Altra BSN, RN

Emergency & Trauma/Adult ICU

Member

  • Content

    6,255

  • Visitors

    44,241

  • Followers

    0

  • Likes

    79

All Content by Altra

  1. Altra

    Keep having to meet with my boss :(

    Altra replied to RN617's topic in General Nursing

    Semantics matter - so your words here concern me a bit. I don't think it's the case that you *feel like* these things are happening -- it appears to be fact that they have actually occurred. Tele...
  2. Altra

    Nurse satisfaction: Nurse-physician relationship impact

    Altra replied to RN-JB's topic in Patient, Colleague Relations

    Unable to participate in your survey, as I feel your problem statement is significantly flawed. Nurse job satisfaction and nurse-physician collaboration impact on patient outcomes are two very...
  3. Altra

    Can you take a patient's medication without their consent?

    Altra replied to balmybalmblam's topic in Patient Safety Issues

    Please understand that legal issues like this need to be resolved not by "discussion" with other members of the team, nor books/websites. You need YOUR agencies policies & procedures. You need...
  4. Altra

    Is your ER using the EDIE system?

    Altra replied to Emergent's topic in Emergency

    Sounds like potentially a beautiful thing. We try to make do with at least integrated EMR within our hospital system, and often helpful hints from EMS partners. "Hey, I see Mr. X there in room 14 --...
  5. Altra

    When Hospitalists Attack

    Altra replied to Anna Flaxis's topic in Emergency

    In my experience, I don't think it's an assumption, or oversight, at all ... it's a game, played by experienced ED
  6. Altra

    When Hospitalists Attack

    Altra replied to Anna Flaxis's topic in Emergency

    I've totally stopped having those conversations -- "Dr. ER Resident - could you come to room 18 please?" If the hospitalist wants to beat up on his/her fellow resident buddy ... go for it. I'm not...
  7. Altra

    I wouldnt allow her to die -Hospice

    Altra replied to Aznurse711's topic in Patient Safety Issues

    From what you've written, I'm not understanding where the conflict is. Is the patient herself upset that she was admitted? Did she attempt to refuse transport to the hospital? If the patient's...
  8. Altra

    Support for PICU Nurses at Children's Hospital & Research Center

    Altra replied to AOx1's topic in Pediatric

    To the CHO PICU staff: I wish to express my support, my gratitude, and my pride in your care of Jahi McMath and her family. Please be at
  9. Altra

    Are my pts "brain dead"?

    Altra replied to smartnurse1982's topic in Patient, Colleague Relations

    That you are unable to answer these questions indicates substandard nursing care. There, I said it. How can we possibly answer here, when we are not assessing your patients? Your patients likely do...
  10. Altra

    Snowed in ER's, what do you guys do?

    Altra replied to Adenosine6's topic in Emergency

    I have lived in the northeast for most of my life. Anytime from November through March ... the roads will often be hazardous to some degree. Road closures or actual declarations of weather emergency...
  11. Altra

    Are my pts "brain dead"?

    Altra replied to smartnurse1982's topic in Patient, Colleague Relations

    My heart aches as I consider the psychology of the denial of the girl's family. I start to get a little testy when reading statements from the family's attorney such as "the hospital has refused to...
  12. Altra

    O2 bad if pt already 100% RA?

    Altra replied to Emergent's topic in General Nursing

    Exactly what applewhitern said ... I would have hoped that the OP would clarify that this post was not about *all* patients to present to his/her ED, but all patients whose chief complaint includes O2...
  13. Altra

    O2 bad if pt already 100% RA?

    Altra replied to Emergent's topic in General Nursing

    While the point about CYA/bill for as much as you can ... is a valid one, your question strikes me as somewhat broad. An ER patient whose chief complaint is dyspnea -- what is in the differential?...
  14. Altra

    conscious pt terminal wean

    Altra replied to taylynnfree's topic in MICU, SICU

    No euthanasia in this story. As an ICU nurse I consider it a good day any time that a patient/spouse/family are all on the same page regarding care. If an alert & oriented patient gets to make...
  15. Altra

    Another heparin protocol...

    Altra replied to nyteshade's topic in Patient Safety Issues

    Are you sure you're supposed to factor in the patient's baseline PTT into the initial infusion rate? Everywhere that I have worked, the nomogram order has listed an initial rate, with further...
  16. Altra

    ER nurses not calling report anymore...

    Altra replied to plinytheRN's topic in Patient Safety Issues

    Hospitals where I have worked have done the same since ... 2005-ish. All 7 hospitals in my current system have the same
  17. Altra

    If a person codes at Walmart..

    Altra replied to Vtachy1's topic in Patient, Colleague Relations

    OP, if you as a long-time ICU nurse have never witnessed families overriding a patient's previously expressed wishes ... or family members disagreeing vehemently about code status, I'd be...
  18. Altra

    If a person codes at Walmart..

    Altra replied to Vtachy1's topic in Patient, Colleague Relations

    Yes, it would likely be covered. Any litigation, even if attempted, likely wouldn't go very
  19. Altra

    The Elephant in the Room

    Altra replied to Anna Flaxis's topic in Emergency

    Stargazer, I think we must have worked together today. Thank
  20. Altra

    looking for my niche in nursing

    Altra replied to sophie<3's topic in General Nursing

    Some perspective ... Two years in a highly specialized environment like the OR is barely getting your feet wet. It's like the blink of an eye. Your profile lists your age as 25 -- you likely have...
  21. Altra

    etomidate and diluting

    Altra replied to tech1000's topic in Emergency

    If Etomidate absolutely required dilution and/or central access ... it would be a poor choice for RSI, now wouldn't
  22. Altra

    What are your pet peeves?

    Altra replied to forgop's topic in Emergency

    I missed ya,
  23. Altra

    Clinical Ladder Transfer Criteria

    Altra replied to juliekidrn's topic in General Nursing

    I imagine there is deep dissatisfaction with the current system at your hospital. To strip away earned designation and accompanying increased pay is short-sighted and punitive, IMO. Really -- doesn't...
  24. Altra

    Can an RN administer general anesthesia?

    Altra replied to Tinkk's topic in General Nursing

    We do procedural sedation daily in my emergency department, and if you ask any patient who has undergone one of these procedures they would probably say they were "out" or "fully under" or some...
  25. Altra

    What was the MOST ridiculous thing a patient came to the ER for?

    Altra replied to JUSTYSMOM's topic in Emergency

    morte is correct - though Medicaid is a federal HHS/CMS program, it is administered by the individual 50 states. ER use (demonstrated in multiple studies to be much higher per capita among Medicaid...