we could afford to support ourselves instead of relying on the government. I think that anyone who's willing to work should make enough to be able to support themselves, their family, provide for their medical care and their retirement. I am a compassionate person. I am a Christan. I love being a nurse. I like taking care of people. But the only person I took on to raise and support was my son. Anything else should be done out of my own heart. Not because it's mandated. Just my opinion. Which, like I said, I am entitled to. I have not criticized anyone else's opinions. Just stated mine.

Had a lol with a hip fracture. Was flat in bed but she thought she was standing up. She kept calling out to us all shift long - begging us to help her lay down. After several hours of this she started getting ****** off and told us were were sadistic SOBs for not letting a hurt old lady lie down.

Before anyone reads my post and thinks I've never been unfortunate, let me say at 22 I was a single mom with an ex-husband who wouldn't pay child support. My parents never paid a penny of my college costs. And lastly, I was diagnosed with cancer in December 2005 and had to quit work because of it. I used to be very liberal and think we owed it to make sure everyone had health-care, that veterans were taken care of, that people had enough to feed their children, etc. That as citizen of the richest country in the world American's had the RIGHT to be well fed, housed and healthy. I've mostly changed my mind. I believe that: People have the right to have ACCESS to health-care. Not to have guaranteed health-care. If I had to work my butt off to get an education so I could have a job that provided insurance then I don't see why others should get it handed to them. People should be responsible for their OWN children. If they couldn't afford them, they shouldn't have HAD them. I managed to provide for my kid and I had enough sense to know I couldn't afford anymore. (To this day my son regrets being an only child but I know I did the right thing) Veterans were PAID for the job they did. We owe it to them to take care of any injuries they incurred serving their country and that's all. (Monetarily speaking that is. We do owe them gratitude but nothing else) This is America. No one is preventing poor people from improving their lot except themselves. I was the first college graduate in my family. I WORKED my way to a better life. I feel we owe the elderly respect. I do not think they have a RIGHT to medications they cannot afford or health-care they can't pay for. By paying into the social security system they have a guaranteed income at retirement. They didn't pay for free health-care. Health-care workers DO have the right to be paid for services rendered. Many put themselves in debt and all worked very hard to better their lives and shouldn't have to have their services devalued. To everyone who is talking about rights. Go read the Constitution and Bill of Rights. I have. Nowhere in these documents are citizens guaranteed health-care, money to help out the poor, or a retirement income. A citizen has the right to life (no one promised it would be long or illness free), liberty, and the pursuit (not guarantee) of happiness. NO right to health-care, food, housing or retirement income!!! I also have yet to find any passage in these documents that gives Congress the right to tax citizens for the purpose of providing charity to others. Nor to tax us to make sure our retirement it provided for. I should have the right to decide what percent of my salary I want to give to charity, if any. Also to decide to whom I want it to go to. I DO give to charity. But I research to make sure my money is not wasted. I want it to go to the deserving. I want it to be used wisely. I want to have the ones it is going to appreciate the fact that my hard-earned money is being given to them. And I expect thanks and gratitude in return for the GIFT. Right now, congress takes my money and I don't get a say in who gets it. I've seen welfare recipients that drive better cars than I do and have better clothes. The Medicaid and Medicare system is very mismanaged and wasteful. I frequently see people receiving government entitlements that are rude and ungrateful. I see patients and families on Medicare/Medicaid waste health-care dollars by demanding tests, procedures, medicines and hospital stays that they would not want if the money were coming out of their own pocket. I DO NOT *OWE* ANYONE *MY* MONEY!!!!!!! I know that a lot of people are going to disagree with this rant. Twenty years ago I thought differently. I respect everyone's opinions and their right to voice them. I ask the same courtesy in return.

I am addicted to medical blogs. A poster quoted an ED patient and my tongue about dropped to the floor. This is what the waste of air said: "I get a goverment entitlement. That means I am entitled." HUH?!!!! :trout:

If you are not short on time, the easiest was that I have found is to insert the tube until it hits the back of the throat. Hold it LIGHTLY. Wait and as the patient naturally swallows the tube will get tugged down the esophagus. You can try to rush this by giving drinks of water. I really prefer not to though. Sometimes the patient chokes. And you have to keep track of the cup, straw, and/or spoon while dealing with the NGT. (TOO MUCH TROUBLE) It's just easier for me to wait until the patient swallows naturally. The upsides of this method are that as the esophageal muscles are doing the inserting and that the airway is sealed off while swallowing - you always get into the correct place. And you can use this method while the patient is prone. Best of luck!

