erniefu BSN, RN

Rainbow special for labs. So many differentials with this one. Blood cultures x2 Blue (INR/PTT, D-dimer) Yellow (viral and bacterial serology say HIV, STD) to query sepsis. Green (Lytes, Urea, Creatinine Troponin, CK) Lavende...

I would ask the MD for a vitamin B and at thyroid panel, as well as an MRI, EEG, EMG if bloodwork is normal.

I see these kind of people all the time when I worked in a stroke unit. These families are usually not nice people and pardon the term, Karens in real life. Even if they consented to hospice care they will still demand you feed them, check their bloo...

Nothing is going to change as long as board of directors collect their dividends and not be personally liable for the deaths. Boards of directors are more interested in " We are Heroes" billboards than providing proper PPE at hospitals. They spend mi...

I think that having experience with the patient population is important in managing the unit. A manager should have knowledge about the kind of patients coming to the unit, when to use authority to push patients out or keep patients and to manage exp...

Yes. If people did proper social distancing and stayed home you are less likely to contract COVID-19. Have hand sanitizer ready and use it after you go touching things in public places. People hoarding masks and tossing them after their 30 min grocer...

A lazy patient needs to be reminded that if they can't wipe their own *** then they can do it in a nursing home or a group home. If you can't show you can wipe your own *** inpatient or rehab, then why should the doctor feel safe about discharging th...

The ANA approach is the acuity based staffing model. Guess what? Hospital employers will game the numbers and won't reassess the model once they get the numbers they want to show to the public. Show me one time where hospitals are doing seasonal or y...

Anything more than 4-5 cm out and you need to x-ray. The danger with it being that far out is that it can coil, rendering the PICC useless (its out of position) and can cause emboli. A PICC pulled out can be fixed by a PICC nurse with over the wire p...

Healthcare administration has no risk if a nurse is overworked with 10:1 ratios and a severe adverse event happens. In that situation the hospital is fined, the nurse is fired and suspended by the board of nursing. The nurse bears the brunt of the pu...

Companies usually budget for PTO so it wouldn't be a liability for vacation owing. That your manager denies your earned PTO means there are cash flow issues. This is just the beginning of more cuts and you should be prepared for the worst.

I think the most important emergency care you need is to not delay calling 911. Too many times families drive a stroke patient to ER when it was in the best interest to call 911 so an ambulance can take them to a stroke centre.

Very informative. In Canada in my academic hospital we have a dedicated stroke unit with a stepdown nurse from the hyperacute stroke unit that gives tPa (if indicated) and accompanies the patient to thrombectomy, freeing up the ER nurse for the next ...

Until management gets hauled to a board of nursing/medicine disciplinary panel and faces charges of negligence and professional misconduct for chronic unsafe staffing ratios, staffing ratios will be treated as an afterthought by management. They get ...

In Canada, a comprehensive stroke centre would be doing stuff like giving tPa, thrombectomies/embolectomies, along with providing stroke care for those outside the window. Patients that are given tPa/thrombectomies are admitted to a hyperacute stroke...

Certainly there are positions that don't involve bedside nursing care (Infection control, public health), but every nurse has to learn to do the nursing process: Assessment, analysis, planning, implementing, evaluating care. It doesn't matter if it i...

If you have religious objections, then Labour and Delivery may not be for you. There are plenty of areas like Med-Surg, Palliative, Rehab that you can work, and I'm sure Duke would not object to transfer you there.

"it is her right to abuse you." It is also your right to e-mail the CEO, CMO, CNO that your supervisor said those words to you and that you expect a formal apology, and to go to the news outlets if such apology is not coming. If your supervisor said ...

Given that a lot of medical surgical patients are NPO before surgery in ER, I think that it makes sense that dilaudid is ordered as subq prn. Unless there is an abundance of IV Tylenol that can be given. Of course if it is post op care then you can a...

98 year old lady that got endovascular coiling for a brain aneurysm

I think that people have a problem with recognizing how do we quantify qualify of life such that we would make ourselves a DNR. For me, if my palliative performance scale was 40% or lower, I would make myself a DNR. I like this scale because it does ...

During this Christmas, the CEO offered to give staff a free Christmas dinner to those that worked. Of course, none of the nurses on the floors got one as the dinners ran out before the nurses could get off the floors for break.

This sounds like something that a geriatician or a geri psych clinical nurse specialist should be involved in.

What was learned was that the supervisor was the one who couldn't handle the pressure and did not prioritize properly. It seems that the supervisor had no idea what was going on in the holding area (already causing the hold to be over census) and sen...

This is one of those patients where you need to implement a behaviour contract. If behaviour charting does not show there is an unmet need (toileting, pain, hunger etc), then this patient is clearly acting like an ******* just for the sake of it, or ...