MunoRN

Anyone who suspects that a death was the result of foul play is allowed to notify the applicable authorities (police) of that concern. Generally speaking, it seems like what you asking is how best to cover up the murder of a patient.

That is a wildly ignorant statement for a licensed nurse to make. A CNA who feels the need to report a suspicion of illegal activity requires no approval of anyone to report that concern.

And it's auditors like this that cause nursing time to be taken away from patient care that contributes to patient safety in order to make auditors happy, and causes patient harm solely for the purpose of making these sociopathic "auditors" happy.

I totally agree with notifying the coroner, the coroner and police are two different entities.

It's certainly one thing if it's a requirement to notify the police in the event of a patient death. But if you're calling the police to remove suspicion that the patient died as a result of foul play, then it seems that would cause far more suspicion than it prevents. If, for instance, family wanted to pursue a civil case against staff or a facility, the fact that someone called the police as a result of the death would be useful ammunition for them. Trying to explain that you called police because no crime occurred would sound pretty fishy.

I guess I'm not clear if you're saying you called the police after a patient death because you were reporting that the death occurred due to negligence / neglect, or that you wanted the police to somehow verify that this wasn't the cause of the death.

Correcting someone spreading misinformation about a health issue, particularly a pandemic where that misinformation can cause people to make misinformed decisions that can result in harm or death, is not a violation of your professional practice standards as a nurse, it's actually the opposite of that.

They might argue religious opposition to the Covid vaccine is different because their religion, MAGAism, didn't exist yet when flu and hep vaccines first came out.

I haven't heard of getting police involved when no suspicion of a crime occurred, I'm curious how that conversation goes with the officers. Officer: "so what seems to be problem?" Facility staff: "Somebody died and we want you to confirm that no foul play occurred." Officer: "Do you have reason to believe the death was the result of a crime?" Facility staff: "No" Officer: "Well then, my job is done here". I'm also not clear why this would only apply to full code patients and not DNR. And I assume there are places where families can request an autopsy, but in various areas where I've worked only the Medical Examiner / Coroner can choose whether or not to perform and autopsy.

And it used to be that ketones were the most followed lab, now we don't even check ketone levels. Both anion gap and CO2 on a metabolic panel (which is actually a measurement of bicarbonate, not directly CO2) measure the resulting metabolic acidosis that occurs as a result of DKA, while theoretically at least excluding metabolic compensatory mechanisms. No matter what measurement your using, the important thing to remember is that early in DKA treatment these measurements start to normalize because the body is getting insulin, it has really nothing to do with what their BG levels are. If a patient has normal BG levels but still has a resolving acidosis, then they still need insulin, and that often means having to give them glucose in order to be able to keep giving insulin.

It varies widely from patient to patient, it depends on how much their hypotension is beta-driven, how much the increase in afterload caused by increasing the levo affects their cardiac output, etc. This is why orders should allow room to adjust titrations to the patient's response to those titrations. Does going up by one mcg result in an increase of 1 mmHg or 10 mmHg? If you've established that for each increase of 1 mcg you get an increase of 2 mmHg and you've dropped to 30 mmHg below goal, then a 15 mcg increase would be a reasonable titration.

And I get that objectively measurable facts really takes the fun out of fact-free bias posing as a reasoned argument.

As your article points out, the annual inflation rate dropped to 8.5%, this is correct. Biden pointed out that the inflation rate change for the month of July was zero, which is also correct. Those are two different things.

I'm not so much concerned about the little air bubbles in the line as I am with the infernal beeping that will commence 2 minutes after I leave the room if I didn't get every last bit of air out of the secondary port (uppermost port). What I would suggest is to make sure you invert and aggressively tap the ports as it's priming, but most important is the cursing. Make sure the ports know what sort of unspeakable acts await them if they do not completely purge themselves of air during the priming process. Family members and/or A&O patients might find your verbal aggression to be concerning, I always make a point of educating them about how this aligns with our mission/vision/and values, and that really no matter what they will eventually share my views on the beeping cacophony that continually surrounds them.