I had advanced cervical cancer. Chemo and radiation. At the time, I was working ICU. My doctor told me I needed to go on disability leave. The chemo regimen I was on didn't make me feel bad. I was neutropenic for most of the time though. The radiation, however, totally exhausted me!!! You didn't say what kind of clinic work. If you work in a specialty clinic (like GI or Neuro) it may be perfectly ok to keep working. If it's general practice, there's a lot of germs floating around. It may be safer to take time off. I agree that you might want a second opinion - it never hurts. If your doctor is a good one he shouldn't be offended. Hugs and prayers!!

Ortho docs rely HIGHLY on nurses. When I worked ortho, the hospital call light system would track call light usage monthly. The ortho unit consistently would have more than double the volume of calls as other units. Ortho patients have a lot of pain and having a appendage that is impaired means you need a lot of assistance. Patient satisfaction depends a lot on prompt response to calls. Which necessitates good staffing. Thus, to keep their pts happy, orthopods depend on us! I found they were usually much more pleasant to nursing staff than other surgeons.

Hansen's (Leprosy). Fairly rare in the US. Most new cases come in states with large immigrant populations (Calif, New York, Texas, Mass). Also appears endemic in Louisiana, oddly, which is not noted for immigration pop. Very sad case. It was not discovered in her until late. Most US docs don't see it enough to recognize. ................................................................ Rocky Mountain Spotted Fever. This one had a dx of FUO for a few weeks while everything else was ruled out because symptoms are so vague and pt did not know he had been bitten by a tick. ................................................................ :bby: GrandBaby girl born 1/15/08!!!:redpinkhe

Received an automated response a few minutes after sending the email: ........................................................................................................... Thanks so much for the email. Due to the volume of mail this may be the only response you see. While I do not always see it in a timely fashion I do try to read all of my mail. However, I average over 1000 letters a day and there is no way I can respond to most letters. I am glad you are listening and even though you may not see a response, I want you to know that I am listening as well. Thanks, Glenn Beck

Okay, I revised some and sent the following message to Mr Beck's email. on his site it says this: This is the general contact for reaching Glenn Beck. Please note that Glenn gets hundreds of emails everyday and while he does read them he does not always have the opportunity to answer them all. So he should read it. If I receive an answer I will post it. The email I sent read: Subject: Regarding your recent bad health care experience Body: Mr Beck: Take responsibility for your care. Participate! Ask questions, ask for explanations. Don't just assume nurses can read your mind and know what you need or what you need to know more about. Ask what medicines you will be given, what they are given for, what side effects they may have, how often should you need them, how safe they are, etc. If you don't ask questions, the medical staff is going to assume you don't have any. If you need help (i.e. a wheelchair) ask for it. If your doctor recommends that you stay overnight - stay. Your doctor had the responsibility to inform you of the amount of post operative pain you would be expected to have. Assuming the doctor knew about your past history of drug abuse, he should have informed you that it is often very difficult to achieve adequate pain control in present or former abusers. He also should have warned the anesthesiologist of the likelihood of your pain being very difficult to control because of this. Nowadays nurses are extremely busy and we prioritize care. If your nurse wasn't spending much time with you, that means you were stable and not in danger. If you were given a PCA, that means it was considered safe and you were expected to use it. If you were afraid of the side effects why didn't you tell the nurse and ask for further information? Monitoring your breathing after surgery is common. When you were allowed to leave the recovery area it was because you were breathing okay and was no longer necessary. If you can talk, you are breathing alright. Panicking about it just makes the feeling of not being able to breathe worse. If the nurse says you are breathing fine - relax. Your wait in the ER was because pain and bladder distension are not life-threating. Life-threating conditions are seen first. And just because the waiting room patients were "sitting down" does not mean their condition was not worse than yours. Nurses cannot take more patients than there is space available in the emergency room. Lots of patients are waiting for a test to be done, labs to be drawn, lab results to come back, a physician to come for a consult, etc. In those conditions the nurse can only wait as well. Nurses do have the right to socialize with their co-workers when they have nothing to do. Your doctor knew that your condition would not be a priority in the emergency room and that you would wait in pain. Calling ahead does nothing - you will not get seen ahead of a sicker patient. The doctor had the option of direct admitting you. You would have bypassed the emergency room and been taken directly to a hospital room. Any orders he wanted for pain control would have been started with no waiting. The hospital system that you vilified did the best they could (excepting the rude nurse in the emergency room). The doctors you praised so highly are responsible for a large part of your bad experience. So, don't assign blame without finding out who the guilty are. In this case - I'm afraid it was largely your doctors and YOU! Sincerely, My name and title here