RazorbackRN

As many have stated, it varies by state and by facility. Our Nurse Practice Act in our state will allow an LPN to access a central line, however, the hospital where I work will not.

You do know that fen-phen is two different drugs, right? It was the "Fen" (fenfluramine) component of the combination that was so dangerous and causing PPH, etc, and was pulled of the market. The phenterimine is still used today, and so far, has had numerous studies that deem it as a very safe drug. Go to youtube.com, they usually have videos about everything.

It is highly recommended to forego employment during school if you are able. I can believe that counselors would say that. Nursing school demands a lot of your time. It is also not flexible. They don't care if you are tired or behind on your work/studies because of a job. You are expected to eat, sleep, and breathe nursing. That being said, there are people who work and do just fine in school. I think it's all in where your priorities lie. I worked through all of my pre-reqs and up until my last year of nursing classes.

You are correct. I bet it doesn't happen much. I think the point here is, you maintain the most sterile enviroment that you can. I firmly believe that nothing is 100% sterile. Once it has been exposed to air, (regadless of negative pressure, etc), some microorganisms will contaminate the surface.

Why would they need to make them completely sterile? Unless you are needing the exterior of the syringe to be sterile, then it doesn't make sense and surely wouldn't be cost effecient. I would think it would be better to just draw up your saline from the sterile vial in a sterile syringe for the instances when you needs a sterile exterior.

Obviously, the plastic overwrap isn't sterile. The syringe itself isn't sterile either, because it has been placed in only a plastic overwrap which isn't a completely air-free seal. However, the internal contents of the syringe (including the plunger, NS, and the inner surface of the syringe) are sterile. If you look on the Kendall website, (which is the co. that manufactures Monojects), you will notice that they guarantee sterility of the fluid and the fluid path. The same is true for the BD brand according to their website.

I'm not familiar with your exact practice, however, I will say that we frequently use an Insuflon cath for Lovenox injections (basically the same concept, sm. butterfly like used sub q). Our pt's still complain of the burning sensation...

Gosh, I love trach care! I know, that's gross, but I really love getting that cannula clean! The brush is primarily used for the outside of the inner cannula and around the lock hub. The pipe cleaners are for inside the cannula.

JCAHO surveyors (entry level may be MSN though, I'm not sure)...I think this would be a totally cool job.

The term bolus doesn't have anything to do with the amount of time the infusion is administered. It has to do with volumes and doses and means giving a specified amount above and beyond, or in addition to, the current amount. For example: Bolus 25 ml of 25% Albumin over 30 mins for CVP.

Your legal, professional title will always be RN, whether you are a DON, Clinical Assoc., or whatever. You can check with your state's board of nursing, but I know that in most states, if you are functioning in the role of your professional title, you are required to use that title. If they want to add their title then so be it, but only after RN is identified. You didn't pass boards for NCLEX-Clinical Assoc., it was NCLEX-RN.

Just FYI, that's not a HIPAA regulation. Some facilities have internal policies regarding disclosing diagnostic information prior to MD to family notification. However, this is not related to HIPAA, this is due to professional liability issues and the possiblity of miscommunications.

Just in case you haven't figured it out yet, when you post on a public internet website asking a question, you are going to get multiple responses. People also tend to provide their reasoning behind the answers. Also, some people are kind enough to also remind one to take x,y,z into consideration, as many people's level of skill, knowledge and experience differ. Perhaps if you do not want multiple, varied answers, you should perform the research for yourself or ask a colleague.

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That would be because they "don't know how" to answer it... For such educated people, some of them are real dummies.

Personally, I think you sound like you're on a power trip. Get over yourself and give these aides some guidance rather than being the "postal" nurse you have self-described.

i also thought careplans were the biggest joke, but once i graduated and started working, i realized how well those careplans had help me prepare to think critically. a few years later, i still remember the pain of the work, but i also still reap the benefits. ( i can't believe i just said this)

I think a lot of it depends on the parent and the enviroment. If we admit the kid to the hospital, of course we let them go to sleep. We just really watch the neuro status closely by waking them frequently for neuro checks. If the kid is not going to be under medical supervision or is at home, we do tell the parents to keep the child awake. This is not necassarily because we're afraid something bad will happen if the child sleeps, but because parents would be much more likely to notice a neuro change in a child who is awake, rather than just attributing the decreased LOC to the child being asleep.

nevermind

22ga PIV placed in L hand x 1 attempt, + blood return and flushes without resistance. Secured with tegaderm and tape, protective tent applied. Heplocked per protocol. Pt tolerated s complication. Will con't to monitor.

I used to be scared (more like intimidated) to talk to them, too. I just started picturing them sitting on the pot or wiping their butt. I figure if they do that, they can't be that much above me.

One more thing - a little OT - in reference to this comment: "I still CANNOT believe that the pharmacist even seemed mad at the MONEY it cost when I wasted the patch.....(like it comes out of HIS paycheck??) " Ultimately, it does come out of all of our paychecks when we are wasteful.

Well, personally, I would've changed the patch. Mainly because she came from another facility and I don't like continuing a medication that I, or my colleagues, @ my hospital didn't initially administer. This is completely a personal thing, nothing else. Just curious though, if the pt was lethargic, why was the Norco administered?

Also, remember that writing doesn't have to involve a pen and paper. Writing is also expressed via emails, texting, and other electronic communication methods.

I agree 100%. Our hospital also does acuity-based staffing and I truly believe that is why our pt loads are so reasonable. Of course, the RN for the pt actually assigns the acutiy levels (not a manager who hasn't cared for the pt), so I'm sure this is a big reason it does work well.