Interesting discussion with a couple nurses

[tommygunz]

Well sounds like everyone agrees, aspirate always..

 

[myosin]

Taking deep breaths...

Absolutely...Its a very tough program, and nurses hold everything together at many facilities.

THANK YOU MICHAEL!!!

Where I live there a ton of nursing programs, (4 or 5) and it is not as difficult as it is, where ever your located. A "B" average will get you in most schools. There is one Unversity where everyone "thinks" they only take the straight "A" student, and only take about 45 students each term. But really it's based on the interveiw process, in reality they actually take more "C" students than any other school.

My wife is an RN and I'm applying next term, not scared at all about not getting accepted. Would be, if I listened to people that were not as informed.

Going to depend on the area, but AS A WHOLE, it is very hard to get into d/t limited availability (private schools are always easier though, got the cash, pretty much got the seat).

Anyhow... guys, I'm trying keep cool here as I am an RN, and if I can say so, a VERY GOOD ONE. Who do the Residents and Attending Physicians want in an emergency? ME. Not perfect, made mistakes (and will)... but some of this thread got into a little nurse bashing... cool it huh?

Yes, some nurses, I AGREE, are just useless... the same goes for Physicians, medics and the lot. Like any profession, you will have your stars and bench-warmers. Just b/c someone got through medical training doesn't mean they remembered, absorbed or assimilated everything... AND, just b/c someone got a medical degree/training, doesn't mean they will be able to put it all together when the rubber meets the road in real world.

hahaha, ok, ok, sorry, I'm done now

 

[Tom]

THANK YOU MICHAEL!!!



Going to depend on the area, but AS A WHOLE, it is very hard to get into d/t limited availability (private schools are always easier though, got the cash, pretty much got the seat).

Anyhow... guys, I'm trying keep cool here as I am an RN, and if I can say so, a VERY GOOD ONE. Who do the Residents and Attending Physicians want in an emergency? ME. Not perfect, made mistakes (and will)... but some of this thread got into a little nurse bashing... cool it huh?

Yes, some nurses, I AGREE, are just useless... the same goes for Physicians, medics and the lot. Like any profession, you will have your stars and bench-warmers. Just b/c someone got through medical training doesn't mean they remembered, absorbed or assimilated everything... AND, just b/c someone got a medical degree/training, doesn't mean they will be able to put it all together when the rubber meets the road in real world.

hahaha, ok, ok, sorry, I'm done now

no disrespect to you myosin but the whole medical profession as a whole needs some kind of policing. i believe you are an outstanding RN. unfortunately there is far too much incompetence in the medical field and if anybody on this board has a loved one in the hospital you should have a family member there 24 hours checking that the proper meds are given, staff and doctors are washing thier hands before seeing your family member and that your questions are answered to your satisfaction.

 

[myosin]

Agree....

no disrespect to you myosin but the whole medical profession as a whole needs some kind of policing. i believe you are an outstanding RN. unfortunately there is far too much incompetence in the medical field and if anybody on this board has a loved one in the hospital you should have a family member there 24 hours checking that the proper meds are given, staff and doctors are washing thier hands before seeing your family member and that your questions are answered to your satisfaction.

thanks Tom, appreciate that, really.... and I AGREE.... too many people see this as just a "job" and do not put their "heart/soul/etc" into it... it's just another paycheck for many. Believe me, in no way do I think the medical professionals can walk on water... they suffer from the greatest ailment of them all... being fallible human beings.

 

[Michaelthomasj]

Where I live there a ton of nursing programs, (4 or 5) and it is not as difficult as it is, where ever your located. A "B" average will get you in most schools. There is one Unversity where everyone "thinks" they only take the straight "A" student, and only take about 45 students each term. But really it's based on the interveiw process, in reality they actually take more "C" students than any other school.

My wife is an RN and I'm applying next term, not scared at all about not getting accepted. Would be, if I listened to people that were not as informed.

