Anna Flaxis

Anna Flaxis BSN, RN

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All Content by Anna Flaxis

  1. Would you send this patient to the unit?

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

    Yes, I thought TLS unlikely given the lytes- sounds more like someone with poor absorbtion/diarrhea/diuretic use or something of that sort. I could even imagine perhaps a person on diuretics who had...

  2. Would you send this patient to the unit?

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

    Is she on diuretics, has she had diarrhea, or does she have some sort of intestinal malapsorbtion problem? The BUN/Cr ratio suggests an intrarenal cause, such as nephrotoxic medications or a...

  3. Problems with ER

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

    I don't advocate sending patients to the floor without orders. They will at least have rapid admit/holding orders from the ER physician, who consults with the hospitalist and will enter any orders...

  4. I don't mean to complain..

    Anna Flaxis replied to Nurse216's topic in General Nursing

    Yes, this is all very true- BUT there are times when you do have to prioritize, and you CAN say "No" or "You will have to wait" in ways that are respectful and let the person feel cared about....

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

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

    That's a assuming that the patient is on a physiologic insulin protocol, not your traditional SSI protocol. In the physiologic protocol, the patient would be receiving a basal dose of long acting...

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

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

    And here is one of the problems with your traditional "sliding scale" insulin. You are reacting to an already elevated CBG and not taking nutritional intake into account. This strategy often results...

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

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

  8. Put my foot in my mouth again....

    Anna Flaxis posted a topic in Emergency

    Is it just me because I'm socially awkward, or does anyone else do this, too? Pt came in by POV through the lobby, shoulder draped with jacket, as if injured. I asked what brought pt in today,...

  9. Broviac Allergy

    Anna Flaxis replied to summer16's topic in Infusion, Intravenous

    Sounds like you've already found a solution. If the pt isn't reacting to the Biatain dressing, you can put gauze between the catheter and the skin and just clean with NS, that sounds fine. As has...

  10. Problems with ER

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

    When I worked cardiac tele, we were the only floor outside of ICU that did certain types of gtts- and then, we had limits on them. I remember one night I had a pt on a nitro gtt for BP control-...

  11. IVP vs Drip

    Anna Flaxis replied to Matt8700's topic in Emergency

    I wouldn't want to infuse benzos or opioids unattended anyway. Antibiotics are one thing, but I prefer to be present when some drugs are

  12. Pt threw a bedpan...

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

    I like my manager, so I wouldn't enjoy that. Managing a nursing unit is no easy task. You're the filling in the sandwich, caught between the slices of bread that are upper management and the nurses...

  13. tracheostomy

    Anna Flaxis replied to teeroze201069's topic in General Nursing

    Well, yeah, there is that. I wasn't gonna say

  14. Problems with ER

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

    Yeah, I don't mean to sound so aggressive. I just get protective sometimes. I think if the focus is truly on safe patient care, then some of the stuff we get criticized for is really stupid. I...

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

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

    Wrong. Rapid acting insulin needs to be followed by food intake. If you use it to "correct" for a pre-prandial CBG, and then the patient doesn't eat, you risk hypoglycemia. Again, wrong. Have...

  16. Problems with ER

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

    Sorry if I sound hostile. I generally like your posts and agree with you on many things. I just find it tiring sometimes to be criticized when folks have no idea what a war zone the ED can be. And...

  17. do you drink coffee during your shift?

    Anna Flaxis replied to aname's topic in General Nursing

    That would be

  18. Problems with ER

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

    I'll try to shed some light for you. In the case of the hypertensive patient, if the patient is having no focal neurologic deficits, we don't aggressively treat high BP ( we treat the patient, not the...

  19. tracheostomy

    Anna Flaxis replied to teeroze201069's topic in General Nursing

    I am an ER nurse and I don't routinely do trach care. However, I did do a short stint in outpatient infusion, and we handled feeding tubes. As you may know, doing home health, a lot of feeding tubes...

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

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

    Technically, they are correct. Novolog is a fast acting insulin and should be followed by food intake. If the patient is not eating, then the fast acting insulin should not be

  21. Do Nurses Work Several Per Diem Jobs?

    Anna Flaxis replied to celtickimba's topic in General Nursing

    I love being per diem. I will never go back- unless my life takes a change for the worse, and I have to work full time to keep a roof over my head or provide for a family member. Then it's nice to...

  22. AWD vehicle for nurses

    Anna Flaxis replied to waiting4ivpush's topic in General Nursing

    LOL, yes I saw the winkies! I wasn't offended at

  23. Do Nurses Work Several Per Diem Jobs?

    Anna Flaxis replied to celtickimba's topic in General Nursing

    I am per diem, but I have only one job. I get plenty of shifts at my one job, so I haven't felt the need to take another one. Different employers have different per diem policies. I am not required...

  24. Ask for advice (then explain why it's wrong)

    Anna Flaxis replied to Emergent's topic in General Nursing

    I think in a lot of cases, the written word is a poor medium in which to communicate clearly. It is too open to interpretation and easy to infer attitudes and ideas that are not there. Some people...

  25. AWD vehicle for nurses

    Anna Flaxis replied to waiting4ivpush's topic in General Nursing

    I won't disclose what state I am in, but I am certainly NOT old! I am mature. And, while at first glance you might think I'm a hippie, I'm a really bad hippie. I eat meat, think vaccines are a good...