August, 2008 Archive

July 28, 2016, 11:19 am

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Lamictal 200mg pills $92.00

Lamictal 200mg pills $92.00 Oh, lamictal 200mg pills $92.00 this is hilarious!

Lamictal 200mg pills $92.00 It is so obviously not a real hospital room!

Lamictal 200mg pills $92.00 The solid white backdrop – no oxygen, lamictal 200mg pills $92.00 no light fixtures, lamictal 200mg pills $92.00 no code button, lamictal 200mg pills $92.00 no intercom.

Lamictal 200mg pills $92.00 Okay, lamictal 200mg pills $92.00 so maybe they didn’t have those back in the day.

Lamictal 200mg pills $92.00 It’s hard to see, lamictal 200mg pills $92.00 but there is a piece of tape on the glass bottle that says “Saline”. Lamictal 200mg pills $92.00 It looks like the tubing coming from the IV is rubber and about the size of a garden hose.

Lamictal 200mg pills $92.00 Is there anyone out there who has been in nursing long enough to remember rubber tubing?  I’m embarrassed to say that glass bottles were still in use when I started (and no pleurivacs, lamictal 200mg pills $92.00 either – just three glass bottle water seal drainge!)

Lamictal 200mg pills $92.00 It seems that they practiced make-up application and used hair arranging as a therapeutic intervention.  That patient looks really sick, lamictal 200mg pills $92.00 doesn’t she?

Lamictal 200mg pills $92.00 Heck, lamictal 200mg pills $92.00 I don’t look that good and I’m healthy!

******************************

I have a problem.  With nursing.  WTF have we accomplished in the last 30 years?

Awhile back I handed a chart to our unit clerk.  On the chart, lamictal 200mg pills $92.00 I had checked the standard blood tests required for a patient presenting with chest pain.  I then turned to tell the doctor about the patient.

Before, lamictal 200mg pills $92.00 I had a chance to say a word, lamictal 200mg pills $92.00 the clerk swiveled in her chair, lamictal 200mg pills $92.00 put the chart in front of the doctor and asked, lamictal 200mg pills $92.00 “Is it okay if I order these?”.

After I picked my jaw up off the desk, lamictal 200mg pills $92.00 I said jokingly, lamictal 200mg pills $92.00  “Betty, lamictal 200mg pills $92.00 are you questioning my author-i-tay?”.

Then I heard something even more astounding.  Betty told me that one of the doctors instructed her to run any and all nurse initiated orders by him first.  So, lamictal 200mg pills $92.00 in order not to get in trouble, lamictal 200mg pills $92.00 she did that with all the doctors.

WTF?  This is wrong on so many levels.

  • First of all, lamictal 200mg pills $92.00 every nurse in my department is a seasoned veteran.  Together we have over a millennium of nursing experience.  I’m serious.  We don’t frivolously order labs or x-rays on a whim, lamictal 200mg pills $92.00 we have the education and experience to know what needs to be ordered when.  Particularly with chest pain patients.  Especially with chest pain patients!
  • Then, lamictal 200mg pills $92.00 to top that off, lamictal 200mg pills $92.00 we have a very substantial nursing protocol for us to use on patients presenting with numerous chief complaints that covers us for the very thing I was trying to order.
  • The doctor in question has never, lamictal 200mg pills $92.00 EVER said anything to the nurses about not ordering tests.  I find having the unit clerk question the order to be surreptitious.

Lamictal 200mg pills $92.00 Let’s make it clear here.  I’m not perfect.

Lamictal 200mg pills $92.00 But I’m also not talking major radiological, lamictal 200mg pills $92.00 invasive studies.  I’m talking labs and extremity x-rays.

Lamictal 200mg pills $92.00 Which brings me to my next issue.

**********

The supervisor on duty that night (a good manager and someone I respect very highly), lamictal 200mg pills $92.00 was astounded that we were “allowed” to order anything!  That we were treading on thin ice.

My response?