Yes! My house is in the process of being sold, and i am moving down to south carolina. I am also going to be applying to schools to get my rn degree. I have a lot of sciences already and hopefully this will give me an edge with the application process. I have been a funeral director/mortician for 14 years now. My brother is a registered nurse, and i should have listened to him before going into the mortuary sciences, but this is what it is.

 

[Michaelthomasj]

no disrespect to you myosin but the whole medical profession as a whole needs some kind of policing. i believe you are an outstanding RN. unfortunately there is far too much incompetence in the medical field and if anybody on this board has a loved one in the hospital you should have a family member there 24 hours checking that the proper meds are given, staff and doctors are washing thier hands before seeing your family member and that your questions are answered to your satisfaction.

I believe this problem is in every field known to man.

 

[Tyrone]

OKAY...

Maybe I'm doing it all wrong and with risk.

I follow How To Do Injections, Injection Instructions, Injection Methods, Injection Guide, Injection Photos, Injection Pictures, Sterile Needles I never aspirate for IM or SubQ...I know what I'm doing.

I warm the fluid, make sure all air is clear that I can, and then inject Deep into the muscle head or do a subq like How To Do Injections, Injection Instructions, Injection Methods, Injection Guide, Injection Photos, Injection Pictures, Sterile Needles says.

What's wrong with that when using 'good stuff'??

I never withdraw to see if I'm in a blood vessel cause I'm deep in the muscle though

 

[Emery]

I am a RN... Aspirate! Enough said!

 

[N623]

THANK YOU MICHAEL!!!



Going to depend on the area, but AS A WHOLE, it is very hard to get into d/t limited availability (private schools are always easier though, got the cash, pretty much got the seat).

Anyhow... guys, I'm trying keep cool here as I am an RN, and if I can say so, a VERY GOOD ONE. Who do the Residents and Attending Physicians want in an emergency? ME. Not perfect, made mistakes (and will)... but some of this thread got into a little nurse bashing... cool it huh?

Yes, some nurses, I AGREE, are just useless... the same goes for Physicians, medics and the lot. Like any profession, you will have your stars and bench-warmers. Just b/c someone got through medical training doesn't mean they remembered, absorbed or assimilated everything... AND, just b/c someone got a medical degree/training, doesn't mean they will be able to put it all together when the rubber meets the road in real world.

hahaha, ok, ok, sorry, I'm done now

No disrespect to ya bro. I know plenty of high quality, compasonate and caring RNs like yourself and I know plenty of know nothing, SOBs who are in it for the money, the one's who won't get up to answer a call light unless theres a box of candy in the room. Here's some quick points we, in the medical community need to mull over.

As long as we import non Western, 3rd world nurses in this country to satisfy the needs of corporate hospitals we will pay the price.

As long as the private "pay your fee and take your C" schools exist we will pay the price.

As long as RNs and ancillary staff are paid below their worth, these profesionals with all the skill and experience will keep leaving the field and we will pay the price


Honestly, I can't continue as ethics is a very passionate subject for me.

I did not intened to slander any nurses as I have ethical issues with as many PTs, RTs, CNAs, residents and the likes. Fuck, I'm the worst out of the bunch.

You see brothers, all dilemas in Western medicine can be answered with one question..."What if it was your mother?" We've thrown all this out. We've traded private hospital for corporate concentration camps whos only concern is profit. We bring in professonals to treat illness and pain while in their culture it's a loss of face to show pain (so the practitioner is less apt to treat the illness accordingly). If we have big cities with few universities, Las Vegas for instance, where is the quality education and the healthy competition it brings.

Sorry about the rant, I just wanted to say i don't mean to slander the noble profession of nursing.

I knew we were screwed when hospital administrators started referring to people as customers and not patients.

 

[efw]

For the type of injections the people reading this board are doing, always aspirate. With certain types of medications, it would be pointless to aspirate due to the pharmacokinetics of particular drugs. In fact, most drugs administered in the HOSPITAL setting are IM/IV and of course usually given IV. So even if you did "hit a vein" it really would not matter. However, with medications suspended in oil, always aspirate.

