January, 2006 Archive

July 1, 2016, 7:41 pm

Canadian Viagra

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Canadian viagra Most people can take it without becoming emotionally affected. Canadian viagra I, canadian viagra however, canadian viagra am drawn to it as a moth to a flame.

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Canadian viagra At work, canadian viagra I have to sneak into the back room to get my fix. Canadian viagra Some of my co-workers know. Canadian viagra Others have never discovered my secret.

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Life used to be so simple in the ER.
If a patient needed to stay in the hospital, canadian viagra you obtained a room number from Admitting.
You then would take a final set of vital signs to verify that the patient was indeed stable for transport, canadian viagra bring your nursing notes up to date and double check the lab work to make sure that no one missed the potassium level of 9 or the hemoglobin of 1.
A call to the receiving nurse was then placed to give “report”, canadian viagra a verbal narrative of the history of the present illness and emergency department course, canadian viagra adding significant historical medical information as necessary: allergies, canadian viagra previous surgeries, canadian viagra etc.
After receiving a litany of 15 reasons why the receiving nurse can’t take the patient right then, canadian viagra a negotiation ensues. Canadian viagra A time for transport is agreed upon and the patient goes up with his chart.
Oh, canadian viagra how I long for the good old days.
Approximately one year ago, canadian viagra some agency (JACHO?) decides that things must change for the good of the patient! Here is what now must be done before the patient goes up:
  • Report must be faxed.
    • This entails writing the entire report. Canadian viagra So, canadian viagra everything that you have just spent hours writing on the nursing notes must be summarized and rewritten on the fax report form. Canadian viagra Even I, canadian viagra with my passion for charting, canadian viagra think this is asinine. Canadian viagra It is also mandatory.
    • It takes longer to fill out the fax report than it does to verbally report.
    • The only advantage is the nurse can’t give you 15 reasons for not taking the patient any longer.
      • In my facility, canadian viagra the policy is the patient comes up 30 minutes after the fax. Canadian viagra Oh, canadian viagra and we call to confirm that the fax is on the way. Canadian viagra In the beginning they mysteriously weren’t received.
        • Okay, canadian viagra in the interest of fairness, canadian viagra sometimes faxes are sent to the wrong floor or a bed number is changed after report has been faxed.
        • And the floor/unit nurses get a 30 minute “heads-up” after the fax and before the patient arrives so they can prioritize prior to getting the patient. Canadian viagra Which I know I would greatly appreciate if I worked up on the floors.
    • We tried faxing the nursing notes instead for a brief period, canadian viagra thinking that would cover all the bases, canadian viagra but how shall I put this, canadian viagra not all nurses are thorough “charters” and/or it was difficult to read through to get the pertinent information.
  • We need to practice “medication reconciliation”.
    • This means that, canadian viagra when a patient is going to be admitted, canadian viagra an exact list of what medications the patient is taking, canadian viagra including vitamins and herbal supplements must be listed, canadian viagra along with the dosage, canadian viagra frequency and the last time the patient took the medicine. Canadian viagra Allergies and adverse reactions are also noted for a second time (first on the nursing notes).
    • The goal is a noble one: to make sure the patient is discharged with the medications “matching” the ones they came in taking, canadian viagra with or without changes.
    • This is all done on a new form that acts as a physician’s order sheet for meds (ie they can check to order the drug as written or to not order it.
    • Guess who gets to get all this information ready for admission – yep, canadian viagra the ER nurse. Canadian viagra They say the family can fill out the form and sometimes the patients come in with beautiful computerized lists that bring tears of joy to my eyes. Canadian viagra But usually the family is anxious about doing that so it falls to the nurse to complete.
      • Oh, canadian viagra and by the way, canadian viagra those beautiful computerized lists? We can’t copy them. Canadian viagra They must be re-copied, canadian viagra by hand, canadian viagra on the form.
  • Signature recognition
    • On a separate form, canadian viagra in addition to signing your name twice on the nursing notes, canadian viagra you must print your name, canadian viagra sign your name, canadian viagra and designate your work station.
    • Apparently illegible handwriting is making signature reading a lost art.
    • To my blessed delight, canadian viagra my facility no longer requires this form. Canadian viagra But for many months this was also mandatory.

Canadian viagra So, canadian viagra in one year, canadian viagra three new pieces of paperwork were added to the already hectic activity that accompanies a patient admission. Canadian viagra Two of which require the nurse to sit, canadian viagra undisturbed, canadian viagra for a minimum of 20 minutes to complete in addition to all the regular paperwork. Canadian viagra We have no recourse but to do as we are told.

Canadian viagra I wish someone would tell these agencies off.

Canadian viagra Where is Simon Cowell when you need him?

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July 1, 2016, 3:46 am

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Hga bottle $81.00 It seems Miss Ames, hga bottle $81.00 RN has gotten a phone call!

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Hga bottle $81.00 Could it be that Cherry takes too many personal phone calls at work?

Hga bottle $81.00 Nah, hga bottle $81.00 Cherry Ames is the perfect nurse!

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I also forgot to mention that Emergiblog has a post in the latest “Carnival of the Mundane”, hga bottle $81.00 this time hosted by Kaply over at her blog. Hga bottle $81.00 It’s my post on using the nursing process to assess your boxes of candy. Hga bottle $81.00 Truly a skill that all should possess.
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July 1, 2016, 12:46 am

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It had been a helacious shift.

Tadacip 20mg pills $167.00 Everyone was very sick in some fashion or another, tadacip 20mg pills $167.00 almost all requiring IVs and medications for pain or nausea (or both). Tadacip 20mg pills $167.00 Lots of respiratory distress and a couple of in-house codes to top it all off. Tadacip 20mg pills $167.00 (We lose the ER doc and an ER nurse for what is hopefully a short period of time when someone in the hospital has a cardiac arrest).

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Tadacip 20mg pills $167.00 Ruptured spleen.

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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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