TiredMD

TiredMD

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All Content by TiredMD

  1. Patient Advocacy and CODE STATUS?! Need feedback please!

    TiredMD replied to gemini81sg's topic in General Nursing

    Don't think that these are easy decisions to make, or that they are made flippantly. Here's a couple things from my perspective: (1) Most DNR/DNIs are poorly written. Usually the main statement is...

  2. Concern about flu shot

    TiredMD replied to inspire's topic in General Nursing

    Exactly. It is tiresome to hear so many health care professionals entertaining these ridiculous notions about vaccines, medicines, etc. Not all sources of information are equal, and there is no...

  3. Positioning after Total Hip Replacement

    TiredMD replied to micstn's topic in General Nursing

    What a truly excellent post. Thank

  4. Are doctors all high and mighty?

    TiredMD replied to trefer84's topic in General Nursing

    I was a CNA for 6 years, and once upon a time had similar feelings. When you work on the floor all day doing manual labor, and all you see is the physicians popping in the rooms for a few minutes, you...

  5. Can anyone insert a foley? Inject IMs?

    TiredMD replied to sandera's topic in General Nursing

    Unless the order was given to the RN, and subsequently delegated to the unlicensed personnel from her, it has nothing to do with her license. Again though, if you argue that the situation is unsafe...

  6. What Would You Like to Chart if You Can Get Away With It?

    TiredMD replied to pagandeva2000's topic in General Nursing

    Or they're Borderlines who aren't actually trying to die, just seeking attention. In such a case, the advice above seems very

  7. Can anyone insert a foley? Inject IMs?

    TiredMD replied to sandera's topic in General Nursing

    I don't see how this is even a question. If you are acting in the role of a case manager, not a skilled nursing provider, it is hard to see why you would have any liability for the CG actions. The...

  8. What's the "real deal" on these Carribean Medical Schools?

    TiredMD replied to justme1972's topic in General Nursing

    In the US, most MD schools have affiliated hospitals, be it hospitals that are a part of the institution (Georgetown, George Washington) or hospitals that have a long-standing relationship with...

  9. What's the "real deal" on these Carribean Medical Schools?

    TiredMD replied to justme1972's topic in General Nursing

    This is a cute catch phrase, but the truth of the matter is that there is a big difference between an institution that (1) puts all of their profits back into the organization, vs (2) pays profits out...

  10. What's the "real deal" on these Carribean Medical Schools?

    TiredMD replied to justme1972's topic in General Nursing

    In the Caribbean, maybe. But not in the U.S. Graduating from school is the just first step in a long process to become a licensed, practicing physician

  11. Questioning Doctor's Order

    TiredMD replied to pagandeva2000's topic in General Nursing

    The day I see Wikipedia charted as a reference in a note is the day I quit medicine and never look

  12. What's the "real deal" on these Carribean Medical Schools?

    TiredMD replied to justme1972's topic in General Nursing

    The Carribean Medical Schools have been around for a long time and have a mixed reputation in the U.S. As pointed out here, it frequently serves as a pathway for U.S. students who didn't do real well...

  13. Use of the nicotine patch

    TiredMD replied to Phillygryl's topic in General Nursing

    I have never used a time-delay, and I've never read/heard that one was necessary. Remember that the nicotine transdermal patch is a time-released dose. So once you put the patch on, you're not...

  14. Trauma Naked?

    TiredMD replied to mark90's topic in General Nursing

    How come male relatives are always more concerned about whether or not their wives/sisters/mothers are naked than if they're medically okay? Those are some seriously screwed up priorities, gentlemen....

  15. Trauma Naked?

    TiredMD replied to mark90's topic in General Nursing

    We don't run, but other than that . .

  16. Trauma Naked?

    TiredMD replied to mark90's topic in General Nursing

    You have to understand that the decision on how a trauma workup proceeds in made based on the individual circumstances of the trauma and the clinical presentation of the patient. It is not a...

  17. acute renal failure scenario

    TiredMD replied to cocolococna's topic in General Nursing

    That's what I was thinking as well. Cholangitis progressing to gram negative sepsis. I think the MRSA thing is a red

  18. acute renal failure scenario

    TiredMD replied to cocolococna's topic in General Nursing

    This case scenario is a classic presentation of acute cholangitis. Since the patient is receiving Vancomycin, which does not cover enteric organisms, he is essentially receiving no treatment for his...

  19. acute renal failure scenario

    TiredMD replied to cocolococna's topic in General Nursing

    Think less about the kidneys and more about the

  20. Does anyone know about the Medical Corps?

    TiredMD replied to Practicalone's topic in General Nursing

    Nurse Corps officers are always BSNs by long-standing policy. This is probably related to the fact that Bachelors degrees are de rigeur for military officers. There are LPNs in the military (at least...

  21. Doctor title, Nurse title

    TiredMD replied to pegbord's topic in General Nursing

    What would you all prefer to be called? Because quite frankly, I'm very uncomfortable referring to nurses by their first names. Unfortunately, I have yet to meet one who didn't insist on

  22. A Doctor lied to make me look bad!

    TiredMD replied to TigerGalLE's topic in General Nursing

    Interesting. I have never worked in a hospital where we didn't call consults personally. Perhaps the community facilities are bit more lax on this than the academic hospitals. Personally though, why...

  23. Who here actually uses percussion when doing assessments?

    TiredMD replied to student456's topic in General Nursing

    I'll use it in a couple of circumstances: - decreased breath sounds and I'm curious if there's a pleural effusion present - used to use it to assess liver size, but I no longer trust it - typanitic...

  24. HIPPAA Dilemma: Pt Privacy vs. Suffering Animal

    TiredMD replied to HapkidoMedicine's topic in General Nursing

    HIPPA and related laws cover medical privacy. I don't think notifying animal control about a patient's dog is covered anywhere in there. I would've called

  25. Doctors and Nurses need to band together against out of touch regulatory overkill

    TiredMD replied to FireStarterRN's topic in General Nursing

    What organization are you talking about? JCAHO is strictly an accrediting body. They have no authority to impose fines or