Latest Likes For Anna Flaxis

Anna Flaxis, ASN 24,877 Views

Joined Oct 15, '10. Posts: 2,864 (67% Liked) Likes: 8,602

Sorted By Last Like Received (Max 500)
  • 12:14 am

    Okay, so this particular student was frustrating. But don't let it spoil you on all students. Many, many students are respectful and grateful for the learning opportunity and will be more than happy to follow your direction and learn from you what they can. Remember how when you were a student, there were some nurses that you held in awe, who treated you with courtesy and were happy to teach you. You can be one of those nurses. Chin up. Move on. Better luck next time!

  • Dec 7

    The doctors do it where I work.

  • Dec 7

    The doctors do it where I work.

  • Dec 4

    Why should any further study be done?
    Assuming this is not a rhetorical question, to put it simply, the smaller the sample size, the less precise the information is.

    Say, for example, you receive a shipment of 500 widgets, and the supplier guarantees you that no more than 10% will be defective. You can't check every single widget, so you take a sample of 10 and find two defective widgets. You could conclude that 20% of the entire shipment of widgets is defective, or you could understand that perhaps you just happened to pull out 2 defective widgets when selecting your sample.

    Now, what if, instead, you select 50 widgets as your sample, and 2 of them are defective? That would be 4%, and consistent with your supplier's guarantee of 10% or less.

    You can apply this principle to individual experiments as well as what we call the "body of evidence". Two studies (with small sample sizes, no less) is not a large body of evidence upon which to form a strong conclusion, it is merely a starting point for further research.

  • Dec 4

    Why should any further study be done?
    Assuming this is not a rhetorical question, to put it simply, the smaller the sample size, the less precise the information is.

    Say, for example, you receive a shipment of 500 widgets, and the supplier guarantees you that no more than 10% will be defective. You can't check every single widget, so you take a sample of 10 and find two defective widgets. You could conclude that 20% of the entire shipment of widgets is defective, or you could understand that perhaps you just happened to pull out 2 defective widgets when selecting your sample.

    Now, what if, instead, you select 50 widgets as your sample, and 2 of them are defective? That would be 4%, and consistent with your supplier's guarantee of 10% or less.

    You can apply this principle to individual experiments as well as what we call the "body of evidence". Two studies (with small sample sizes, no less) is not a large body of evidence upon which to form a strong conclusion, it is merely a starting point for further research.

  • Dec 4

    Why should any further study be done?
    Assuming this is not a rhetorical question, to put it simply, the smaller the sample size, the less precise the information is.

    Say, for example, you receive a shipment of 500 widgets, and the supplier guarantees you that no more than 10% will be defective. You can't check every single widget, so you take a sample of 10 and find two defective widgets. You could conclude that 20% of the entire shipment of widgets is defective, or you could understand that perhaps you just happened to pull out 2 defective widgets when selecting your sample.

    Now, what if, instead, you select 50 widgets as your sample, and 2 of them are defective? That would be 4%, and consistent with your supplier's guarantee of 10% or less.

    You can apply this principle to individual experiments as well as what we call the "body of evidence". Two studies (with small sample sizes, no less) is not a large body of evidence upon which to form a strong conclusion, it is merely a starting point for further research.

  • Dec 4

    Why should any further study be done?
    Assuming this is not a rhetorical question, to put it simply, the smaller the sample size, the less precise the information is.

    Say, for example, you receive a shipment of 500 widgets, and the supplier guarantees you that no more than 10% will be defective. You can't check every single widget, so you take a sample of 10 and find two defective widgets. You could conclude that 20% of the entire shipment of widgets is defective, or you could understand that perhaps you just happened to pull out 2 defective widgets when selecting your sample.

    Now, what if, instead, you select 50 widgets as your sample, and 2 of them are defective? That would be 4%, and consistent with your supplier's guarantee of 10% or less.

    You can apply this principle to individual experiments as well as what we call the "body of evidence". Two studies (with small sample sizes, no less) is not a large body of evidence upon which to form a strong conclusion, it is merely a starting point for further research.

