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Y2KRN's Latest Activity

  1. Y2KRN

    Haldol IV??

    I say bring on the vit. H IV preferred!!! However any route will do!! Y2KRN
  2. Y2KRN

    When does it get better

    Hello, I just wanted to tell you that my thoughts and prayers are with you!! You have received good advice here and you are definately on the right track. It is soo hard to be a young single mother, I was raised by one! I am soo proud of my mother and I know that your daughter is proud and will always be proud of you. You have accomplished soo much in your young age. You have made it through nursing school a feat in half in my book and are raising your daughter. Most nurses have chosen nursing as a second career or later in life as I did myself. I don't know that I would have been able to handle nursing at such a young age. I am very glad that you chose nursing as a profession, we need nurses just like you. You will bring a lot to nursing throughout your career, and believe it or not you already do. I am always pleased when I see a young person in nursing, you bring a whole new perspective to the field, so don't sell yourself short!! Keep the faith concentrate on your daughter and yourself, the rest will fall into place!! I hope one day when I am ill, I will have someone like you looking over me and caring for me or my family. Let us know how things go!! Denise
  3. Y2KRN

    My son has Constipation

    Hello, My son is six and a half years old. He had a bowel movement on Saturday nov.15th. His x-ray showed that he was " full of stool" as the DR. nurse said. They did not do any lab work just the x-ray of his abdomen. They also checked his blood sugar because he had some ketones in his urine. I asked for a promethazine supp. The Doc said that she finds that really does not work after a child has Ketones. The Doc told me to try fluids first. I got home and my phone was ringing and I was told he was " full of stool" and constipated. The nurse said that he had a large amount of stool in his rectum and that is was going to be very hard for him to pass. She said now the Doc wants me to administer the suppository with a lot of vaseline on it and if need be do a disimpaction. I gave him the suppository and he had bowel movement without any difficulty about an hour later. He has not vomited since I gave him the phenergan, he is still complaining about his belly hurting and the thought of food makes him "weasy" he said. Now I know he pooped most of the phenergan out and but, some of the medicine probably was absorbed. I truely hope that it is just constipation. However he had only gone three days without having a bowel movement priior to the one he had last night. I was expecting the bowel movement to be hard for hime last night and it was not. Plus all the vomiting. His belly is benign, he says it hurts, but it is soft and supple and bowel sounds are hypoactive. His pain is not localized. Anyway, thanks for the replys!! He has a re-check at 10:00 this am. Y2KRN
  4. Y2KRN

    My son has Constipation

    Hello Peds nurses, I have got a question for you! My son has been vomiting since Sunday morning. He had a fever of about 101.1, could not keep fluids down. I thought it was the flu, so I gave him lots of tlc and fluids every hour ( even though he was wretching) Gave hime tylenol and motrin around the clock. Monday came and he remained afebrile, still vomited could not keep anything down. More tlc and pushing of fluids. Got up this am vomited first thing out of bed. Called Peditrician, got an appointment for 14:45, he remained afebrile for the day. Took him to the Doc. got an x-ray of the abdomen flat and upright. Results called to me at home. Told he is constipated. I am an ER nurse have treated many children for constipation. None ever had a fever. Could he have become constipated because of the fever and dehydration?? I must confess I was thinking he may have a small bowel obstruction, but x-ray supposedly shows it is in his rectum. I would think if the obstruction is that low the child would not vomit 5+ times a day, or about 15 -20 minutes after drinking water. I kept an ongoing assessment of him, he never became tachycardic, had tears, and was voiding a little less than usual. Blood sugars remained okay. Urine at the Doc office showed some ketones not surprising he has been vomiting for three days. I guess I am just not convinced it is constipation. This is a child who has a great constitution. He however has not had a bowel movement in three days. But, did have a normal one the day before he got sick. Am I just being too synical. Does a fever go along with constipatieon??? Any insights would be appreciated. I respect my colleagues opinions and experiece. Thanks Y2KRN
  5. Y2KRN

    Tired Of Abuse!

    Hey Speculating, That was a lot of extra work but, sounds like the outcome was well worth it for the child!!! You did the right thing!! I wish I could have had the warm fuzzies after my situation. I know I did the right thing for the little boys, but still to be treated the way I was, was awful. They have not complained as of yet so I will see what happens. I know that mom probably never followed up with a peditrician. I know I would do it again. However, I will have security with me the next time. Thanks for all the posts. It is nice to have support from colleagues!!! Y2KRN
  6. Y2KRN

    Tired Of Abuse!

