Hope888

Hello again fellow nurses, Happy Nurses Week! So I asked my co-worker this the other day and turns out I was right -- apparently, we DO see vag moms come to us in PP with foleys, especially if they had an epidural. I asked what they do with the foleys when the moms push, and she said apparently L&D will just deflate the balloon when mom pushes. I find this such a strange practice because there still could be urethra trauma even with the balloon deflated.

I'm sorry, I'm a new grad nurse and just recently started on this unit and now that I think about it - I'm not sure if I'm mixing up my c-section and lady partsl moms. I know that almost all our c-section moms come to us with foleys, whereas it's not always the case for lady partsl deliveries, esp if they are midwife patients then midwives usually don't like placing Foleys. Having said that, I'm PRETTY sure I've had vag moms who have had epidurals come to us with foleys. I think the reasoning is because they are numb from the epi & can't get up to pee yet (altho I still think I&O are better). I guess I should also clarify that the mom I was talking about in this post- she had a vag delivery with EPI, and actually had a postpartum hemorrhage and had to get a D&C done so that is probably why she had a catheter.

Hello fellow nurses! I'm sorry if this is a stupid question. Last night my patient asked me why her urine in the Foley drainage bag would be bloody or pink-tinged if the catheter is in her pee hole (urethra)? To me, I never gave this much thought because they are bleeding so much in the postpartum period, and I figured the blood and urine could mix, but then I thought that she does have a point and if the tube is in her urethra up to her bladder, it wouldn't mix? I have seen pink-tinged or a bit of bloody urine/clots in the foley bags for our other PP moms and the other nurses don't seem to be concerned, so I just wanted to see what you guys thought. This has been confusing me! - Also, I wanted to ask you if you put in foley catheters for your PP lady partsl deliveries because I find it strange that we do it on our unit. I feel like other hospitals just do I&O which I agree with because it prevents UTI incidences and encourages ambulation. Thank you for your help.

Oh, that makes sense! I guess if someone sneezes on your face then you're getting a greater quantity of pathogens entering your system, but if it's on your clothes and then you touch your face then only a few of those pathogens may enter your system - which is not enough to cause an infection. Is this correct? Thanks for your help!

Hello fellow nursing friends, So I understand that contact precautions require us to wear gowns, but I was wondering why we're only required to wear masks/N95 during droplet or airborne precautions & not gowns too? I know that in droplet or airborne precautions the pathogens can be transmitted when a patient talks, coughs or sneezes and the secretions land into our nose/mouth/eyes, but can't the pathogens also land on our clothes, where we or someone else may accidentally touch our clothes then our eyes or mouths after? Thank you for your help!

Hello fellow nurses, I will be graduating nursing school this June and I've decided to apply to level 2 NICUs. I shadowed a nurse one day in Sunnybrook's level 3 NICU and decided it was too intense and sad for me. I would rather work with less critical babies as a new grad first. I was just wondering if any of you fellow GTA nurses out there could recommend any good Level 2 NICUs in the GTA area. For example, I have applied to Trillium Mississauga hospital's NICU, as well as St. Joe's Toronto Health Centre, but I've heard of horrible things about St. Joe's, which is making me kind of scared. I've volunteered and had placements at both Mount Sinai and Sunnybrook hospital and I know they're both great institutions, but unfortunately they're not level 2 NICUs. Thank you for your help in advance!

Thanks so much Jenny for your help! How did you like the level 2 NICU? I shadowed a day in level 3 and it was too intense and sad for me so I'm hoping I will enjoy the level 2 unit a lot more.

Hello Fiona, thank you so much for your insight! I really appreciate it.

Hello Fellow Nurses! I will be graduating nursing school this April and I'm planning to write my NCLEX this June/Early July, and I have been freaking out over finding employment. So I know I may get backlash for not wanting to work in the hospital as a new grad but please hear me out. I know that a lot of people recommend working in the hospital when you start out to acquire those "real nursing skills" which is a term I don't like to use, but I've had many placements in the hospital before and I know it's an environment that I don't necessarily enjoy or thrive in. I'm passionate about preventative/primary health and my dream job would be to work at a paediatric clinic and serve my community members. I'm just scared I'll have a hard time finding a job in a paediatric outpatient setting because I heard they want nurses who have acute care/hospital experience. Is this true? And for my fellow new grad nurses in the Greater Toronto Area, have you had any luck finding jobs in any outpatient/ambulatory settings? I'm currently looking at postings for outpatient paediatric clinics in hospitals, as well as any paediatric urgrent care or walk in clinics. I feel like a lot of paediatric doctor's offices don't hire nurses. I'm also willing to drive further for my job. I feel like the suburbs would have more opportunities available. I would also be open to family practice clinics as I do like to learn and work with various age groups. Although I prefer an outpatient setting, I also did apply to level 2 NICUs to open up more doors. I shadowed a nurse one day in a level 3 NICU and I couldn't imagine myself working there because it was really upsetting seeing all those sick preemies, but I feel like I would enjoy level 2 NICUs/special care nurseries more because it seems like a lower acuity environment. For nurses that work in a level 2 NICU, do you enjoy your job? Anyways, thank you guys so much for your help and support in advance. I'm so appreciative of this positive nursing community that we have.

