offlabel

offlabel

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All Content by offlabel

  1. How do you deal with angry/upset with patients?

    offlabel replied to Karlie2114's topic in General Nursing

    3 words. Validate...validate...validate. All they want is to be heard. They don't really care about the issue because at some level they realize they know nothing about the issue. Just say: "You are...

  2. Nurse opinions on "Birth Rape"

    offlabel replied to EKUGRAD's topic in Ob/Gyn

    That was too long to read all of it...so I didn't...but reckless malpractice and criminal negligence isn't made more egregious by re-lableing them "rape". In fact they are reduced because of the...

  3. Nurse opinions on "Birth Rape"

    offlabel replied to EKUGRAD's topic in Ob/Gyn

    So you're not making a distinction between an individual that is meaning to do harm (rapist) and one that is obliged to act in the patient's best interest (heath care provider)? What if consent is...

  4. Who gets the write up?

    offlabel replied to kosmopolitan's topic in MICU, SICU

    Understatement of the

  5. CRNAs vs. AAs

    offlabel replied to Yoonsung0506's topic in Student Registered Nurse Anesthetist

    Most CRNA's today will never work with AA's. For those AA's and CRNA's that will work together, the only reliable way to tell them apart will be to look at their ID

  6. Fourfold dilemma- Primigravida, domestic violence, substance abuse and refusing assistance

    offlabel replied to Subby317's topic in Advanced Practice

    Only one dilemma there...she's refusing help. Be available to her with your resources and guidance and go about your

  7. Swan-Ganz catheter & PCWP

    offlabel replied to SamanthaRT2020's topic in Cardiac

    Especially now that a simple bedside echo gives far more relevant information than a PA catheter in the majority of cases. They're really not worth the trouble except in very specific

  8. Trans Patient

    offlabel replied to Neo Soldier's topic in Psychiatric

    I could see severe psychic trauma to a female room mate of a transgendered woman that began, for example, masturbating in front of her. The sexual trauma women bring to in patient psychiatric...

  9. Discipline

    offlabel replied to Subby317's topic in Nurse Practitioners, NP

    When a patient suffers you need to discipline a colleague? If it was from negligence, recklessness or incompetence, that isn't a "colleagues" job to address. That is for a superior or governing board...

  10. To donate or not to donate

    offlabel replied to Sas0930's topic in Nurse Practitioners, NP

    I think framing the choice not to deliver his wife to harvest in terms of "not getting it" and "unfounded fears" is pretty paternalistic. The thought of my child or spouse undergoing organ harvest,...

  11. When you thought it was patients you needed to watch...

    offlabel replied to smf0903's topic in General Nursing

    If what you wanted me to say is "doctors choking nurses is wrong and should be opposed by everyone everywhere", I now say and endorse that. Sorry for not being more clear. I wasn't aware that it was...

  12. When you thought it was patients you needed to watch...

    offlabel replied to smf0903's topic in General Nursing

    What will happen: physician will be found to be diverting and using. He will charged with aggravated assault, be given a suspended sentence, inpatient treatment, community service/probation,...

  13. When you thought it was patients you needed to watch...

    offlabel replied to smf0903's topic in General Nursing

    The first thing that should be done in a case like this (after the immediate arrest) is a trip to the ER for a urine tox screen. Way more to this story and odds are, diversion is part of

  14. Picc line accidentally pulled out 5 cm.

    offlabel replied to ncrete1220's topic in Infusion, Intravenous

    Fine...prep the area, run a wire up the existing catheter, take it out and run a new one over the wire. Take a picture for placement. Doesn't have to be a big

  15. occurrence report=doctor hates me

    offlabel replied to avado's topic in General Nursing

    Had an "out of left field" catastrophic "occurrence" once. Huge potential for a brain dead or all dead patient, neither of which happened. Walked out of the hospital 2 days later despite over 30...

  16. Defasciculating dose before Succs?

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

    I'm still not sure why folks use succs for non (bonafide) RSI in the first place when they're just going to follow it up with with an NDM

  17. Picc line accidentally pulled out 5 cm.

    offlabel replied to ncrete1220's topic in Infusion, Intravenous

    Might be able to re-wire and advance as

  18. Help! How do I deal with frustrating patients

    offlabel replied to FDE123's topic in Neuro Intensive Care, ICU

    For starters, I'd recognize that the patient and their families don't think it's a picnic either. But they don't go home after your

  19. Epi Spritzers

    offlabel replied to Julius Seizure's topic in General Nursing

    I think a lot of that has to do with the "mystique" of epinepherine. Sort of like how levophed got named "leave 'em dead". People are, by and large only accustomed to using the drug in very specific...

  20. Sleeping IM

    offlabel replied to chillywil's topic in General Nursing

    What shot would a patient get for a bad dream? They're already

  21. Difficult conversations in the ICU

    offlabel replied to Ddestiny's topic in Critical Care

    If we are so determined to make medical advances and in so doing demonstrate how capable and intelligent we are in our expertise in prolonging life, we had better be ready to accept the consequences...

  22. Best things to ask for in designing an OR room as a staff nurse?

    offlabel replied to mhy12784's topic in Operating Room

    Spend 60 hours a week in an OR and you'll understand why. Yes. Just for staff

  23. Drug question-epinephrine soaked sponge

    offlabel replied to mel2234's topic in Operating Room

    1:1000 is one mg/ml epinepherine. A fully soaked, unwrung sponge can hold up to 10 mls and if you stuff 10 mg of epinepherine into the bone you will get a big sympathetic response and an unhappy...

  24. endoscopy anesthesia job?

    offlabel replied to Anesthesia16's topic in Certified Registered Nurse Anesthetist, CRNA

    If a CRNA didn't feel comfortable intubating patients on leaving his training program, the program would have had no business letting him graduate. That should be the least of his

  25. endoscopy anesthesia job?

    offlabel replied to Anesthesia16's topic in Certified Registered Nurse Anesthetist, CRNA

    At least as important is knowing when the case should not be done at an out patient endoscopy center. Those are as few and far between as dicey airways, but no less critical in recognizing. And that...