What do you need to know as a nursing student about Chronic Kidney Disease?

Today I'm going to be talking about chronic kidney disease. 
When a patient has a problem with their kidneys, it can either be an acute problem or a chronic problem. So it could be acute kidney injury which can often be reversed and fixed or it could be chronic kidney disease and that is not reversible. With chronic kidney disease they will eventually need dialysis or a kidney transplant. Chronic kidney disease is an irreversible loss of kidney function that happens slowly over time. It's often called a “silent disease” because it usually presents with no symptoms at first. We can say that a person has chronic kidney disease once their glomerular filtration rate or GFR is less than 60 ml per minute.

Chronic Kidney Disease

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The difference between working in a hospital and working home health is night and day. I’m going to be talking about my experience as a home health nurse, what a day in the life looks like. I’m going to touch on some myths about home health nurses, kind of the reputation that they have and if I think that that’s warranted or not. And how it compares to working in the hospital. These are just things to kind of tuck in your back pocket if you’re going through nursing school right now, or if you’re about to go through nursing school. And if you’re anything like me, I had no idea what kind of nursing I wanted to do after I graduated. Some of my friends knew exactly what they wanted to do and I always envied that. But that was not me, and I think in some ways, I’m still looking. You know, but I don’t think there’s any shame in that. I think it’s good to be curious, and I hope I’m forever curious and forever learning. And that’s what I’m doing right now. I’m learning about different specialties within nursing, and that is the beauty of nursing. 

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Home Health Nursing For The Win

Today we're talking about a basic one but a big one. We’re talking about falls. We're gonna get into what constitutes a fall, because it may not be exactly what you think a fall is but it would still count as a fall. We're gonna get into what makes a person more likely to have a fall; we're gonna get into what we as nurses can do to help prevent falls, and we're also going to touch a little bit on the good and bad of placing so much importance on preventing falls.

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FALLS

Let's continue talking about the pros and cons of working night shift vs day shift as a new nurse. 

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First up, on the day shift, there are more meds to give. So, that can be good if you’re trying to practice your skills, but bad just because it’s more work and it’s going to take longer to do each of your med passes. Especially that first morning med pass. That’s when the patients are getting the bulk of their medications. 
And you can have the full gamut of pills, IV bag meds, IV push meds, plus topical medications, all in one med pass, for one patient in the morning. So if you’re doing that for 5 or 6 patients, for one med pass, that can take up a lot of your time and can be stressful to feel like you have to rush rush rush to get it done. 
And there were times, only on day shift, when I started my shift at 7am and it was 9:30-10am and I was being called away to do something else, and I’m like, “I can’t. I still am not done with my morning med pass. 
You know, my meds are an hour and a half late.” And that’s not ok, but I was just so busy that that’s what the situation was honestly. And that was very stressful to me because I don’t wanna be late on my med pass. I want to give my patients their meds when they’re due because that’s what’s best for my patients. 
So it’s very stressful when you feel like you’re just one person, but you’re being given the workload of three people. Especially when you’re a new nurse. You know, maybe a seasoned nurse would not have been late giving those meds, but as a new nurse, that was just my reality. And that was very stressful. But yeah, on night shift, you typically have a lot less meds to give. 
And if you’re in clinicals, you can look this up in your patient’s orders, if you get a chance, just compare what medications they’re getting during the day (especially that first morning med pass) versus what they’re getting at night. And it’s almost always a lot less at night. 

Night Shift vs Day Shift (Part 2)

Today I want to talk about the differences between day shift vs night shift for nurses. Maybe you’re on the fence, you don’t know if you want to work day shift or night shift when you graduate, so I want to go over the pros and cons of each to help you make your decision.

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After August, you can still get 20% off Lecturio with this code: nursingschoolwbw20 Now I have worked both day shift and night shift on a med surg unit and in the emergency room, so I feel like I can talk to the pros and cons of both. Alright, so first up, I definitely have to mention that if you’re in it to make more money, then the night shift is the obvious way to go. Because you’re gonna get that night shift differential, which is usually, some places do it differently. Some places do it like just a set amount per hour more, like 7 dollars more per hour if you’re working on the night shift; then other places will give like 1.25 times your base hourly rate. But either way, you’re gonna make more on the night shift. 

And when I calculated it out, it was basically a car payment every month. So about $600 more per month than what I would have made on the day shift. So that’s pretty significant. And if you’re working night shift on the weekend, then you’re gonna get even more cause you’re gonna get that weekend shift differential in addition to the night shift differential. So that’s what I tried to schedule myself when I was working nights. I would try to make it on Friday, Saturday, and Sunday night so I would get both of those differentials to maximize the pay. Cause if you’re there, putting in the time, you might as well get paid the most you can possibly make. Alright, another difference between day shift and night shift, is that, and this can be seen as either a pro or a con, depending on how you look at it, but during the day shift there are more doctors around, more physical therapists, more occupational therapists, more social workers around, and more management around. 

So this can be a good thing, because if an emergency situation arises or if you need to change verify an order, then the doctor is just a chat or a phone call away. Or if the patient starts going downhill fast, you can reach out to the doctor easily and you don’t feel like, you know, you have to wait until it’s an absolute emergency because you don’t wanna wake up the doctor in the middle of the night, and what if they get mad at you and yell at you? You’re not as worried about that because the doctors are already there working anyway. So that is a good thing, but it can also be a bad thing; because there’s something nice about it, I mean that’s one reason why the night shift is more quiet and less hectic because there are just a lot fewer people there; a lot less doctors putting in orders, changing orders, wanting procedures done right then and there. 

 



Night Shift Nursing vs Day Shift

You just graduated from nursing school, and now you're working as a nurse in the emergency department. The EMTs bring in a 26 year old female with generalized weakness of the left lower and upper extremities, and a sudden headache. What do you do? Can you complete all 5 critical actions, or will you carry out a dangerous action? Learn the most important things to do for stroke patients as a nurse.

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Chronic Kidney Disease

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