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macawake

macawake MSN

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macawake has 13 years experience as a MSN.

macawake's Latest Activity

  1. macawake

    How To Start IVs In The Hand

    When I place an IV catheter in the dorsal metacarpal veins I make sure to immobilize the vein by stretching the skin distal to the vein. The initial entry angle will vary a bit depending on the depth of the vein, but I will usually insert the stylet (bevel up) in a patient’s hand vein at about a 15 (to 20) degree angle. When I see blood return in the hub of the cannula I will advance the stylet slightly and then level off the angle so that it’s level with the patient’s skin and then advance the cannula until it’s all the way in. This works for me and the catheter will end up well within the lumen of the vein, but won’t transect/puncture through the back wall of the vein. (Disclaimer: English as a fourth language, so I hope I got the names for the different parts of the catheter right). The metacarpal veins are usually prominent and easy to visualize and aren’t located over a point of flexion but they sure do like to roll. I place the catheter so that the tip doesn’t extend over the wrist joint and so that the hub of the catheter doesn’t extend over the knuckles. I think the best thing for you to do, is to ask a coworker who’s skilled at IV insertions to demonstrate/explain in real life as it is a bit tricky to explain well over the internet 🙂 Best wishes!
  2. macawake

    Sexually assaulted at work

    No, you’re not being dramatic and the patient’s behavior was unacceptable in any setting. I think that the question mark in the thread title should be removed. What you’ve described is an assault. Reading this makes me angry. It your supervisor actually thinks this wasn’t a big deal, then in my opinion s/he isn’t the right person for a supervisory position. If this had happened to me or a coworker I wouldn’t have hesitated for one second before calling the police. My reasoning would be to let the police and courts decide if diminished capacity applies. That’s not my job. But I would make sure that any individual who commits violent crimes against persons was made aware that kind of behavior won’t be tolerated. I’m very sorry this happened to you! I’m also sorry that your employer doesn’t appear to have your back. I hope you’re doing okay. Take care!
  3. I find that concerning as well, but sadly I’m not at all surprised. I personally don’t regard Trump supporters as conservatives as much as I view them as worshippers. They seem to view him as a deity (perish the thought...) If I’m honest, I think I’m more of a conservative than he is. In my opinion he’s simply an opportunist who realized that a significant part of the electorate were ripe for the picking. What’s happened with Trump is of course extreme but I have to admit that as a European I’ve always found U.S. politics strangely focused on the party leader as opposed to the party’s policy and ideology. We have elections every four years as well and they are extremely boring affairs compared to U.S. elections. Much less drama and showmanship and a whole lot less money involved. There is no way a candidate could ever fill a sports arena with adoring fans. We have a handful of televised debates close to the election where the party leaders participate but most people don’t care about the person. They care about the policy they’re proposing. In the months running up to the election they will usually travel around the country speaking in some town square, drawing a crowd of 100 people on a good day 😂 But it’s not that people don’t care about politics, they do. In the last election in 2018, voter turnout was 87.18% of eligible voters.
  4. macawake

    Getting Flack For Not Getting Covid Vaccine

    Completely anecdotal... three (out of +100) of my coworkers had a very strong response to the first vaccine dose and they all had antibodies from a previous infection. The rest of us had no or mostly mild symptoms after the first dose, but many had stronger responses with the second dose. But the three with the first dose strong immune response weren’t the only ones with a previous Covid diagnosis, so not everyone with antibodies got a strong reaction. None of all this qualifies as scientific data, I just think it’s a bit interesting. https://www.euronews.com/2021/02/12/france-s-health-authority-recommends-single-vaccine-shot-for-people-who-have-had-covid-19 Preprint... https://www.medrxiv.org/content/10.1101/2021.01.29.21250653v1 Any way, I’m glad you seem to be feeling a bit better 🙂
  5. macawake

    Getting Flack For Not Getting Covid Vaccine

    I’m just thinking out loud here, but isn’t it a possibility that your immune system is reacting so strongly to your first vaccine dose because you’ve had a Covid infection? It kind of is the second ”dose” as far as your body is concerned. Hope you feel better soon!
  6. macawake

