October, 2005 Archive

June 25, 2016, 8:26 pm

Viagra Online Kaufen

Viagra online kaufen Lucy thinks this is bad? She should try working in an ER. Viagra online kaufen I’ll take dog germs any day. Viagra online kaufen In recognition of Halloween, viagra online kaufen I have compiled a list of questions I would ask The Great Pumpkin, viagra online kaufen who, viagra online kaufen as we all know, viagra online kaufen rises out of the pumpkin patch once a year to answer rhetorical questions such as:

Viagra online kaufen Did Dixie McCall ever leave the nurses’ station on “Emergency”?

Viagra online kaufen Why is it easier to stay up until 0700 than to get up at 0700?

Viagra online kaufen Why is it that when you have a child requiring transport to a pediatric facility, viagra online kaufen the patient is well enough to be throwing a football to his nurse when the transport team arrives?

Viagra online kaufen Why would my husband even remotely suggest that I want to watch “Trauma In the ER” on my days off?

Viagra online kaufen Why is it when a law enforcement officer seeks medical attention in the ER, viagra online kaufen the entire force on duty at that time comes in to say hi? Ditto with the fire guys?

Viagra online kaufen How can they say we don’t have universal access to health care when anyone at anytime can walk into any ER for any reason and by law cannot be turned away because of lack of funds?

Viagra online kaufen Why are they always defibrillating patients in asystole on TV?

Viagra online kaufen Have you ever noticed that if the wait is too long, viagra online kaufen patients will “self-triage” themselves out of the emergency department?

Viagra online kaufen What is it about “No Cell Phones” that is so hard to comprehend?

Viagra online kaufen Why is it that a person will stand in line for three hours for a flu shot and then gripe if their entire ER visit takes the same amount of time?

Viagra online kaufen Ever notice how a warm blanket will soothe the cranky patient?

Viagra online kaufen Why would county dispatch send four ambulances to one ER within 15 minutes when none of the other hospitals are on ambulance diversion?

Viagra online kaufen Ever feel like Sally Brown when you are trying to work and it seems like the entire world is trick-or-treating?

Viagra online kaufen How did the nurse on “ER” auscultate a sys-
tolic BP of 40 without a sphygmomano-
meter or a stethoscope?

Viagra online kaufen Why would a facility feed into the “instant gratification” culture by placing this ad in the local paper: “It takes longer to walk to your mailbox than it does to be seen in our ER”?

Viagra online kaufen And finally, viagra online kaufen how much candy will be on the break table at work tomorrow?

Viagra online kaufen Happy Halloween! Here’s to no tricks and a ton of treats!

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2:28 pm

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Antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 I’m a Cream of Wheat fanatic, antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 myself. Antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 Freakin’ nectar of the gods, antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 it is! Trust me, antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 when you’ve been NPO for 36 hours and you are status-post intubation, antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 that first swallow is absolute heaven. Antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 A little sugar, antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 a little milk…..ahhhh…..the epitome down-home comfort food! I never will figure out how it qualifies as a full liquid, antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 though.

Antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 I realize that it has been a long time since I’ve worked anywhere in a hospital but the emergency department. Antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 I realize that life on the telemetry and med/surg units has changed in the last 16 years.
But…

Antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 Why on earth does an entire floor have to shut down because one patient goes critical?

Antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 Let me give a hypothetical example. Antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 Say there is a telemetry floor that holds 50 patients, antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 but the census is at 45. Antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 There are nine nurses (5:1 at night), antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 a unit clerk and a charge nurse. Antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 A patient at one end of the unit goes critical. Antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 At this point:

  • The ER cannot obtain a room number for the new admission because
    • the charge nurse is busy assisting the nurse whose patient is crashing
    • only the charge nurse can assign a room number
  • If a room number has already been assigned, antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 no nurse on the unit will take report
    • because a “patient is crashing” on the unit.
    • they are busy
  • The new admission happens to be assigned to the nurse whose patient is now critical.

Antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 Now it doesn’t take the logic of Mr. Antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 Spock to figure out that:

  • The charge nurse
    • knows which rooms are available for an admit
    • knows which nurses are open for the admit
      • doesn’t need an hour to figure this out
      • can delegate the assigning of the room
      • can make a decision and revise prn
  • The nurse taking the new admit with room assignment
    • has an open room ready and assigned
    • is not involved with the critical patient
    • has no reason not to take report or accept the patient after report has been given
      • hectic activity in one room does not preclude giving care in any other room
      • is able to assess his/her patients without the charge nurse
      • can hold paperwork if necessary until unit clerk is available to process orders
  • The nurse of the critical patient, antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 if assigned the new admit, antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 should have the admit given to another nurse and be open for the next admit after they have transferred their patient to ICU.

Antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 Am I missing something here?

Antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 In the ED we have critical patients on a continuous basis along with a rotating census in every other bed, antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 but the unit does not come to a halt because there is a code going on. Antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 Patients keep getting triaged, antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 orders keep getting written and carried out, antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 nurses multitask and take over for each other where necessary.

Antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 Two nurses, antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 a doctor and a respiratory therapist (or two) can run a critical patient and get them transferred to ICU. Antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 It does not take an army….or an entire unit of nurses.

Antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 Can someone shed some light on this?

Antidepressants > remeron 7.5mg pills (generic) > 90 pills > $132.00 I just don’t get it.

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June 25, 2016, 12:16 am

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Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 Being a nurse never helped me as a parent. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 When my first baby ran a temperature of 104.8 I ran to the ER as fast as I could get my old VW bug to fly. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 When I found my 2-year-old son blue and drooling on the side of my bed after a febrile seizure, blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 we went 911 all the way. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 Of course by the time I had #3, blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 I was an ER nurse and an experienced parent. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 She never even saw the inside of an ER until she was 14 and that was only because she was having an allergic reaction.

Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 I know what it is like to be absolutely terrified because your child is sick.

Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 In the ED, blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 the child may be ill but you are caring for the parents as well. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 I find parents fall into three categories:

  • The Newbie: a parent who is dealing with a sick child for the first time. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 They have no clue about what to do for the fever and they are frantic because the child vomited once and has not stopped crying/fussing. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 They truly feel this is an emergency. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 They did not call the pediatrician, blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 having rushed to the ER after the first emesis. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 They usually have at least one grandmother with them for support. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 The child is dressed in a diaper, blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 a onesie, blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 a second onesie, blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 a one piece sleeper with footsies, blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 a sweater, blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 a jacket with hood and a thick flannel blanket. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 They are scared to death.
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  • The Veterans: They’ve seen it all. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 The kids are older, blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 or the child is the youngest in the family. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 They can handle the usual stuff at home, blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 so the child will be in with asthma exacerbation, blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 an orthopedic injury or a laceration. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 They’re concerned, blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 but not anxious.

Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 So how do we help the parents while we care for the child?

  • Acknowledge that the parents are concerned/worried/anxious.
  • Begin treatment at triage. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 If appropriate, blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 give the medications for fever allowed by the triage protocol. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 If the child will need to wait to be seen, blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 let the parents know that the fever is being addressed while they are waiting.
  • Tell the parents that if they become worried about their child while waiting, blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 you (the triage nurse) are available. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 This will help allieviate some of their anxiety about waiting.
  • Reassure the parents that although the patient seemed deathly ill at home but is now playing peek-a-boo with the respiratory therapist and trying to stand on their head on the gurney, blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 this is not unusual for children and we do believe their story…
  • Discuss the care for the illness as you care for the child. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 For example, blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 talk about the need for minimal clothing in the presence of a fever as you undress the child for a weight. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 Go over what a clear liquid diet consists of when offering the child Pedialyte.
  • Encourage the parents to ask questions if they are concerned about an aspect of care.
  • Be sure to reinforce aspects of care that the parents did right. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 This is especially important for new parents who may not be confident in their ability to care for a sick child.
  • If the parents are very anxious, blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 they may not retain a lot of what is discussed. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 Let the parents know that everything will be written in the discharge instructions given at the end of the visit.
  • Discuss options for care of future illnesses at discharge. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 The parents may not realize that there is a doctor on call for their pediatrician 24 hours a day and they are able to give out telephone advice. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 They may utilize an advice line after hours. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 During office hours, blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 their pediatrician may be able to fit them in to a same-day appointment. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 It is important that the parents are not made to feel that bringing their child to the emergency department was wrong.

Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 In the beginning of my career in ED nursing, blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 pediatric patients were not my strong suit. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 Adult intensive care skills did not transfer over to caring for children. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 I took a PALS class and told my co-workers I wanted every pediatric patient that came through the door for two months. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 I became comfortable with pediatric assessments and treatments. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 Now, blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 after 16 years of ED experience I don’t think twice when my patient is a child. Blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 I learned early on that when you care for a child, blood pressure > zestril 10mg pills (generic) > 180 pills > $270.00 you are caring for a family and that the needs of both the child and the parents must be addressed for a successful outcome.

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About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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