RN, BSN, CVICU

 

[joesamphilip]

Hmm

I've been self administering AAS since the last year and a half and am' on trt and do blast once every two months thereabouts. I have never aspirated and never hit a nerve. If one is careful in choosing his injection spot, i don't think there will be a problem.

And yes, i do rotate sites and do outer quads, glutes and delts.

 

[Rex Feral]

For the type of injections the people reading this board are doing, always aspirate. With certain types of medications, it would be pointless to aspirate due to the pharmacokinetics of particular drugs. In fact, most drugs administered in the HOSPITAL setting are IM/IV and of course usually given IV. So even if you did "hit a vein" it really would not matter. However, with medications suspended in oil, always aspirate.

RN, BSN, CVICU

This correct. I read through the whole thread somewhat amazed that no one answered this correctly.

The recommendations for non-aspiration come primarily from vaccination protocols in the pediatric population. These recommendations are sanctioned by the CDC and are not invalid. Primarily for the reasons stated above, but also due to the population, the size of the needle and the injection site.

No nurse gives IM injections of oil into areas like the biceps for example. Plenty of people here do though. In that case, aspirate always. How many nurses here have ever given an oil injection to anyone but themselves? Not many if any. In 17 years the only time I have ever given an oil based that I can remember is when I was partnered in an HRT clinic.

So the answer, with regards to aspiration, like most things, is not so black and white. For the large part in traditional medical practice, using traditional medications in traditional sites w/ specific needle length specifications, there is no need to aspirate. For oil based injections in highly venous sites and/or without careful consideration of needle length aspiration is advisable. There is no data to support the need for aspiration, thus the lean towards non-aspiration. But in our population, which is highly specific, there is clearly a need in my opinion. Personally, I always aspirate regardless, b/c that's how I was taught and its somewhat ingrained. But I will not disagree that is largely useless in traditional practice.

Air of course does not matter. Complete joke that people still believe this. As long as there is less than 60 ml of air or so, which no one here ever has to worry about.

There is also no data to support the use of alcohol on the site prior to injection. This is also becoming somewhat controversial. For the large part it is completely useless given the person has reasonably clean skin and proper hand washing is adhered to. As one of my early mentors in ICU used to say, "All that does is move the germs around." I use alcohol swabs on alert patients mostly because its expected and for no other reason. I have never used alcohol swabs on myself personally in 23 years of self injections and I very rarely used them on non-alert ICU patients without incidence. The alcohol would have to sit for a period, anywhere from 2-10 minutes depending on what data you look at, to even possibly have any reasonable effect on microbes. The practice in and of itself is clearly questionably necessary as long as prudence of aseptic technique is adhered to. But the way that 99.9% of the people here practice it, swabbing with alcohol is completely useless.

Rex.

 

[eroc613]

No disrespect to ya bro. I know plenty of high quality, compasonate and caring RNs like yourself and I know plenty of know nothing, SOBs who are in it for the money, the one's who won't get up to answer a call light unless theres a box of candy in the room. Here's some quick points we, in the medical community need to mull over.

As long as we import non Western, 3rd world nurses in this country to satisfy the needs of corporate hospitals we will pay the price.

As long as the private "pay your fee and take your C" schools exist we will pay the price.

As long as RNs and ancillary staff are paid below their worth, these profesionals with all the skill and experience will keep leaving the field and we will pay the price


Honestly, I can't continue as ethics is a very passionate subject for me.

I did not intened to slander any nurses as I have ethical issues with as many PTs, RTs, CNAs, residents and the likes. Fuck, I'm the worst out of the bunch.

You see brothers, all dilemas in Western medicine can be answered with one question..."What if it was your mother?" We've thrown all this out. We've traded private hospital for corporate concentration camps whos only concern is profit. We bring in professonals to treat illness and pain while in their culture it's a loss of face to show pain (so the practitioner is less apt to treat the illness accordingly). If we have big cities with few universities, Las Vegas for instance, where is the quality education and the healthy competition it brings.

Sorry about the rant, I just wanted to say i don't mean to slander the noble profession of nursing.

I knew we were screwed when hospital administrators started referring to people as customers and not patients.

