MaxAttack

The vast majority of my experience has been critical care, including three level I trauma ICUs. My absolute favorite shifts are getting those crashing and burning admissions but my biggest gripe is exactly the same - the vast majority of patients are there for monitoring or are "critical" but not unstable. I've never done ER because I've always thought the stomach aches and little complaints would drive me insane, but after reading your post I'm realizing that I really need to give it a shot.

Coming from someone who worked at a transfer center for over a year, this right here is part of the problem: You're in a position that requires being a voice of authority, even if it feels uncomfortable. "This is your assigned patient and room number. This is the ETA.” Some people will push back or be rude, but if your goal is to network and build rapport for life after nursing school, remember: the ones who can't handle meeting expectations without getting nasty aren't the people you want to end up working for anyway. Others might not like it, but they'll respect someone who gets things done. On top of that, you'll stand out in a good way with the nursing sup - who likely has more pull than anyone else. Good luck!

You should first clarify what exactly you're looking for. Management of osteomyelitis? Outcomes of osteomyelitis treated outpatient vs inpatient? IV vs oral? Then turn it into a PICO question (Patient/Population/Problem, Intervention, Control, Outcome). So for example: In adult dialysis patients with osteomyelitis, is outpatient intravenous antibiotic therapy non-inferior to inpatient therapy for time to infection resolution? Break your PICO question down into search terms and look at the databases available through your school.

The day I stop seeing panic alarms for "asystole" when there's clearly a rhythm on the monitor or for desats when the probe isn't even on a finger is the day I'll even start to think AI can do this job. Even then, there's too much hands-on care to realistically have a machine take over. Placing cuffs and electrodes, priming and hanging IV tubing, wound care, IV insertion... the list could go on forever. If anything, it might eventually augment what we already do.

While I don't agree with FullGlass's implication that there's something morally wrong with money for sex, I DO agree that posting on a public website is in no way, shape, or form "private." Honestly, I couldn't care less either way, but when you're running for public office, these things have a way of surfacing - man or woman, nurse or CEO. The Astronomer CEO recently learned just how powerful the court of public opinion can be.

Glad to see the Appeals Court is following her advice and is continuing to ensure grossly incompetent and dangerous nurses are held accountable in the appropriate way.

That's nuts. Using AI to suggest proper treatment, OK makes sense. But giving AI full prescriptive authority is absolutely crazy at this stage.

I've never had an issue, and I would do it again.

The more I read about this case the more I'm convinced she ended up the fall guy and will spend her life in prison because the alternative would've been for a hospital to actually take accountability for poor care. The testimony read more like it came from a script of Grey's Anatomy than from anyone who's actually dealt with critical patients. Some of the "circumstantial evidence" was just dumb. The judge said she had "morbid records" of her crimes because she kept records and looked up families of the deceased. Or maybe, just maybe, people have different ways of coping with the death of infants while being overworked, undervalued, and unsupported. I've kept certain records and I have printouts of agonal rhythms and aystole. I was present at those deaths. I must've done it by the same logic applied to her case. Now we have a panel of 14 neonatologists who say wait, there are actual medical reasons for these deaths. Dr Lee was a co-author for a paper that was part of the prosecution's evidence and he's already gone on record saying it was misinterpreted. The more that comes out the more it unravels. And yet in an article that covers the fact that an international panel of experts reviewed the medical records and couldn't find any evidence of murder, she's still referred to as a child murderer: It's so much easier to sensationalize the idea of a psychotic murderous nurse that was living amongst us than to admit that sometimes hospitals don't live up to standards and patients suffer. Plus, how else are hospitals supposed to keep understaffing and underpaying their staff while giving them minimal tools to work with if the public actually realizes lives are on the line? Sweep it under the rug. If that doesn't work, blame the nurse and move on.

The unfortunate thing is even if you provided feedback to the hospital, administration would take that as a sign of poor nursing without considering the factors that lead to it. They focus on the bottom line and start cutting from other departments so the bedside nurse becomes environmental, PT/OT, IT, etc. PCA hours start getting cut back so there's less help and more to do. Staff nurses sick of the increased workload and getting treated like just another body leave and those spots get filled in with travelers who can sometimes care less and new grads who are willing to learn but inexperienced and overwhelmed. BUT if it's one of theirs, you're told they're a "VIP" and are expected to give them special treatment. Really, it's just the treatment every patient in the hospital should be given. Profit before people.

I was failed for being unsafe one semester in nursing school. I kept going, and yeah I felt like I was on the radar and that I barely squeaked through. But I did. I now have almost ten years of critical care experience, including level I trauma centers and a transplant CVICU. I still sometimes think back to that, and you know what? They had a point. Everyone makes mistakes, and I can admit I've done my share. Learn, grow, and be the best version of yourself you can be. Counseling is a great idea. Sometimes, it takes a few tries to find someone you click with, but it's so worth the effort. "It's not about how hard you hit. It's about how hard you can get hit and keep moving forward." -Rocky

That first response was way out of line. I find it hard to believe they are a nurse and are so oblivious to such a prevalent disorder. Autism is a disability covered under the ADA. HR would handle reasonable accommodations so I would speak with them first. It will hopefully be as simple as that. I also do not think it is unreasonable to ask for a policy concerning floating to an entirely different facility. It's not like it's unheard of for administration to pull fast ones on nurses.

