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February 2019 Caption Contest: Win $100! Read more... ×

Joe V

IT Director / Strategist / Developer

Joe V is a web programmer and obstacle racing enthusiast. “It’s gratifying to teach others what you know. At the same time, it’s very satisfying to learn from others.”

Reputation Activity by Joe V

Reactions Given

Like 576
Thanks 4
Haha 2
Disagree 1
Sad 2

Reactions Received

Like 146
Thanks 21
Haha 13
Disagree 1
Sad 4

  1. Like
    Joe V reacted to ICUnurse1997, MSN, APRN in February 2019 Caption Contest: Win $100!   
    Looks like Bob finally got away from the  JCAHO surveyor that followed him all morning.  
  2. Like
    Joe V reacted to ICUnurse1997, MSN, APRN in February 2019 Caption Contest: Win $100!   
    Everyone thought Fred had seen a ghost until the betadine stain on his shirt revealed that he had just inserted a foley on his morbidly obese patient.  
  3. Like
    Joe V reacted to ICUnurse1997, MSN, APRN in February 2019 Caption Contest: Win $100!   
    That moment when you are trying to go home after an exhausting 12 hour shift and your relief has not shown up.  You are not sure whether you should laugh or cry. 
  4. Like
    Joe V reacted to TNViking in February 2019 Caption Contest: Win $100!   
    "I just had to trudge down the hallway, past room 55, JACHO, and a code brown. I've been places, man."
  5. Like
    Joe V reacted to Jayne47 in February 2019 Caption Contest: Win $100!   
    All in a Days work! Nurses are great under pressure!
  6. Like
    Joe V reacted to propofolbff in February 2019 Caption Contest: Win $100!   
    SERENITY NOW.....!!!!!!
  7. Like
    Joe V reacted to rn&run in February 2019 Caption Contest: Win $100!   
    Allnurses— where you’re just as sane as the rest of us!
  8. Like
    Joe V reacted to rn&run in February 2019 Caption Contest: Win $100!   
    Logging onto Allnurses after a crazy shift, ready to tell my tale of woe like:
  9. Like
    Joe V reacted to NurseBlaq in February 2019 Caption Contest: Win $100!   
    "Another new admission?"
  10. Like
    Joe V reacted to NurseBlaq in February 2019 Caption Contest: Win $100!   
    "If she rings the call bell one more time...."
  11. Like
    Joe V reacted to NurseBlaq in February 2019 Caption Contest: Win $100!   
    Entering the break room 10 hrs into a 12 hr shift......
  12. Like
    Joe V reacted to spotangel in February 2019 Caption Contest: Win $100!   
    When the C Diff/Melena smell follows me home after an "Of course we have this under control"shift in my insane ER!
  13. Like
    Joe V reacted to t114294, LPN in February 2019 Caption Contest: Win $100!   
    "I thought it was chocolate"
  14. Like
    Joe V reacted to NormaP in February 2019 Caption Contest: Win $100!   
    "Finally made it home after another long day on the floor."
  15. Like
    Joe V reacted to Susie2310 in Atrial Fibrillation, Strokes and the WATCHMAN Implant   
    Thank you very much for this information.  I had heard of this device but hadn't got round to doing more research yet.  This information is very useful.
  16. Like
    Joe V reacted to Horseshoe in Atrial Fibrillation, Strokes and the WATCHMAN Implant   
    This is a timely article for me. My Dad was visiting me for Thanksgiving this year and had a severe stroke. He has been on Coumadin for 25 years, and was very compliant with his regime. His INR was therapeutic, yet he still developed an enormous blood clot in his carotid artery. Because of his INR, he was not eligible for TPA; he had to be care flighted to a facility that could do a thrombectomy. We lost valuable time for that transfer. Dad is progressing in his recovery, but will probably not ever be completely back to normal.
     One of the cardiologists mentioned that we might want to check out this procedure down the line. I had not yet taken the time to fully research this procedure. 
    Thanks for posting.
  17. Like
    Joe V reacted to J.Adderton in Atrial Fibrillation, Strokes and the WATCHMAN Implant   
    For individuals diagnosed with AFib, the risk of stroke is very real.  In fact, a person with Afib is 5x more likely to suffer a stroke than someone with a regular heart rhythm.  In order to order to understand how the implant works, you must first be familiar with the basics of Afib.  In Afib, the heart’s atria flutter and send erradic electrical signal to the ventricles.  As a result, blood pools and clots in the heart’s left atrial appendage (LAA).  In non-valvular Afib, more than 90% of blood clots resulting in a stroke are formed in the LAA.  A stroke occurs when these clots travel to the brain and prevent adequate blood flow.  Afib is more common after age 50 and often occurs without symptoms.
    Watch an animation of Afib from the American Heart Association