    Getting Flack For Not Getting Covid Vaccine

    Welcome to AN. That doesn’t seem very strange considering we’ve been living with a devastating pandemic with significant morbidity and mortality for almost a year now. That’s what sets your twelfth year apart from your first eleven.
  7. If Officer Joe who was on duty and present when the insurrectionists stormed the Capitol on January 6 calls Officer Jill who is vacationing on the French Riviera and tells her that the violent mob were chanting ”hang Mike Pence”, then Officer Jill’s testimony in a court of law about the chanting would be hearsay. Officer Joe’s testimony on the other hand, would be eyewitness testimony of something he witnessed first-hand. The latter is admissible evidence. NRSKarenRN clearly said that she’d want to see police relate what they heard rioters say or chant. Even though she didn’t specify, I think it’s reasonable to assume that she had the police officers who were actually present at the event in mind. I have no idea why you appear to have assumed that she was referring to police officers who weren’t present? No, we do not know that at all. I’m convinced that if your ex-President hadn’t lied, lied and lied, over and over and over again about the election being stolen, rigged, fraudulent etc. etc., that mob of violent insurrectionists wouldn’t have congregated in DC and stormed the Capitol and murdered a police officer and wounded dozens more. He and his sycophants deliberately spread disinformation that wasn’t supported by any evidence. That was an act of undermining the electorates faith in your democratic process. Utterly disgraceful and extremely dangerous behavior. You’ve had many Presidential elections prior to this one and each and every time one political party won and the other lost the election. Before 2020 the losing side didn’t react by storming the Capitol and commit violent crimes. What was the new factor in 2020 that wasn’t present for the earlier elections? All other Presidents or candidates have accepted their loss like men. The criminals who stormed the Capitol are responsible for their own decisions and actions. But pretending that they hadn’t been systematically whipped into a frenzy is in my opinion either naive or disingenuous and out of touch with reality.
  8. macawake

    Help Ban Genital Cosmetic Surgery on Children

    Do you genuinely believe that no one will ever change their minds? I think you’re right that it’s an emotional topic. And I also think that internet arguments probably aren’t the most likely venue to bring about change, but I still think it’s an important topic to discuss. I personally think that over time, people can and do change their minds. Customs change. We did a lot of things in the 15th century that we wouldn’t dream of doing today. I’m hopeful that the ancient practice of trying to control women’s and men’s sexuality through surgical removal of body parts, will lose popularity. That trend can be observed in some countries that used to have a higher rate of male circumcisions but where a new generation of parents now chose to let their son’s bodies remain intact.
  9. macawake

    Help Ban Genital Cosmetic Surgery on Children

    I interpreted the verbal flailing as an attempt to deflect. A lot of time and energy spent on detailed descriptions of various bodily secretions while the heart of the matter, whether children should have the right to not have their healthy body parts surgically removed, is ignored.
  10. macawake

    Vaccine Hesitancy

    There are a lot of things I don’t know but that doesn’t mean that I can’t use what I do know to interpret and evaluate claims, data and information. Let’s say that you are the triage nurse at the local ER. A patient presents with xyz complaint and then tells you to please tell the nurse who will draw her blood that she is a bit unusual and doesn’t want the nurse to freak out when the blood comes out green. According to the patient this will happen because she claims to not have blood in her circulatory system, but Type IV Aircraft Deicing Fluid instead. Would you give your coworker the headsup that the blood sample will be green or will you correctly deduce that ethylene glycol couldn’t support human life and the patient’s belief is wrong? The next patient you see claimed that when he went to the bathroom to urinate, a violin ”came out” and that it was quite a painful experience. (Knowing the diameter of the urethra we obviously realize that must have hurt. A lot.) So do you the triage nurse suspect some kind of psychiatric illness, head trauma or drug intoxication? Or do you send them off for a CT scan because you are dying to know exactly how many violins can fit into a human bladder? I don’t think you’d have any problems figuring out the above patients. Why aren’t you also able to apply your knowledge as a nurse and realize right away that the mind-altering vaccine baloney is just that? Baloney. Even without being a specialist in neuroscience I’m sure that you realize that the process that takes place when we feel things, remember things and make decisions is very complex. What would be this vaccine’s mechanism of action? Targeting what exactly? With what? How would this vaccine work pharmacologically and physiologically? And what on earth would the vaccine maker be hoping to accomplish? It just doesn’t make sense. I’m not poking fun. I just find it deeply troubling that you would even entertain the concept of Gates or anyone else having created a vaccine that can change people’s political or religious views. You didn’t have to say that you believe it. The fact that you made a post mentioning this tells me that you don’t think it’s impossible. Personally, I dismissed it out of hand. I’m an ECREE (extraordinary claims require extraordinary evidence) kind of person. You see, I don’t think that either Gates or anyone else has either the means nor the motive to do this. It’s as much fantasy as a person walking into an ER with deicing fluid coursing through their arteries and veins. Kooky Korky, you appear to believe that all claims no matter how illogical, outrageous and most importantly unsubstantiated, have equal value and should be afforded the same consideration. To me, that’s not a rational approach to interpreting the world we live in.
  11. macawake

