Elvish BSN, DNP, RN, NP

Elvish is a BSN, DNP, RN, NP and specializes in Community, OB, Nursery.

Elvish's Latest Activity

1. 

   Are We Still Holding Back Baby's Head?

   Elvish replied to Kooky Korky's topic in Ob/Gyn

   You're describing a prolapsed cord, and that is exactly what you're supposed to do about it, (as an EMT) until you get to a hospital and the patient gets to an OR for a stat c/section. Placental abruption is separation of the placenta from the uterine wall prior to delivery, and it can range in severity.
2. 

   Matt Lauer Fired due to Inappropriate Sexual Behavior. Has This Happened to You?

   Elvish replied to traumaRUs's topic in Headlines

   Agreed, 100%. The male victims of Kevin Spacey's abuse should be supported and believed just as the female victims of [insert whatever powerful man is behaving badly today, because tomorrow there will be another]. The most enormous difference is, women are socialized our entire lives to keep men happy. To keep them from getting angry with us, because who is to say that the butt grab today, if we report it or tell them to stop, won't turn into an assault on our lives tomorrow? Women are told we shouldn't wear that dress, or we shouldn't be drinking, or we shouldn't be at that party, or we shouldn't be out alone at night, and a ton of other unwritten rules that men as a group literally never have to spend a second thinking about, in order to 'prevent' sexual assault. The reality is, men need to behave better. Most (if not all) women I know have a story to tell about sexual harassment or sexual assault. Most if not all women I know take precautions to attempt keep themselves safe in literally every public space they ever go to. Does every man you know have to do this? If not, why not?
3. 

   Matt Lauer Fired due to Inappropriate Sexual Behavior. Has This Happened to You?

   Elvish replied to traumaRUs's topic in Headlines

   There is video evidence that it was, in fact, lewd behavior, and not anything consensual.
4. 

   Matt Lauer Fired due to Inappropriate Sexual Behavior. Has This Happened to You?

   Elvish replied to traumaRUs's topic in Headlines

   I've only ever been sexually harassed by patients at work (there have been other times, but at work it was only patients and not coworkers). As sexual harassment goes, it was not as bad as others' experiences and did not escalate beyond verbal.
5. 

   Flu shot, get sick

   Elvish replied to Taina33's topic in Activism

   I have friends who have had actual, documented severe reactions to the flu vaccine. Two. They (appropriately) won't be getting the vaccine anymore. Beyond that, better a little sick than a lot dead. Flu kills. It kills the very old/very young, but it also kills young healthy low-risk people as well. I understand not wanting to feel poorly for a while, but if that's all it is, congratulations! Your immune system is functioning exactly as it was meant to!
6. 

   Umbilical Cord Cutting

   Elvish replied to Nursenotslave's topic in Ob/Gyn

   Of all the things in the world you have to worry about, I would put something bad happening to this kid at the very bottom of the list. Like other posters, I understand your concern about there being video evidence of anything, but some harm would have had to come to the baby for there to be any negative consequence to you. Cords avulse more often than people realise. Not every day, of course, but it happens. The last avulsion I saw - well, most avulsions I see, really - is due to residents yanking too hard on the placenta and baby is still attached (we delay clamping on everyone unless baby needs resus). You did the appropriate things to correct the action and baby was fine afterward. Chalk it up to a lesson learned the hard way, and now you know you will always double check to make sure SO cuts between the clamps!
7. 

   Delivery table set up

   Elvish replied to Sholt72's topic in Ob/Gyn

   Ours come in a premade pack and whenever delivery is close - if a multip is going fast it'll probably be on admit or whenever she's 5-6, whichever is first. Primes we usually set up once they're rim-ish, unless she's just rocking and rolling. Instruments & laps are stored separately so they're opened onto the field whenever we're setting up. If delivery isn't imminent or gets stalled for whatever reason we'll cover in sterile plastic and it's good for up to 24 hours.
8. 

   Inmate patients- keeping the guard happy too

   Elvish replied to angiebelle440's topic in General Nursing

   When I worked postpartum our hospital had an exclusive contract with the DOC so all the pregnant inmates came to us to deliver. If they had pregnancy issues they were with us during their antepartum stay as well, either until they delivered or were discharged back to the prison. There was a wide variation in COs. Some were kind and respectful to both the patient and me, others were more abrupt. A very few were downright rude but thankfully they were few and far between. Occasionally I had runins with them over the prisoner being shackled to the bed, one hand and one foot. We are a mother/baby unit and it made it real hard for these moms to take care of their babies with one hand chained to the bed. Or we'd get the c/section moms whose lower extremities got pretty edematous POD 2ish and the shackles would get too tight. Unless I got an order for it, the cuffs would stay on, so I had no problems at all getting MDs to order that the pt be cuffed to the bed with one hand only (if LE edema) or one foot (so she could care for her baby). The MDs would give me that order in a heartbeat. I realize that's a bit of a special situation and not most units in the hospital. Even if they were prisoners it always broke my heart when they had to go back to prison and leave their babies in the hospital. Most of our patients were not a danger to society, not even many of the ones in for murder (most of the time it was an abusive spouse they'd killed), and I never had an issue with any of the inmates. I always treated them exactly the same - same food, drink, amenities - as any other patient. If the COs had a problem with that I offered to let them speak to my charge or manager, but I was never asked to change my practice.
9. 

