jdub6

Was browsing AN and came across this in a post by Stargazer Feb 2001: "This reminds me of an article on another nursing website (sorry, don't remember which one)about a year ago on how one ER had decided to have all patients fill out a "satisfaction ...

For me personally, i can attend teaching sessions, read policies and manuals and talk through use of equipment and certain procedures, but the only way i actually get comfortable is to actually do it in real life. If there are certain procedures or ...

You cannot do everything all at once. You did what you could. WRT to septic patient, you noticed the AMS and reported it to all concerned parties. The patient was sick, that's why they were hospitalized (if they just needed fluids/abx they could g...

This may be petty but propofol is not a "narc." It is not on a DEA schedule. It is a legend drug. I have never worked in a facility where "every drop must be accounted for" i.e. I've never had to waste with a witness and actually have never gotten...

I agree that the danger of a physical conflict may be worse than some jewelry. But, then don't make the rule at all. Patient A's earrings are very sentimental to her, but she understands and appreciates safety efforts and turns them in. Patient B do...

If a stud there is a sharp-ish end, a hoop could be broken to create one, and either could be used to cut oneself or if swallowed has potential to cause damage much like a swallowed soda can tab. It's certainly possible, maybe even likely that they ...

You probably already know that spitting into the eye or mouth areas is also a body fluid exposure and should be reported immediately. And at the same time security should be called. Perhaps they can give you a panic button if you're going to be dea...

What do you guys do with kids brought by EMS because the parent is the patient and the child can't be left alone? What if the parent is unable to speak/arrange care? if the parent is intoxicated or psych (psychotic or a suicide attempt)? I recently ...

Thats what it is-frustrating. Recently had a parent come in with dizziness and feeling confused (normal Neuro exam) freely admitted having been on a 3 day crack and MDMA binge. 4yo daughter in tow. Parent couldn't/wouldn't find child care, we prov...

First off thanks to all who replied. I know the med surg floor had a problem like this one-elderly patients spouse brought the dog to spend the night. The patient was being made comfort measures and they do allow pet visits for dying patients but th...

Glad things worked out for you. I'm sure you know this already but even if you HAD given Tylenol, liked everyone else said it wouldn't have prevented the seizure most likely. While it might have looked better to the principal if you could say you'd...

A similar question with that would be the personality disordered individuals who come neck time and again with either non-lethal attempts or those who have many moderately lethal attempts? When all meds and therapies have been tried and they still h...

I'm not a psych nurse. I currently work ED and have great respect for you guys. I am wondering if you'd share your thoughts on something that's been troubling me. Paramedic. 40. Divorced (10 years). Suicide attempt by hanging-nearly succeeded-very ...

I guess that's part of my issue-that guy was honest with us, i think because he felt he had nothing to lose or didn't care. But if he had summoned the energy to try to get out i feel he would have just lied his way out so he could kill himself. In ...

In my state death in restraints is reportable with the exception of ICU patients who die in 2 point soft wrist restraints. (There may be an exception for comfort measures also but I'm not sure.) Regardless its definitely reportable if they fall and ...

16 weeks is shorter than some new grad ICU programs but the thing is youre 14 weeks in. Finding another job if you leave now will be tough and you may not be given new grad orientation at this point. Try really hard to make the best of where you ar...

Actually this is starting to sound more plausible now. Some EMRs have different defaults for different meds which could explain why its just this med. Honestly I kind of want to believe OP even though diversion is the most logical explanation becaus...

With specific protocols yes for Narcan (the protocol gives dose change per a scale assessment as well as criteria for consulting MD and frequency of vitals/re-assessment.) Phenobarb in my unit really is used mostly for status epilepticus and we have ...

2 IVs is the standard. Central lines placed in ED are supposedly more likely to be "dirty" (meaning both placed in groin and/or to develop line infections) because of the environment. Most pressors can run via PIV initially for a set time. If the...

To OP: in my experience ICU is different in that report is much more detailed (expect to know exert detail of the patient and any device and med and lab result). Nursing rounds with the docs-this is time-consuming but a great time to learn about yo...

Some days are like that in ANY specialty (especially appreciate #24-this happens in ED and on the floors as well! You forgot 24.5 though "step away from drawing specimen #5 to answer call from resident about why said specimen has not been sent. Exp...

This is a great answer and probably what your school wants. Note though that if the patient is older and/or chronically ill that it is not uncommon for many people to have chronically low protein/albumin levels even if not acutely ill. I always scr...

Hahaha! That last line was a gem. I very much identify with the rest of your post though i haven't (yet) had to have a mammogram or biopsy. I am also a bad follow-upper and could see this happening to me. I am fascinated that you report that your ...

This is the thing...we ignore the bad effects of opiates (and there is evidence to support them) in favor of the thought that opiates are powerful and therefore must work. We don't have good evidence for opiates for a lot of pain conditions. We DO k...

Some of the "old-ish- articles and studies and texts (including what some of us were given in school) were funded and influenced by the manufacturers of opiate drugs. Sadly the public and The Joint Commission and other "official" sources parroted th...