Penelope_Pitstop

Hey there! These are two completely different scenarios. A serum lithium level is measuring the amount of lithium in the blood. An INR isn't actually measuring the amount of a medication in the blood. It's result that informs the provider of the amount of time it takes for blood to clot. If a person is not taking warfarin/Coumadin, then his or her INR is expected to be in the range you suggest, this indicates normal clotting time. Someone who is taking warfarin is taking in for the purpose of clot prevention, so we want their INR to be between 2 and 3 typically (often 2.5-3.5 if they have an artificial heart valve). so in this case, the INR is out of range because we want their patient to have a HIGHER INR.

You had a heckuva mom, Ben! Thanks for sharing her with all of us for so long. Please accept my condolences, I'm very sorry for your loss.

I did middle management for four years. I did enjoy it for about 2.5 of those years, but the manager above me started to flounder and I had to clean up those messes. Loved my staff! But I couldn't take the compounding responsibility and stress and went back to a staff position myself. I'm glad it's on my resume! But would I do it again? Unlikely

Thanks for sharing with us, Marla. sharing so much of your nursing knowledge, so many funny stories, so many pearls of wisdom. and being vulnerable in sharing your diagnosis with us, we aren't owed any explanation or any of your personal information, yet you share your final message to us so beautifully you are one of a kind, and your earthside time will not be forgotten.

When you're a new grad, you don't know what you don't know. In home care, you're a bit of a lone wolf. A visit may be only thirty minutes or so and quite possibly just one or two visits per week. Not like a shift at a hospital or facility that is eight hours long. In home care, you can't go back and recheck your assessment, you can't ask your charge nurse to check on the patient if something is off. And when people are in their home environments, they a lot of times simply do not look nearly as sick as they are. They may appear within normal limits, but the problem is that when you're a new grad, "normal" isn't something that is carved out yet. I started homecare after nearly 11 years of nursing and I see new things constantly!

Rehab. I'm in homecare now and I don't think it's really appropriate for a new grad. Rehab is closer to "hospital nursing," also.

"My doctor told me I got diabetes from not eating enough sugar. That's how it works."

A woman took scissors to her Clintron bed because she thought her dog was trapped inside of it. (I'm glad I wasn't on call that night. This was in home care).

The first amendment does not protect the use of "fighting words." Furthermore, an employer may have a policy dictating public behavior. This isn't even necessary for dismissal in an at-will state. I don't know which states are at will.

Yes, did that woman end up wearing a bra to work? Did the deers get that nursing student? WHAT ABOUT THE PARABENS, FOR THE LOVE OF GOD???

The vast majority of actions in my state involve controlled substances. This includes diversion, intoxication and/or recreational use of non-prescribed substances, forging scripts, count errors or charting errors involving said substances. Another one is not having enough CEUs, but claiming you have them and then being picked for an audit. It's probably the least severe disciplinary action but it still counts. Lying on an application about criminal or substance history, or if you've had discipline in another state is one as well.

**sniffles** No, I'm not a sister. I am an only child, I always wanted **sniff** siblings. **Sob** My husband is also an **hiccup** only child so I'm not even a **sob** sister in law **bawls**

I... Um... uhhhh.... Yeah, I got nothin'. And I NEVER have nothing...

Yes, I've also had the dream wherein a patient is forgotten all shift. My favorite, though? Well, okay, not really...but it certainly stand out! In my dream, there was a patient sitting in the hall in a geri chair. I was charting, nothing really was going on at all. Then...a tall, thin man wearing all black appeared and stabbed the patient in the jugular. I ran to get help, but discovered all of the other nurses were on the porch (riiiiight), smoking. The patient died. And when I woke up, I realized the murderer was a surgeon I knew.

Root Cause Analysis