You've hit the nail on the head when it comes to why "conservatives" should be prohibited from having any role in this process. What the article points out is that without any sort of regulatory price controls, shifting the costs to government programs would increase the cost to government programs. No ***ing *** sherlock. The alternative is to do what every modernized economy has done since the beginning of time, which is to say, this is what we're willing to pay. If you don't like that offer, feel free to bow out of the market and we'll get our product from the remaining vendors who agree to pay that price, if there's nobody left willing to offer a product for that price, then that's on us.

It's actually pretty inexpensive to produce insulin. Big vats full of either yeast or bacteria literally *** it out in large quantities, just needing fairly basic nutrients. There have been some specific types of bacteria used where the culture media was somewhat expensive, resulting in as much $6 or more in manufacturing cost per 1000 unit vial, which have since been replaced with cheaper to maintain bacteria, which is why an insulin vial today typically costs between $2 and $4 a vial to produce. This is where conservatives either misunderstand or are oblivious to what a "free-market" is, despite claiming to be the champions of free market economics. In a truly free-market, all the participants in that market are able to exert their force on the market; manufacturers want a good profit, consumers want a fair price. As consumers, the really only effective way to exert influence within the free market is as a group through some form of collective representation, also called a government.

When a provider enters an order that is clearly inappropriate, where following the order as written has the potential to cause harm to the patient, it is the legal obligation of the licensed nurse, whether RN or LPN to insist that the order be corrected, and this should be documented in the patient's chart to ensure that this concern has been effectively communicated as their license requires that they do.

Biden is responsible for "open borders" because his administration is too focused on preventing people from crossing the border illegally? How is that an "open borders" policy?

The term "diaper" is weird because we make it weird. I've never had a patient who found the term cringeworthy but have had many who didn't know what I was talking about when I said "Incontinence brief". I explained that people find it embarrassing when we call it a diaper, and it was only at that point that they realized they should be embarrassed because they were wearing an incontinence brief, or diaper, or whatever you call it, and at that point I realized I was the asshole in this scenario.

Many employers expect "professional" references but at the same time have a policy of not giving "professional" references, instead only giving out employment start date and end date, no references. If you are applying at an employer who expects professional references but at the same time has a policy to not give professional references then you should simply beat the *** out of them. As a default I would stop just short of actually kliling them, but this is where you should consult an attorney for further clarification.

They took them away a couple of years ago, the GI docs demanded we get rid of them. I've noticed on Physician discussion boards that the opposition to them among Docs is surprisingly common.

Having the entire staff for a an LTC wing with 36 patients constantly in one patient's room is also a life or death issue. Unfortunately part of our job is to prioritize care, which is a nice way of saying deciding who isn't going to get otherwise needed care and for how long so that other patients don't suffer excessively. Even in an ICU during Covid the standard rule became q 4 hour diarrhea cleanups, this was for diarrhea that occurred literally continuously, so that means close to 4 hours of sitting in your own stool. We don't have a healthcare system that is set up to provide continuous stool removal and cleaning.

It's quite possible we all interpreted different promises as being the big ones, but: Repeal and Replace the ACA? Border wall paid for by Mexico? Eliminate the Federal Budget Deficit? (We set new records for federal spending, largely driven by his spending initiatives). He pushed for codifying DACA as law, then didn't, then was for it again.

It's certainly not specific to conservatives, which is why Russian disinformation campaigns were spread throughout various social media, including more conservative-specific sites. But if we take your assertion as true (even though it's well established that it's not), apparently it was enough to have a large portion of Americans as well as American media repeating the disinformation.

Even if there wasn't anything else involved in Russian election meddling, I'm not sure how it wouldn't be concerning that all it took for a foreign adversary to cause a contingent of American voters to do their bidding was 100k in facebook ads.