MunoRN RN

Critical Care

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All Content by MunoRN

  1. MunoRN

    CDC now banned from using "evidence based" and other words per White House

    MunoRN replied to babyNP.'s topic in Nursing News

    Obama never banned the terms "Islam", "Islamic extremism", or "Sharia". He did understand the basic definitions of the terms and used them correctly. It's often incorrectly believed that "Islamic"...
  2. MunoRN

    What is a post cath interventional unit like?

    MunoRN replied to moomoo-lop's topic in CCU, Coronary, Cardiac

    There's no standard definition for the characteristics of units that patients go to post cath. What it sounds like you're referring to is the unit they would go to after going through the immediate...
  3. MunoRN

    Discharging by Wheelchair

    MunoRN replied to MunoRN's topic in General Nursing

    And that would be an example of a situation where the patient was discharged by wheelchair because the specific circumstances were considered. To apply wheelchair-only discharges as a general rule,...
  4. MunoRN

    Discharging by Wheelchair

    MunoRN replied to MunoRN's topic in General Nursing

    I'm not sure where it was claimed or even implied that everyone some degree of activity intolerance can't be discharged from the hospital. Again, I'm referring to the blanket belief that no patient...
  5. MunoRN

    Discharging by Wheelchair

    MunoRN replied to MunoRN's topic in General Nursing

    It's definitely not "standard of practice". "Standard of care/practice" is a legal term, and means a practice is universally accepted as the only way to do something. Requiring that all discharged...
  6. MunoRN

    Discharging by Wheelchair

    MunoRN replied to MunoRN's topic in General Nursing

    It's actually similar distances. Typical home ambulation is similar to the ambulation distance between a patient's room and the closest pick up area, which even in large hospitals is not usually more...
  7. MunoRN

    Discharging by Wheelchair

    MunoRN replied to MunoRN's topic in General Nursing

    I think there's some confusion about what "liability" is. Liability is not determined by geographic location, liability is in action or lack of action which a prudent person would have taken that...
  8. MunoRN

    Discharging by Wheelchair

    MunoRN replied to MunoRN's topic in General Nursing

    I should clarify I'm not referring to patients where an inability to ambulate a reasonable distance has been a consideration in discharge planning, and where appropriate arrangements have been made to...
  9. MunoRN

    starting IV on same arm as a mastectomy

    MunoRN replied to coletanner123's topic in General Nursing

    There's no reason not put a PIV on the side of a previous mastectomy. A very long time ago it used to be common to also perform lymph node removal when a mastectomy was done, although that's not...
  10. MunoRN

    starting IV on same arm as a mastectomy

    MunoRN replied to coletanner123's topic in General Nursing

    I do know of a fairly large healthcare organization where "DNR" is defined as comfort measures only, not saying I agree with it, just saying that definition does unfortunately
  11. MunoRN

    Discharging by Wheelchair

    MunoRN replied to MunoRN's topic in General Nursing

    I ask this because part of my FTE is as a sort of liaison between our risk management and clinical practice. We had a case where a patient was suing for unsafe discharge after falling at home after...
  12. MunoRN

    Discharging by Wheelchair

    MunoRN replied to MunoRN's topic in General Nursing

    So if you feel they aren't able to safely ambulate independently at the time of discharge, why do we assume that something magical will happen in the 5 or 10 minute car ride home that will suddenly...
  13. MunoRN

    EPIC EHR individualization and mutuality

    MunoRN replied to JBMmom's topic in General Nursing

    Meaningful use refers to the capabilities of an EMR and it's ability to be used, mainly for data abstraction, to support outcome improvement. While Epic is highly customizable, the functionality that...
  14. MunoRN

    How to tell between Mobitz II and 3rd degree heart block

    MunoRN replied to Irving's topic in General Nursing

    In Mobitz II there is an intermittent blocking of signals from the atria to the ventricles, and in 3rd degree all the signals are blocked. Where this block occurs can vary. If the block occurs...
  15. MunoRN

    Living Will Tattoo

    MunoRN replied to jeastridge's topic in General Nursing

    It's never actually legal to "follow the family wishes" if they contradict the wishes of a competent patient, that would actually be clearly unethical a potential felony. That doesn't mean it...
  16. MunoRN

    Living Will Tattoo

    MunoRN replied to jeastridge's topic in General Nursing

    That's not correct. We are required to abide by the patient's wishes even if they conflict with what the family would prefer. The role of the family/ POAs, etc is to convey what the patient's wishes...
  17. MunoRN

    Living Will Tattoo

    MunoRN replied to jeastridge's topic in General Nursing

    A family or even a POA can't actually legally substitute their wishes for the patient with the patient's expressed wishes. The POA/family is only allowed to make sure the patient's wishes are being...
  18. MunoRN

    Living Will Tattoo

    MunoRN replied to jeastridge's topic in General Nursing

    It seems the criteria required to honor an Out-Of-Hospital (OOH) DNR and what criteria a Physician is expected to use when determining code status are getting confused. The story was about how a...
  19. MunoRN

    Accused of making a medication error

    MunoRN replied to ONCRN2017's topic in General Nursing

    As someone who follows up on medication errors, I find the actions of manager concerning, and arguably grossly negligent. The purpose of investigating and discussing a medication error with those...
  20. MunoRN

    ekg fun...or not

    MunoRN replied to zacarias's topic in CCU, Coronary, Cardiac

    They both look like A-fib, the first in particular has a disturbingly long QTc. If I had to guess, I'd say the first patient probably got Amiodarone for the A-fib which then produced an excessively...
  21. MunoRN

    How late after your shift do you stay at work?

    MunoRN replied to FLnurse1127's topic in General Nursing

    I will stay over for however long it takes to do report and do the charting that is legally required of me, which really isn't that much. Being in a no-mandatory-overtime state I am free to leave...
  22. MunoRN

    Mandatory Cross-training

    MunoRN replied to Nikjraccoon's topic in General Nursing

    It's certainly not unusual for hospitals to adjust over time to changing needs, which means you can't really expect to only be asked to care for one type of patient forever. The need to adapt to...
  23. MunoRN

    Needless Intravenous Connectors

    MunoRN replied to rj27's topic in Critical Care

    I worked at a facility that had a sudden increase in occlusions with a switch to valved catheters and connectors, as it turned out this was primarily due to flushing technique, educating to use a...
  24. MunoRN

    Staff Nurses Who Refuse To Precept Or Teach?

    MunoRN replied to All4NursingRN's topic in General Nursing

    I don't think there's any basis for arguing you shouldn't have to do something that's an obligatory part of nursing just because it's not your favorite thing to do. I don't like cleaning up patient's...
  25. MunoRN

    How to Search Hospitals Policies

    MunoRN replied to Cominginhot's topic in General Nursing

    Most hospitals don't publicly share their policies, although there are number of more forward thinking hospitals that do. Regardless of the policies that other facilities have enacted, you're better...