    Hello Fellow ER nurses, I just have to vent!!! I am soo tired of the abuse we take as ER nurses. Here is the scenario, just happened on my last shift! Come in get report, have a patient little boy, six up for discharge after his bolus of fluids are infused. Told little boy had tylenol for his fever. Go into room, mother out smoking, father in the room, tylenol laying on counter not adminsitered. Fluids on the IV pole not attached to the prn adapter. No pump in the room, however some progress is made, buretrol tubing is primed and hanging capped off. Mom comes back from smoke break and has another little boy with her who is waiting to be triaged. I get him triaged his temp is 104.5, I agree to take on the child as an extra patient so we can keep the family together, charge nurse not happy. Then mother decides that she needs to be seen. Kids don't seem to be comfortable with Dad, Mom is the one who they want and the one who calms them. So, I go to the Doc. tell him that mom wants to be seen as well. I triage her and start a line. Again Charge nurse not happy but, works with me to keep family together. Now I have a seven patient load, and of course my trauma room is occupied. One child has bronchitis the other a virus that we treat for with antibiiotics. Discharge finally comes and I go in to re-vitalize the family. One of the little boys fights getting his temp taken. I understand he is sick and just wants to be left alone. After much convincing by the parents the child allows me to put the thermometer in his mouth. He starts gagging immediately and says I am sticking it down his throat. I tell the parents that I am going to go check another patient and that I will be back. As I leave the room I hear the mother say, that f#$%*^& b!@*& better stop sticking my kid or I am going to punch her in the face. I spin on my heels and go back into the room and explain that the child is not feeling well and that I did not stick the thermometer down the childs throat. They then started screaming that I have been mean to them all night long and that I kept giving the children dirty looks. They stated in a not so nice way that they wanted me removed from the case. I really wanted to let them have it both barrels! I didn't though I just said fine. I got one of my co-workers to go in and discharge them. I was soo mad though. I am tired of going the extra mile to be treated like crap!!! I wish we could bring back some respect for our profession. Or at least be able to defend ourselves when white trash people such as these decide they want to threaten us, without feeling that if we did so the hospital would have our job! It is all about customer service and I felt that I gave those little boys excellent care and kept them together for their comfort. I know I did the right thing for the boys but, the mother and father (who by the way were not even married anymore) needed to taken out back and shot in the head!!!! UGH, I was supported by management, staff and the physcian in the case thank-goodness. I really hope that they call and complain!!! However, I wonder how much support I would have been given if I would have told them exactly where to go and what kind of parents I thought that they were? For the record the kids had been sick for a week. Mother did not give a lick of medicine and brought herself in two days before and was treated, before she ever brought the little boys in. Thanks for letting me vent Y2KRN
  7. Y2KRN

    My kids are sending me to the psyc. ward

    Hello, Can empathize with and feel your pain!!!!!!! Husband was a sub-mariner for first 5 yrs of our marriage. Six month madatory deployments, and travel overseas while on shore duty. I was in nursing shcool when he went to England for three weeks. My daughter was three months old, my son 2 and a half. I was never closer to losing my mind as I was then. He felt the stress all the way to England and actually had a dream that I was going to divorce him. My daughter had gotten sick the second week and I had no family around me to help watch her. I had to miss clinicals it was hard. I can tell you though from experience it does get better, just hang in there you are not alone!!! y2krn
  8. Y2KRN

    What do your coworkers do to annoy you?

