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

Remember that in every line of work, crap runs downhill. Chances are, your management has received negative feedback pertaining to these issues, so of course, your managers let the crap slide down the hill to the floor staff. I had a manager OBSESSED with bed alarms. Everyone needed one, even a young person who wasn't a falls risk and was otherwise independent. Turns out she'd been chewed out by her boss because we had a spike in falls for a quarter or something like that. To me, this doesn't sound like a deal breaker. But that's me. Everyone has a different deal breaker.

I have seen him live four times. If he comes to your area, he is well worth the ticket price.

It's very similar to the concept of "leading the witness" in court.

Yes, that's the right way to answer! I agree completely. But what answer did you expect or want, OP?

There's a number of things going on here that concern me, but mostly I agree with JKL. If you wanted to keep your distance in a professional sense, why bring him up when your "friend" was using her computer? What did you want her to say? I mean, you put yourself in her place, how would you have responded?

Excellent comments above mine. I would like to add that you are human and that is it okay to not be capable of understanding everyone. Should you always be professional and polite? Absolutely. Even in non-working matters, being polite costs you nothing. However - everyone has "soft spots" or breaking points. I can tolerate a great deal, including being cursed at, snapped at, yelled at, etc., but once a demented elderly patient called me "so fat" again and again that I felt my kindness and patience wane over the course of a shift. Now, had she called me stupid, or evil, or a bad dresser or whatever, I would have laughed it off. But this actually HURT my feelings. So please, remember that you are human and we all have sensitive spots and that sort of thing. And...some people are jerks. Does everyone who is a jerk have a reason for being that way? Probably. But you're not going to get to the bottom of that during the course of an ED visit. So keep that in mind, that they're just "passing through" and won't be your problem after your shift (or even before the conclusion of your shift, being in the ED!) But, at the end of the day, you should not be a punching bag, either. You can absolutely keep someone "in check," so to speak but be courteous while doing it. Picking your battles is a part of nursing judgement. And you'll get there. Oh, last thing! Congratulations!!!

It's a good idea to, even if you're not within three feet and in the same room. Once when I was (essentially) circulating for a central line placement in the ICU, the resident became woozy and I crawled under the drape, caught her as she fainted and dragged her over to the window. I mean, that's probably not going to happen to you, but I wouldn't have had time to mask up at that moment. (We did not break the sterile field, the senior resident finished the job. And she was fine and went on to pass out a few more times in similar situations).

I agree that the friend request in of itself is not a stalker action; however, the motive and the way my name would have been found out by her? Yes, that's getting there with the stalker thing. Perhaps stalker was too harsh; however, in this case, I might note that we had multiple friends in common but that we didn't know each other. That, to me, indicates something strange. Perhaps not stalking action, but clearly for some specific purpose. Again, the MLM thing. I receive friend requests from friends of friends who are attempting to get me to join their teams. Also, I have a friend who friend requests the attractive girls who are friends of his Facebook friends. And the last point of mine...word might get around through the departments that chica has requested EVERYONE. Now, again, is that stalking? No, but it's not going to bode well when considering a person for a job. I hope no one was playing a drinking game with the word "friend."

I use pure maple syrup and a truvia/cane sugar blend as well as raisins. So it's not at all diabetic friendly by any stretch; however, all of the sugar is at least from natural sources. Let me look up the link... Simple Grain-Free Granola | Minimalist Baker Recipes

Disclaimer: I didn't read all of the responses. But, here are my thoughts: - that is a lot of time devoted to something that may have no positive result - if she requested me, I would not accept, but I would remember her name and if she were to apply and interview, my thought (as well as the thought of coworkers, I am sure) would be "no, we can NOT hire this stalker chick!" - I wonder if her life is saturated with MLM contacts who engage in aggressive social media networking to make sales? And, an anecdote... there was a fellow employed by the hospital in the transport department. He requested so many nurses, techs, clerks, etc from our very large hospital that Facebook temporarily suspended his account because I guess it appeared to be spam activity.