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  1. Hematocrit13

    Cardiology tests?

    Hello everyone, I work in a clinic and occasionally, not often, it happens that one or two patients want to meet with me privately. I recently met with a 50 year old female patient who says she occasionally has SOB, some palpitations (PVCs, according to a recent progress note) and transient chest pain, including a burning pain. She inquired about which tests she should get to rule out heart disease. Naturally, I advised her to talk to her provider, she said she does and will, but she just wanted to see what I thought in the meantime. Her blood pressure is fine, she does have severe sleep apnea, which is treated with CPAP. There is a strong family history of heart disease, but no diabetes or kidney disease, and her labs are all apparently fine. She says in the past her doctor ordered echocardiograms which she’s had two of over the last 4 years. They show some mild regurg in one or two valves (she can’t remember), and everything else with the echos are normal, but she worries nonetheless, concerned about the occasional pain below the left breast. Would either a stress test or halter monitor be something I could suggest she talk to her PCP about? She was asking how she can tell if there’s any blockage, inflammation or anything else wrong with her coronary arteries and if she should get anything like a CT. She seems to know that there are several tests to ask about because she also asked about the coronary calcium scan, but I felt bad because at the time I couldn't tell her much about it, or many other tests, frankly! I will strongly recommend she talk to her doctor, obviously, since I am far from an expert, but I thought I’d tap the resources here to see if anyone has any suggestions about how to shape this conversation, so I can maybe be a bit more prepared when she returns next week. Also, I myself will let the doctor know that she dropped by, and what her suggestions would be for this patient.
  2. Hematocrit13

    Thumbs down button?

    Does the thumbs down button show up on a comment? Once I have a nanosecond more of free time, I intend to go through the site to see what's different, because at first glance, and I am someone who navigates this site for the most part based on things I'm following, there is a lot different, especially in terms of the above - going through my own activity. Not making sense, I know, wish I had more time to do so.
  3. Hematocrit13

    Top 10 Nursing Apps You Need to Download Today

  4. Hematocrit13

    Why do you love being a nurse?

    Great post, would love to hear some follow up, and wondering what you might think is different at your institution than at those responders who don't (always) feel the same way. My initial thought was, if management was put under as much scrutiny as nurses, we would have better run hospitals.
  5. Hematocrit13

    Why do you love being a nurse?

    Overcome fear by seeing the ridiculous yet the funny side of every experience. -Edgar Cayce Just "discovered" Cayce! Wow.
  6. Hematocrit13

    More proof (in case you needed it) that HCA is evil

    Sorry - what is HCA?
  7. Hematocrit13

    Woman dies from tap water netipot use

    Distilled or sterile. Does not have to be exclusively sterile. If you choose to make your own saltwater solution, it's important to use bottled water that has been distilled or sterilized. Tap water is acceptable if it's been passed through a filter with a pore size of 1 micron or smaller or if it's been boiled for several minutes and then left to cool until it's lukewarm. --Mayo - but honestly I would never use tap water again. I stopped after first reading about the case in Louisiana a few years ago.
  8. Hematocrit13

    Woman dies from tap water netipot use

    But doctors need to be a lot more mindful about telling their patients to use one. You can't just say "try a neti pot." You have to also follow it - and use with sterile or distilled water. And she/he might even mention the risks associated with tap water. And how do you wash it out? Detergent? Tap water? Distilled? Unsure. I've used mine now only a handful of times a year, and always use distilled. But I warm it on the stove, after cleaning the pot I'm warming the water in a LOT (with distilled water). It becomes a chore. So I've opted for the saline spray from CVS. A bit less environmentally friendly, maybe, because of the plastic, but less labor intensive.
  9. Hematocrit13

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    After watching a great special on PBS about the thai cave rescue, my understanding was that the boys were dosed with ketamine.
  10. I work with someone (a nurse) who has, that I know of, saved two people's lives. I do not particularly gravitate to her one way or the other. She has never once mentioned that she's saved two people's lives. One of the patients has. No one else has mentioned it to me. As tense as things get at work, and whatever else happens, there is one thing I will never forget - this woman saved two people's lives. I suppose my point is, Good People Know in their depths who's doing what and who is really valuable.
  11. Hematocrit13

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    Thank you for that dose of rationality and clear-eyed summation of real world reviews, MunroRN.
  12. Hematocrit13

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    Guys, calm down. I get it. And, I agree. I think we agree on most things, here.
  13. Hematocrit13

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    Fair enough, but most of my posts are not really meant to assign blame, but perhaps widen the discussion some. Again, there's no question this nurse should lose his/her job. But is there anything else to talk about besides that? The answer seems to be yes. At least to me. Because, again, there's still a lot we don't know, and I read the report.
  14. Hematocrit13

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    Nothing, and that wasn't my point. My question was what led her to that point, and it could be any number of things. That's what needs to be examined and challenged. Was there, for example, a little cognitive dissonant hesitation that we've all had - we either 'override' it, or give in to it and examine it and catch the mistake we're about to make. There are other factors that might have led her/him to both that point of dissonance and the decision to override it (if indeed it happened, which like so much else, we simply do not know).
  15. Hematocrit13

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    When I read about cases such as this, the assumption I have is that of course the RN needs to be disciplined, that that should almost go without saying. It is beyond me to speculate about disciplinary measures that would apply. Yes, the rights of med admin apply of course. But there's a lot of Monday morning quarterbacking going on. What led this RN to the point of not checking? That's what we don't know. I read the report, and while I and we sit here and take in this lesson and try to learn from it, I see a huge backdoor wide open - the ME was not even informed of the drug error. There are many errors made after the fact, upon investigation, which are going to make advocacy for a slower work culture more difficult. And that includes not classifying it as a hospital caused death.