candicenguyen

Hmm this made no sense. Those S/S are not typical for sepsis unless he has a septic emboli, but if CT at admission did not show hemorrhagic stroke and the 2nd CT was positive for hemorrhagic stroke then you did the right thing by calling the stroke alert

The patient came in with those symptoms...he may already have a stroke...tho not 100% sure from the post so it may not be a suspected CVA. See my post above for explanation. I used to be Neuro ICU responding to stroke alert.

I am a bit confused with your post. You said your patient came in with those symptoms (but worse ) and neg CT without contrast? So sound like the patient had a stroke when he came in. Just to make it clear you know but the purpose of CT without contrast at admission in patients who come in with stroke/TIA is to rule out hemorrhagic stroke...not ischemia stroke. So even tho his/her initial CT without contrast is negative...it does not mean that he did not have a stroke. CT without contrast does not show early stroke. You need CT with contrast to show a clot or MRI to confirm the stroke. You said the second CT with contrast showed stroke...I assumed it showed clot. Is it a new clot or the clot the patient already had from admission. Another theory I have (I scanned through your post so I may misunderstand) is the patient had a stroke at admission. His symptoms may worsen because of continuing edema...which peaked 72 hours after stroke particularly those with large MCA stroke. So technically you did not need to activate stroke alert or can just wait for the physician to return call again...but just a gentle inform the physician about neuro change. Most of time, there is not much to do. Neurosurgeon may choose to do a hemicrani but not until more significant neuro change or midline shift...hence why I said this matter can be dealed with in a urgent...not emergent manner. My opinion: you did the right thing if he/she did not have a stroke at admission...but your post (the continuing stroke symptoms) told me he did...stroke alert is for new stroke. Stroke alert is not for neuro change.

Are you trying to say new nurses are the same as experienced (older nurses)...There are exceptions...but overall, experienced nurses tend to know more.

One again, if you have no constructive feedback, please save your time and my time. I voiced my experience with nursing school...agree or not, it is my experience. Do I sit here and try to argue with you about your perspective and experience or how you look at things differently than me. My experience has nothing to do with my family's experience. We do not even go to the same school. So stop making assumption from my opinion on nursing school and really don't bother to waste your own time if you have nothing better to say. Don't you feel like your time will be better spend maybe volunteering or something? Because that would be how I rather spend my time to help people instead of sitting on an online forum and making ridiculous comments and assumptions. Where did I say lowly nurses huh? I said I learned nothing from my nursing school and a lot from the jobs. Don't get offended yourself and put words that I did not say....

Sorry I am busy with medical school and research I don’t have to write the whole story for you...so if you want to give constructive advice I would appreciate it. If not, I don’t think I need to spend my time sitting here answering all your irrelevant questions okay.

*** my bad...I meant this nursing program 4 semesters graduation rate is ~50% and 6 semesters graduation rate is ~60% VS med school ~85%...

I am sorry but if a school with attrition of 50%, they should not be opened and teach...even med school attrition rate is higher than that.

Don’t you ever want to help your family member? “Some”...most clinical instructors in the areas are nurses who are working just like me...some are newer nurses than me...so ya “experience”...whatever LOL...

If you spend as much time to read through the post as you make assumptions about the student that would be rate. The school degree attrition is 50%...that says a lot about the school quality ?‍♀️

Thank you for not making an assumption. Unfortunately he is in his final semester, so he invested a bunch. The problem with few nursing schools around here is they want to make money and graduate nurses. They don’t have enough clinical sites for them and try to compensate it with simulation. I fortunately went to a university one so the quality is not as bad...even though in my opinion, I did not feel like it prepared me well enough for my first nursing job. I learned most on the job. Anyway, I feel bad for these students for failing out of school because of the school quality.

Why is it so hard to not give advice without making assumption. See the school attrition rate for your info ?‍♀️

Before you all make an assumption about the person's fault. Just FYI: the school attrition rate is 50%. This is a very sad figure OK. They barely have many rotations even before COVID time. They replace it with simulation. I already thought that was shady. The simulation should be an addition instead of a replacement. He passed his clinical portion pre-COVID time but failed during COVID. If you all just make assumptions and have nothing better to say, please feel free to save your time instead of posting useless comments. BTW, your college professor friend is sure someone legit to quote. I honestly don't give a **** what a random college professor has to say.

Lmao...I was a ICU nurse before I decided to go back to medical school to become a surgeon.

I did not say whether he did his assignments or not...and you made the assumptions LOL.