Capp

I just need mechanism of action, IV compatibility, adverse effects, that sort of thing. I would love a description of the drug as well, but that is hard to find in my experience.

I'm not sure if anyone else does this, but I sometimes find it helpful to have a drug reference app on my phone. Does anybody have one they can recommend? I use Epocrates, which is useful but doesn't always have the info I need.

I have a stupid question for nurses who have more experience with dialysis than me. Obviously a patient on dialysis is expected to have lower urine output than normal, but is there a point when you are supposed to be concerned about low urine output in a dialysis patient? Or do you just not worry about it?

Hmm, those are all good things. Salaries are a bit lower, but obviously that might be outweighed by the cost of living. Thanks for the thoughts.

Yeah, it was something she clearly just did out of spite.

Are there reasons why those states are good for nurses or do you just like that part of the country? I had actually been researching Wyoming a bit because I had seen in a couple of places that land can be really cheap there.

I remember elementary school well enough to recognize your style of behavior and that you are trying to make me angry, but you are not succeeding.

I’m confused. Can you quote where the OP stated she was so completely enraged? [Reference to your previous post, not actually asking.] Pointing out obvious hypocrites like you doesn’t mean I’m enraged.

Exactly. I wouldn’t just read the cliff notes if it was like great literature or something. For a bill, the cliff notes is more than enough.

This pointless line of conversation that you started when you tried to insult me by lying about how you read all bills and your mind is "boggled" that there is anyone out there who is too stupid to not READ (in all caps) any bill that might affect them (meaning pretty much all bills.) As for the bill, I didn't read it, but I know it's not "very interesting." I'm open to being proven wrong, but I would be willing to bet a lot of money that there is nothing "very interesting" in this bill.

So your story changes again. First it was disdain for anyone who doesn’t read all the bills, then it was “well I only read all the bills that affect me personally,” now you are saying you only read bills that you mention on allnurses. Except, you aren’t even saying that; you are saying you would read “about” it. I’m basically 100% sure that you have never read a single bill in your entire life.

Oh, then I’m assuming you read the new tax law that just went into effect? How was that 1000+ page read?

Yeah, I’m poor enough that I often need to work that many hours a week, so it isn’t hyperbole. It boggles my mind to find out that you apparently read every bill proposed in your state legislature (and the US Congress as well, I suppose, since that also affects us.)

No. I have never read any bill.

"Well, if we have an issue with nurses getting tired, let's quit letting them do 12-hour shifts, let's let them do 8-hour shifts. Like most standard shifts are," Walsh said on Tuesday. "Twelve hours, I know they want it, but then they come back and they start talking out of both sides of the mouth and telling us how tired they are." This is the part that is most interesting to me rather than the card playing part. It seems to show pretty plainly that she introduced the 12 hour shift ban out of spite.

Does anybody have any insight into the best states for nurses as far as pay, cost of living, etc?

The nurse that hung the antibiotic is fairly new so I suspect they might be doing the thing where you make up an imaginary rule and pretend that the new nurse is some kind of moron for not knowing about it. I've seen this a lot.

A coworker had a one-hour antibiotic infusion scheduled for 0600. She opted to hang it at 0635 so it wouldn't finish at an inopportune time during the 0700-0730 shift change. Another coworker indicated that this was seriously inappropriate of her. They even said, "Well, it's your license on the line," implying that action could be taken against her license. I'm really curious what could possibly be wrong with this. An antibiotic scheduled for 0600 can be started any time between 0500 and 0700 (at this hospital at least) and still be considered on time. I don't see any reason why the person who hung the antibiotic has to be the one to saline-lock afterwards. It's not like you have to stay with and continuously monitor the patient during antibiotic infusions. If that were the rule we would have a 1 to 1 nurse-to-patient ratio. Does anybody agree with this other nurse? Is there something I'm missing that makes what the nurse did horrible?

I think of all the passive-aggressive attacks poorly disguised as well-meaning attempts at psychoanalysis from a stranger on the internet that I've seen, this was by far the funniest. I think the last sentence really ties it together. If you were writing this as a satirical commentary on people who make those kinds of attacks you would be a comical genius. I also love how in your first paragraph you are criticising me for my example of a patient put in a very unfair position (a situation which is 100% inevitable based on the new policy) on the grounds that "realistically, how often does that happen?" So the number of patients that happens to probably is rather small, so who cares? Then, at the end of your second paragraph you conclude that you have so much empathy for this poor, random person on the internet that you've never met that you genuinely hope I somehow manage to overcome my clearly deeply pathological obsession with this imagined "injustice," for otherwise I will surely die a lonely, bitter old man. I've been thinking from the beginning of this conversation that it is interesting the way that people use words like "inconvenience," apparently to try to trivialize things to set up attempts at making me look petty. I don't think it really matters to me if we choose to use a word like that. Even just inconveniencing patients without good reason isn't right if you ask me. It also isn't a question of magnitude, as some people have implied. Yes, there are bigger injustices in the world; ISIS is worse than this policy. Yes, there are greater struggles that an individual may be forced to cope with in life. Yes, the patient in my example might be able to get to Walmart before they close and in so doing avoid the 14 hours of unnecessary pain. But it will cost them more than if they had gotten the prescription at an in-system pharmacy. And it will "inconvenience" them. I personally think that is enough to conclude that it isn't right. Side Note: Repliers who said things like, "I agree this is messed-up, but it isn't the end of the world," please don't think any of my rhetorical ripostes are directed towards you. We are, I think, in exact agreement. My original question was, "Is this messed-up?"

