Tuesday, December 16, 2014
Thursday, December 11, 2014
I order my Santa Letters and Packages here, supporting nonprofit org The Mommies Network
Friday, December 5, 2014
Fever, seems to be the most common complaint of parents in the middle of the night as I work my weekender shifts. The children can range from very ill to very playful. Parents can be very well educated and some not so much at all (sad but true). Lots of education needs to be done about fever, parents for some reason just freak out if their child is running a fever......ekkkkkkk.
By all means if your child is not breathing, in distress, having a seizure, blue in color or unconscious --Please call 911!!! Do not try and drive to the ER!
Most often if a child is brought to the Emergency Department for a fever, the parent has really not tried to do anything at home to first bring the fever down. They just drop everything and rush to the ER...OMG!!
Caution: Now if your infant child is less than 90 days old and is running a temperature greater than say 100.5 rectally (yes in the bum bum- rectal is most accurate) or your Peds doctor will tell you a specific temperature to call for. Please attempt to call your doctor first! They want to be called before you rush to the ER!
Infants less than 90 days old with a high fever is a medical emergency, these little ones still have mommas antibodies floating around from birth. They should not have fevers that high. Be prepared if you take an infant that small to the ER with a high fever that he/she will get a full septic work up which may include blood work , catherized urine specimen's(most sterile collection), xray's, lumbar puncture(spinal tap looking for ?meningitis) , IV with antibiotics amoung the most common things ordered by an ED physician.
Even in older children a call to the Peds doctor first can save you stress, time and the very expensive cost of an ER visit. Not to mention the germ exposure to your other family members.
Many cooling methods can be performed before you visit your local ED or even your doctors office.
First of all, give your kids some medication for fever. Acetaminophen (Tylenol) or Ibuprofen (Motrin: if they are over 6 months of age) is made for just that reason, they are fever reducers and pain relievers. You are not going to overdose or kill your child by giving these medications. You can even given them together in appropriate situations, they are metabolized in different areas of the body (kidneys and liver) so it is perfectly ok if your pediatric doctor or the ED doctor tells you to give the medications together for one dose to reduce a high fever, then alternate the medications from then on.
A Fever is the body's defense mechanism for fighting off some kind of process going on, such as viral or bacterial infection. It is ok for your child to have a fever (don't flip out on me now). Fever in the body's natural reaction to a stress reaction going on inside the body. It is trying to fix the problem in its own natural response.
Febrile seizures most often will occur in children that might be prone to these (due to a problem with the temperature thermoregulation). A febrile seizure occur due to a sudden rapid rise in the temperature.
Children can burn up a lot of fluids when they run fever, hydration is important. Don't worry so much about trying to feed them, just make sure they are drinking fluids such as water, electrolyte solutions (Pedialyte/ Ricelyte), coconut water, juices, clear sodas( if that's all they will drink- especially older kids) Popsicles etc.
Avoid dairy products please,unless you want to see the clabbered milk again.....yuck, dairy tends to just make them vomit. I will never forget the time my husband gave my feverish 1yr old daughter a whole bottle of milk just before I got home from working a 12 hour night shift. She proceeded to cover me in hot milk vomit as soon as I tried to pick her up.......lovely it was.
The info-graphic below has some great info about fever, please educate yourself.
Thursday, November 27, 2014
Nurses are thankful for many things, but they seem to have a strange way of showing there gratitude sometimes. Only another ER nurse that has been in the trenches day after day (or night after night) understands the gratitude shown by another ER nurse. We are an odd breed of nursing creature, we are.
Humor helps us cope with the stress, chaos, drama, unrelenting flood of patients, death and dying, and our own misfortunes too. We have a dark side of humor that most laypeople just don't understand. Believe me, most of the time we are laughing with you and would never wish to hurt your feelings by laughing at your pain or loss. Laughter is a coping mechanism for healthcare providers.
When you hear laughing and joy in the Emergency Department, don't get upset and think the staff is just goofing off, not doing their jobs and have forgotten about you or your loved one.
Laughter is a good thing, it means the nursing staff is able to destress a minute,cope with the situation at hand, and they might be distressing together as a team.
You want your nurse to be happy.
