Anna Flaxis

Anna Flaxis BSN, RN

Member

All Content by Anna Flaxis

  1. Problems with ER

    Anna Flaxis replied to ReggieN's topic in Patient Safety Issues

    Again, it is protocol to transport tele patients on monitor- I'm not advocating otherwise. I'm simply posing a question that nobody has answered, but are only expressing horror. My question is, how...

  2. If you were to move from ER...

    Anna Flaxis replied to MassED's topic in Emergency

    Hospice.

  3. IVP vs Drip

    Anna Flaxis replied to Matt8700's topic in Emergency

    Since I don't deal with regulatory issues, I'm speaking from experience as an infusion RN as well as policy at every facility I have worked at. While there may or may not be actual regulations by...

  4. COPD and O2 sat

    Anna Flaxis replied to Soran's topic in Emergency

    In five years of treating acute COPD exacerbations, I have seen oxygen-induced hypercapnia exactly

  5. But you're a nurse, you could've done this....

    Anna Flaxis replied to Madras's topic in Patient, Colleague Relations

    Yes, that is true for the vast majority of EMS systems. I realize in my above post I was speaking as an RN, not an EMS provider, and the person I was responding to was speaking as an EMS provider. I...

  6. Chronic Pain (as an RN)

    Anna Flaxis replied to fitzfan82's topic in Emergency

    Just wanted to add that if the ER you go to has a dedicated Fast Track, or is not very busy at the time you go, you could get in and out pretty quickly. But this would have nothing to do with your...

  7. Chronic Pain (as an RN)

    Anna Flaxis replied to fitzfan82's topic in Emergency

    I don't triage based upon whether you are a nurse or not. I assign acuity based upon chief compliant, VS, presence or absence of high risk situation, etc. As described, your chief complaint would be...

  8. 4 Point Restraints in the ER. Is that Abuse?

    Anna Flaxis replied to Vickymay's topic in Emergency

    Restraints can lawfully be used for either medical or behavioral reasons. If a patient is pulling at their lines or tubes, restraints can be used for the purpose of keeping their lines/tubes intact....

  9. Constant Negativity from Staff

    Anna Flaxis replied to fitzfan82's topic in Emergency

    Yes, I worked in an ER where the culture was very much like you describe. It's not like that everywhere. Maybe a change of scenery would help. In the meantime, have you spoken up about your own...

  10. help!!

    Anna Flaxis replied to yorkshire's topic in Emergency

    I wish I could pat you on the hand and tell you it's okay, it happens to all of us, but honestly the worst med error I have made was giving insulin SQ instead of IV (force of habit, floor nurse to ER...

  11. How would you handle this situation?

    Anna Flaxis replied to freckles23's topic in General Nursing

    I'd be putting in applications

  12. But you're a nurse, you could've done this....

    Anna Flaxis replied to Madras's topic in Patient, Colleague Relations

    You cannot give a medical diagnosis, but you can give your impression. Telephone triage nurses do it all the time. In my state, RNs are qualified to perform a Medical Screening Evaluation to...

  13. But you're a nurse, you could've done this....

    Anna Flaxis replied to Madras's topic in Patient, Colleague Relations

    Gosh, I guess I'm in the minority here, but from what it sounds like, I wouldn't have summoned EMS. Even in the setting of an epidural hematoma, what are the EMTs going to pick up on in the absence...

  14. IVP vs Drip

    Anna Flaxis replied to Matt8700's topic in Emergency

    There is a difference between an IV push and an infusion. They are two different things, requiring two different types of

  15. IVP vs Drip

    Anna Flaxis replied to Matt8700's topic in Emergency

    If you want to split hairs, the IVP med put into a minibag isn't a continuous gtt, but technically an intermittent infusion. However, an intermittent infusion does need a concentration and a rate. By...

  16. Problems with ER

    Anna Flaxis replied to ReggieN's topic in Patient Safety Issues

    Tele patients should be brought up on monitor because it's protocol. BUT- having said that, what difference will it really make? If the patient becomes unresponsive on the way to the floor, the...

  17. IVP vs Drip

    Anna Flaxis replied to Matt8700's topic in Emergency

    This is a bad example, because you're still giving the insulin IV push. Simply diluting it in a flush does not change that. If you were to mix the insulin into a minibag and thus change it into an...

  18. Correcting low sodium too quickly

    Anna Flaxis replied to Birdy2's topic in Patient Safety Issues

    Based on the above, to me it sounds like this person had hypertonic hyponatremia r/t the high CBG. A serum osmolality of >295 would confirm this. If she was hyponatremic for 48 hours or less...

  19. Would you send this patient to the unit?

    Anna Flaxis replied to Birdy2's topic in Patient Safety Issues

    Interesting thought, but wouldn't the K+ be elevated in

  20. I lack social skills and confidence. Is nursing a possibility for me?

    Anna Flaxis replied to DerAustin's topic in Pre-Nursing Students

    I agree. I prefer "cleaning people who have

  21. Remaining professional with rude, disrespectful family members

    Anna Flaxis replied to litbitblack's topic in Geriatric, LTC

    Try to remember that this has nothing to do with YOU personally. She would have treated anyone like that. You are the face of the institution, and a symbol of her father's decline and eventual...

  22. Would you send this patient to the unit?

    Anna Flaxis replied to Birdy2's topic in Patient Safety Issues

    That ER sounds like a war zone. It sounds like a high volume, high acuity, understaffed ER. Maybe there is a lot of turnover because of low morale, and maybe they hire new grads or inexperienced ER...

  23. Sliding scale insulin...give or hold?

    Anna Flaxis replied to Annie Wilkes RN's topic in Long Term Acute Care

    Here's the thing, though. If he were on a physiologic insulin regimen, he would be receiving basal doses (perhaps his oral agent is taking the place of that) plus nutritional boluses based on PO...

  24. Problems with ER

    Anna Flaxis replied to ReggieN's topic in Patient Safety Issues

    Hospitalists are treated like dirt at a lot of places, routinely overworked, having their practice dictated by patient satisfaction and reimbursement, and a lot of the same issues faced by nurses. If...

  25. I don't mean to complain..

    Anna Flaxis replied to Nurse216's topic in General Nursing

    I think this is an important point. How it works is that when patients fill out their patient satisfaction survey, they can comment about why they gave the score they did. You will see comments like...