offlabel

offlabel

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All Content by offlabel

  1. Educating Teens About Long-Acting Birth Control

    offlabel replied to FNP2writer's topic in Advanced Practice

    Just look at the data. For the past 5 decades there has been unprecedented access to abortion and birth control, especially in lower socio-economic, minority areas of the country. Yet the rates of...

  2. Whistle blower nurse now destitute

    offlabel replied to hppygr8ful's topic in Nursing News

    Wow...more to the story here? Seems like this would be political red meat for any politician wanting to make points on the abysmal immigration problem right now, especially in exposing complicit Biden...

  3. Educating Teens About Long-Acting Birth Control

    offlabel replied to FNP2writer's topic in Advanced Practice

    Counter intuitive, right? https://www.ajog.org/article/S0002-9378(20)30106-X/fulltext And as a result:...

  4. Educating Teens About Long-Acting Birth Control

    offlabel replied to FNP2writer's topic in Advanced Practice

    What counseling is given to these young women about choosing honorable men that won't abandon them when they find some other woman that will surrender their bodies to them that they are attracted to?...

  5. CRNA School Acceptance

    offlabel replied to studentnurse1004's topic in Student Registered Nurse Anesthetist

    Have 5 years of ICU type service before you

  6. Facility leaves J loop open to air

    offlabel replied to blackIrish's topic in Infusion, Intravenous

    Just brief outpatient procedures? The patient has the IV in for a few hours tops? Extremely tacky on it's face and just putting a cap on it wouldn't take 2 seconds to do, but odds of infection are...

  7. LPN Supervisor Would Not Let Me Call Doctor

    offlabel replied to Googlenurse's topic in General Nursing

    So, that's my question...why not (the MAP was 63)? The MD would be very aware of the risk of sepsis in this population. What would you have him or her do based on that blood pressure alone? What does...

  8. LPN Supervisor Would Not Let Me Call Doctor

    offlabel replied to Googlenurse's topic in General Nursing

    No one is questioning the role of advocate for the nurse. But we can't cloak ourselves in such a noble title if we all we do is reflexively respond to wooden parameters completely removed from the...

  9. LPN Supervisor Would Not Let Me Call Doctor

    offlabel replied to Googlenurse's topic in General Nursing

    Lethargic at 0200? Need more information. His mean arterial pressure is between 60 and 65 and he's sleepy. You don't say what the sleeping BP normally is, but if I had to guess, it wouldn't be to far...

  10. Critical Care Unit

    offlabel replied to PeachTea7's topic in General Nursing

    ICU in a hospital you describe is not the same as ICU in a regional medical center or bigger. If you have a ventilated patient there for very long at all, I'd say it was because the decision to let...

  11. When to Contact Anesthesia

    offlabel replied to Sirrahsim's topic in PACU

    So we're back to running it by the charge nurse. From there it's a medical judgment call. Giving Narcan to a breathing patient with normal oxygenation and an open airway or not is a call the...

  12. When to Contact Anesthesia

    offlabel replied to Sirrahsim's topic in PACU

    Quite a determination for not knowing the age of the patient, the surgery, patient history, intraoperative course... But by all means, if flip chart nursing is what works, have at

  13. Etomidate Vs. Propofol for Standard Inductions of GA

    offlabel replied to stevesmithSRNA373's topic in Certified Registered Nurse Anesthetist, CRNA

    I don't know what the argument here is. If ASA 4 and 5 patient's are 'routine' then routine etomidate use is defensible. Niche scenarios? These are every single day scenarios. Just asking...how many...

  14. When to Contact Anesthesia

    offlabel replied to Sirrahsim's topic in PACU

    To a healthy, non co-morbid patient, hypercarbia is harmless. It passes without any issues unless a sleepy patient in the PACU is an issue. Pulmonary hypertension? COPD? Different story. Which ones...

  15. When to Contact Anesthesia

    offlabel replied to Sirrahsim's topic in PACU

    Why is 12 an important number? This is my point. Lot's of patients do just fine right out of surgery with a rate of 6-8 and will gradually come around over time without intervention. Sure, the 80 year...

  16. Etomidate Vs. Propofol for Standard Inductions of GA

    offlabel replied to stevesmithSRNA373's topic in Certified Registered Nurse Anesthetist, CRNA

    I bled cardiac induction into my thought, but the principle still carries....patients with higher risk for morbidity and mortality tend to get etomidate and don't do well independent of a one time...

  17. Etomidate Vs. Propofol for Standard Inductions of GA

    offlabel replied to stevesmithSRNA373's topic in Certified Registered Nurse Anesthetist, CRNA

    Association is not causation, I.e. is the morbidity 2/2 the reason that etomidate was chosen in the first place? Propofol isn't an agent chosen very often in very sick/high risk heart. Read the...

  18. When to Contact Anesthesia

    offlabel replied to Sirrahsim's topic in PACU

    For what surgery? What co-morbidities? What age? What anesthesia type? When did the surgery end? Getting the point? For a general rule of thumb, if hemodynamically stable with an O2 sat > 92 on...

  19. Palliative care medications, I’m confused! Please help!

    offlabel replied to Nurseunite's topic in General Nursing

    He needs more medicine. You don't say what the concentration of ativan is, but it sounds like he needs more. These patients have tolerances to doses that would put a horse to sleep. Give the patient...

  20. Brachial Artery IV Accident

    offlabel replied to NewRN2222's topic in General Nursing

    No concern Just put in a note documenting normal sensation, motor and perfusion of the hand and all is good. 20 ga brachial arterial lines, while not ideal, are placed all the time when there is...

  21. Doppler guided IV placement

    offlabel replied to St.BaptistRN's topic in Critical Care

    You can stand up in a canoe, but why would you want to? In the end, this type of thing just ends up with multiple sticks, needless pain and distress and finally someone putting an IV in with

  22. Art Lines in High Acuity

    offlabel replied to Savanna8's topic in Medical-Surgical

    It's less of an issue *that* the patient has an A line than why. No reason why one RN couldn't have 2 stable patients with A lines, tho if an RN had 2 patients without you'd have to wonder why they...

  23. Unable to get complex patients assigned to me

    offlabel replied to SometimesRN's topic in Critical Care

    You've only been there for a couple of months. They don't know you. Your job for the next 8-10 months is to gain credibility through quiet hard work, situational awareness, interpersonal...

  24. Stupid Questions To Ask A Newly Graduated Nurse Practitioner During An Interview

    offlabel replied to DNPgrad2022's topic in Advanced Practice

    Contrary to the prevailing narrative, advanced practice nursing is not nursing. It's medicine. People in medicine think differently than people in nursing. They have to. Doesn't mean that one group is...

  25. Retroperitoneal Bleeding

    offlabel replied to ambersky004's topic in CCU, Coronary, Cardiac

    This can present immediately in the cath lab as well as, as you've seen, in a delayed timing. It's a 'rare' complication but since PCI in all it's permutations occurs over a million times a year, it...