Maybe I gave too many details in my original post, because people are kind of fixating on irrelevant details. I guess I shouldn't have said "the hospital pharmacy" but "the main pharmacy in our system." Basically we are talking about a group of our patients and how we choose to treat them. This group happens to be employees as well as patients, but my whole point is to ask why does that matter? How is it right to treat a patient crappily just because of who they work for. I personally would think that was wrong whether it was Chic-fil-A employees or healthcare workers from a rival system that were being discriminated against. Also, I guess I shouldn't have mentioned my own situation as an example because that just stirs up people's natural instinct to make things personal. "Quit whining . . . Get over it. . . Etc." The change technically doesn't impact me personally because I don't have any current prescriptions anyway. I was saying that I personally think all patients deserve to be treated the same regardless of who their employer is. Obviously the consensus is that I am wrong. Here's another example that doesn't involve me. Say I have a patient who is supposed to discharge in the evening and is supposed to pick up a prescription upon discharge. Normally I would have the patient get their meds sent to the main pharmacy because it is the only one open late. With this new change, if it is an employee, basically they're just screwed. If it's pain medication, for example, they have to be in pain for the next 14 hours or so. CaliOtter would presumably tell the patient to quit whining and that they're stupid for selfishly expecting everything to be open late just for their convenience. I personally don't think that is a fair way to treat a patient. Again, obviously the consensus is against me, so we will have to agree to disagree.

Thanks for the reply. I'm not sure where from my post you got the impression that we are only are allowed to use one pharmacy; sorry if I was somehow unclear about that. We can use any pharmacy we want, but the cost is higher for in-network rather than out-of-network and is higher for in-network rather than in-system. So even if you are going somewhere that is in-network it will cost more if it is outside of the system. There are no pharmacies in-system that are open during the hours that night shift employees are awake, so we basically have to forgo sleep or pay more. The recent change that I was talking about was not the fact that there are different prices for in-network versus out-of-network, which is the norm. I was referring to the recent change that employees (who are penalized for using services outside of the system) are now limited in what system services they are permitted to use. Also, it isn't a change in insurance, that a particular pharmacy I preferred is now designated as "out-of-network." Rather, we are disallowed from the using the hospital pharmacy altogether. If they were having severe problems with wait times it would make sense to me to say that the pharmacy is no longer open to outpatients in order to reduce wait times for inpatients and emergency patients. I think it is different to say that the pharmacy is still open to outpatients, but employees are disallowed. I may be missing something, but I actually don't understand generally why being an employee means that you are not welcome as a customer. Also, as a side note, I have never been to the pharmacy at a time when there was someone else there; this is probably because I typically show up at 2 am in pajama pants to pick up sleeping pills, which I always imagined is funny for the pharmacy staff. In any case, it sounds like you are disagreeing with me, which is perfectly okay.

I find myself really irritated with this recent decision by my employer, and I was curious what other people thought of it. Am I being unreasonable? Or is this messed up? I work for one of the major health systems* in my area, and us employees are forced into health insurance plans that penalize us for using services outside of the system. They recently made a new rule that employees of the system are no longer allowed to use the outpatient pharmacy at the hospital. Apparently there is a clinic somewhere in a less convenient location that has much more restrictive hours that we are allowed to use. I work night shift and the hospital pharmacy is the only 24 hour pharmacy, so I will have to forgo sleep if I ever want to pick up a prescription. Alternatively, there may be a 24 hour Rite Aide or something out there, but even if there is the cost will be much higher since it is out-of-system. Also, apparently my family is also now banned from the hospital pharmacy. My wife was heading from her doctor's office to the hospital to pick up a prescription and they called her while she was en route and basically said, "So where do you want us to send this prescription that just came in, 'cause you're not welcome here anymore." They didn't give much of a rationale for the change, but seemed to be suggesting that the goal was to reduce wait times. I guess if you deny services to a group of people than your wait times will improve, but it seems to me the same rationale would work equally well to justify discrimination against any group. I think in a way, it would sort of be less unethical for them to deny services to any other random group since we are the one group of people who are forced into insurance plans that penalize us for using out-of-system services. So, am I being unreasonable? *I didn't mention the employer by name in case it is against some policy here on Allnurses.

Hey, cool. Now I have an avatar. Don't think you can read it though. Oh well.

Alternatively, you could rub hand sanitizer on your ears. Perform ear hygiene.

That's a good point. If you put on gloves before mask then there's a risk of transferring germs from your ears to your gloves.