    ER Nurse here, I consider myself very flexible, not much gets to me. I will change to overfilled needle box, get more gloves, hang another IV bag, when I come on and the bag is dry. Will get the urine that has not been gotten in the 8 hours previous to me coming on. All with a smile and an attitude that this is why we change shifts so that the work will get done and the patient will get to their next destination. My biggest pet peeve is when the other shifts are complaining about, (when we come in the trauma rooms are not stocked, the needle boxes are overflowing, this urine has not been gotten in the 8 hours previous to them coming on shift. etc. etc.) It is a big circle and the things that most complain about I have found are things that they themselves do not always get done. I am exaggerating about the urine here. One time I was out of the building and walking to my car when a day shift unit clerk came out yelling that my charge nurse was paging me overhead, I thought my patient was dying or something, I get in there. My charge nurse looks at me and apoligizes and says the oncoming nurse wants to talk to you. A urine was sent to the lab labled with the correct patient, and with the correct order requisition, however the lable printer did not print a medical record number, this nurse was losing her mind because the lab said they could not accept the urine without the lable having the medical record number. "Now I am going to have to tie up a tech" (of course not herself) to walk to the lab a 2 second jaunt, to take a lable with the medical record number, otherwise she would have to get another urine sample. I don't know, I felt this was not something to sweat, this patient was a young healthy female with some abd. pain, she could have produced another specimen. After this nurse finally saw that I was pretty annoyed and not completely devastated by this quote unquote error. She says to me, you need to be more careful and check the medical record numbers, I said you cannot tell me that you look at the medical record number everytime you send a specimen especially if you are busy, she said yes I do. I said I don't believe you and walked off. Two months later, guess who didn't check a medical record number or a name for that matter, we had two patients with the same last name, she labled the urine wrong. I was tempted to call her butt, at 0300 am and tell her but, it was enough satisfaction to know that she is not perfect either. I guess I think we need to pick our battles wisely. I will say something if I feel a patient has been neglected or their care seriously jepordized. Otherwise I say we should not sweat the small stuff. It is hard to tolerate tardiness though I agree. Y2KRN
  9. Y2KRN

    surgical tech to RN?

    Hello Kats, I started out as a surgical tech, thought that I would go straight into nursing school from there. I ended up being a surgical technician for ten years. The money was okay and I got to do a lot of traveling, got married etc, etc. I went to nursing school thinking I was going to an Operating Room Rn. I am now an ER nurse and love what I do. So much opens up for you when you go to nursing school. I was able to transfer some classes toward the nursing program. Things like Anatomy and Physiology, microbiology, english, math courses, psychology. As for program specific courses there were none that could transfer. You will get an in depth curricula about the instrumentation, sterilization procedures, and go into depth about a surgical procedure itself. These I felt were valuable courses that I did not get with a nursing program. I have never regretted being a surgical technologist first. It is very informative and you learn about the human body very well. It is nice for me now because when I have a patient that I am getting ready to go to the OR, I actually know what is going to happen with their surgery, it will help you in nursing school too when you are doing assessments to know how they did the surgery. When you go to get your nursing degree it will be helpful. If you want to be an OR nurse you will have a great advantage because you will know how to scrub. You do not learn how to do this in nursing school, you don't learn the surgical instruments, and surgical scrub how to manage a back table and mayo, or do sponge, needle, and instrument counts. Surgeons love to teach that has been my experience more so than many other types of physicians. The OR is very technical and you will be able to see the role of the RN, observe how to assist with intubation, position patients, use laser, phaco machines, sterilizers, endoscopes etc. Call pay is good and if you work in a bigger facility you may get a perfect flexible schedule, so that you can continue to work and go to nursing school. I have not heard of any program that bridges surgical tech to nursing but, it does give you a good base for going into nursing. Nursing school teaches you how to assess patients and you learn much more about disease process and the big picture of things. But, when you have a heads up of how the inside of the body works it makes a lot more sense to learn how to assess the function and disease processes that are going on in the body. I wish you luck, with whatever you decide to do. Y2KRN
  10. Y2KRN

    Lazy Student Nurse Preceptors!

    I think that your nurse was proably very qualified, however, I could understand her not wanting to let you fly because she was so unfamiliar with the place herself. Believe me I was in your shoes not too very long ago and you will get plenty opportunity to learn IV's etc. I went to shcool in New England and we were not even allowed to start IV's and you should see me go now others seek me out to start their iv's. You will get the experience you need. Good Luck Y2KRN
  11. Y2KRN

    am I wrong?

    I say have a party on the 9th and label it " Ding Dong the Witch is Dead" party!!!!!!!!! She doesn't sound as though she even deserves as much as a good riddens!!! Y2KRN
  12. Y2KRN

    Teamwork...better at night or during the day?