Adenosine works on the AV node so it would be ineffective in afib. Amio is a good first-line drug, but procainamide and sotalol can be effective. I don't know that there's a time per se to wait before a patient is shocked. I know stable vs unstable vtach is controversial, but I've seen it go on for some time in a perfectly awake and happy patient. It sounds like the patient was sicker than he looked and tachycardic as a compensatory mechanism to maintain their cardiac output (CO = HR x SV). When they were shocked into a normal rhythm their output plummeted and their hemodynamic status with it. You can't always predict it. It doesn't sound like anything was done wrong. Sometimes sick bodies don't play nice.

I'm sure worse things have happened, but now you know for the future. The biggest issue I see in this particular situation is contamination. I've seen experienced nurses disconnect an infusion set and leave the end open to air and it drives me insane. I imagine it's also technically practicing outside your scope. I think kicking you out and crucifying you in the town square would be a little extreme, but live and learn.

This case is kind of scary. This all started because someone noticed that a particular nurse was on shift during patient deterioration and deaths. If you pick up shifts and are quick to help in an emergency, that would be you, too. The first thing I thought of when I looked at this was where are the hours worked and typical patient acuity? I know a couple of nurses that pick up a ton of hours and are usually given high-acuity patients. Would there be a correlation? Absolutely. Does that mean they're responsible for the deaths of their patients? Of course not. Also this fun quote (Lucy Letby: What did the nurse do to babies in her care?): My specialty is adults but you get prior warning on every single patient? Are neonatal bodies so different from adults that they are immune to sudden cardiovascular collapse? I've seen patients ready to transfer end up dead less than 24 hours later. Maybe neonates are just that special, though. This does not seem like an investigation where all angles were looked at. This was a witch hunt with a single suspect in mind. I'm not saying for sure she didn't do it, but I am saying it's disturbing how quickly she became the first and only explanation.

Ahhhh gotcha. Yep, it's not ideal but typically the physicians want to see what's going on for themselves and evaluate for any missed injuries.

He's going to head to the trauma bay first where the binder would be removed to allow for a complete assessment and a foley would be inserted (good research - part of that is checking for blood) before the binder is reapplied. I don't know what you mean about anatomically. Foley goes in and it points downward and the binder goes on. IDK it might be the way you're visualizing it but it works.

https://theintercept.com/2023/09/25/chaturbate-susanna-gibson-washington-post/ She posted the videos on Chaturbate - a publicly accessible Media site. What probably happened was she posted it and then took it down at some point assuming that once she takes it down it's gone forever. The rest of the world knows that's not how the internet works. She's complaining not that the original video was not consensual, but that others posting the video elsewhere made it some sort of non-consensual sex crime. That logic is ridiculous. That's equivalent to writing an article for The Washington Post and then complaining that The New York Times also ran the story. So ultimately it's not about the initial video (which to be fair is a personal choice and one I support with the understanding that actions may have lasting consequences) but that it caught up with her after she tried to hide it. This isn't a private photo that someone posted online (eg revenge Media). This whole sob story of her being a victim comes across as her trying to push off responsibility. She did it. Own it.

Oh man, I would have been horrified. It sounds like he was cool about it at least! We're all human. I feel like I've done a thousand things that make me wish I could disappear. Most recently I had a patient with a tanking blood pressure. After cranking my pressors, giving a couple of pushes, and calling the intensivist I realized the multi-port had disconnected from the patient. All of my drips were going straight to the sheets *smh*. That's life.

Your specialty is "research" but you need help navigating Google and/or databases? ? I have a feeling when you see ARR numbers you'll think you've been vindicated and not realize that at a population level those numbers quickly become huge. You seem to believe in the concept of vaccines at least (even if you struggle with applying the same logic to the covid vaccine), so while you're at it you should look up the ARR for other vaccines and then the impact vaccines have had. Those small percentages add up quickly. But I'm sure HR and infection control would love to hear your thoughts.

Hospitals aren't a lawless land where patients can do what they want. It's funny to me that security is useless everywhere. I feel the best step would have been to get the police involved. I have nothing against weed at all but if they want to be an idiot about it and play games then let them play with big dogs. "Moreover, the court noted that searches were permissible if conducted on the belief that one or more hospital patients possessed contraband, such as a dangerous weapon, drugs or liquor, which could impair patients, interfere with their treatment or create a dangerous situation at the hospital" Health Care Law Monthly (Vol. 2012, Issue No. 10)

Considering most of the covid vaccines weren't withdrawn for safety reasons but because there were better formulations available and that the information you're asking for is readily available online, I'm wondering what "gotcha" moment we have coming here. In addition - as all viruses mutate and change over time - comparing a vaccine 12 months after introduction we would expect to see a decline in efficacy. It's like asking to compare last year's flu shot to the current season. There's a reason there are different formulations every year. The covid shot available now is not the same one from 12 months ago. As for safety: It's constantly reassessed. Besides the continuous monitoring that regulatory bodies perform, go to your database of choice and search. There's a world of information out there just waiting to be seen.

Reality should not be this difficult. This is so detached from objective truths that I can only assume you're trolling at this point.

Some actually have street value and are used recreationally. I imagine they're looking for the use of meds without a script or the program's knowledge.

It's always strange to me when anti-vaxxers are nurses. Why choose a field based on science if you don't believe in it? Or maybe they believe in science but don't take the time before forming their opinions to learn how to analyze evidence. It's fascinating to me when people ignore large trials, expert opinions, society consensus statements, and guidelines but cling to every word a random dude who published a paper in a fly-by-night journal writes or a random "expert" on facebook. I don't think it's just America, though.