LMPhilbric

What kinds of bad things have you been hearing? I just graduated from USA and I am very happy with the program. Now the ACNP program, from what I hear, is extremely intensive. The booklist will be published on the South Alabama College of Nursing w...

First, with the 5 year-old, that was in 1939, so I would question the accuracy of her age. I've had many people from rural Latin America who have no idea when their birthdays are or how old they are, so I would say it's entirely possible that she co...

This is good advice unless you are going to be drawing blood at the same time you start the IV. The extra tourniquet time can cause a falsely elevated potassium level. For pts getting lab draws at the same time, tourniquet time should be kept to a ...

Bounce your finger up and down on the spot. Veins bounce. Other structures don't. Once you think you feel the vein, take the tourniquet off. If it goes away, that is the vein. Tendons, ligaments, etc will feel the same without the tourniquet.

Lay off on the caffeine??? No, then I'd be in a coma. Seriously, if the shaking is from nerves, then you just have to be confident in your own skills that 1) Yes, I WILL (not try) get this IV started 2) Let the family watch - now they'll see my mad...

I'm at South Alabama in the ER Nurse Practitioner Program. I finish in 26 days (not that I'm counting). It's an excellent program and I'm very happy w/ it, but the ED program is transitioning somewhat right now. They are going to a dual FNP/ACNP p...

I forgot one of my all time favorite dumb orders. We had a pt admitted for a TURP. Doc comes in and writes his usual pre-op orders. 1) Senekot S 2 tabs po at hs. 2) Tap water enema in AM. 3) Bilateral below TED hose. Great orders with the exc...

OK, I'm laughing so damn hard right now my dogs are looking at me with alarm (both females, I'm happily married so they don't have to worry...lol). What the hell could you possibly be thinking when you do something like this? And the best part of t...

What did I get out of getting my BN? Interesting question. The primary reason I got my BN was so that I could get my MSN as an NP. However, I did learn interesting things along the way that I didn't get to learn in nursing school (I was a diploma ...

My all time favorite dumbest order ever written...We had this pt in ICU who had just expired when the doc walked in. As we were trying to explain to him what had just happened, this doc walks in, does his "assessment", compliments the pt on how cool...

Better give him the whole freaking tree at that point. And we let these people reproduce...it's really frightening.

I had one from the same doc for metoprolol 25 mg IVP and Lovenox 40 mg IVP. I said "Let's not try to finish the patient off all at once, shall we?" Try po and sc. The only time we did IV Lovenox was during a clinical trial (that mustn't have been ...

I would have an awful lot of hs sugars around 114 in that case.

Did he work as an executioner somewhere before????

My #1 rule of engagement: If you are bigger than I am and land on the floor, you stay there. I don't pick up anything bigger than I am. I also love the ones who have "anaphylaxis" from Tylenol, but they can take Lortab or Percocet. Is it really su...

Huh? After the ER???? After I leave the ER, I'm going to retire. OK, I'll be honest. I'm in school to be an Emergency Nurse Practitioner, but I'm still going to be in the ER. I'm never leaving the ER. I'm not going back to the floor, I'm not go...

Admit for 200?????!!!!!!! We would have a full house year round. 200 in my ER is a total lightweight. We hold them until the BAC is under 300 if they have a sober friend or they get a ride to the Hoosegow for the night. Under 80 they can walk. H...

That is so true. We often refer to our hospital as the Ritz Carlton Hospital when we get someone who wants 1000 thread count sheets on their stretcher or some other such ridiculous demands. "Pardon me, while I stop the CPR that I'm doing so that I ...

I wear silver Nikes with a purple Swoosh...guess that's not going to fly there, eh?

Hi, Sharrie, We do use tramadol here. It goes by the trade name Ultram. It can also be called Ultracet when it's combined with acetaminophen (paracetamol). I used to use these names in Canada, but it's been so long...lol.

I know exactly what you mean! We have several whose names are not to be uttered out loud in the ER. My little dog's nickname is Bacon because her kennel name is Porscha, and my family brought her home and starting calling her "Pork Chop". One of o...

OK, I have a new one. I had a pt come to triage with 2 brownish, reddish streaks on the lateral aspect of her R foot. She said "My mom told me it's blood poisoning and I think's it because I had this infection on my toe [of her left foot] last year...

OK, I'll admit to this one. I have been known to say (jokingly to pts with whom I have a good rapport) "You're starving? It takes 14 days to starve to death, and, honey, you haven't been here THAT long".

Under EMTALA, ERs are required to screen and stabilize. If the screening shows that an emergency medical condition does not exist, happy trails. So, the foot fungus x 1 year that is screened by a provider and determined not to be an emergency, does...

We take basic orders, diet, activity, labs, meds that can't wait to get the patient through until the doc can get there. I don't want my docs writing orders. Then I get phone calls from the nurses upstairs who can't read the writing or want to know...