  • Nov 29

    A headache certainly can be an emergency, although I do agree that most of the time, it is not. But this is what the triage process is for - to use the tools at our disposal to determine whether we suspect an emergency condition exists and get that patient in front of a doctor sooner, or if it is less likely that an emergency condition exists and the patient can wait.

    I went to the ER last night & was diagnosed with an ear infection. Are you telling me that I should've waited until Monday to see my PCP? I think we both know that, that's a bad idea.
    Yes, assuming that you are not immune suppressed, you could have waited until Monday to see your PCP. Treating uncomplicated ear infections with antibiotics right away is no longer the standard of care, and a wait and see approach is reasonable. If, after 48 hours, there is no improvement or there is a worsening of symptoms, it would be reasonable to call your family doctor.

    Migraine sufferers need help right away. It's not a life threatening emergency, but their suffering is profound.
    As a person who suffers migraines and as an ED nurse, my opinion is that a person with chronic migraines should be under the care of a primary doctor who can prescribe medication for their condition, and they should try this before seeking further treatment. An Urgent Care clinic is capable of providing effective treatment for a migraine headache. While it's understandable that there may be issues with insurance or hours of operation that drive people who have migraine headaches to the ED, the ED should be the last resort. Unfortunately, many use it as a first resort, before they've explored other reasonable alternatives. I think, for some of us, that is where the frustration lies. It's like the person who has a PCP, who vomits one time and comes to the ED without even calling their doctor's office - calling your PCP and trying simple home care measures for the first 24-48 hours is appropriate for most simple and non-life threatening illnesses.

  • Nov 26

    The way I see it, each of us falls somewhere on a continuum. On one end is a very low threshold for distress, and on the other end is the opposite. Most of us don't fall on one end of the continuum or the other, but rather, somewhere in-between. Where we fit in the continuum is not static- it shifts during different stages in our lives, when we're undergoing personal stressors such as divorce or the death of a loved one, or when we ourselves fall ill or aren't feeling well, to name a few circumstances. Additionally, each of us has a different set of tools that we are equipped with to help us cope with distress, and new tools can be learned.

    For me, when things aren't going as planned and I feel like I'm hanging on by the skin of my teeth, this is "eustress". I find it exhilarating and it brings out my better qualities. For others, variance from the predictable routine is a cause of "distress" (google "eustress vs distress").

    Congratulations on being someone who is able to adapt and cope with the stressors involved in nursing more fluidly than many of your peers. You probably fall closer to the end of the continuum with a high stress threshold, and you probably have some great tools in your coping toolbox.

    Unfortunately, as the above poster points out, your post does come across as condescending. Experience will remedy that in time, as experience has a way of humbling us.

    Don't get me wrong- I'm glad that you seem to be doing so well in your first year out of nursing school. It's a tough time for most of us- and thank you for the tips you've shared.

    But just....maybe tone down the air of superiority just a little bit?

  • Nov 24

    I mean this in the kindest way possible, but this is a patient that I would definitely be worried about. Not being able to read the hospitalist's handwriting is no excuse for not knowing what the plan is for this patient. It shouldn't take the monitor tech overstepping to spur you to act. You are the nurse. The buck stops with you. Again, I don't mean to be unkind. I hope you take my feedback in the spirit of improving your practice and doing better in the future.

  • Nov 22

    A headache certainly can be an emergency, although I do agree that most of the time, it is not. But this is what the triage process is for - to use the tools at our disposal to determine whether we suspect an emergency condition exists and get that patient in front of a doctor sooner, or if it is less likely that an emergency condition exists and the patient can wait.

    I went to the ER last night & was diagnosed with an ear infection. Are you telling me that I should've waited until Monday to see my PCP? I think we both know that, that's a bad idea.
    Yes, assuming that you are not immune suppressed, you could have waited until Monday to see your PCP. Treating uncomplicated ear infections with antibiotics right away is no longer the standard of care, and a wait and see approach is reasonable. If, after 48 hours, there is no improvement or there is a worsening of symptoms, it would be reasonable to call your family doctor.

