TiredMD

TiredMD

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All Content by TiredMD

  1. "I want him extubated NOW...I dont care if he's not ready"

    TiredMD replied to jbp0529's topic in General Nursing

    In that case: I would coat the foley bag and tube in a layer of vaseline, so that the next time she tries to steal a urine sample, she'll get it all over her hands. When she asks you about it, get...

  2. "I want him extubated NOW...I dont care if he's not ready"

    TiredMD replied to jbp0529's topic in General Nursing

    Here's what I thought (yes, I'm prepared to get flamed for this): Although this person is incredibly irritating and demanding, she's not doing anything that harms the patient or interferes with his...

  3. Maggot Debridement Therapy

    TiredMD replied to Keepstanding's topic in General Nursing

    I was a little skeptical the first time one of my Staff told me to start leech therapy, but after a couple days of therapy and a bunch of reading, I'm a believer. Leeches save flaps that would...

  4. Care for pt with PE

    TiredMD replied to strugglingnurse's topic in General Nursing

    Embolic strokes usually occur when clot dislodges from the arterial system (eg - aortic thrombus in pt with afib) and passes directly to the cerebral vasculature. Alternatively, a DVT can produce an...

  5. Maggot Debridement Therapy

    TiredMD replied to Keepstanding's topic in General Nursing

    Agreed, sounds like leeches to me. Those I've used a couple times, lots of fun, worked like a charm. Never gotten to do the maggots

  6. Homan's Sign: Useful or Useless? What's your opinion?

    TiredMD replied to UM Review RN's topic in General Nursing

    My opinion: 1) Homan's sign is worthless. It is variously reported as 10-50% sensitive and 60-80% specific. Personally, I think most clinical signs/symptoms are worthless in DVTs. When you really...

  7. Dnr

    TiredMD replied to deletethisaccount's topic in General Nursing

    Amen, my

  8. Do You Find MDs Often Miss MRSA Diagnosis?

    TiredMD replied to VivaLasViejas's topic in General Nursing

    Good catch then. Easy to overlook a developing abscess in skin that is already

  9. Dnr

    TiredMD replied to deletethisaccount's topic in General Nursing

    I don't know how this myth started, but let's be clear: A family member cannot legally invalidate a living will previously signed by the patient. The problem that arises (and I think why people get...

  10. Do You Find MDs Often Miss MRSA Diagnosis?

    TiredMD replied to VivaLasViejas's topic in General Nursing

    A rash you've had for over a year is unlikely to be MRSA. Of course, you could get a MRSA abscess over a pre-existing skin condition (eczema, cellulitis, fungal infection, and on and on and on). But...

  11. Anesthesia and seizures

    TiredMD replied to Epona's topic in General Nursing

    As the limbic system disassociates from motor control, the patient will often exhibit jerking motions and involuntary movements. Or so the gas-passers tell me. My guess is that it wasn't a

  12. Nightmare Families and Hospital protocols

    TiredMD replied to annmariern's topic in General Nursing

    Ah, now this is a different issue, and one I'm happy to get involved with. If it's just nurses, techs, or other staff getting irritated with a family's behavior, I'm not your guy. But the moment there...

  13. Nightmare Families and Hospital protocols

    TiredMD replied to annmariern's topic in General Nursing

    I am essentially cut out of anything non-medical that happens on the floors. I have to beg charge nurses to let children under 12 visit their sick parents. I get rebuffed when I ask for spouses to...

  14. Co-worker stabbed in surgery

    TiredMD replied to ScaredNewNurse's topic in General Nursing

    For what

  15. Nightmare Families and Hospital protocols

    TiredMD replied to annmariern's topic in General Nursing

    I get called for this once in a while, which is amusing, since I have absolutely no discretion over visiting hours or policies. Call your charge nurse, nursing supervisor, or administrator on-call....

  16. really gross doctor

    TiredMD replied to aye caramba's topic in General Nursing

    Personally, I utilize the 10 second rule, but I guess to each their own. I can't help but wonder about this story. I've never met a doctor who gave rat's behind about how meds were passed, if a pill...

  17. suctioning

    TiredMD replied to busy-bee's topic in General Nursing

    Some of my families mistake the "death rattle" for excessive secretions. Unfortunately, as the body fails, the airways collapse and snap open, you can't clear even minimal secretions, and there is...

  18. suctioning

    TiredMD replied to busy-bee's topic in General Nursing

    Morphine, morphine,

  19. Health food store giving medical advice

    TiredMD replied to mom4jesus's topic in General Nursing

    You kind of mixed two different concepts there. No one in their right mind would argue against using "natural" products, since as you point out, many (if not most) of our pharmaceuticals were...

  20. Health food store giving medical advice

    TiredMD replied to mom4jesus's topic in General Nursing

    Of course there's no source, since doctors can't go on strike. This is just one more attempt to denigrate modern medicine and promote fraudulent products that exploit people at their most vulnerable....

  21. exposure!

    TiredMD replied to skinc1's topic in General Nursing

    Blood contact on intact skin is not considered to be a vector for exposure. For mucosal exposure, the risk for HIV transmission is estimated at about 0.09%....

  22. packing a child in ice for a fever of 105 degrees?

    TiredMD replied to TooterIA's topic in General Nursing

    I think the underlying fear is that a very high temperature can cause brain damage. However, I was taught that, unless a person had a brain injury resulting in hypothalamic dysfunction, the body will...

  23. difficulty using arm after lobectomy?

    TiredMD replied to Mattsgrl83's topic in General Nursing

    Think about the possibility of an intraoperative

  24. Code status and end of life should be nursing decisions.

    TiredMD replied to Woodenpug's topic in General Nursing

    Actually, physicians can make a patient no code, if they judge that any further intervention would be medically futile. Physicians are under no obligation to offer care that they do not believe would...

  25. I'm so sick of MRSA!!!!!

    TiredMD replied to FireStarterRN's topic in General Nursing

    http://www.journals.uchicago.edu/doi/pdf/10.1086/527392?cookieSet=1 Actually, seven cases ever in the U.S. Five in Michigan, 1 in PA, and I think one in NY. Once upon a time, staph was susceptible to...