TiredMD

TiredMD

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All Content by TiredMD

  1. Geriatric family member needs a PICC line

    TiredMD replied to MsDelta's topic in General Nursing

    Some of us will use an ultrasound to place a PICC, followed by a quick xray to confirm placement. Useful when you don't feel like waiting for IR to make room on their

  2. Does this concern anyone else?

    TiredMD replied to handyrn's topic in General Nursing

    She's probably not going to get MRSA from the patient, and yes, she's just as likely to get MRSA from a shopping cart as she is from the patient's wound. And if the patient is getting antibiotics for...

  3. Co-worker hitting up the Dr.s for meds during shift?

    TiredMD replied to babiesX2's topic in General Nursing

    I occassionally write scripts for friends, family, and coworkers. Generally I won't write for narcotics or birth control, but other non-controlled substances they're already on I'm usually willing....

  4. Co-worker hitting up the Dr.s for meds during shift?

    TiredMD replied to babiesX2's topic in General Nursing

    We don't work for the Administrators. We pay their

  5. Can they rescind job offer due to this at employee physical?

    TiredMD replied to RNOTODAY's topic in General Nursing

    I would never in a million years write this letter, and I can't imagine why any physician would. It's like sticking a "sue me" letter to your

  6. please tell me what this is...

    TiredMD replied to LVNwannaBE2007's topic in General Nursing

    As others have pointed out here, you are talking about the Nissen fundoplication. The gastric fundus is folded up and wrapped 360 degrees around the lower esophagus. The rationale behind this surgery...

  7. Did he get too much morphine?

    TiredMD replied to Deb123j's topic in General Nursing

    My God. I'm hyperventilating just thinking about managing a postop patient with those restrictions on the floor

  8. Say Hello to Dr. Nurse

    TiredMD replied to tanthalas's topic in General Nursing

    Most of your points are very well-taken, but here I think you're just wrong. Medical education occurs along a medical model, while NP education proceeds along the nursing model. These are two...

  9. Say Hello to Dr. Nurse

    TiredMD replied to tanthalas's topic in General Nursing

    Do you introduce yourself to your patients as "Dr.

  10. How to fix the nursing shortage?

    TiredMD replied to wish4RN's topic in General Nursing

    Some might argue that, back then, the patients were far less sick, the interventions far fewer, and the technology much less

  11. A prime lawsuit

    TiredMD replied to xoemmylouox's topic in General Nursing

    I like your philosophy, and it's the kind of surgeon I'm trying to become. What I hate (hate hate hate) is justifying scans to the radiologists, which I also have to do in my facility. They're bright...

  12. A prime lawsuit

    TiredMD replied to xoemmylouox's topic in General Nursing

    i see what you're saying. yeah, when they're sick they aren't going to drink. and yeah, if you got a big fat perf (especially if there's an abscess) you can often see it on a non-con or iv-only scan....

  13. grrrr

    TiredMD replied to chenoaspirit's topic in General Nursing

    Got this one the other night at 3:30am: Me: "Mr. Jones, I understand you don't want an IV?" Pt: "I'll take an IV. But these nurses have to clean up in here first." Me: " . . . what?" Pt: "There's...

  14. I am getting terminated tomarrow

    TiredMD replied to nl2005's topic in General Nursing

    Ah, the absentee admitting physician. Amazing that people get worried about residents taking care of them, but never bat an eyelash when their attending physician manages their admission via cell...

  15. I am getting terminated tomarrow

    TiredMD replied to nl2005's topic in General Nursing

    Common enough mistake, it happens. I can't help but wonder why the ED even had non-water soluble contrast on hand at all. You're responsible for determining where the patients go after admission?...

  16. A prime lawsuit

    TiredMD replied to xoemmylouox's topic in General Nursing

    And this really isn't a bad approach, as long as you don't mind a significant number of negative operations. Historic rates in the U.S. were as high as 50%, which was fine until folks started suing...

  17. A prime lawsuit

    TiredMD replied to xoemmylouox's topic in General Nursing

    Everything you wrote in this post except "Ex CT radiographer" is

  18. A prime lawsuit

    TiredMD replied to xoemmylouox's topic in General Nursing

    actually it wouldn't have. ct scans of the abdomen looking for appedicitis or other intraabdominal pathology use contrast material; either oral/rectal, iv, or both. this contrast is white on the...

  19. Appendicitis

    TiredMD replied to emlsp's topic in General Nursing

    Then it's an

  20. Do nurses actually measure liver span during physical assessment?

    TiredMD replied to student456's topic in General Nursing

    The scratch test. Very nice technique, also can be used on the spleen if you know what you're doing (I don't). Personally, I like to percuss out the liver, not because I think it's any more accurate,...

  21. Am I going to die?

    TiredMD replied to 2bnurselovescoffee's topic in General Nursing

    My answer is usually: "Everybody's going to die eventually, but today's not your day." Unless, you know, I actually think they might die. Then it's usually something along the lines of, "We're going...

  22. Americans With Disabilities Act

    TiredMD replied to Olli's topic in General Nursing

    It's not the DOJ's responsibility; it's the hospital's. http://www.hhs.gov/ocr/discrimdisab.html Covered entities must: Provide services and programs in the most integrated setting appropriate to...

  23. Paramedics Calling for Pt Info

    TiredMD replied to nurseby07's topic in General Nursing

    Been thinking about this thread the last 30 minutes, and I'm getting more and more irritated about this story. Both on this board and in my real life, I hear nurses in the hospital talking about how...

  24. Bladder Scans

    TiredMD replied to floatRN's topic in General Nursing

    1) Make sure you have the correct gender entered into the machine. 2) Make sure the probe has the arrow pointing in the correct direction. 3) Find the pubic symphysis, use liberal amounts of...

  25. Paramedics Calling for Pt Info

    TiredMD replied to nurseby07's topic in General Nursing

    I think you did everything right, especially given that the patient specifically told you that he didn't want to give his personal information to this person. Further, I think it would have been...