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LilPeanut MSN, RN, NP

NICU/Neonatal transport

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LilPeanut has 8 years experience as a MSN, RN, NP and specializes in NICU/Neonatal transport.

LilPeanut's Latest Activity

  1. LilPeanut

    Questionable actions that make you go hmm?

    "I didn't have diabetes before I was here, I'll need teaching." "Uh, you should be fine, it'll just be temporary." "But temporarily, I'll need to understand how to deal with this." "You just check your sugar, based on the number you get, you inject how much insulin it says." They basically still did nothing and I got no teaching. I did file a complaint.
  2. LilPeanut

    Questionable actions that make you go hmm?

    I loved the resident who, when rounding, stated confidently that despite the high dose steroids, I've not had blood sugar issues, so should be fine to discharge without any. "Uh, I've been getting insulin twice a day and I still haven't been eating. I'm pretty sure my blood sugar is going to go up more when I'm eating." Later in the same hospitalization, still trying to get discharged, have never been diabetic before, but because of said steroids, have a touch of diabetes LOL Anyway, the discharge home instructions from the doc "Just follow a sliding scale, check your sugars as normal and you'll be fine." 1. I am an NP, but for neonates. I deal with babies on insulin drips, I've not used a sliding scale, you're going to have to teach me. I was not diabetic prior to this. 2. How am I supposed to check my sugars without a glucometer? Checking my sugars as normal would mean not at all, since I wasn't diabetic. 3. when I finally did get discharged home and we picked up all my supplies, they forgot to prescribe the needles that go with the insulin pen. I couldn't figure out what I was doing wrong! (I hadn't ever used an insulin pen before) 4. and obviously no diabetes teaching. Shoddy discharge planning.
  3. LilPeanut

    Social Media and Doxxing - Your Thoughts???

    You can know what EMR they use without saying you work there. I know what EMR several hospitals use that I don't work at. And I know how to figure out if they use Epic.
  4. LilPeanut

    Nurses Charged in Deaths of 12 Nursing Home Residents

    I definitely agree - anyone the staff spoke to should also be charged and arrested. Yes, the RNs had more knowledge presumably about the patients and medical situation, but unless the RNs were outright lying about conditions ("It's 68 degrees inside and not humid at all") which I highly highly doubt they did, anyone would have known that it was dangerous. The fact they were so close to a hospital though for evacuation does though make it harder to justify any reason the nurses didn't get help. The whole chain is responsible. edited to add: That even includes administrative staff who were there (secretaries and the like) because it does not take any sort of medical training to know that was dangerous. Those adults were vulnerable. They deserve protection.
  5. LilPeanut

    Oversupply of Nurse Practitioners

    neonatal nurse practitioners are in short supply all around. There are not enough of us.
  6. LilPeanut

    $200,000 salary as a RN, it's true

    Really, the houses here are more like >700k, but buying is not the best option for everyone. It's a lie we've been sold. Just have to keep repeating this.
  7. LilPeanut

    $200,000 salary as a RN, it's true

    That is not the same as every illegal alien with no ssn can get free community college tuition, which is what you implied. It is intended for children who have lived in this country for their whole lives to still be able to attend college.
  8. LilPeanut

    Feedback appreciated

    Because it was on the MAR for more than one shift. Not being able to get an order in immediately, that's understandable. But many hours later isn't. I'm a provider and when stuff is crazy, some orders will get missed, but within a few hours, nurses will remind me that x and y still need ordered or discontinued. Example: our orderset for methadone automatically includes narcan, because it was designed for outpatient use. Neonates on methadone are all being weaned off narcotics and should never be given narcan ever. If they have respiratory depression, we will support them, but not give narcan. It could cause seizures. Forgetting to discontinue narcan is very easy to do. But it is an accident waiting to happen. All it takes is a float nurse who isn't as familiar with our withdrawal protocols and is used to older children or adults. So as providers, our responsibility to prevent that mistake is to keep the MAR up to date as far as orders. You can put in comments that a provider needs to be spoken with prior to administration. The nurse was wrong, but the provider could have helped prevent the error from occurring.
  9. LilPeanut

    $200,000 salary as a RN, it's true

    Citation please.
  10. LilPeanut

    $200,000 salary as a RN, it's true

    In San Francisco it is!
  11. LilPeanut

    Feedback appreciated

    Yes, the doc should have discontinued the order, or placed in the comments that they needed to be contacted prior to administration. Especially since it has been on the MAR for more than one shift as an inappropriate PRN. You also could document a "not given" with the reason "per provider, should not be given" at the beginning of the shift, to document for anyone to look at the MAR that it shouldn't be given, and then it will fall back on the provider that they didn't keep their orders accurate. Honestly, the whole thing is just crazy. This is exactly how the stuff in vanderbilt happens. Nurses who don't look at MARs, don't talk to others, don't document in a timely fashion. There are some systems issues that can be addressed to protect from the incompetent nurse, but part of the systems fixes are also to get rid of the incompetent nurse. It's totally unacceptable.
  12. LilPeanut

