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Here.I.Stand

Here.I.Stand BSN, RN

RN
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Content by Here.I.Stand

  1. Here.I.Stand

    Please tell me what to do

    On the chance you are for real... Sure it can be ignored... quit spying on your neighbors. You have really watched her closely enough to have counted 90 people? How creepy.
  2. Here.I.Stand

    Do I have to disclose mental illness

    But, if your MEDICAL diagnoses — be they DM or lupus or PTSD — don’t make you a danger to yourself or others, it’s really none of their damn business. It’s ridiculous that we push for de-stigmatization of mental illness... unless it’s one of us who has it.
  3. Here.I.Stand

    I was slapped by a patient

    As long as we continue to allow this behavior, it will continue to happen.
  4. Here.I.Stand

    I was slapped by a patient

    Here’s a virtual hug... now go report this to law enforcement! What he did was called assault and battery.
  5. Here.I.Stand

    Magic Mushrooms as Medicine? Mind-Body Connection Pt. 3

    Little problem with advocating for hallucinogenics... they’re illegal. It’s not even in our scope of practice to recommend legal drugs... no way would I ever consider recommending illegal ones. 1) the BON doesn’t tend to like us breaking the law, and 2) as they are illegal we’re talking about pts buying them off the street. That is ALL kinds of irresponsible — do YOU trust drugs bought on the black market? Plus, as trials are underway and therefore incomplete, there really isn’t enough safety and efficacy data for me to be comfortable “sharing and advocating these modalities.”
  6. Here.I.Stand

    Nurses Are So Bossy...

    “You screwed up putting an iv in and when questioned you get pissy.” I missed this part the first time reading through... If a spouse is interfering in patient care, heck yeah they’re going to get out! Behaviors have consequences.
  7. Here.I.Stand

    DNR? details please

    Well the ACLS drugs are useless without compressions/defib.... even defib needs to be paired with compressions — the brain needs that blood circulation until the heart can provide it. Years back I remember hearing about “chemical code”... but that would be pointless. You can inject until the cows come home, but the drugs can’t even circulate if nothing is pumping the blood by the same token you can’t really have a DNI order alone.. you can’t resuscitate without an airway....... I mean technically they could use an ambu bag with a facemask or a LMA, but I’ve never really seen adequate respiratory function the second we achieve ROSC. They still need mechanical ventilation The DNR order NOT with a DNI makes sense; the pt in this situation would probably want to be intubated if they had pneumonia or something similar that doesn’t require compressions
  8. Here.I.Stand

    Nurses Are So Bossy...

    Bossier than Florence Nightengale?
  9. Here.I.Stand

    Interesting case of the spilled pills

    What the actual what?? Just following orders isn’t a defense true... and it’s disgusting true... but why is anyone willing to risk their own safety like that?? The sharps container is a one-way street! And last I checked, pharmacy school doesn’t result in microscopic vision. His eyeball test doesn’t fly!!
  10. Here.I.Stand

    Why is it "legal" for patient to decline male nurses?

    Why is it “legal?” It’s a little ethical principle called “autonomy.” A female patient is under no obligation to allow any access to her body that she doesn’t agree to. If you feel butthurt that is YOUR issue — it’s not a patient’s job to alleviate your butthurtedness. The reverse is true as well. If a modest man doesn’t want me inserting a foley, I wouldn’t dream of coercing him... or saying ugly things about his character. Comparing modesty to bigotry... You need some serious education. Your assertion that the concept of modesty is an antiquated idea and we must be behind the times? Please. Respect and sensitivity are ESSENTIAL traits. Lack of those traits is a sign of immaturity and ignorance.
  11. A few thoughts... For those who point out “why was Versed used in the first place?” What in the world does that have to do with anything when you aren’t checking your Rights? What if they had ordered Ativan... she could just as easily typed “A-T” and overridden atracurium. I don’t know that anyone is calling for her to be charged with MURDER... but is there evidence that she was negligent? CLEARLY she was. Did her negligence result in the death of a human? Yes. I don’t get why a charge of negligent homicide (or whatever TN’s equivalent is... I don’t recall) is inappropriate. Say an overwhelmed, sleep deprived new mother doses her baby with a syringe of something, rather than check the bottle and the dose? Eh... it kind of looks like infants Tylenol. But it wasn’t, and the baby died. She could reasonably be charged in the baby’s death, no? So why does a licensed professional get a pass? Should we not hold ourselves to a higher standard? Just Culture does not mean nurses get a pass for egregiously unsafe nursing practice. We are not talking about firing a nurse for giving Colace to the wrong patient. Do systems issues contribute to errors sure. But at the end of the day we and nobody else is responsible for our own nursing practice. RV’s nursing practice was... I have no words. How can we expect respect as a PROFESSION, if we are going to defend such incompetence? Shame on the TN BON. Just about every first semester nursing student practices more safely than that... but it is acceptable to allow her access to the public?? While others who have gotten help for the DISEASE of addiction, gotten healthy years before... but are subjected to monitoring programs? What the [againstTOS]????? I wonder how the deceased woman’s family felt seeing all of the strangers in scrubs at the arraignment? Nurses don’t hold a monopoly on on-the-job stress. Air traffic controllers, military, firefighters, hostage negotiators etc have way more stress. Sorry, it’s true. If they screw up, people die. Why is it that when a nurse screws up and kills someone, we say “oh but she probably had distractions... she had phone calls and people demanding turkey sandwiches!!” Really? REALLY?? Do I think she needs to hang NO...but held legally accountable for her negligence which caused a woman to die? And a horrible death at that? (It’s been said in news pieces that vec is used in lethal injections? Even serial murderers get sedated before getting a neuromuscular block!) ABSOLUTELY.
  12. Here.I.Stand

    Bring back our childhood diseases!

    “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....
  13. Here.I.Stand

    Tracheostomy question

    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.
  14. Here.I.Stand

    #metoomovement, General Hospital and Nurses

    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.
  15. Here.I.Stand

    Active Shooter Training

    We actually have this as part of our annual training. Good info!
  16. Here.I.Stand

    The Nurses BreakRoom: Going, going ... been gone?

    Yes we have one, and we use it nearly every shift. I'm sick to death of the "Nurses don't get BREAKS" mentality to be honest.
  17. Here.I.Stand

    SHE COMES FIRST!

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

    Why did she do this to me?

  19. Here.I.Stand

    Stop the Silence...Violence Against Nurses

    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.
  20. 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. :)
  21. 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!
  22. Here.I.Stand

    Nurse Satisfaction comes before Patient Satisfaction

    Unacceptable. That should warrant a call to security, not faster waitressing.
  23. Here.I.Stand

    Nurse Satisfaction comes before Patient Satisfaction

    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.
  24. Here.I.Stand

    NTI 2016: Family Presence During Resuscitation?!

    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.
  25. Here.I.Stand

    The Obesity Problem in Rural America

    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. :)
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