Altra BSN, RN

Emergency & Trauma/Adult ICU

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All Content by Altra

  1. Altra

    Your nursing practice varies from mine, therefore, you suck!!

    Altra replied to wooh's topic in General Nursing

    Your thread title made me smile
  2. Altra

    New Interns are coming

    Altra replied to esrun00's topic in General Nursing

    And July 1 this year is the Friday leading into 4th of July weekend ... Should be a blast ... Seriously though -- we have a picnic as a meet & greet event. And my dept. always double schedules...
  3. Altra

    You don't work in anER. Get over it.

    Altra replied to Guest219794's topic in Emergency

    A growing number of insurance plans specifically indicate a copay for an urgent care visit - sometimes it's the same as an ER copay, sometimes
  4. Altra

    THE DOORS

    Altra replied to kc87t's topic in Emergency

    Emergency! True Stories from the Nation's ERs Long before the hit TV show E.R., emergency room doctor Mark Brown decided that the world just had to know about real life in a hospital's E.R. He...
  5. Altra

    Credit check along with background? *****??

    Altra replied to choc0late's topic in Job Search, Interview, Resume

    I'm sorry you're experiencing this stress. Credit checks have been used in the hiring process in many industries for some time now. I've had my credit checked for every job I've held since the late...
  6. Altra

    How do I 'toughen up?'

    Altra replied to GoLauraGo's topic in General Nursing

    For the sake of argument ... Let's say you do quit. You seem to believe that would satisfy your perfectionistic tendencies. You could take another nursing job, or even pursue a completely different...
  7. Altra

    My horrible hospital stay. What would you do?

    Altra replied to Carebear77's topic in General Nursing

    No, it's not that it's contraindicated. However, IV Dilaudid is no longer an order option for patients on med-surg floors at several hospitals in my area, as I described in my posts above. It can...
  8. Altra

    My horrible hospital stay. What would you do?

    Altra replied to Carebear77's topic in General Nursing

    I hear ya ... like I said, back in the day we gave out Dilaudid like pretzels too. Different sentinel events at different hospitals in my area ... the common theme was sedation/hypoxia after IV...
  9. Altra

    My horrible hospital stay. What would you do?

    Altra replied to Carebear77's topic in General Nursing

    Agree. The site should have been assessed by a nurse during a part of overall assessment. Simple removal of a lock is a task that can be
  10. Altra

    My horrible hospital stay. What would you do?

    Altra replied to Carebear77's topic in General Nursing

    Only IV. The rationale is ... q 30 minute VS and continuous pulse ox monitoring. The chole patient, as in the OP's example, would never have had IV Dilaudid as an order option where I work unless...
  11. Altra

    My horrible hospital stay. What would you do?

    Altra replied to Carebear77's topic in General Nursing

    There was a time when this was common in my ER too ... but no more, for a few years now. Some sentinel events r/t Dilaudid in my
  12. Altra

    How fast does dopamine work?

    Altra replied to ornurse25's topic in General Nursing

    Although a SBP of 88 is not necessarily a big deal in a stable renal patient, I can see the decision to start the pressor, given that the patient was known to be septic. There is a risk of rapid...
  13. Altra

    My horrible hospital stay. What would you do?

    Altra replied to Carebear77's topic in General Nursing

    I agree that the comments allegedly made, within hearing distance of that patient and probably other patients and visitors, were very unprofessional. A couple of things ... In my experience, yes...
  14. Altra

    E.R Security

    Altra replied to Crux1024's topic in Emergency

    Two security staff in the ED at all times, more if you need them, within seconds. And they're Big. Strong. Guys. I love the idea of a K9 unit. I remember reading a research study a few years ago...
  15. Altra

    What is procedure when patient is unable to take medicine?

    Altra replied to Marnie S's topic in General Nursing

    In the US, this varies based on the patient's status at the moment -- are they currently admitted to the hospital voluntarily? If so, then they most likely have the right to refuse any and all...
  16. Altra

    Anyone else have Extended ER???

    Altra replied to RNwillie's topic in Emergency

    I think there are several things wrapped up in your question. In and out of the ER in under 4 hours ... is either a low-acuity/urgent care type patient on a good, not very busy, fast-moving day OR a...
  17. Altra

    When is patient education TOO much?!?

    Altra replied to Nursey103's topic in General Nursing

    This is standard-issue manipulative behavior. This may be the first time you've seen this ... but it will not be the last. Medicate within your order parameters and in accordance with your nursing...
  18. Altra

    Selecting syringes

    Altra replied to queenjulie's topic in General Nursing

    The size of the syringe you use also depends on what is stocked in the med room at the precise moment that you need it ... While it seems most efficient to use the smallest syringe which will hold...
  19. Altra

    HCAHPS Scores = hospital pay

    Altra replied to A&OxNone's topic in Nursing News

    No. Remember, this is just Medicare reimbursement, so these scores are from the surveys that CMS (Centers for Medicare & Medicaid - a division of HHS) sends to their patient population. However...
  20. Altra

    Does anyone change their propofol tubing Q24h?

    Altra replied to Murse_1's topic in General Nursing

    That's some really long tubing you must have. We only have one type of tubing - it contains a vent which can be opened for Propofol, NTG, or anything else in a bottle. End - to - end it holds about...
  21. Altra

    What is procedure when patient is unable to take medicine?

    Altra replied to Marnie S's topic in General Nursing

    I'm very surprised to learn that you are working in an acute care hospital. From your initial post, I had assumed this was an LTC situation. I'm trying to better understand your situation. In an...
  22. Altra

    How long does it take to give report?

    Altra replied to DemonWings's topic in General Nursing

    This is highly variable by the type of unit, report format, and the way that patient assignments are structured. In the unit it can easily take 30 minutes to give report on 2 patients. In the ER, I...
  23. Altra

    Give me the numbers regarding "Nursing Shortage"

    Altra replied to kalevra's topic in Activism, Healthcare

    Lots of aggregate data at http://www.bls.gov/oes/ "Projected nursing shortage" media coverage often originates from national health statistics on the percentage of the population, particularly the...
  24. Altra

    As basic decency slips away....We watch them die and do nothing.........

    Altra replied to greenfiremajick's topic in General Nursing

    OP, are you saying the "basic decency" of the bystanders, including firefighters, has slipped
  25. Altra

    As basic decency slips away....We watch them die and do nothing.........

    Altra replied to greenfiremajick's topic in General Nursing

    This is San Francisco Bay ... not a swimming pool.