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MunoRN

MunoRN

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  1. MunoRN

    Will marijuana ever be okay in nursing?

    Epidiolex contains only CBD, it does not contain even trace amounts of THC, you're thinking of Sativex.
  2. MunoRN

    Can nurses use medical marijuana?

    Tests for active THC levels are widely available and utilized. As oppossed to the THC metabolite tests that are commonly used for pre-employment screening. States that have legalized recreational marijuana have also defined an impairment level based on active THC levels, similar to BAC used for alcohol. At least in terms of nursing practice, a number of state boards have already come out and said they don't care about metabolite levels, only active THC levels while at work.
  3. MunoRN

    Understanding the Risk of Firearms: Suicide vs. Homicide

    There's only two possible interpretations of "well regulated militia", one is the military term of 'regulated' which would then mean the amendment doesn't apply to individual ownership unrelated to an organized militia not under federal control, which today is called the National Guard. The preferable interpretation for gun rights advocates is that it refers to being 'sufficiently restricted', ie that the right can in fact be restricted, restricted to certain individuals and certain firearms. This is the interpretation currently in place as defined by the Supreme Court, and not by a pro-gun-control majority opinion but by Scalia, the most pro-gun Justice on the court at the time.
  4. MunoRN

    Understanding the Risk of Firearms: Suicide vs. Homicide

    I think you're wildly misrepresenting the view of the majority of gun owners. I am a gun owner and part of the vast majority of gun owners who support "stricter gun laws", the main law that's been proposed at the federal level is universal background checks, which are supported by 75% to more than 90% of gun owners depending on which poll you prefer. Universal background checks have been shown to reduce the flow of guns to the black market, and as a gun owner I can't imaging selling a gun to someone without going through some sort of reliable process to ensure they are legally allowed to have a gun.
  5. MunoRN

    Understanding the Risk of Firearms: Suicide vs. Homicide

    As you pointed out earlier, criminals don't voluntarily follow the law, which is why there has to be some mechanism to apply the law to firearm transfers, which is why universal background checks should be required on a comprehensive basis.
  6. MunoRN

    Understanding the Risk of Firearms: Suicide vs. Homicide

    To clarify, that's not the second amendment, or at least not all of it, the second amendment is "A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed." You can't just ignore the first part, which can be interpreted in at least a couple of different ways, and currently is interpreted by the SC to mean that there should be sufficient restrictions on the right, including that who can own firearms can be restricted and the types of firearms can be restricted, specifically that only firearms for a primarily lawful purpose are protected. As a supporter of the second amendment, it's overstating or misrepresenting the second amendment that I would argue it the biggest risk to the second amendment. And yes, a semi-auto rifle with a bump stock can fire at or well above 400 rounds per minute. The problem is that currently they don't even have to go through the effort of stealing them, they are only prevented from purchasing firearms when going through an FFL in most states, and it's not hard at all anymore to purchase a firearm outside of an FFL.
  7. Post held for review, no mods available to review post. Once it is reviewed it's posted in order of the time of the post instead of posted as the most recent post, which can put it a page or two back in a thread when it's finally posted. This is super annoying.
  8. Like many states, RNs in Florida are expected to ensure not only that the person actually signed the consent (you don't have to see the signature happen, you can just ask them if that's their signature) but to also confirm they were actually consented.
  9. MunoRN

    Safe Nursing a thing of the past?

    Triage by definition does not include a full assessment, same goes for the role of ER which is only to rule out an immediately life threatening condition. As to your examples such as " if a pulse ox is 98%, do we then assume the cap refill is prompt?", the theoretical purpose of capillary refill is not to measure oxygen saturation, it's to measure perfusion, although even that isn't relevant because cap refill is not a valid indicator of perfusion (or anything else).
  10. MunoRN

    Safe Nursing a thing of the past?

    I realize when it comes to a family member it's easy to think every possible resource should be immediately directed towards them, but what you describe was handled appropriately and after ruling out acute pathologies, the most appropriate action is to defer your mom to her primary care MD for further assessment and treatment.
  11. MunoRN

    Safe Nursing a thing of the past?

