TiredMD

TiredMD

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All Content by TiredMD

  1. Family Doesn't Want Patient To Know?

    TiredMD replied to missjennmb's topic in General Nursing

    I think everyone in health care comes to a point someday where they have to decide (1) what's the right thing to do, and (2) whether or not to do it. I would tell the patient, and consequences be...

  2. I gave a lot of money to this place

    TiredMD replied to ShayRN's topic in General Nursing

    "The decision was made"? Who made it? Who wrote the admit orders? And why wasn't her physician seeing her over the weekend? This is whole thing was a waste of your time. And the "director" needed a...

  3. INR for Hemophilia A patient.

    TiredMD replied to curetheworld's topic in General Nursing

    If you recall, blood clotting can occur by two pathways. One is referred to as the extrinsic pathway, and occurs when factor VII is released from vascular endothelium. The other (the 'instrinsic'...

  4. Army Medic 68w

    TiredMD replied to doctorita's topic in General Nursing

    Why not just take the Nurse Corps scholarship and then get commissioned

  5. What are CNA's allowed to know? (HIPAA question)

    TiredMD replied to Donnagg123's topic in HIPAA Challenges

    I don't know the answer to this (although I'm sure the "minimum necessary info to do your job" part applies here). I've seen facilities swing to either extreme. I will tell you though, when I was a...

  6. thoughts on only Paralytic while intubated....

    TiredMD replied to MassED's topic in General Nursing

    This is the kind of crap that makes me want to quit clinical medicine and work full-time as an expert plaintiff's

  7. thoughts on only Paralytic while intubated....

    TiredMD replied to MassED's topic in General Nursing

    Why in God's name did they give a paralytic in the first place? Are we talking "paralyzed after RSI" or were they intentionally paralyzing the guy? Regardless, I've never heard of such an insane,...

  8. CNA's Aide the nurse... right!

    TiredMD replied to CNA_Timmy's topic in General Nursing

    Fair enough, these days I pretty much bounce out of rooms at the first sign of poo. On the other hand, I did spend 6 years as a CNA/tech before I got my MD. And I gotta tell you, there were a lot of...

  9. An old stethoscope

    TiredMD replied to callmekipling's topic in General Nursing

    I was taught that a bell allows you to hear low-pitched sounds better, while a diaphragm picks up high-pitched sounds better. The trick is that you can't push hard on the skin with a bell, because...

  10. Patient freaking out

    TiredMD replied to alcrab01's topic in General Nursing

    Yes. On the other hand, you're not breaking confidentiality if you are taking steps to say it in a voice low enough that you cannot be overheard. Plus, if she does actually try to get you into...

  11. Is it okay to give an IM through clothing?

    TiredMD replied to njinsky's topic in General Nursing

    I had no idea either. Gosh, just seems like such a bad idea, huh?

  12. Interprete Lab/Tests resutls to patients

    TiredMD replied to seriousnurse's topic in General Nursing

    I don't interpret lab/imaging tests ordered by consultant physicians. Not because I can't do it (actually, I can't always do it) but because when folks order tests, they do it for specific reasons and...

  13. Digoxin Error, How should it be handled? Worried for a Pt.

    TiredMD replied to WVStarFish's topic in General Nursing

    I'm betting the patient's blood pressure couldn't tolerate the beta-blocker, for whatever reason. The reason the OP has to tell the physician is that he/she's not just dosing the dig based on serum...

  14. CHF and low BP

    TiredMD replied to RNKPCE's topic in General Nursing

    Presumably this patient was admitted with a bit of decompensated CHF, judging by the BNP. So you're trying to balance getting rid of 3rd space fluid (Lasix), maintaining adequate intravascular volume...

  15. Why isn't there's a Men's Health NP specialty

    TiredMD replied to ThatPoshGirl's topic in General Nursing

    http://www.nytimes.com/books/first/m/maines-technology.html?_r=1&oref=login

  16. Need Help With Electrolytes!

    TiredMD replied to Vaporize's topic in General Nursing

    When you maintain an open forum on the internet, you take what you get. If the people who owned/ran this website wanted to limit it exclusively to nurses or student nurses, there are relatively easy...

  17. Need Help With Electrolytes!

    TiredMD replied to Vaporize's topic in General Nursing

    I'm not aware of any rule for Calcium and Magnessium, and a quick look through my hospital handbooks doesn't show one either. Really, it's all just voodoo. There are multiple stores of the various...

  18. Explain HIT

    TiredMD replied to keludtke's topic in General Nursing

    In short, heparin + certain antibodies = an immune complex that causes platelets to activate (prone to sticking to each other and vessel walls). This results in the formation of "platelet clumps"...

  19. RN's at my job tell me "Diastolic BP is when the sound 'changes' NOT when it stops!"

    TiredMD replied to student456's topic in General Nursing

    Maybe you're pushing too hard with your stethoscope. Just like how every patient has an abdominal bruit if you push too

  20. NP's calling themselves MD's

    TiredMD replied to shelly304's topic in General Nursing

    :) I wouldn't be so ridiculous as to call myself a doctor unless I had the degree to back it up. You know, you really ought to google these topics before you issue challenges like "Name one DNP...

  21. Why is nursing considered a sexy career?

    TiredMD replied to pumpkin1984's topic in General Nursing

    sometimes i go shirtless under the white coat just to put on a show . .

  22. NP's calling themselves MD's

    TiredMD replied to shelly304's topic in General Nursing

    Even worse, I think, because I'm pretty sure the PA heard the RN introduce him and chose not to contradict her statement. I didn't. That's why I said I was talking about a small minority. I think...

  23. Why is nursing considered a sexy career?

    TiredMD replied to pumpkin1984's topic in General Nursing

    Is it really the profession, or is it the fact that the profession has a disproportionate number of women in the 20-29yo age range? Because I don't think nurses are hot. But I do think that hot nurses...

  24. NP's calling themselves MD's

    TiredMD replied to shelly304's topic in General Nursing

    I think you're mostly wrong about this, but I'll leave the issue to core0, who knows far more about it than I. I had a PA once mislead me about their qualifications. I was a medical student, and ended...

  25. Second opinion, how to ask doctor for?

    TiredMD replied to dcampbell's topic in General Nursing

    It's real important to be upfront with the doc you're going to a second opinion for. When you call to make the appointment, tell them it's for a second opinion, and make sure you take copies of your...