MunoRN 60,368 Views
Joined: Nov 18, '10;
Posts: 8,990 (71% Liked)
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Critical Care; from
10 year(s) of experience
To paraphrase, you want to start a business where you recommend what nutritional supplements someone should use to lose weight/gain muscle/improve health? I'm not trying to be snarky (it just comes naturally) but that job already exists, it's a salesperson at GNC.
Just based on the positioning of the gastric port it wouldn't be surprising that you wouldn't get all 30ml back, aside from the lack of a rational basis for her assessment technique there is no such thing, she apparently has misunderstood some other premise of enteral feeding.
I'm not clear from your description if you're saying blood was coming from the sheath itself and that this was because the stopcock had failed? It would be highly unusual for a stopcock to fail allowing for the free flow of blood, but if that was the case it should have been clamped externally rather than pulling the sheath.
Until you can show the people of the United States that they are safe there will be no "ban" on guns. As has been stated many times the culture of America is based around our right to protect ourselves. If you say no the the wall and want to ban guns it will be more than an uphill battle.
You can compare raw statistics from Australia and the United States and see that we do have higher rates. Doing so however is not genuine. You are comparing apples to kiwis. America was colonized and a revolution was fought for our split from Britain. Australia was given it's independence from Britain. Australia was colonized by previously criminal people that were released and given land. There weren't many guns in a colony full of ex cons. America was colonized by free men with the will and need to fight the native populace.
Someone previous stated "it's simple statitics if you took a class". Well statistics isn't simple. There is usually a variable; on many occasions there are multiple variables. I could tell you that the rate of automobile deaths in the United States is double that of Australia per 100000 people. Simple statistic. What are the variables? How many cars? How many miles driven? License requirements? Age?
TL;DR-The United States is a great and unique country. While another country may have a partial answer, using another policy will NOT work in ours. People here have an expectation and belief that they can and will defend themselves.
P.S.- To the nurse that stated they would have killed people if they had a weapon I call BS. I don't remember your name on here, and I'm not going to go back and look, but straight up BS. Anything...ANYTHING could be used as a weapon to kill. Your excuse that it would have had to be a gun is ridiculous. If you were to the point you claim you were, then someone would have been dead. +5 troll points to you.
I don't generally find it's a lack of knowledge or lack of sufficient intent to keep patients active, it's almost completely a workload issue. Assisting patients up to a recliner for meals takes time, assisting them to the bathroom instead of using a bedpan or BSC takes time, taking them for a walk around the floor takes time, and the problem is that particularly for floor nurses that might have 5 or 6 of these patients there are just too many demands on their time.
The irony, of course, is that the mandate was originally a conservative idea -- they were all about it right up until the moment the Democrats embraced it in a futile attempt to build a bipartisan plan that could get some Republican support. Then, it magically became the work of the devil as far as the GOP was concerned.
The "rules" you're asking about do exist, they are called "significant digits", all calculations should done based on this mathematical rule, the final measurement would be based on how accurately the final calculation can be reliably measured.
This doesn't mean that all nursing school instructors will consider this to be the correct answer, which is because technically speaking many of them are ignoramus's when it comes to mathematical principles.
Just based on the limited information you've provided it's not really possible to say whether or not the other nurses were charting inadequately or if the problem is that you over-chart and are concerned that other's don't do the same. There's an important distinction between something that is clinically significant and something that is not, and the main reason why we have nurses is to differentiate between the two. The only specifics you've provided is that you're upset something wasn't charted even though it didn't prove to be clinically significant, so I'm not sure what your complaint is.
I wouldn't worry too much. A good manager would want to meet with you and your preceptor before you've even done patient care with your preceptor just to set a plan for how you will transition from initial learning to observed independent practice and how your progress will be assessed and how the plan will be adjusted based on that to ensure you have a successful transition, I think there's more reason to see this as comforting rather than concerning.
I've read your scenario a few times and I'm still not clear on the specifics. It's not unusual that patient's sign a HIPAA disclosure agreement as part of standard paperwork when you establish care at a clinic, go into an ER, are admitted to a hospital, etc which states that they will obtain necessary records to provide care and will share records as appropriate with other clinics, hospitals, etc where you seek care. There are some records where this kind of sharing can't be covered under this sort of blanket agreement, but for the most part any provider treating you should have access to all relevant history. There are also some types of information, such as prescribing scheduled medications, where no disclosure to the patient is required to share this with other providers and the patient cannot decline that this information be shared.
I don't think shifting views on the part of BONs are "decades away" since a number of BONs have already put out position statements on medical and recreational marijuana. BONs are state based and are not under federal law, some have stated that there concern is only with impairment at work and that they don't intend take action due to use outside of work that doesn't result in on-the-job impairment, basically their stance is the same as on alcohol use.
We do actually give IVP potassium all the time, it's just slower than most pushes. The problem is that with a lot of IV terminology, there is no universal definition, and there are some contexts that consider anything other than a continuous infusion to be a push, using the term interchangeably with intermittent. It seems pretty clear for the majority, there are continuous infusions, intermittent infusions, and pushes.
Salbutamol (aka albuterol here in the US) comes already in a solution which is typically saline. Some formulations are already diluted with saline to an appropriate concentration for nebulization, others will include instructions for dilution with saline.
And what do you think they will do? Allow insurance and pharmaceutical companies to squeeze more money out of consumers?
I thought this article from NPR and ProPublica about high medical costs interesting.
Health Insurance Hustle: High Prices Can Boost Profits : Shots - Health News : NPR
Aging baby-boomers are going to continue to age and have increasing health care needs, while Republicans hint about cutting "entitlements". So premiums and costs will go up, people will lose coverage because of pre-existing conditions, and insurance executives will earn more.
I'm not necessarily opposed to Trump's refusal to defend the ACA, a law which neither he nor republicans appear all that opposed to, since that will only serve to force the hand of Trump and Republicans to finally do what they've been promising to do for years.
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