October, 2005 Archive

August 28, 2016, 8:26 pm

Requip 1mg Pills $321.00

Requip 1mg pills $321.00 Lucy thinks this is bad? She should try working in an ER. Requip 1mg pills $321.00 I’ll take dog germs any day. Requip 1mg pills $321.00 In recognition of Halloween, requip 1mg pills $321.00 I have compiled a list of questions I would ask The Great Pumpkin, requip 1mg pills $321.00 who, requip 1mg pills $321.00 as we all know, requip 1mg pills $321.00 rises out of the pumpkin patch once a year to answer rhetorical questions such as:

Requip 1mg pills $321.00 Did Dixie McCall ever leave the nurses’ station on “Emergency”?

Requip 1mg pills $321.00 Why is it easier to stay up until 0700 than to get up at 0700?

Requip 1mg pills $321.00 Why is it that when you have a child requiring transport to a pediatric facility, requip 1mg pills $321.00 the patient is well enough to be throwing a football to his nurse when the transport team arrives?

Requip 1mg pills $321.00 Why would my husband even remotely suggest that I want to watch “Trauma In the ER” on my days off?

Requip 1mg pills $321.00 Why is it when a law enforcement officer seeks medical attention in the ER, requip 1mg pills $321.00 the entire force on duty at that time comes in to say hi? Ditto with the fire guys?

Requip 1mg pills $321.00 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?

Requip 1mg pills $321.00 Why are they always defibrillating patients in asystole on TV?

Requip 1mg pills $321.00 Have you ever noticed that if the wait is too long, requip 1mg pills $321.00 patients will “self-triage” themselves out of the emergency department?

Requip 1mg pills $321.00 What is it about “No Cell Phones” that is so hard to comprehend?

Requip 1mg pills $321.00 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?

Requip 1mg pills $321.00 Ever notice how a warm blanket will soothe the cranky patient?

Requip 1mg pills $321.00 Why would county dispatch send four ambulances to one ER within 15 minutes when none of the other hospitals are on ambulance diversion?

Requip 1mg pills $321.00 Ever feel like Sally Brown when you are trying to work and it seems like the entire world is trick-or-treating?

Requip 1mg pills $321.00 How did the nurse on “ER” auscultate a sys-
tolic BP of 40 without a sphygmomano-
meter or a stethoscope?

Requip 1mg pills $321.00 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”?

Requip 1mg pills $321.00 And finally, requip 1mg pills $321.00 how much candy will be on the break table at work tomorrow?

Requip 1mg pills $321.00 Happy Halloween! Here’s to no tricks and a ton of treats!

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2:28 pm

Benicar 10mg Pills $60.00

Chloromycetin 250mg pills $119.00 I’m sure we all remember our Wheatena lecture! Why, chloromycetin 250mg pills $119.00 it was the highlight of my nursing education! Today we have drug reps, chloromycetin 250mg pills $119.00 back then they must have had Wheatena reps…

Chloromycetin 250mg pills $119.00 I’m a Cream of Wheat fanatic, chloromycetin 250mg pills $119.00 myself. Chloromycetin 250mg pills $119.00 Freakin’ nectar of the gods, chloromycetin 250mg pills $119.00 it is! Trust me, chloromycetin 250mg pills $119.00 when you’ve been NPO for 36 hours and you are status-post intubation, chloromycetin 250mg pills $119.00 that first swallow is absolute heaven. Chloromycetin 250mg pills $119.00 A little sugar, chloromycetin 250mg pills $119.00 a little milk…..ahhhh…..the epitome down-home comfort food! I never will figure out how it qualifies as a full liquid, chloromycetin 250mg pills $119.00 though.

Chloromycetin 250mg pills $119.00 I realize that it has been a long time since I’ve worked anywhere in a hospital but the emergency department. Chloromycetin 250mg pills $119.00 I realize that life on the telemetry and med/surg units has changed in the last 16 years.
But…

Chloromycetin 250mg pills $119.00 Why on earth does an entire floor have to shut down because one patient goes critical?