So the state boards need to be harder? That's what gets the liscense to become a registered nurse....not the degree itself.
Funny story, for you....My wife graduated with a girl that ranked #2 in her graduating class, this girl got a job at the same place as my wife. (4.0) student now....guess what, she couldn't handle it, was constantly making mistakes, and finally had to quit.
Not everything is about numbers, if your an intelligent person you now this.

Just like this thread had many different veiw points from intelligent people, but this last post(not the one I quoted) and one other, took it a step further to explain. That doesn't make the other people posting less intelligent, or not able to do the same job.

 

[J_Diggs]

This correct. I read through the whole thread somewhat amazed that no one answered this correctly.

The recommendations for non-aspiration come primarily from vaccination protocols in the pediatric population. These recommendations are sanctioned by the CDC and are not invalid. Primarily for the reasons stated above, but also due to the population, the size of the needle and the injection site.

No nurse gives IM injections of oil into areas like the biceps for example. Plenty of people here do though. In that case, aspirate always. How many nurses here have ever given an oil injection to anyone but themselves? Not many if any. In 17 years the only time I have ever given an oil based that I can remember is when I was partnered in an HRT clinic.

So the answer, with regards to aspiration, like most things, is not so black and white. For the large part in traditional medical practice, using traditional medications in traditional sites w/ specific needle length specifications, there is no need to aspirate. For oil based injections in highly venous sites and/or without careful consideration of needle length aspiration is advisable. There is no data to support the need for aspiration, thus the lean towards non-aspiration. But in our population, which is highly specific, there is clearly a need in my opinion. Personally, I always aspirate regardless, b/c that's how I was taught and its somewhat ingrained. But I will not disagree that is largely useless in traditional practice.

Air of course does not matter. Complete joke that people still believe this. As long as there is less than 60 ml of air or so, which no one here ever has to worry about.

There is also no data to support the use of alcohol on the site prior to injection. This is also becoming somewhat controversial. For the large part it is completely useless given the person has reasonably clean skin and proper hand washing is adhered to. As one of my early mentors in ICU used to say, "All that does is move the germs around." I use alcohol swabs on alert patients mostly because its expected and for no other reason. I have never used alcohol swabs on myself personally in 23 years of self injections and I very rarely used them on non-alert ICU patients without incidence. The alcohol would have to sit for a period, anywhere from 2-10 minutes depending on what data you look at, to even possibly have any reasonable effect on microbes. The practice in and of itself is clearly questionably necessary as long as prudence of aseptic technique is adhered to. But the way that 99.9% of the people here practice it, swabbing with alcohol is completely useless.

Rex.

Wow. Thanks for the very detailed feedback. We appreciate it.

 

[ronnieron]

So the state boards need to be harder? That's what gets the liscense to become a registered nurse....not the degree itself.
Funny story, for you....My wife graduated with a girl that ranked #2 in her graduating class, this girl got a job at the same place as my wife. (4.0) student now....guess what, she couldn't handle it, was constantly making mistakes, and finally had to quit.
Not everything is about numbers, if your an intelligent person you now this.

Just like this thread had many different veiw points from intelligent people, but this last post(not the one I quoted) and one other, took it a step further to explain. That doesn't make the other people posting less intelligent, or not able to do the same job.

some people just have book smarts, but are unable to handle pressure of the job, whether its the pressure or the people whom they come in contact with that they can not stand.

Anyway I had a question about the licensing, once you get your RN, are you required to do anything after that to keep it valid? How often? Does it vary by state?
was wondering because IMO AZ's RN's are to say the least not good. was just curious if they are required to do any further testing or anything to renew or keep their license valid

 

[Rex Feral]

some people just have book smarts, but are unable to handle pressure of the job, whether its the pressure or the people whom they come in contact with that they can not stand.

