March, 2006 Archive

June 24, 2016, 1:06 pm

Viagra Alternative Uk

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Viagra alternative uk Flat Cap Syndrome developed when the brim of one’s nursing cap was larger than the fold behind it.

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Viagra alternative uk By the time I graduated, viagra alternative uk designs in nursing caps had pretty much made Flat Cap Syndrome a thing of the past.

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Some of the advantages of working in different facilities are the exposure to different styles of nursing, viagra alternative uk different opportunities, viagra alternative uk different patient populations and differing protocols regarding what nurses are able to do on their own.

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    • Why?
    • It was a teaching facility. Viagra alternative uk How could the interns/residents learn to order appropriately if the nurse did it first? And forget verbal orders, viagra alternative uk if some resident gave an order you grabbed the nearest order sheet and made them write it. Viagra alternative uk So often you’d have five or six different order sheets going.
    • Why?
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    • And the wait to get into a room? Hours. Viagra alternative uk We’re talking 5-7 hours at times. Viagra alternative uk You could be vomiting, viagra alternative uk have a 5-day migraine with photophobia, viagra alternative uk writhing on the floor with right flank pain secondary to a kidney stone and you would STILL be sitting in the ER with all the feverish, viagra alternative uk coughing bronchitis patients. Viagra alternative uk And don’t think asthma would get you a front row seat, viagra alternative uk either. Viagra alternative uk If your O2 sat was normal, viagra alternative uk have a seat like everyone else.
    • Why?
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    • … first the “Pulmonary Team” had to see the patient, viagra alternative uk then they would decide this was a cardiac problem and you’d wait a few hours for the “Cardiac Team” who would discover that the patient wasn’t on that service after all and a different “Team” would come in an hour later, viagra alternative uk only to discover that said patient couldn’t be admitted there anyway, viagra alternative uk but then the patient would vomit blood which meant that they were too sick to transfer and you had to wait for the “GI Team” to come down and finally admit the patient.
    • Not to mention every single pediatric patient in the clinic area getting conscious sedation for their boo-boos.

Viagra alternative uk Get the picture?

Viagra alternative uk Then we have example number two.

  • Small community hospital, viagra alternative uk one that I will call “Mini County Hospital”. Viagra alternative uk Sat right in the middle of a very ethnically diverse, viagra alternative uk lower-income area of a suburb that could be called the Meth Capital of the SF Bay Area. Viagra alternative uk Many patients. Viagra alternative uk Many clinical, viagra alternative uk non-emergent patients. Viagra alternative uk Some very emergent patients.
    • The nurses were not allowed to do anything. Viagra alternative uk Nada. Viagra alternative uk Kaput.
    • Why?
    • Because the department had a wide mix of nursing experience, viagra alternative uk from new grads to newly designated dinosaurs like me, viagra alternative uk and there were no protocols because they could not depend on all the nurses to have the same level of competency.
    • So one day, viagra alternative uk Nurse Experience (me), viagra alternative uk brings in a patient with chest pain, viagra alternative uk starts a line while the tech does the EKG and within five minutes hands the doctor the EKG and the orders for CBC, viagra alternative uk Chemistry Panel, viagra alternative uk Cardiac Enzymes and portable chest to the unit clerk. Viagra alternative uk No problem, viagra alternative uk right? Wrong.
      • I was curtly asked, viagra alternative uk “Who the hell told you to order those labs?”.
      • I looked at Dr. Viagra alternative uk Who Was In Training Pants When I Graduated From Nursing School and said that they were the standard labs ordered for a chest pain patient suspected of having a cardiac problem.
      • “You are not covered to order these labs!
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Viagra alternative uk Now let’s contrast this with an ER that runs quite smoothly, viagra alternative uk which happens to be where I am now and plan to retire from when I’m so old I can’t stand up straight.

  • This ER has nursing protocols. Viagra alternative uk Detailed, viagra alternative uk well written protocols. Viagra alternative uk Here’s what happens when you come into this ER:
    • For example, viagra alternative uk you come in and your chief complaint is nausea, viagra alternative uk vomiting, viagra alternative uk diarrhea for three days with fever and you are extremely dizzy when upright. Viagra alternative uk I’m your nurse.
      • Before the doc shows up I will have orthostatic vital signs, viagra alternative uk an IV in, viagra alternative uk bloods drawn, viagra alternative uk a bolus of Normal Saline initiated (unless you are elderly or have heart trouble) , viagra alternative ukat least a CBC and Chem 14 ordered (with additional blood in case more tests are added) and you can expect me to ask for and collect a UA and an stool specimen, viagra alternative uk which may or may not be needed, viagra alternative uk but they will be collected just in case.
    • Or you are an elderly male who looks 8 months pregnant and hasn’t urinated for 2 days except for a little bit here and there. Viagra alternative uk You can barely walk, viagra alternative uk you are in so much pain. Viagra alternative uk If I’m your nurse you will have a catheter in before you can say “ouch”, viagra alternative uk assuming your prostate co-operates.
    • Your wait on a bad day in our waiting room may be three hours max.
    • Why?