   Opioid Epidemic: Innocent Victims (NAS)

   Elvish replied to jeastridge's topic in General Nursing

   I hope most (if not all) inpatient facilities have appropriate orders or guidelines in place to screen/care for these kids when they're born. Could be too much optimism on my part, but I've been working at a facility that's taken care of NAS babies for well over a decade. My bigger worry is what these kids are up against when they are discharged.
10. 

    What's Your Best Nursing Ghost Story?

    Elvish replied to steffck's topic in General Nursing

    Not a ghost story per se, or maybe it is. In either case it's not creepy but comforting. My uncle died last year after a 3-yr battle with colon CA. He never had any kids so my cousin and I were really close to him. He spoiled us rotten. Anyway, he went into hospice in May of last year and died close to 3mo later. I was in a review class for the FNP certification exam the day he died; I got the phone call before leaving my hotel room. He had died just a few minutes before 4am. I called my cousin and told her that he'd died early in the AM, and she responded, "Well, that explains the dream I had about him early this morning. I dreamed I was at the house [my grandma's house where all of us grew up, including my uncle] and he was there. He was marching in a parade in the livingroom and he was surrounded by light. He turned to me and his face looked just like it did when he was in his 20s, and when he turned to me he smiled his million-dollar smile. Then he waved to me and turned to walk away." My cousin, my grandma, and I believe to this day that it was him coming back to let us know that he was leaving but that he was happy and alright. I am not a woo-woo kind of person, but I don't have any other explanation for it.
11. 

    Do mom's still use Sitz baths ?!

    Elvish replied to BSNbeauty's topic in Ob/Gyn

    I had one with each kid. I started working mother/baby between Kid 1 and Kid 2. I had fallen so in love with them that if my pts had anything more a 1st degree I at least offered. Some took me up and some didn't, but those that did wanted to hug and kiss me for giving it to them. I would have them do it at least once in the hospital so I could compare the pt's pain behaviors before and after. I think they should be a standard part of the postpartum toolbox!!
12. 

    Sleep-night shift

    Elvish replied to Vtachy1's topic in General Nursing

    I'm gonna be straight up with you. I worked nights for 9 years and I'm sure it took years off my life - even with sleeping pills etc. I did the earplugs, box fan, dark room, melatonin, Ambien, Rozerem, you name it. I just didn't sleep well and even on my days off I didn't feel rested. I work days now, and while 0515 comes super early, I feel 10 years younger. I guess my question is - why do you want to do this to yourself again? Is it going to be worth the hit your physical and mental health are going to take? Please don't feel the need to answer me here, just ask yourself and be honest in your self-assessment.
13. 

    Are you supposed to check a boy's foreskin during a physical?

    Elvish replied to SydneyKidney's topic in NP

    The AAP doesn't recommend retracting at all until the foreskin is fully retractable, and even then only gently. Physicians in countries where circumcision is not the norm- who are used to dealing with foreskin every day all day - don't retract at all, ever, unless there is a problem. If there is a foreskin issue that is bad enough to need intervention, they will be apparent without retraction far more often than not. The number needed to treat on foreskin retraction is not low enough to justify it routinely.
14. 

    Wireless monitors: Monica/Novii, other telemetry

    Elvish replied to yinzerlabornurse's topic in Ob/Gyn

    Our L&D unit had/has similar experience with the Novii. Doesn't pick up FHR well at all & almost impossible to detect patters. It was supposed to be a New Great Thing because it could go in water but isn't used much at all.
15. 

    Organizing Emergency supplies at Delivery

    Elvish replied to ruralscnurse's topic in NICU

    L&D has radiant warmers in each room where they stock hats, diapers, cord clamps, neopuff masks/tubing, suction tubing, extra bulb syringes, & intubation equipment in all sizes (00/0/1 blades & tubes sizes 2.5-4). Our radiant warmers have pulse ox capability. NICU team comes to the delivery and brings a portable pulse ox for backup (RT brings this), and the RN brings a tackle box with emergency meds and equipment to drop an umbi line if needed. Did I read correctly that L&D does not have a radiant warmer in each room? I can imagine that hinders things a good bit.
16. 

    The flu shot making people sick

    Elvish replied to psu_213's topic in Disasters

    When people tell me they feel crummy for a couple days after getting a flu shot (and a lot of people do), I always say, "Fantastic! That means your immune system is responding to the flu vaccine exactly like it's supposed to!"