This Thanksgiving I am so very thankful to be a nurse, for listening to my mother when she talked some sense into me at age 16. I wanted to be a veterinarian, but I don't do well taking care of sick animals (makes me cry) lol. So she suggested nursing instead since I was already working as a junior volunteer at a local hospital. Since 1979, I have loved being in the healthcare field, very thankful for such great nurses that took the time to show me their tips and actually believe in me.
Here is a list of other things that ER nurses can be thankful for:
- Great co-workers, nurses, nurses assistants and ancillary staff all included- we all work together for the common goal.
- When you actually have a great manager that listens to you, believes in you, and is fair all around, not unwilling to roll up his/her sleeves and work along side their staff to get the job done.
- Educators that educate, consistently making sure staff is up to date on certifications, new policies, new procedures etc. Not just making pretty bulletin boards (pet peeve), also willing to work in staffing when needed.
- Equipment that works
- EKG machines that print clear readings on the first try
- A well stocked supply room (yes I am reaching here)
- Benefit plan that fits your family needs -- they are not all perfect, but at least we have them
- No Psych pts on your shift...lol
- Sober patients are always nice
- Nice big juicy veins- and the ability to hit your iv on the first stick all day
- QBT---quality butt time....lol when we have an unusual night
- Laughter with great friends
Working in the ER changes you as a nurse, sadly the chaos, tragedy, stress and constant living on the edge carves away at your inner being. Many nurses working in this environment for many years become cynical, hardened, and pretty much burnt to a crisp. These nurses begin to think about other fields of work to try, but learn that they are used to a certain lifestyle and pay. Without going back to school or changing professions completely they feel stuck in a dead end job.
They also make their co-workers around them miserable, the team player is no more. Vocal and verbally negative, they complain constantly about everything from their own health to their patients (the very patients that they are there to care for).
Working with a "negative Nancy or Ned" is one of my most "unthankful" things, it drains me and makes me sad.
If you are that unhappy with your job, you need to find a new one ...fast.
I come to work in a great mood, happy to have a job and after many years still love my job. Yes some days are more stressful than others, but all in all the patient is why we are there to work. Whether it is a negative nurse, doctor, or even part of the ancillary staff, that person can pull everyone down and make the work environment unhealthy emotionally for everybody, then the patients ultimately suffer.
Here is a list of Un-Thankful things:
- Negative Nellies (or Neds) - get your head out of your butt
- Uncooperative staff (that complain about every new change- even if it is good)
- Co-workers that consistently call in sick (and you know your health is worse than theirs)
- Constant complainers- something is always wrong with them- always sick or have a problem
- Nurse Bullies (Horizontal Violence) - nobody has time for that
- Gossipers (mind your own business and let me do my job)
- Nosey Nosela's -- we all seem to have one or two that need to know it all (and tell it all)
- Superheros that know it all (but really don't) these nurses scare me- nobody knows it all
- Loners-- those that will not ask for help ( it is ok now to ask for help!)
Sunday, October 26, 2014
Early detection will save your life. Be a breast-friend and buddy up to remind your BFF this month too!
Saturday, October 25, 2014
If you are a nurse and you are reading this, you may be just as bewildered as I was once about heart arrhythmia's.
I learned to always look at my patient first and formost, know normal sinus rhythm , and then learn from there.
Is your patient pink, warm, dry and talking to you.....then you are ok!
Is the patient moving in the bed? is he scratching his chest? well you might just have some artifact and you almost jumped on your patient and scared the living crap out of him. Look for the simple fixes first unless he is grey, blue, or a nice shade of purple with no pulse.....then you can shout OH Sh@# and get some help......lol
Those crazy monitors are not always right, just because it says he is in Vtach, is he?? maybe, maybe not!
Practice, practice, practice and it comes with time and experience. A few embarrassing moments aside and you will learn, it has happened to all of us, don't let any ER or critical care nurse tell you that they have not been fooled before by a patients cardiac rhythm before, they are lying if they tell you otherwise.
Now what if you are not medically inclined? how do you interpret this chart? Best thing is to find out what kind of irregular problem you or your loved one has and learn as much about it as you can from your cardiac doctors or credible websites. Knowing all these different cardiac rhythms if you don't need to will just overwhelm you right now. Learning normal is a great way to learn what abnormal is. Start with the normal ECG components at the top and the anatomy of the heart itself, it is a fabulous organ.
I will review those in another post...............until later, have a great day or night!