    I would agree there are legitimate criticisms of ER treatment, but that doesn't mean everyone who thought their family member wasn't appropriately treated was in fact not appropriately treated, this appears to be an example of that. A headache by itself or more specifically a migraine is not indicative of a CVA, particularly of the type of CVA where time to treatment is definitively restricted (embolic CVA). If your mother was seeking an MSE and truly never received one, then that's an appropriate reason to lodge an EMTALA violation complaint. If the concern is that your mother wasn't more quickly treated for a severe headache and other non-specific symptoms to CVA, then no, that's not a valid complaint.
  12. MunoRN

    Understanding the Risk of Firearms: Suicide vs. Homicide

    I'm a gun owner and supporter of the second amendment, and it's people like you who are the biggest threat to the preservation of rights for gun owners. As a sort of separate issue, your contention that David Hogg was "at home" during the shooting, which has been well debunked, as well as putting Parkland "sruvivors" in quotes minimizes and discounts what kids go through in these situations, which makes you a generally horrible human being. The best protection of the second amendment is not to overplay our hand, which is what people like you do. The second amendment protects the rights of law-abiding gun owners to own guns which are primarily for a lawful purpose. None of the commonly proposed 'gun control' laws violate these rights, and it's these measures that will best protect the second amendment.
  13. MunoRN

    Mandatory Vaccination

    There is no Christian or Jewish prohibition of vaccinations, the bible does not prohibit vaccinations (which don't actually contain 'toxins' as you've claimed), it does however strongly promote protecting those at risk of an otherwise preventable death or injury. Buddhism not only doesn't oppose vaccinations, it was Bhuddists who effectively 'invented' the precursor to modern vaccinations; variolation of smallpox. And if you're going to just copy and paste from a chiropractors website, you really should appropriately source the quote: Facts about Vaccine Religious Exemption in Florida Opting out of Vaccines in Florida
  14. MunoRN

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    I've done adverse event review at a couple of different organizations, and one of the biggest challenges in implementing changes to prevent repeat events is the belief or desire to believe that the failure to avoid these events are due to a single, isolated error. Current best practices for avoiding medical errors are two-tiered. The first goal is to prevent the primary error, but it's a bit ignorant to believe that those primary errors can be reliably avoided completely so the second tier is to ensure that individual errors would have to make it through a gauntlet of systemic error prevention strategies in order to make it to the patient, and this is a pretty clear case of both an individual error, as well as multiple failures to prevent or mitigate the error through systemic error prevention. The result of viewing this is primarily an individual error is typically ineffective, we remind nurses to read the vial when removing it from the pyxis and prior to administering, the problem is that it's unlikely the nurse in question had never heard this suggestion before. This often not only the easiest (laziest) fix, there seems to be some psychological comfort for us to believe that risks to patients are simple rather than complex, so we ignore the larger problems. A systemic fix on the other hand to pulling the wrong med, which we've done at my current facility and found it effective, is to first change the predictive text to require 4 letter before any medications are shown, and we've also added decoys to the med list that results, so your med is not always the first med on the list even if you type the full name, this changes the habit from typing part of or the full name of the med and then reflexively picking the first med on the list to having to always hunt for the med. Our rate of 'wrong med' scans at the barcode scanning step has dropped from almost 2 a day to less than 2 a month. For a few years prior to this, the issue was addressed an individual error issue and should be fixed by reminding nurses to look at their meds, which had no effect on the problem. The same basic premise is true here, viewing this as primarily a problem with the actions of an individual nurse isn't likely to changing the serious systemic failure that also contributed to this patient's death.
  15. MunoRN

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    A bit off topic, but some have questioned why midazolam (Versed) was ordered and not lorazepam (Ativan), suggesting lorazepam would have been safer. Between the two, midazolam is generally considered the safer procedural anxiolytic. It's shorter acting, so the CNS depressive effects will at least be of shorter duration, and even though both lorazepam and midazolam fall generally under benzodiazepines, midazolam has an added dissociative-like effect which for the same amount of procedure-tolerance effects will produce less respiratory depression and overall CNS depression.
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