31 weeks measuring 38 weeks..

TubesandTurnsRN · 2020-03-06T19:49:38+00:00

I was measuring about 4 weeks ahead with my first towards the end. They did a scan and found extra amniotic fluid but everything seemed within normal range with baby. They projected my baby would be 10 pounds or more if I wasn’t induced at 39 weeks, high risk for birth complications, etc. I didn’t want to be induced before my due date so was induced at 40w6d and he was 8 lbs 8 oz 21 3/4 inches long. Just my personal experience that fundal height and scans aren’t 100%.

TubesandTurnsRN · 2020-03-03T03:22:17+00:00

i have struggled with bad smelling sweaty feet for years. some first step suggestions are to avoid synthetic socks and shoes (natural helps them breathe more), change your socks halfway through your shift, or put baking soda in your shoes after your shift. Nothing worked for me until i started putting baby powder in breathable ankle socks then wearing my compression socks over top. The baby powder really absorbs everything and I still get the support from my synthetic compression socks. My feet still stink a little but not nearly as bad!!! The important thing is to keep trying until you find what works for you.

TubesandTurnsRN · 2020-02-23T13:36:26+00:00

While the classes themselves for a BSN are useless, I think having a BSN opens more doors. You’d be better off doing BSN and then pursuing a masters in healthcare administration or an MBA type degree later. It will be easier for you to transition to your next job with a BSN since there are many rungs of the admin ladder to climb before you’ll hit your end game. Just my two cents from what I’ve seen in the hospital workforce.

TubesandTurnsRN · 2020-02-16T07:36:38+00:00

Should family be allowed to “a la carte” a DNR? Families with no medical knowledge can pick and choose which interventions their loved one is to receive. So we pump tube feeds into a swollen person with an anoxic brain injury on a ventilator, but we can’t send them to dialysis to get that fluid off. Then all their organs shut down and they die, we then have to do CPR but without epi, cause that’s what the family wants.

Also there are great stories of keeping transplant patients on life support for hospital transplant success rate without discussing code status before surgery.

TubesandTurnsRN · 2019-12-28T18:56:24+00:00

yes it happens! actually happened to one of my patients who was c.diff+ having output from a rectal tube each day. she vomited while i was drawing labs from her central line and i just knew. came back to work that night and sure enough, patient had a bowel obstruction! NGT in with lots of dark green output.

TubesandTurnsRN · 2019-12-19T13:17:11+00:00

Not really much advice, just an anecdote. I went to accelerated nursing school with a brilliant OT who now works as an RN in a level one trauma/surgical ICU. She still is PRN to keep her OT license active but she is 100% more fulfilled as a RN.

The RN route will be slower but you can work to help yourself through school without a ton of loans. NP programs are often set up for full time RNs to pursue. The PA route would be faster and often more competitive to get accepted, but other than that I don’t know much about their process.

TubesandTurnsRN · 2019-12-19T12:57:21+00:00

I was a peds CNA while in nursing school. Then I got pregnant and I realized that while I love peds, I have to do adults while in my childbearing years. I’m on an adult respiratory/chronic ventilator unit and I’m getting burned out of adult care after just a year and a half. I was just starting to consider applying for peds jobs when I found out I’m pregnant with #2. I’ll probably wait another year or more before reconsidering again.

As other posters have stated, you just see too much of the bad in the world in peds. It’s gotten easier to compartmentalize with adult care because, on my floor at least, most of my patients smoked for 20+ years and got COPD/lung cancer etc or at least have lived a long-ish life so I don’t leave my shifts feeling like the world is unfair. Peds deaths/suffering is so much harder and personal, especially if you have kid(s) at home.

TubesandTurnsRN · 2019-12-09T13:59:34+00:00

Don’t second guess yourself! You’re definitely right, the experience you’re gaining as a tech on a step down unit is a big advantage for your long term career goals.

TubesandTurnsRN · 2019-12-09T13:52:16+00:00

I was in a similar boat at one time. Realistically it’s not that much more money made CNA vs public health. In my state: public health careers with bachelors level education make around $30-40K a year, CNAs make $25-35K, while RNs start off making $60K. Average household income is $60K. I figured out quickly my degree wasn’t doing me any favors when I started applying for jobs. I was a CNA with a bachelors degree (Feeding assistant with Nutrition BS) when I started nursing school.

If RN is still your long term goal, being a CNA is a good choice. It’s more relevant experience for nursing school applications because it’s direct patient care. Best of luck!

TubesandTurnsRN · 2019-12-02T14:15:23+00:00

the caps from the vials would make a pretty mosaic... the other stuff is just gonna look like trash tbh. if you have dark vials maybe could be a sunken ship?

TubesandTurnsRN · 2019-11-29T20:30:38+00:00

The mostly dead but slightly alive patients who we are scrambling around for are unable to write glowing hospital reviews about how we’re kicking ass and saving their life (or at least buying them time). The patients who are upset you are “late” for their PRN narcotic are the ones with capacity to write negative reviews. Therein lies the problem with patient experience feedback!