    Help Ban Genital Cosmetic Surgery on Children

    But that’s the thing. I haven’t made counter assertions. The studies that I had previously read on the topic had flaws so I was curious if you had located some better quality studies. I was asking for the studies that support the claim you made: ”there are a multitude of studies that indicate that uncircumcised men have a higher incidence of contracting STDs, especially HIV. That’s science that’s reproducible, reliable and validated”.
  12. macawake

    Help Ban Genital Cosmetic Surgery on Children

    I completely agree. Surgically removing healthy body parts makes no sense to me. But if an informed and consenting adult wanted to do it, that would be one thing. A child on the other hand, who can’t legally consent, should in my opinion be allowed to have their body intact until they are old enough to decide what they want, or don’t want. I’m Scandinavian but I have lived in the U.S. and in other parts of the world as well. What I did notice in the U.S. was that many people, both men and women, have been culturally conditioned to view a natural penis as something ugly or unclean that needs to be fixed. Most people frown on the act of surgically removing parts of female genitalia, but it’s okay to do it to boys? As nurses we advocate for patients’ autonomy and integrity. I think children have a right to that as well. I’ve noticed some really emotional and defensive reactions in this thread, when one dares to question the ratinonale behind male circumcision. It appears to be a sensitive topic.
  13. macawake

    Help Ban Genital Cosmetic Surgery on Children

    Perhaps it’s just the internet where tone can be hard to discern, but I perceive the way you reply to me as hectoring. You’re issuing ordes as if you you were my CO. I haven’t forcefully and bitterly attacked anything so your use of the word diatribe is incorrect. I’ve only asked you questions and asked if you could provide links to sources since you did make the claim that a ”multitude of studies” exist that indicate that uncircumcised men have a higher incidence of contracting STDs. The reason I asked you to provide the links was because I haven’t found a single well-designed RCT that supports this. No I don’t think there’s a higher percentage of flawed study designs in trials carried out somewhere on the African continent as opposed to on any other random continent. The reason I asked of you had links to RCTs closer to home was because generalizability of a study result from one continent to another could possibly be problematic. Since I had no way of knowing which studies you had in mind, because you chose not to mention what the ”multitude of studies” consisted of, I was looking for clarification.
  14. macawake

    Vaccine Hesitancy

    I was thinking the exact same thing. I agree with the eating healthy and exercise parts and would like to add getting enough sleep. As far as the supplements goes, a healthy diet have most nutrients covered. Quercitin is a plant pigment. I’d choose the plant over a supplement any day. Most of them are quite tasty 🥦🍇🍒🫐🧅
  15. macawake

    Vaccine Hesitancy

    Can you provide a source which supports your claim that most educated people are opting out? Because I’ll post a link that appears to indicate the opposite. https://www.pewresearch.org/science/2020/12/03/intent-to-get-a-covid-19-vaccine-rises-to-60-as-confidence-in-research-and-development-process-increases/ It seems that people with a postgraduate degree are most likely to take get the vaccine, followed by college graduates. The survey indicates that those least likely to take the vaccine are individuals with high school or less or some college education. Completely anecdotal, but on my unit 97% have now received their first vaccine dose 🥳 (vaccination is voluntary). My unit only has nurses and physicians employed. The vaccines that have been granted EUA’s are not Phase 1a. If you’ve actually been involved in pharmaceutical research you should darn well know that your statement is incorrect. They have gone through phase 3 trials and the results have been reviewed and have met the criteria for emergency use authorization. 1a is an initial safety phase that involves a very small number of people. https://www.fda.gov/patients/drug-development-process/step-3-clinical-research I try very hard to not do that 😂
  16. macawake

    Vaccine Hesitancy

    If you divide your population by 78,000 the result is 2.37 x 10^-4. That’s the same as 0.000237 but it’s not the same as 0.0002%. It’s 0.02%. Still, I agree that it is a tiny part of the total population. What do you know about statistical power? There is nothing unusual about the size of the phase 3 trials for these vaccines, if anything they were actually quite large. How big do you think that the trials were that preceded the approvals of many of the medications that you give to your patients on a daily basis? You might be surprised by the relatively small size of them. (Any clinical trial will sound tiny if you compare it to the entire population and in this case you might as well divide your 78,000 with the global population since the vaccine trials took place in several countries and are now being distributed worldwide). Personally I didn’t hesitate to take the vaccine when it was offered. When weighing the known risks of a Covid-19 infection and the significant effect that this pandemic has had on our lives against a possible but very rare vaccine side effect, it wasn’t a difficult decision. Driving a car is likely a significantly bigger risk and my parachuting hobby definitely is.