    $200,000 salary as a RN, it's true

    I know how to use public transport and used it while I was in Cleveland. To get home from the airport, I had to take the train, then get the bus. I needed to budget two hours for travel to the airport. In a car, it would take 30 min. https://www.google.com/maps/dir/13800+Fairhill+Rd,+Shaker+Heights,+OH+44120/Cleveland+Airport,+Riverside+Dr,+Cleveland,+OH/@41.452368,-81.7908589,12z/data=!3m1!4b1!4m14!4m13!1m5!1m1!1s0x8830fc89769dc2f9:0xad96864c9ff5d428!2m2!1d-81.5880192!2d41.4899226!1m5!1m1!1s0x8830eced544890cd:0xbbaf031e9364e392!2m2!1d-81.8538669!2d41.4057985!3e3 To get to my son's allergist, which was the closest allergist our insurance would accept (because I was not thrilled about going to twinsburg.) it would take >2 hours while driving was 30 min. https://www.google.com/maps/dir/13800+Fairhill+Rd,+Shaker+Heights,+OH+44120/Twinsburg,+OH/@41.2833081,-81.8498518,10z/data=!3m1!4b1!4m14!4m13!1m5!1m1!1s0x8830fc89769dc2f9:0xad96864c9ff5d428!2m2!1d-81.5880192!2d41.4899226!1m5!1m1!1s0x88311ee1cdf4800f:0x717e21af3de8996e!2m2!1d-81.4401129!2d41.3125552!3e3 To get to Aldi's, it would take over 45 min by RTA, 8 min by car. https://www.google.com/maps/dir/13800+Fairhill+Road,+Shaker+Heights,+OH/ALDI,+10815+Kinsman+Rd,+Cleveland,+OH+44104/@41.477754,-81.6280388,14z/data=!3m1!4b1!4m14!4m13!1m5!1m1!1s0x8830fc89769dc2f9:0xad96864c9ff5d428!2m2!1d-81.5880192!2d41.4899226!1m5!1m1!1s0x8830fb5ea8de4a77:0x23ec995ca5835e2b!2m2!1d-81.6083969!2d41.4697878!3e3 It's possible to get to places, sometimes with more walking than others, in often inclement weather, but you are going to spend way more time doing it, to the point where it is not worth it to do anything. It's possible to not have a car, I know not everyone has a car. But living in a dense city vs spread out city is a no brainer when it comes to cars. Everyone who lives in the city travels out of town. I'm probably the only person who doesn't regularly go to Tahoe or the Russian River or some other place when they have a couple days off. I can even get to Monterey for under 5 bucks, only take 30 min longer if I go by bus than car. It's often *faster* for me to go by bus or muni train or bike than by car. The vast majority of people living in Cleveland would say a car is necessary. The vast majority of people living in SF would say a isn't necessary, and might be a hindrance.
  13. LilPeanut

    $200,000 salary as a RN, it's true

    To be clear, I love Ohio (O H I O) I am a two-time Buckeye and grew up in Columbus. But I remember needing to get my driver's license ASAP because I needed friends and parents to drive me places.
  14. LilPeanut

    $200,000 salary as a RN, it's true

    The buses and RTA are more expensive and less extensive than public transportation here. Getting to a grocery store in Cleveland was not possible without a car. I lived in Shaker - the buses and trains are not nearly enough to be functional. Add on to that, in the winter and the summer, it becomes difficult to conduct the same activities outside. I can't ride my bike comfortably year round. Maybe some people bike in the snow, but they're crazy. You can find places to go using buses and RTA, but trying to actually live without a car? I dare you to try it for a month or two. Preferably in the worst of winter. Downtown C-land does not have the vibrancy nor the availability of services as a city like SF or NYC has. Riding a bike to work is possible in the summer in C-land, if you have the ability to shower at work. Otherwise it's not actually feasible, unless you don't sweat. Our lows in the summer/winter at at worst mid 40s, it never gets freezing here. I live in a high rise and like cooler temps. In the coldest times, I close my windows. But thanks to global warming, we´re having more hot days In general though, our temperature here is between low fifties and high sixties. I don't think there's been a day that hasn't reached the mid fifties, even during July. You wear layers and just adjust PRN Fun facts about that quote: https://www.anchorbrewing.com/blog/the-coldest-winter-i-ever-spent-was-a-summer-in-san-francisco-say-what-says-who/ https://www.sftravel.com/article/san-francisco-weather For the micro-climaters - I live in the so-called "east cut" (self named that no one likes) but most consider us either Rincon Hill or the border between SOMA and South Beach. Personally, I'd prefer to live in Pacifica, the Presidio or the Sunset, but I can't beat the convenience to Mission Bay where I work. It is technically possible, but very difficult to not have a car in Cleveland. In SF it's difficult to have a car. That's a luxury. The city is far more friendly to walkers and bikers. There's bike shares, scooter shares, buses, muni, bart, caltrain, ac trans, etc. I can get to the IKEA in Oakland in less time by taking the bus than by driving. I can go to San Jose by train in almost the same amount of time it would take driving (faster if there's traffic). It takes nearly three times the amount of time it would take to drive to take the bus from Shaker to Kent. My son goes to Kent and has had to take the bus before - but it takes far longer and far more limited as to when you can use it. Again, ask most Cleveland and its suburbs residents to give up their car, they would say it wouldn't be possible. Especially if you ask them in winter when there's a few feet of snow on the ground.
  15. LilPeanut

    $200,000 salary as a RN, it's true

    I don't even have roommates (apart from my kids LOL)
  16. LilPeanut

    Unhappy and stressed as NP- seeking advice.

    I would suggest some therapy also to help deal with unreasonable anxiety.
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