    I also believe that it is night shift hands down. I have worked days and eves. Days seems in my experience to have the least amount of team work. Eves are great but, overwhelmed most of the time, you don't see anyone because you are soo soo busy, and nights stick together. I believe what everyone else says that it depends on the team. I also think that more type b personalities work the night shift. Day shift has to deal with management and the like and seem to be more uptight IMHO. Y2KRN
  13. Y2KRN

    Hi Everyone

    Welcome!!! Look forward to seeing you around!!! Y2KRN
  14. Had a Doc that would write TSTL too stupid to live, or on the discharge orders would write OTDDTR out the door and down the road. He would also put on drunks charts do not drink alcohol ever again, consuming alcohol can cause death. Y2KRN
  15. Y2KRN

    I Passed Nclex!!!

    Way to go! Congratulations, welcome to the profession. Happy Holiday's! Y2KRN
  16. Y2KRN

    Faxed Report

    Hello ernurse728, I think that they are still working out the details of this new system. We got a memo stating that we call the floor and alert the unit clerk that we are going to be faxing report on the patient going into 420. Then we fax report, ( we have a totally computerized charting system specific to the ED) all of our ER nursing notes go to the floor, from triage information to in er treatments and medications given. After that the floor has twenty minutes till the patient arrives. We carry phones with us, so we give our name and portable phone extension so if the floor nurse has any questions they can contact us. I don't know how to fix the dilemma that came up with me on the first night. I didn't see patient that the floor nurse had questions about. However, the questions she was asking were things that she just needed to look for, however if it was a question about baseline or medication administration or something then I probably would not have been able to help her anyway. Which can happen even when a report is called. However, no we do not at this time need to confirm with the receiving nurse that the patient is being moved. We do not fax report to any of our ICU's or our Rapid Admissions Unit. We still call report to them. We are supposed to be expanding our rapid admissions unit soon. We do not send a cover sheet though and I think maybe we should. Our management thinks labs can be looked up by the floor nurse, as well as x-rays. If the house Doctor has seen the patient then we fax their orders as well. We try to initiate any orders the house Doc has given. If I was the nurse receiving report I would like to know if the patient has a high k+ or something without having to look it all up. I send the lab results anyway. I think a cover sheet would be good to, just to give a little baseline nursing observation. "The patient has been comforatable, or is anxious, may be a little stoic you may want to ask him about his pain etc. There has been many changes since I started working at this Ed. We went from a 30 bed Er seeing 80,000 patients a year, to a brand new 50 bed er not including fast track. On top of this major move, we went live with an all computerized charting and tracking system specifically designed for an emergency department however the catch is "we are this new company's beta site." So, they are working out their kinks with our ED. I was completely overwhelmed at first, but it is getting better. Our computer system in the ED is separate from the rest of hospital and there were major issues to deal with. We are now interfaced with the lab so that is a great improvement, but we are still not interfaced with radioloy which is our weakest link right now. During the early summer we had so much hate mail via editorials from the community, morale became very low. Complaints were mostly about wait times which could be up to 6-8hrs. Plus we had many staffing issues. They have improved on staffing issues and are now hiring paramedics (god bless our medics, and techs) which has also helped greatly. Holding patients is another issue. Our beds fill up fast and the hospital is currently building an addition which will house two more ICU units and I think more monitored beds. We have three ICU units now. CICU, MICU, and SICU. I think the worst part is not moving patients though because the family wants you feed them, do all their meds, etc. and really doesn't understand that we just can't do all that when the code or trauma is in the next room. Some families understand but, most don't you tell them we have a critical patient and their retort is well you should have enough people to help because our family member is critical too. What can you say to that?? Our patient ratio is 5 to one and most assignments include a trauma room. This is a big improvement however to the not so long ago past when we would have to cover for lunch and have 10 or a little more patients to look after. When we would have a trauma then the rest of our patient's were fending for themselves however that was more of a staffing issue. Whew, I went off on a tangent, but it feels good to get all out. It is getting better and the floors are still not happy with the faxed report but, I think it will take time to adjust. I know that one good measure I think from being a floor nurse is that, they will not have to come to the phone to get a report from the Er and can continue that med pass or endo-tracheal suction they were doing. I remember that I hated to be called to the phone, when I was trying to push multiple crushed meds through a g-tube or suctioning a vent patient. Thanks for listening, Denise