Sunday, July 15, 2012

Seeking School Nurses

Any school nurses out there?  Since I am a former teacher, it's something I am considering for the future, or even teaching health classes to high school students.  If you have an experience as a school nurse to share, (good or bad) please contact me.  I'd love to hear different opinions on the subject.  I'm open to guest posts, too...

Wednesday, July 11, 2012

Breastfeeding resource site

Another helpful website that I have found is this one.  It is sponsored by WIC, and gives a lot of good information on breastfeeding, including preparation, pumping, storing breastmilk, etc  I hope you find it helpful, as well.

Tuesday, July 10, 2012

Are you monitoring peak flow readings?

We have many children in our practice who we see for various forms of coughing/wheezing/asthma-type symptoms.  Signs and symptoms of respiratory distress are always a concern, and are more of an emergency in babies, of course.

A great way to monitor children with a history of asthma is to use a peak flow meter.  Children above the age of 6 should be able to use one fairly accurately, and they are inexpensive and portable.  There is some great information here, with a video, on how to use a peak flow meter.  Acceptable ranges should be set by your child's physician, based on their height.  Once you have that information, you can plug in their height and peak flow reading on this calculator to see if he/she is in the green range.  Using a peak flow meter to manage asthma should go hand in hand with an asthma action plan, set up by your child's physician, reviewed yearly, and a copy should be given to your child's school nurse, along with any rescue medications he or she might need at school.

**Just to be clear, this is to be taken as informational only, not as medical advice.  I don't know you or your children, and I am not acting as a representative of the medical practice where I work.  If your child does have asthma or other respiratory issues, you should contact your child's physician.

Monday, July 9, 2012

Pediatric Advisor

I've been a pediatric triage nurse for 10 months now, and on the days when I am not rooming patients, doing procedures, completing monthly VFC reports, ordering supplies, or training new employees, I answer phone notes on the computer from patients' parents who call in for advice.  Most of the calls are fairly simple, but others become more complex, due to the patient being out of town, not wanting to come in for an office visit, having an unclear diagnosis, etc.

One of the resources that we use at work is Pediatric Advisor.  It's an alphabetical index of different conditions that pediatric patients might have, and it gives clear, simple information.  It's a great tool to use for reference, but not as a substitute for advice from your child's physician, of course.  Think of it as supplemental reading material...

Saturday, July 7, 2012

The saga of my first nursing job, part 3

If you are just starting to read this, you may want to read part 1 and part 2 first, so that this makes more sense to you. I know it's been months since I last posted, but I really want to finish this series and not leave the few of you who are still reading this hanging. I started my first nursing job in July of 2011 and was so excited/nervous. I was hired at the recommendation of a classmate of mine from nursing school, who I knew, but not well. She offered me to ride to the office with her in the beginning, because she was still in training, and not out in the field on her own yet.

 I spent my first few days of work in the office, completing paperwork and learning policies and procedures. I was itching to go and see patients, even though I had no idea what to expect. I knew that the job would be heavy on wound care, medication management, and admitting patients for physical therapy. I had my equipment ready to take vital signs, and was given a glucometer and finger pulse oximeter. My friend and I were so excited the day we received those, and packed up our very own plastic tub of wound care supplies.

 For the first few weeks of being "out in the field", I would ride along with one of the agency's experienced nurses to see patients. I saw areas of the city that I had never been to, and the long days of riding in the car in the hot summer sun were exhausting, after commuting over an hour to reach the office. I received training on two different kinds of wound vacuums, and also on the online documentation system that the agency used. The most fun that I had during that time was trying different restaurants for lunch in the different parts of the city. I started out slowly with my own patients, tag-teaming with my friend. Between the two of us, we would see 5-6 patients per day, all over the city. Some days, we would go back to the office to complete paperwork or pick up supplies, and other days, we would finish early enough with patients to go home and chart. We really enjoyed working with each other and getting to know each other.

 For the few weeks that we worked together, we continued to inquire as to when our territories would be established, and when we would start seeing patients in the area where we live, as promised. The answer was always vague, because I don't believe there really was a plan for this. The owner of the agency wanted to establish in the area where we live, but didn't have enough contacts, nor did he have therapists in the area, so that eliminated the number of patients who we could see. There began to be a lot of pressure to take patients on the weekends, and my friend ended up taking a couple of weekend patients, but I refused. Weekend pay was less than my normal hourly rate, and with the gas and time required to see weekend patients, it was not worth the time away from my family to me. Plus, I was not willing to work seven days a week. Because I would not see weekend patients (even though I specifically asked about that in my interview), I began to be "punished" by being assigned patients even farther away from my home (120 miles roundtrip with no compensation for mileage), or being told that I had to go and sit at the office on the days that I did not have a full patient schedule. While I enjoyed the patients, I began to really regret my decision to accept the first nursing position that I was offered.

 Near the end of this time, I was contacted by a friend of mine, who was the administrator of a pediatric practice, asking if I would be interested in a job. His wife was one of the pediatricians in the practice, and I had done some interning with them while I was in school. This is also the pediatrician who my children see, and the practice is five minutes from my house. I REALLY wanted to work with children, and felt that this would be my dream job, if I were hired. They brought me in for an interview, and I didn't hear anything back from them for several days. I was so excited when I was finally offered a position as triage nurse. I was so relieved to know that my days on the road were coming to a close. I gave two weeks' notice at the home health agency, ended up working just one more week for them, and started my new job the day after Labor Day 2011. That's the story; I know it would have been more detailed had I not waited almost a year to finish it, but I have just reached the point where I am feeling a little more comfortable juggling work and life.
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