Hello fellow Nursies! I am currently a second year nursing student, and I was really looking for some assistance regarding what kind of nursing field I should go into. So I am someone who doesn't have problems studying, reading books, and understanding concepts, and I have been doing pretty well in all my Nursing classes. The one thing I can't seem to get are the PRACTICAL aspects of nursing - aka doing procedures. Sometimes I feel like I'm just book smart and that I don't have any common sense. I think I am probably being a little bit hard on myself as the "hands-on" tasks of nurses do require experience and practice - but I have never really LOVED the practical tasks of nursing, such as inserting catheters, IVs, dressings etc. I feel like I really have a problem because I feel like that's what nursing is all about! Maybe part of it also is because I'm such a perfectionist that if I forget to do one little step, it will drive me crazy and I will always put myself down for it. I find what I enjoy most is being able to TALK to my patients, or to teach/guide patients. My main goal in nursing school was to become a Labor and Delivery/Post-Partum/NICU nurse, but I'm even starting to doubt that because I don't know if I'll be able to handle the stress, the constant charting, and all the procedures I'll be doing. I am also someone who gets stressed REALLY easily, so I was wondering if any of you guys would have any suggestions for me I've even considered community nursing as well, but I feel like I'd miss out of the aspects of mother/baby which is what I've always wanted to do. Sigh, I just feel so hopeless right now. I am so sorry for the rambly post, guys. I look forward to your replies, thank you so much in advance. Hope you are all have a great night/day. Sincerely, An anxious Nursing Student

Hello fellow Nursies! I had a question regarding blood pressure vs blood flow. I think I understand the main idea, but I have always been a little confused over this concept: So I know that vasoconstriction increases blood pressure, as the diameter of the vessel is smaller and so the blood will be hitting against the artery. However, what I'm confused about is this. So if someone was hypotensive, a compensatory response would be to vasoconstrict the arteries, as that will bring the blood pressure back up. But, doesn't vasoconstriction DECREASE blood flow, as the systemic vascular resistance is increased now, so I don't understand why vasoconstriction would be helpful if it decreases blood flow. Here are 2 reasons why I think vasoconstriction is important in this situation, and I would love it if someone was able to clarify if my thinking is correct: 1. I think that it depends on WHICH vessels are vasoconstricted. So, it would make sense to me that organs that are not critical (such as the skin and intestines) would be constricted so that blood flow could be re-routed to critical organs, such as the brain and heart. 2. I'm guessing that vasoconstriction would also be helpful in the case of a low blood volume because if the vessel diameter decreases, that would build pressure, thus forcing blood to flow, and at a faster rate - I'm most uncertain about this, though, so I would really appreciate it if someone could clear up this confusion for me! I guess I'm just confused about this whole vasoconstriction/vasodilation thing in relation to blood pressure and blood flow. At one end, I feel like vasoconstriction would increase Pressure, thus helping our blood to flow - but then if our vessels constrict, that would also decrease blood flow? It just seems very contradictory to me. Thank you guys for your help in advance!

Thank you for your reply MunoRN! That makes so much sense. That's nursing for you I guess, there is never really a clear-cut answer, as everything can vary depending on the situation and the patient. However, would it be correct to say that the rationale for TKO is to keep the line patent from blood clotting, esp since we just administered blood that caused a reaction would it tend to make the blood clot even more?

Hi Everyone! I'm currently a nursing student and we recently just learned about blood transfusions. I kept reading about how after the patient has a blood transfusion reaction, you should "Keep the vein open" with normal saline to maintain IV access in case we need to administer an emergency medication. I don't get how running normal saline at a slow rate will maintain the IV access, can't you just insert the new IV but not have the saline run, or at least just do a saline flush? Does the continuous saline infusion just wash out all the clots? Thank you for your help in advance!