Anyway I had a question about the licensing, once you get your RN, are you required to do anything after that to keep it valid? How often? Does it vary by state?
was wondering because IMO AZ's RN's are to say the least not good. was just curious if they are required to do any further testing or anything to renew or keep their license valid

CEUs (continuing education units) are generally required yearly or bi-yearly. Yes, it varies tremendously from state to state. Here in CA it is 30 hours. This is near the top end, or the most required by any state. AZ does not require CEUs at all. So you see it varies widely. Just b/c you have CEU credits though it doesn't necessarily mean anything. Any CEUs will suffice, so it may or may not have anything to do with what you actually do. Many, you basically pay and get the CEUs without having to do much of anything. The better nurses take responsibility for their own continuing education. Most could care less though and meet the min requirements for CEUs in the easiest way possible.

There is little congruence in nursing b/c it is run by angry, miserable cunts who for the most part would prefer to stab each other in the back and eat their young rather than work together to advance the practice.

Rex.

 

[myosin]

Geez...

I think I sounded too upset with my post sorry guys, thanks for the positive feedback though

Rex: There is little congruence in nursing b/c it is run by angry, miserable cunts who for the most part would prefer to stab each other in the back and eat their young rather than work together to advance the practice.
I never get over the attitude of some nurses... I find it so interesting. There is also the "ambiance" of where they work that they think they have to be a "certain way" (ER, ICU's, etc.) I always find it kind of funny when I bring a trauma patient from the field to the ER... even if the kid just has a broken leg everyone seems to act like they're on a TV show hahahahaha

As far as wiping with alcohol... I still think it's a very viable practice... I posted a thread a while back with a "black-light" highlight of injection ports and how much bacteria was present varying from 0 second wiping to 15 second wiping. While the port isn't sterile from this, it does remove the bacteria... I'm thinking more along the lines of those with
1) A central line
2) compromised immune system
3) poor nutritional status (which can lead to #2)

D/T these reasons our ID department implemented the "15-second rule" for central line injection ports to prevent Blood Stream Infections (BSI)... so far we've had no BSI's for 9 months (proper site cleaning and occlusive dressing being important too of course).

Always enjoy your stuff

Oh- went back and found the link...
http://www.professionalmuscle.com/f.../56671-how-clean-injection-site-pictures.html

 

[maldorf]

I dont trust nurses like I used to.

When I was in ICU and on an IV of Heparin, my nurse made a mistake and put on a bag of dopamine instead of the heparin when he changed the bags. My heart was so weak but had recovered so that I didnt need dopamine anymore but this ass screws up and puts me back on it again. To make matters worse the dose was set like it was Heparing and not dopamine so my dose was like 3 or 4x what it should have been! My fucking BP spiked to about 200/ 165 or so. I felt like I was going to die all over again, and probably could have. I told him something was wrong but he blamed it on me getting up after eating a big dinner. Another nurse came into the room for something else and noticed the mistake thank god, or I would have been on that IV any longer. I hate to think what might have happend to me. They wanted me to sign papers, but I refused. Definite malpractice in my book!

 

[myosin]

!

When I was in ICU and on an IV of Heparin, my nurse made a mistake and put on a bag of dopamine instead of the heparin when he changed the bags. My heart was so weak but had recovered so that I didnt need dopamine anymore but this ass screws up and puts me back on it again. To make matters worse the dose was set like it was Heparing and not dopamine so my dose was like 3 or 4x what it should have been! My fucking BP spiked to about 200/ 165 or so. I felt like I was going to die all over again, and probably could have. I told him something was wrong but he blamed it on me getting up after eating a big dinner. Another nurse came into the room for something else and noticed the mistake thank god, or I would have been on that IV any longer. I hate to think what might have happend to me. They wanted me to sign papers, but I refused. Definite malpractice in my book!

Holy Cow Mal! So sorry that happened man. Here's what makes that worse...
1) Some drugs, like lasix and versed, have a VERY similar label (same color, etc) so mistakes happen from this, BUT, heparin and dopamine DO NOT

2) There is SUPPOSED to be a "double check system" in place any time someone hangs an IV med which is OFTEN not done.

 

[Tom]

if you find yourself in the hospital question every iv bag, pill and injection before they put it into you. the staff will hate you but that's too damn bad. if you are unable to communicate make sure a family member will watch out for you. the number of med errors( some fatal) in the u.s. alone is astronomical!!!!