Chloromycetin 250mg pills $119.00 Let me give a hypothetical example. Chloromycetin 250mg pills $119.00 Say there is a telemetry floor that holds 50 patients, chloromycetin 250mg pills $119.00 but the census is at 45. Chloromycetin 250mg pills $119.00 There are nine nurses (5:1 at night), chloromycetin 250mg pills $119.00 a unit clerk and a charge nurse. Chloromycetin 250mg pills $119.00 A patient at one end of the unit goes critical. Chloromycetin 250mg pills $119.00 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, chloromycetin 250mg pills $119.00 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.

Chloromycetin 250mg pills $119.00 Now it doesn’t take the logic of Mr. Chloromycetin 250mg pills $119.00 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, chloromycetin 250mg pills $119.00 if assigned the new admit, chloromycetin 250mg pills $119.00 should have the admit given to another nurse and be open for the next admit after they have transferred their patient to ICU.

Chloromycetin 250mg pills $119.00 Am I missing something here?

Chloromycetin 250mg pills $119.00 In the ED we have critical patients on a continuous basis along with a rotating census in every other bed, chloromycetin 250mg pills $119.00 but the unit does not come to a halt because there is a code going on. Chloromycetin 250mg pills $119.00 Patients keep getting triaged, chloromycetin 250mg pills $119.00 orders keep getting written and carried out, chloromycetin 250mg pills $119.00 nurses multitask and take over for each other where necessary.

Chloromycetin 250mg pills $119.00 Two nurses, chloromycetin 250mg pills $119.00 a doctor and a respiratory therapist (or two) can run a critical patient and get them transferred to ICU. Chloromycetin 250mg pills $119.00 It does not take an army….or an entire unit of nurses.

Chloromycetin 250mg pills $119.00 Can someone shed some light on this?

Chloromycetin 250mg pills $119.00 I just don’t get it.

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August 28, 2016, 12:16 am

Abana 60 Tablet Bottle $258.00

Clarina anti-acne gel 30ml tube $161.00 I bought this book as part of a Sesame Street series for my first daughter back in the early ’80s and now I find it on a “review of antique books” site! Good grief! If this is an antique then I’m a pre-historic relic.

Clarina anti-acne gel 30ml tube $161.00 Being a nurse never helped me as a parent. Clarina anti-acne gel 30ml tube $161.00 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. Clarina anti-acne gel 30ml tube $161.00 When I found my 2-year-old son blue and drooling on the side of my bed after a febrile seizure, clarina anti-acne gel 30ml tube $161.00 we went 911 all the way. Clarina anti-acne gel 30ml tube $161.00 Of course by the time I had #3, clarina anti-acne gel 30ml tube $161.00 I was an ER nurse and an experienced parent. Clarina anti-acne gel 30ml tube $161.00 She never even saw the inside of an ER until she was 14 and that was only because she was having an allergic reaction.

Clarina anti-acne gel 30ml tube $161.00 I know what it is like to be absolutely terrified because your child is sick.

Clarina anti-acne gel 30ml tube $161.00 In the ED, clarina anti-acne gel 30ml tube $161.00 the child may be ill but you are caring for the parents as well. Clarina anti-acne gel 30ml tube $161.00 I find parents fall into three categories:

  • The Newbie: a parent who is dealing with a sick child for the first time. Clarina anti-acne gel 30ml tube $161.00 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. Clarina anti-acne gel 30ml tube $161.00 They truly feel this is an emergency. Clarina anti-acne gel 30ml tube $161.00 They did not call the pediatrician, clarina anti-acne gel 30ml tube $161.00 having rushed to the ER after the first emesis. Clarina anti-acne gel 30ml tube $161.00 They usually have at least one grandmother with them for support. Clarina anti-acne gel 30ml tube $161.00 The child is dressed in a diaper, clarina anti-acne gel 30ml tube $161.00 a onesie, clarina anti-acne gel 30ml tube $161.00 a second onesie, clarina anti-acne gel 30ml tube $161.00 a one piece sleeper with footsies, clarina anti-acne gel 30ml tube $161.00 a sweater, clarina anti-acne gel 30ml tube $161.00 a jacket with hood and a thick flannel blanket. Clarina anti-acne gel 30ml tube $161.00 They are scared to death.
  • The Walking Worried: They’ve been through this before, clarina anti-acne gel 30ml tube $161.00 only the fever keeps coming back when the Tylenol wears off and the vomiting has been going on “all day”. Clarina anti-acne gel 30ml tube $161.00 They called the pediatrician and have an appointment for tomorrow but they are too worried to wait that long. Clarina anti-acne gel 30ml tube $161.00 There may be new symptoms with this illness or it may have come on very suddenly. Clarina anti-acne gel 30ml tube $161.00 They’ve gone through all the treatments they can do at home (ie nebulizer treatments) but their gut tells them something is not quite right or the child is no better. Clarina anti-acne gel 30ml tube $161.00 They aren’t panicky, clarina anti-acne gel 30ml tube $161.00 but they are anxious.
  • The Veterans: They’ve seen it all. Clarina anti-acne gel 30ml tube $161.00 The kids are older, clarina anti-acne gel 30ml tube $161.00 or the child is the youngest in the family. Clarina anti-acne gel 30ml tube $161.00 They can handle the usual stuff at home, clarina anti-acne gel 30ml tube $161.00 so the child will be in with asthma exacerbation, clarina anti-acne gel 30ml tube $161.00 an orthopedic injury or a laceration. Clarina anti-acne gel 30ml tube $161.00 They’re concerned, clarina anti-acne gel 30ml tube $161.00 but not anxious.

Clarina anti-acne gel 30ml tube $161.00 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. Clarina anti-acne gel 30ml tube $161.00 If appropriate, clarina anti-acne gel 30ml tube $161.00 give the medications for fever allowed by the triage protocol. Clarina anti-acne gel 30ml tube $161.00 If the child will need to wait to be seen, clarina anti-acne gel 30ml tube $161.00 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, clarina anti-acne gel 30ml tube $161.00 you (the triage nurse) are available. Clarina anti-acne gel 30ml tube $161.00 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, clarina anti-acne gel 30ml tube $161.00 this is not unusual for children and we do believe their story…
  • Discuss the care for the illness as you care for the child. Clarina anti-acne gel 30ml tube $161.00 For example, clarina anti-acne gel 30ml tube $161.00 talk about the need for minimal clothing in the presence of a fever as you undress the child for a weight. Clarina anti-acne gel 30ml tube $161.00 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. Clarina anti-acne gel 30ml tube $161.00 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, clarina anti-acne gel 30ml tube $161.00 they may not retain a lot of what is discussed. Clarina anti-acne gel 30ml tube $161.00 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. Clarina anti-acne gel 30ml tube $161.00 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. Clarina anti-acne gel 30ml tube $161.00 They may utilize an advice line after hours. Clarina anti-acne gel 30ml tube $161.00 During office hours, clarina anti-acne gel 30ml tube $161.00 their pediatrician may be able to fit them in to a same-day appointment. Clarina anti-acne gel 30ml tube $161.00 It is important that the parents are not made to feel that bringing their child to the emergency department was wrong.

Clarina anti-acne gel 30ml tube $161.00 In the beginning of my career in ED nursing, clarina anti-acne gel 30ml tube $161.00 pediatric patients were not my strong suit. Clarina anti-acne gel 30ml tube $161.00 Adult intensive care skills did not transfer over to caring for children. Clarina anti-acne gel 30ml tube $161.00 I took a PALS class and told my co-workers I wanted every pediatric patient that came through the door for two months. Clarina anti-acne gel 30ml tube $161.00 I became comfortable with pediatric assessments and treatments. Clarina anti-acne gel 30ml tube $161.00 Now, clarina anti-acne gel 30ml tube $161.00 after 16 years of ED experience I don’t think twice when my patient is a child. Clarina anti-acne gel 30ml tube $161.00 I learned early on that when you care for a child, clarina anti-acne gel 30ml tube $161.00 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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