hajordan

You can't care for anyone else if you can't care for yourself, right? Just think the patients were better off without you being there sick. I always feel guilty, but you can't be a martyr for your patients. Don't forget to take care of yourself too.

Hi everyone, I am currently doing my post grad diploma in critical care and I need to focus on an episode of care I gave of a cardiac patient. This particular man had been diagnosed with dilated cardiomyopathy, and was prescribed the appropriate medications and follow up. However, he decided to go down the natural remedy route (I'm struggling to write this without any bias!) and consequently he ended up in hospital in end stage heart failure, and required a dobutamine infusion. (Don't get me wrong, natural remedies do work, I just wish he'd picked another part of his health to try it out on...) Has anyone come accross any good journal articles that would reflect that kind of refusal of treatment? The only articles I'm able to find are in regards to Jehovas' Witnesses, and if possible, I'd like to stay away from the religious belief reason for refusal articles. Thanks!

I feel like you just spouted out all of the things I am feeling! Cardiac, severely understaffed etc. I have made a big decision in the last few days, I need to leave. I feel after 5 days off, I am still not sleeping right, and I am anxious all the time about work. I haven't stopped thinking about it. And I'm so tired/depressed/angry that I worry it's starting to really impact on my relationship. Not to mention how awful I feel myself. Would you ever consider being a Cardiac Liason Nurse, or go into educating the new staff? After 4 years, you must be a mine of information. This is my plan anyway. Nicer hours, less pressure. If this doesn't work out, I'm going for plan B. I'm gonna be a florist. Who wouldn't want to go home smelling of roses?! Take the plunge. Even if you're bored, you're not running yourself into the ground. Work is NOT worth killing yourself for. Good luck!

Would the purely cath people rotate into EP every now and then? Push then into a different environment, their attitude might change. You unfortunately can't force mutual respect, you can only give it a helping hand. Putting them into each others shoes might be a step in the right direction.

So you would pull both together, and not pull one, tie purse strings, then pull the other, tie those purse strings?

Ah ha, see here's where it might differ for me then, MendedHeart; I am an Australian nurse, trained and registered in Australia and worked for a couple of years before moving to Ireland and working there now. We removed chest drains in both places. Unfortunately there is a lot of literature referring to the removal of A drain. But none of removing more than one. We also removed femoral sheaths post angio too back home. I never got around to up-skilling myself to that, maybe when I move back.....and getting published on something would be great....just need to find something unique. Maybe this IS it!

It's a nurse-led procedure at my hospital, and on the rare occasion, the consultant may do it if he feels he put them in in such as way that may cause damage as they come out. So it falls to us to make sure we're doing it right. Maybe it's just my preference to do one at a time. I just would've thought there would be a bigger risk of pneumothorax if you are pulling them all at once. Maybe I'm worrying too much :)

There's my problem. We don't have a library, and any online access I'm using through my college. Our hospital is fairly new, so we're working through policies and procedures now. But does anyone have any ideas about whether it's one or two at a time?

Hi Rose_Queen, thanks for the suggestion but our policies...If I can find it.....are usually fairly poor! I just can't find any literature to tell me one at a time or not. I'm also compiling a new education pack for new staff and this I think will be a bone of contention!

1 inch?!? Unless he has a very LARGE fissure, that sounds ridiculous.

Hi Christy1019, Yes, I've seen it a few times myself, and the idea is to use it sparingly, because quite rightly, syncope and hypotension is a risk! And lol at the women mixing up the creams. A bit of an ewww too at that!

Vodka T PRN nocte. He was a geriatrician. On reviewing the second patient that day, he tried to prescribe it for her too! Apparently to stimulate the appetite. I suppose I get a bit hungry after drinking a bit of booze!

Hi All, I was working yesterday and was helping a collegue pull out 2 chest drains. He wanted to do both at once. I wanted to do one at a time. I would have assumed one at a time would reduce your risk of pneumothorax, but I can't find any literature on this.....or even on google!! Which is correct? Thanks! :)

Was pseudomonas what I could smell? OMG it was bad. Thank god we managed to discharge that one!

Urine. It just gets up my nose. And I think it's evaporating so it's some kind of sick urine steam. UGH. And I've started to despise talking to families. In the last week, I've been yelled at 4 times. So naturally, this week, it's not a task I like at all.