    Migraine sufferers need help right away. It's not a life threatening emergency, but their suffering is profound.
    As a person who suffers migraines and as an ED nurse, my opinion is that a person with chronic migraines should be under the care of a primary doctor who can prescribe medication for their condition, and they should try this before seeking further treatment. An Urgent Care clinic is capable of providing effective treatment for a migraine headache. While it's understandable that there may be issues with insurance or hours of operation that drive people who have migraine headaches to the ED, the ED should be the last resort. Unfortunately, many use it as a first resort, before they've explored other reasonable alternatives. I think, for some of us, that is where the frustration lies. It's like the person who has a PCP, who vomits one time and comes to the ED without even calling their doctor's office - calling your PCP and trying simple home care measures for the first 24-48 hours is appropriate for most simple and non-life threatening illnesses.

  • Nov 8

    Quote from OrganizedChaos
    Well I guess since I have had the throat/ear pain for awhile & was prescribed an antibiotic, the doctor felt differently.
    I'll let you in on a little secret. Lots of doctors just follow the path of least resistance. ;-)

  • Nov 4

    Quote from canoehead
    Is it bigger than a bread box?
    I love that! Gonna have to remember that one...

  • Oct 31

    Quote from rubyagnes
    I definitely feel that I get hung up on "phrasing" - for instance instead of saying "patient walked to their bed" my preceptor tells me I should say "pt is ambulatory"
    Although I'm not certain that it's all that critical whether you use the word "ambulatory" rather than "walking", I tend to use language such as: "Pt ambulatory with steady gait to rm XX", or "Up to BR independently, urine spec collected", or "Ambulatory to BR with stand by assist", simply because "ambulate" is the technically correct term.

    I try to avoid language such as "Pt sleeping", "MD aware", "Call light in place, pt knows how to use it", or language that speaks to what others are aware of or know. Instead, I'll state "Resting quietly with eyes closed, respirations even and unlabored", "MD informed", "Call light within reach, pt instructed in use, verbalizes understanding". I don't have any way of knowing what someone else knows or is aware of- it's an assumption. I only know whether I've informed someone of something and what their response was.

    When writing a triage note, I try to avoid language such as "Pt hit head on door jamb", instead saying "Pt reports he hit his head on the door jamb". Even better is using quotes, such as Pt states "I hit my head on the door jamb". I don't know that the patient hit his head on the door jamb, I wasn't there. I only know what the patient is telling me.

    Make sense?

  • Oct 31

    A headache certainly can be an emergency, although I do agree that most of the time, it is not. But this is what the triage process is for - to use the tools at our disposal to determine whether we suspect an emergency condition exists and get that patient in front of a doctor sooner, or if it is less likely that an emergency condition exists and the patient can wait.

    I went to the ER last night & was diagnosed with an ear infection. Are you telling me that I should've waited until Monday to see my PCP? I think we both know that, that's a bad idea.
    Yes, assuming that you are not immune suppressed, you could have waited until Monday to see your PCP. Treating uncomplicated ear infections with antibiotics right away is no longer the standard of care, and a wait and see approach is reasonable. If, after 48 hours, there is no improvement or there is a worsening of symptoms, it would be reasonable to call your family doctor.

    Migraine sufferers need help right away. It's not a life threatening emergency, but their suffering is profound.
    As a person who suffers migraines and as an ED nurse, my opinion is that a person with chronic migraines should be under the care of a primary doctor who can prescribe medication for their condition, and they should try this before seeking further treatment. An Urgent Care clinic is capable of providing effective treatment for a migraine headache. While it's understandable that there may be issues with insurance or hours of operation that drive people who have migraine headaches to the ED, the ED should be the last resort. Unfortunately, many use it as a first resort, before they've explored other reasonable alternatives. I think, for some of us, that is where the frustration lies. It's like the person who has a PCP, who vomits one time and comes to the ED without even calling their doctor's office - calling your PCP and trying simple home care measures for the first 24-48 hours is appropriate for most simple and non-life threatening illnesses.


close