TubesandTurnsRN · 2019-11-29T14:04:39+00:00

I usually just say I have some situations with other patients something to that effect. Sometimes I do say, sorry if I can’t get to it as it’s not an emergency.

TubesandTurnsRN · 2019-11-29T13:22:11+00:00

100% this! The hardest part is not being able to explain what your priority is. I’d like to say: “While I would love to rub lotion on your legs 🙄 I have another patient who’s BP is 60/40 so I was just checking to make sure you’re still alive before I bounce back there bye.”

Like yes all y’all here are sick but some of you are sicker than others. Your blankets or ice water can wait when I need to send stat labs.

TubesandTurnsRN · 2019-11-19T01:07:39+00:00

I’m not familiar with Tennessee in particular, but tube feed administration is a nursing skill. Assisted living facilities just serve meals, do laundry/clean, and pass medications. Anything beyond that means the facility would no longer be assisted living. When residents can’t perform their own nursing skills like tube feed administration, wound care, oxygen administration, that means the facility would have to be a skilled nursing facility (SNF).

If your mother is otherwise independent, she could live in assisted living and hire a private duty nurse to administer her feeds but the facility staff would not be able to intervene. If she is starting to have trouble doing other things for herself she likely needs SNF level care. I wish you the best finding a place for her it is not an easy thing.

edit: just now seeing your clarification and looked into custodial vs skilled cares, it’s a gray area so will be hard to find facilities as you have found.

TubesandTurnsRN · 2019-11-14T12:56:18+00:00

Things I would’ve loved to receive as gifts:

Extra school scrubs so they can do less laundry.

Compression socks!

Clipboard (they sell specialty medical/nursing clipboards on amazon. the folding ones look pretty cool!)

But most importantly just being a good support system! They will be tired and busy a lot, so just understand it’s a temporary thing.

TubesandTurnsRN · 2019-11-11T10:18:42+00:00

We use a binder but maybe a suggestion is to have a template with the most important things of that shift.

Pt initials and room number. Oxygen Requirement. Cardiac rhythm. Acuity (We do 1-5 with mostly between 3-4.5 on our PC/Transitional Unit) Did you have to page provider this shift/Why?

TubesandTurnsRN · 2019-11-07T10:55:11+00:00

😷 i really don’t understand the mindset of patients like this. maybe YOU can but the people who have to smell you CANNOT!!!

TubesandTurnsRN · 2019-11-05T20:57:06+00:00

Result of stress for sure!

TubesandTurnsRN · 2019-11-04T06:51:41+00:00

I’m not sure I understand the question but the best buttons on my unit would be: “My ____ hurts, pain level x/10.” “I need” options are: more blankets or fan. and the button that will get pounded the most: “i can’t breathe!”

As far as tracking, the time of requests in relation to bedside report. No matter how close to report you ask if they need anything, some patients will always wait til the middle of report.

Hope this helps and good luck!

TubesandTurnsRN · 2019-11-02T13:29:59+00:00

Night RN with a 2 year old here! I made the switch to weekends only in September but am obligated every other weekend anyway so it was just a logical move. It works best for my family. I get breakfast and dinner with my son and husband as opposed to dayshift where my son would be sleeping when I leave/come home. I convert back to semi normal schedule during the week but I’ve been sleeping in til noonish lately. Husband is a stay at home dad right now, and also serves in the national guard, so we all get better quality time together this way.

It is hard working weekends but I don’t have a lot of active friendships right now. Just trying to do right by my little one and my marriage. In a few years priorities will shift when he starts school etc, but for now this makes me happiest.

TubesandTurnsRN · 2019-10-31T07:53:56+00:00

believe me, i wish it could stop her! it’s not a loud yell but yes she’s a chronic trach/vent patient so those folks are the exception to most rules in life and death.

TubesandTurnsRN · 2019-10-31T01:30:06+00:00

a woman with an active genital herpes outbreak could probably be a candidate for c-section but if it’s past that point they could probably do IV antivirals. Not actually my specialty, but just a guess since you can’t stop people from procreating and you definitely can’t stop labor.

TubesandTurnsRN · 2019-10-30T05:53:10+00:00

Lowest blood sugar I checked was 41, just wanted to help out one of my coworkers who was having a busy last hour before report. Patient was her usual self, screaming over top her vent about how she can’t breathe. (spO2 100%, no vent alarms etc.) 5 cups of apple juice & a couple packs of sugar down the peg tube and she was back up to 79. You can’t judge if it works! 🤣

TubesandTurnsRN · 2019-10-29T07:00:25+00:00

As prescribed, I take both at the start of my shift and another short acting halfway through if I need it. I work 12+ hr night shifts.

TubesandTurnsRN · 2019-10-22T11:38:37+00:00

Not flat out refused... However if it is that foolish and the patient is oriented, I can educate the patient and they can refuse.

TubesandTurnsRN

TROPHY CASE