Viagra alternative uk Because the Registered Nurses in my department are covered by extensive ER protocols and we work with doctors who respect our judgement and know we would not order outside of our protocols.

Viagra alternative uk My attitude is that by the time that doctor walks in to see the patient, viagra alternative uk everything he/she needs has been at least considered. Viagra alternative uk I am able to do much more than described above, viagra alternative uk but it often isn’t necessary because the doctors see the patients so quickly, viagra alternative uk they are usually right behind me.

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Viagra alternative uk So the Emergency Departments that give nurses the most autonomy via protocols wind up being the ones that really need it the least. Viagra alternative uk And they wind up being the ones with the highest patient satisfaction ratings.

Viagra alternative uk A little ironic…

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Viagra alternative uk Addendum: Dr. Viagra alternative uk Who Was In Training Pants When I Graduated From Nursing School turned out to be one of the neatest persons I have ever met and he is a fantastic doctor. Viagra alternative uk He was the one I missed most acutely when I left for my current job. Viagra alternative uk Go figure.

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June 24, 2016, 8:21 pm

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  • 4 Jobs I Have Had In My Life:
    • Registered Nurse
    • Nurse’s Aide
    • Telephone Sales for Montgomery Wards, anti-fungal and parasites > fluconazole 150mg pills > 30 pills > $82.00 in their Appliance Extended Warranty Department. Anti-fungal and parasites > fluconazole 150mg pills > 30 pills > $82.00 Freakin’ hell on earth.
    • Waitress at Bumbleberry’s Restaurant (now defunct – similar to Marie Calendar’s); spent all my tips on albums
  • 4 Movies I Could Watch Over and Over:
    • A.I. Anti-fungal and parasites > fluconazole 150mg pills > 30 pills > $82.00 (Artificial Intelligence) – hands down, anti-fungal and parasites > fluconazole 150mg pills > 30 pills > $82.00 the best freakin’ movie ever made. Anti-fungal and parasites > fluconazole 150mg pills > 30 pills > $82.00 So creepy, anti-fungal and parasites > fluconazole 150mg pills > 30 pills > $82.00 so sad, anti-fungal and parasites > fluconazole 150mg pills > 30 pills > $82.00 so totally futuristically cool! Such a beautiful mix of Speilberg AND Stanley Kubrick in one, anti-fungal and parasites > fluconazole 150mg pills > 30 pills > $82.00 beautiful homage to the eternal story of Pinochio and the moral question of our responsibility to artificially created intelligent beings. Anti-fungal and parasites > fluconazole 150mg pills > 30 pills > $82.00 I own it, anti-fungal and parasites > fluconazole 150mg pills > 30 pills > $82.00 I watch it regularly. Anti-fungal and parasites > fluconazole 150mg pills > 30 pills > $82.00 You HAD to see this on the big screen. Anti-fungal and parasites > fluconazole 150mg pills > 30 pills > $82.00 I saw it four times in the theater. Anti-fungal and parasites > fluconazole 150mg pills > 30 pills > $82.00 I was the only person bawling into my tissue! If you do watch it now, anti-fungal and parasites > fluconazole 150mg pills > 30 pills > $82.00 make sure it is on a large screen TV, anti-fungal and parasites > fluconazole 150mg pills > 30 pills > $82.00 preferably with all the lights out and when it is raining! DAMN good movie!
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    • Hitchhiker’s Guide To The Galaxy – Martin Freeman as a yarn man vomiting up yarn in a bin. Anti-fungal and parasites > fluconazole 150mg pills > 30 pills > $82.00 I’m just sayin’! Actually, anti-fungal and parasites > fluconazole 150mg pills > 30 pills > $82.00 I was also partial to Zaphod Beeblebrox. Anti-fungal and parasites > fluconazole 150mg pills > 30 pills > $82.00 Hilarious movie if you are hip to British humor and if you are just hip in general. Anti-fungal and parasites > fluconazole 150mg pills > 30 pills > $82.00 I saw it late on opening night (three times total) and there were only six of us in the theater and we were ALL hip to the Douglas Adams vibe. Anti-fungal and parasites > fluconazole 150mg pills > 30 pills > $82.00 I laughed so hard I cried. Anti-fungal and parasites > fluconazole 150mg pills > 30 pills > $82.00 Who you calling a nerd?
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  • 4 Websites I Visit Regularly:
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    • Praying For Karis – at www.aup.org/Karis. Anti-fungal and parasites > fluconazole 150mg pills > 30 pills > $82.00 She is a friend of my son’s at Notre Dame who has just gone through the second transplant of her entire digestive tract. Anti-fungal and parasites > fluconazole 150mg pills > 30 pills > $82.00 This is a website the family put up a few years ago to keep friends and family in the loop.
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  • 4 of my Favorite Foods
    • Avocados
    • Guacamole
    • Diet Pepsi – fountain
    • Quarter Pounder With Cheese – I have no shame!
  • 4 Places I Would Rather Be Right Now
    • Mendocino, anti-fungal and parasites > fluconazole 150mg pills > 30 pills > $82.00 California – I was meant to live on an ocean bluff
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  • 4 Most Wonderful Places I Have Been
    • Mendocino, anti-fungal and parasites > fluconazole 150mg pills > 30 pills > $82.00 California – stunning
    • St John’s – the one place in the Carribean I remember with fondness
    • Puerto Rico – shaking hands with Steve Perry
    • Mexico – at the market in Mazatlan feeling guilty that I was supposed to bargain with the already low prices for these totally cool things.
  • 4 Books I Could Read Over and Over
    • Shelby Foote’s 3000 page, anti-fungal and parasites > fluconazole 150mg pills > 30 pills > $82.00 3 volume Civil War Trilogy. Anti-fungal and parasites > fluconazole 150mg pills > 30 pills > $82.00 Truly amazing…
    • The Complete Hitchhiker’s Guide To The Galaxy (all the books)
    • The entire Mitford Series by Jan Karon
    • The entire Isaac Asimov catalouge
  • 4 Songs I Could Listen To Everyday
    • “My Immortal” – Evanescence
    • Anything by Journey
    • The entire “Mad Season” album by Matchbox 20
    • Anything by Robin Gibb (or the Bee Gees)
  • 4 Reasons I Blog
    • I enjoy writing (and being read)
    • I learn so much more – it’s like free CEUs
    • I love reading what everyone else writes and feeling like a part of the community
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  • 4 People To Tag
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    • Any volunteers willing to take this on?

