Here.I.Stand

“The entire Baby Boom population alive today had the #Measles as kids Bring back our #ChildhoodDiseases they keep you healthy & fight cancer” Because Baby Boomers have such low M&M of cancer? Mmmmkay....

Real-world thoughts: You suction if you hear secretions. (AND the pt is unable to clear them on their own. If the pt has a strong cough and can fire their secretions across the room, no need to stick a tube in there.) No secretions = nothing TO suction... but that suction catheter will irritate the hell out of that airway.... which doesn’t help anyone breathe. If there are secretions, that is adding another mechanism of airway obstruction, along with the constriction — and the medicine doesn’t make them go away. Sputum has to be physically removed. Do you know anyone with asthma? They have wheezing and treat it with albuterol — but the wheezing is not necessarily accompanied by a productive cough. I mean if they have pneumonia yes, you can expect to see secretions. But a teenager who has been healthy, but left her albuterol at home and skied a 5k in -10F weather (true story)? She had plenty of wheezing with a dry airway. A trach is a surgical airway — a hole cut to allow the insertion of a plastic or metal tube. The native respiratory system south of the trach functions like any other respiratory system; sometimes we have a dry cough, sometimes a productive one. Sometimes our muscles are strong enough to clear our airway, sometimes they need a bit of help. Assess your patient first and foremost.

I haven't watched it since the '80s (my mom watched it every day!) Glad they've improved their tackling of the subject since Luke and Laura.

We actually have this as part of our annual training. Good info!

What a beautiful story. It makes me proud to be part of the same profession as you.

Yeah no...that doesn't work for me, and it shouldn't work for you either. They cannot prevent you from calling 911, going to the police or the DA, or going to the media if needed. I live not too far from a well-publicized case of assault against nurses, so doubt that the hospital would want THAT kind of publicity -- the employer who cares nothing for occupational safety...against the most trusted profession, no less.

Spidey's mom -- interesting info on cosleeping! Anecdotally, a couple of scary things happened during my oldest daughter's first few months: 1) I fell asleep sitting up on the side of my bed as I was feeding her. I do have quick reflexes so managed to not drop her -- for a split second she did start to slip. And 2) one night I put her back in her crib with zero recall the next a.m. I have no idea if I took care to not throw a blanket over her head, I have no idea how I even put her in the crib vs on the dresser that was right next to the crib, and the same height. That to me felt unsafe. I am also a very light sleeper and woke the second I came into contact with her. Again my experience, and I completely based that decision on how I felt vs on any research. But hey, my mama's pretty smart and her #1 piece of advice to me was to trust my instincts. :)

I am hugely pro-breastfeeding, and I get the goal of supporting/educating moms. I mean in the past, moms were discouraged from it. Many decades/maybe a century ago there was even a stigma attached to breastfeeding. In an ideal world everyone would do it and nobody would have difficulty. Trouble is, we don't live in an ideal world. I feel like the pendulum has swung too far. Shaming women and making them feel less of a mother does not help, especially in such an emotionally delicate time as the postpartum period. Ideology aside, the baby needs to eat. Sure keep trying if you want to, but in the meantime you can't malnourish the baby on a principle. And thanks to modern innovation, they are making formula more like breastmilk all the time. I also think the it's-natural-therefore-it-should-be-easy idea is oversimplified. I have 5 kids and breastfed all of them. I read everything I could get my hands on during my first pregnancy. One thing that every book said was "if you do it properly, it should not hurt." Imagine my surprise when for the first two weeks it felt like this toothless person was chewing my nipples off!! It was like nursing a piranha. My midwife (also an IBCLC) checked her latch, assured me it was fine... I kept going because I am that stubborn and it got better. Not what your wife experienced, but it's a pet peeve, setting up unrealistic expectations...which creates feelings of failure when those expectations are not met. Good for you for standing up for your wife. I'm sure this is difficult for her -- she's putting all this effort in (and pumping is a huge effort!) That LC added insult to injury with her, uh, "coaching" style. And again, putting an ideology ahead of the baby's immediate need for food. You seem like an amazing husband and I'm sure are a great dad too!

Unacceptable. That should warrant a call to security, not faster waitressing.

Except from what I hear (I've heard "pt satisfaction surveys" come from my manager's mouth exactly once in the four years I've worked under her) this isn't generally what happens. Rather than using that info as an incentive to increase staff, they blame the nurses. Remember that empathy exercise where the nurses were made to lie on a cart in the ED hallway, wearing goggles and denied access to the BR? I want to say it was a hospital in Illinois? They would have done well to staff more nurses, but they decided that the nurses simply didn't do well enough because they don't know what it's like to be a pt, nor did they care.

I'm having trouble picturing where they would stand...our rooms get SO crowded. The pharmacist doesn't even come inside our ICU rooms -- they stand just outside the doorway next to the crash cart. Families if present are allowed to stand outsidr of the room, just out of the way of staff. The chaplain is at their side to give comfort and explain in general what is happening, as clinical staff are of course focused on the rescucitation efforts.

I too am from a very rural community in Wisconsin. Most of my extended family still live there. The obese from what I can tell are obese for the same reasons suburban and urban dwellers are: sedentary lifestyle, dietary choices, and non-modifiable factors like genetics. There is possibly a higher consumption rate of fresh corn on the cob during the summer (with butter and salt of course) because so many farmers and gardeners grow it...and because it's delectable. . But otherwise, the grocery stores carry the same things any other grocery store carries. Five miles south of my childhood home is a local frachise grocery store, and 20 miles north is a Wal Mart Supercenter. Fresh produce is very abundant in the summer! You can't drive more than a couple miles without seeing handmade signs for fresh berries, tomatoes, or corn. There are lots of commercial berry patches, Amish wives selling surplus, etc. My parents receive medical care at a Mayo Clinic affiliated practice; my mom's MD even does dietary education with her, as she has high triglycerides and is trying to avoid meds. Local EMS is all volunteer, and the nearest hospital is 20 miles away, but anecdotally I see more people dying not because they didn't get EKGs but because they don't call 911. Men especially -- the Scandinavian farming type tend to be quite stoic. But my 93 yr old grandma survived bilateral PEs a few years ago, her family and team was so quick to act! Excercise is an issue in the winter. It's often dangerously cold to go for a walk, and daylight is short. At winter solstice time, the sun sets before 1630. They've had some small fitness centers open in recent years though, and people can buy a treadmill as easily as suburbanites can -- nearest Wal Mart is 20 miles. My parents took up Nordic skiing and snow shoeing for variety, weather permitting. :)

Absolutely!! I'm pretty introverted, and remember as a student being SO nervous, not knowing what to say to pts/families. I mean, sometimeswhat can you say? So then, what do you do? You can't just stand there... That was definitely a learning curve.

Well, I do think "skills" are a valid concern when students go through their entire program without giving a single IV med, even attempting a single IV start, or other things that I see new grads describe here on AN. Manual skills do require manual practice. Otherwise though, I agree completely about practicing the art of nursing and how important that is. Good piece!