“Julie, lamictal 200mg pills $92.00 are you telling me that an experienced, lamictal 200mg pills $92.00 educated, lamictal 200mg pills $92.00 professional registered nurse is out of line ordering x-rays for obvious fractures or initiating a cardiac workup when a patient obviously requires it?”

That was exactly what she was telling me.

Oh dear Lord.

That could explain why a very esteemed colleague of mine stood in the very same facility and watched her father die while the telemetry floor nurses would not get an EKG, lamictal 200mg pills $92.00 order a chest x-ray, lamictal 200mg pills $92.00 call respiratory therapy or draw blood work because “the doctor would be coming in”.

Shouldn’t we, lamictal 200mg pills $92.00 as nurses, lamictal 200mg pills $92.00 have those things ready when the doctor shows up?  Isn’t that the point of working in the hospital, lamictal 200mg pills $92.00 to facilitate the care of our patients, lamictal 200mg pills $92.00 to intervene when they go critical, lamictal 200mg pills $92.00 to be prepared for the unexpected?  Especially in the emergency department, lamictal 200mg pills $92.00 of all places, lamictal 200mg pills $92.00 especially in an emergency department that prides itself on door to dilatation times that are so fast they can give you vertigo?

Am I nuts here?

What the hell are we nurses these days?  Chopped liver?

HELL NO!

*****

How can we fight for our professionalism when our own nurse leaders at the grass roots level don’t support it?

How are we really being perceived when doctors pay lip service to us one minute and then have the unit clerks run our basic protocol-driven nursing actions by them before initiation?

What the hell is going on with my profession?

*****

Please excuse the language, lamictal 200mg pills $92.00 but I am pissed off.

This profession needs to get its you-know-what together if we are ever going to be taken seriously by anybody.  We can differ, lamictal 200mg pills $92.00 but we have to present a solid front to the public, lamictal 200mg pills $92.00 our community and to the medical profession.

And that front needs to be, lamictal 200mg pills $92.00 say it with me….professsional! I don’t care if you spend your shift emptying bedpans or writing national nursing policy.

Nursing is an autonomous, lamictal 200mg pills $92.00 distinct profession with it’s own research and evidence-based practice.  How long before we start to get treated like it.

Nurses, lamictal 200mg pills $92.00 we had better take the reigns here because no one else seems to (a) want us to do it or (b) even think we might actually KNOW something.

How the hell do we ever expect it to change if we don’t do it from the grassroots up?

Even if it means taking it one person, lamictal 200mg pills $92.00 one institution at a time.

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July 28, 2016, 10:41 am

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Zebeta 10mg pills $253.00 I wonder what Zippy thinks?

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Rima from The Doctor Blogger has submitted a proposal called The 3G Project to the American Express Members Project. Zebeta 10mg pills $253.00 The projects that get the most votes will be funded. Zebeta 10mg pills $253.00 Rima does not receive the money, zebeta 10mg pills $253.00 but the institution administering the project does.

In fact, zebeta 10mg pills $253.00 here is a bit about what the project hopes to accomplish:

Teach health ed to pre-school age kids living in disadvantaged homes while parents and/or grandparents are present to also learn in a non-threatening setting. Zebeta 10mg pills $253.00 Kids hear the information early and all generations can work together to make healthy choices. Zebeta 10mg pills $253.00 Use a digital web based approach to “Teach the Teacher” what to say and how to say it.

Right now, zebeta 10mg pills $253.00 Rima is around #27 and needs to make the top 25.

She can do it if we go to the site and nominate the project. Zebeta 10mg pills $253.00 I have put in my nomination. Zebeta 10mg pills $253.00 It costs nothing and takes a few keystrokes to accomplish. Zebeta 10mg pills $253.00 You do not have to have an AmEx card to vote.

Preliminary votes must be in by September 1st.

Good luck to Rima and The 3G Project! Be sure to keep us posted!

*******************

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Zebeta 10mg pills $253.00 Another round of thanks to all who have volunteered to host Change of Shift! We are up into January dates now! Holy cow – I’m going to have to put up dates way into 2009!

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July 28, 2016, 8:01 am

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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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