Altra BSN, RN

Emergency & Trauma/Adult ICU

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All Content by Altra

  1. Altra

    Dealing with an overdemanding doctor

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

    I don't doubt for a minute that this provider may be a pain in the bee-hind to work with. jadelpn's post above gives some great suggestions. Consider too -- what's in the differential diagnosis for...
  2. Altra

    Advanced Directive

    Altra replied to umcRN's topic in General Nursing

    The specifics of advance directives do indeed vary state to state. You should discuss this with your surgeon or the physician you will be admitted to following your surgery -- s/he will be the one to...
  3. Altra

    It's Tough Out There!

    Altra replied to Anna Flaxis's topic in General Nursing

    Wishing you well,
  4. Altra

    I don't need a PCP- I have the ER.

    Altra replied to Guest219794's topic in Emergency

    Have said essentially this for years ... Even for those with "good" insurance -- for one copay of $100-$200 the ER can be a convenient one-stop shop. I have had patients who had insurance, financial...
  5. Altra

    Report - acute/critical care

    Altra replied to NurseyPoo7's topic in General Nursing

    There shouldn't be a need to regurgitate the timeline of events during a patient's stay in every change of shift report. Why the patient is here -- physical assessment & pertinent labs/diagnostic...
  6. Altra

    It's Tough Out There!

    Altra replied to Anna Flaxis's topic in General Nursing

    ~Stargazer~, what happened - thought you had taken a happy non-bedside
  7. Altra

    After shift rant

    Altra replied to Sassy5d's topic in Emergency

    What sort of message? At the very least, a horribly dependent one. I think you know that. You mentioned that the patient is on meds - psych meds? If there is psych history and he is brought to the...
  8. Altra

    Contacting HR after an interview - opinions please

    Altra replied to Lucky724's topic in Job Search, Interview, Resume

    Some interviewing/hiring managers seem to not have the verbal skills to conclude/close an interview politely but noncommittally, without directly or indirectly implying that an offer is imminent. Or...
  9. Altra

    Odd ER visit

    Altra replied to inshallamiami's topic in Emergency

    This was my thought -- that the crux of the matter was whether or not there had been an actual loss of
  10. Altra

    Odd ER visit

    Altra replied to inshallamiami's topic in Emergency

    Bingo. Feeling dizzy/woozy/near-syncopal vs. actual loss of consciousness is a key assessment point, and in the absence of anything else that emerged during the workup -- most likely the key decision...
  11. Altra

    Family Members/Patients Who Write Down Your Name

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

    My most recent patient who had a self-appointed scribe stated, "I've asked you ... (flips notebook pages) ... 4 times if she could get something to eat." The beauty was that I had the patient's chart...
  12. Altra

    Odd ER visit

    Altra replied to inshallamiami's topic in Emergency

    ..........
  13. Altra

    New job: "Don't worry about following the MAR" & other scary stuff

    Altra replied to kak85's topic in Patient Safety Issues

    1. Double-checking insulin is a common (though not universal) practice in acute care, where you likely had the bulk of your clinical experiences as a student. It is not universally required. 2. For...
  14. Altra

    For-profic Urgent Care clinics

    Altra replied to mcnacht's topic in Emergency

    Without getting into ethics ... this is not unique to urgent care facilities. The entire US healthcare system is fee-for-service. "Insurance" payors including the government (CMS) complicate the...
  15. Altra

    Independent nursing, providing physicals.

    Altra replied to bekindtokittens's topic in General Nursing

    I agree that fitness for duty interpretation is probably out of the scope of an RN. OP, consider too, the tax/financial implications of self-employment. Tons of info for self-employed folks/contract...
  16. Altra

    Safe beds for patients

    Altra replied to Morainey's topic in General Nursing

    I see these used from time to time for adult
  17. Altra

    Restraints, What's Unacceptable?

    Altra replied to Hooch's topic in General Nursing

    OP, please consider the security function of locked/limited access units, and consider the regulatory environment in which we practice. Across long term care, subacute, and acute care ... if Patient...
  18. Altra

    Male Nurse Hair Styles

    Altra replied to Benners's topic in Men in Nursing

    What is considered "acceptable" will vary hugely based on region, employment setting, and individual workplace cultures. The personal styles of my male coworkers run the gamut from faux-hawks to...
  19. Altra

    Am I the only one who hates 12 hour shifts?

    Altra replied to jdubs99's topic in General Nursing

    Throughout the whole entire hospital? Only 12 hour shifts in ... the OR ... PACU ... ambulatory surgery ... admissions testing ... procedural areas ... radiology? It seems unlikely, as these activity...
  20. Altra

    Professional/Personal relationship with patients

    Altra replied to mammac5's topic in Nurse Practitioners, NP

    IMO, yes. I would sincerely wish them well, and suggest that they can send a card to the unit to update us on the patient's progress if they wish, and leave it at
  21. Altra

    Ins and outs- what's the point?!

    Altra replied to Bringonthenight's topic in General Nursing

    I/O is a crucial assessment point for many patients. If documentation is done inaccurately, my response would be to take the steps necessary (re-education, providing good data collection tools, etc.)...
  22. Altra

    Am I the only one who hates 12 hour shifts?

    Altra replied to jdubs99's topic in General Nursing

    This is a huge, inaccurate generalization. I have yet to work in a hospital which was ALL 12-hour nursing shifts. Your point - your personal dissatisfaction - can be heard without the hyperbole and...
  23. Altra

    "I don't want an admit..."

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

    I would like to see greater acceptance of the reality that acute care is about relatively quick turn around times for patients -- that by definition we are to get patients in and get patients out of...
  24. Altra

    I get out on time...

    Altra replied to nursedanny614's topic in General Nursing

    I would be quick to call BS on nurses who "aren't ready" to take report at the beginning of their shift. You get to work on time, and assume care of assigned patients. Looking up labs/orders before...
  25. Altra

    Proper disposal in the SICU

    Altra replied to rort's topic in MICU, SICU

    Any measurable volume of liquid should not go into the garbage - regardless of the color bag. That is just asking for liquid to splash the next time something is tossed, or the bag to break during...