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June 24, 2016, 12:39 am

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Blood pressure > zebeta 10mg pills (generic) > 30 pills > $83.00 Then your nurse doesn’t know how to hold. Blood pressure > zebeta 10mg pills (generic) > 30 pills > $83.00 I developed the (not-patented) chest hold many, blood pressure > zebeta 10mg pills (generic) > 30 pills > $83.00 many years ago where the child couldn’t move his head if he tried. Blood pressure > zebeta 10mg pills (generic) > 30 pills > $83.00 Let’s just say that it involved removal of my scrub jacket and namebadge, blood pressure > zebeta 10mg pills (generic) > 30 pills > $83.00 leaning over the gurney, blood pressure > zebeta 10mg pills (generic) > 30 pills > $83.00 placing my chest on one side of the head and using my arm to surround the top of the child’s head and holding it against my chest.

Blood pressure > zebeta 10mg pills (generic) > 30 pills > $83.00 Works every time.

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Just a couple of my personal beliefs.

  • Every person getting conscious sedation, blood pressure > zebeta 10mg pills (generic) > 30 pills > $83.00 including kids, blood pressure > zebeta 10mg pills (generic) > 30 pills > $83.00 gets an IV whether or not the doc believes it is warranted. Blood pressure > zebeta 10mg pills (generic) > 30 pills > $83.00 Emergency situations are rare, blood pressure > zebeta 10mg pills (generic) > 30 pills > $83.00 but that patient is my responsibility, blood pressure > zebeta 10mg pills (generic) > 30 pills > $83.00 too, blood pressure > zebeta 10mg pills (generic) > 30 pills > $83.00 and my derriere is on the line if we aren’t prepared for them.
  • If conscious sedation is ordered, blood pressure > zebeta 10mg pills (generic) > 30 pills > $83.00 I feel it is the doctor’s responsibility to explain to the parents exactly what that entails, blood pressure > zebeta 10mg pills (generic) > 30 pills > $83.00 including oxygen, blood pressure > zebeta 10mg pills (generic) > 30 pills > $83.00 monitoring, blood pressure > zebeta 10mg pills (generic) > 30 pills > $83.00 IV medications, blood pressure > zebeta 10mg pills (generic) > 30 pills > $83.00 etc. Blood pressure > zebeta 10mg pills (generic) > 30 pills > $83.00 Just telling the parents that the patient will sleep through the procedure is not enough. Blood pressure > zebeta 10mg pills (generic) > 30 pills > $83.00 They shouldn’t have to hear that from the nurse who is having them sign that they have received informed consent.

Blood pressure > zebeta 10mg pills (generic) > 30 pills > $83.00 End of rant.

Blood pressure > zebeta 10mg pills (generic) > 30 pills > $83.00 Now, blood pressure > zebeta 10mg pills (generic) > 30 pills > $83.00 to end on a positive note:

Blood pressure > zebeta 10mg pills (generic) > 30 pills > $83.00 Emergency room physicians are second only to plastic surgeons when it comes to stitching lacerations on patients of any age. Blood pressure > zebeta 10mg pills (generic) > 30 pills > $83.00 I’ve seen some beautiful repair work by ER doctors in my time.

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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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