    The goal of Afib treatment is to prevent clots from forming, control pulse rate and restore normal heart rhythm.  Anticoagulants (warfarin, others) are given to prevent blood clots and reduce the risk of stroke.  There are individuals that require blood thinners long-term.  The risk of bleeding is higher when taking blood thinners.  The Watchman implant is an alternative to long-term anticoagulant therapy for stroke prevention when the risk of bleeding outweighs the medication’s benefit.
    The WATCHMAN device is for people meeting the following criteria:
    Diagnosed with Afib not caused by a heart valve problem Diagnosed with Afib and physician is recommending blood thinners Are able to take warfarin but need an alternative ***Individuals may need an alternative to warfarin for the following:
    History of serious bleeding while taking blood thinners Are at risk for major bleeding to due lifestyle, occupation or physical condition Take warfarin but have difficulty maintaining therapeutic PT/INR, have difficulty getting regular blood tests or cannot take a different type of anticoagulant The WATCHMAN device is not for patients:
    Who are unable to take warfarin, aspirin or clopidogrel Who should not or cannot have a heart catheterization Allergic to the device materials With a LAA that is too large or small for the device to fit appropriately Doing well and expect to continue doing well on anticoagulants. "Ed is a 74-year-old patient with a long history of Afib.  Over the years, Ed has undergone multiple cardioversions and cardiac ablations.  Due to Ed’s high stroke risk, he was placed on warfarin and has been taking for several years.   Ed has had multiple falls and remains a high fall risk secondary to vertigo.  When Ed visits his cardiologist, he expresses fear of causing a major bleed because of his falls.  However, he wants to continue to be active with his grandchildren and occasionally golf.  The cardiologist explains the WATCHMAN procedure to Ed as an alternative to warfarin."
    How It Works
    The actual Watchman implant is about the size of a quarter and fits directly into the LAA. The implant permanently closes the LAA- preventing clots from leaving the heart and entering into the bloodstream.  Since the implant is permanent, placed once and does not have to be replaced. 
    The Watchman procedure is minimally invasive and typically performed in a heart catheterization lab.  The procedure is monitored by the medical team and utilizes imaging to visually guide the device in place.  A thin catheter is inserted through a vein in the groin and guided into the heart’s right atrium. A second puncture is made in the muscle wall between the right and left atrium.  The catheter is then advanced into the left atrium.  The physician uses imaging to advance a smaller inner catheter, with the compressed device enclosed, into the LAA.  Once the implant is in the right place, the implant will open- much like an umbrella.  Within 45 days, a thin layer of tissue will grow over the implant. 
     
     
    Always a Risk
    Any medical procedure carries risks and the Watchman is no exception.  Review common risks here.
    Clinical Studies and Evidence
    The Food and Drug Administration approved the Watchman implant in 2016 based on long-term data from clinical trials.  The trials ( PREVAIL study, PROTECT AF study and CAP Registry) included over 2400 patients and >8000 patient-years of follow-up.  Data from the trials supporting FDA approval include:
    Device successfully implanted in 95% of patients 45 days after implantation, 92% of patients were no longer taking blood thinners >99% were no longer taking blood thinners by 1 year Significant decrease in disabling and fatal strokes (largely due to the reduction in hemorrhagic stroke) Demonstrated similar ischemic stroke reduction when compared to warfarin Reduced major bleeding events vs warfarin by 72% at 6 months In addition to clinical trials, the Watchman procedure has been performed over 20,000 times worldwide.  It is the only device of its kind approved by the U.S. Food and Drug Administration. 
    What new and emerging advances in stroke prevention have you seen in your area of practice?
    For additional information, visit www.watchman.com
  18. Like
    Joe V reacted to fnptobe123 in February 2019 Caption Contest: Win $100!   
    Crawling out of night shift like...
  19. Like
    Joe V reacted to meticulo in February 2019 Caption Contest: Win $100!   
    I’m so done. Don’t call me. Don’t wanna hear bed alarms. I don’t wanna answer call lights. Leave me alone.
  20. Like
    Joe V reacted to meticulo in February 2019 Caption Contest: Win $100!   
    I am so damn tired, so damn drained, so done. I need your help!
  21. Like
    Joe V reacted to borkowskikid in Baby nurse doo doo doo doo....   
    I literally LOLd reading this. Good stuff. Real talk.
  22. Like
    Joe V reacted to SobreRN in Baby nurse doo doo doo doo....   
    Depends upon the other patients. Everything went great but if you have another patient who has stat needs the extra help from rapid would be good.
  23. Like
    Joe V reacted to BostonFNP in Baby nurse doo doo doo doo....   
    Lol it was fantastic click bait of a title! It is lost on some I guess.
  24. Like
    Joe V reacted to HIPAAPotamus in Baby nurse doo doo doo doo....   
    "I don't mean to be rude" = I'm about to be rude.
    Have you not heard the "Baby Shark" song? It's a joke. And it was a clever one.
  25. Like
    Joe V reacted to Susie2310 in Baby nurse doo doo doo doo....   
    OP, I don't mean to be rude but the title of your post is unnecessarily demeaning. Why are you referring to yourself as a "Baby nurse doo doo doo doo?" You are not an infant, but the title of your post makes you sound like one. How about "New nurse?" You are a licensed RN, correct?
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