offlabel

offlabel

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All Content by offlabel

  1. Agitated terminal agitation or a hospice nurse's worst nightmare

    offlabel replied to laynicrn's topic in Hospice, Palliative

    Dumb question.... but is the IV in a

  2. Pacer capture

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

    You might be surprised about that. Even with a 3rd degree block with a ventricular rate of 60, the native ventricular conduction pathway is intact. That means that the speed of conduction of the...

  3. Pacer capture

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

    When you do this, pace well over the patient's native rate. You say it was 60. Pace at 90 to get a more clear picture of what is going on sooner. This is so you don't take as long and so you won't...

  4. New to OR -need advice -arrogant rude surgeon

    offlabel replied to ORGeek's topic in Operating Room

    Hah...a highly accomplished surgeon. Beat out major competition to get in to medical school and residency. Is probably in the 99th percentile for income and IQ... but he has to pick on the new OR...

  5. ET tube questions

    offlabel replied to Thedevinestman's topic in Critical Care

    Sure it does... flex the neck and the tube tip moves caudad. Extend the neck and it moves cephalad. Add lateral flexion or extension introduces more chances of dislodging the tube. We don't use c...

  6. What are the pros and cons of working in the rural areas?

    offlabel replied to xiaobear007's topic in Nurse Practitioners, NP

    Rural advanced practice is a really neat thing. If you're up to it. If you like to hunt and fish, it's absolutely awesome. If you value your privacy, it's awful. Remember the "Cheers" TV show theme...

  7. ET tube questions

    offlabel replied to Thedevinestman's topic in Critical Care

    I've intubated literally thousands and thousands and thousands of patients and your advice holds true. Lots of different kinds of providers care for intubated patients, whether they personally placed...

  8. ET tube questions

    offlabel replied to Thedevinestman's topic in Critical Care

    OP is a second year nursing student that is a nursing assistant in an ICU. Surely the RN's in her unit know this and would be willing to let her listen to breath sounds if she said pretty please? It's...

  9. Home births gone wrong

    offlabel replied to MNNICU, RN's topic in NICU, Neonatal

    The study cited isn't even published. It's a story in the lay press about a non peer reviewed study. It means as much as my grandma's opinion on home

  10. Scared to faint

    offlabel replied to padme007's topic in Emergency

    People who vagal and/or pass out are nearly 100% observers. They are not active participants in the scene. An as an ER nurse, you'll have a role in the event and will be able channel the stressful...

  11. ET tube questions

    offlabel replied to Thedevinestman's topic in Critical Care

    Really not much to say. Make sure it's at an appropriate depth, check lung sounds, confirm it's well secured and make sure it stays there. I will say that my personal practice is disconnecting the...

  12. DHCA

    offlabel replied to ECMO's topic in Cardiac

    Ben Carson used it for the first time ever to separate twins conjoined at the

  13. The Silent Victims of Human Trafficking

    offlabel replied to lorimadden's topic in General Nursing

    Big events like the Super Bowl bring large numbers of prostitution/trafficking to a city. This year it's in the SF Bay area, so Santa Clara, Palo Alto, San Jose, Oakland and San Francisco and points...

  14. Do you feel ill will from doctors?

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

    Anonymous comments on a website forum are one thing, reality is wholly another. Artificial, manufactured emotion expressed without the possibility of consequences is a straw house. Ignore

  15. MAC anesthesia versed / propofol

    offlabel replied to ffliper27's topic in PACU

    As sedation for pre procedural local anesthetic infiltration. Brief periods of intense

  16. Administering Tylenol to a friend

    offlabel replied to Em31200's topic in General Nursing

    I'm going to out on a limb here and say that I doubt that's how the story really went down.... could be wrong I suppose, but there's probably more to the story. My

  17. MAC anesthesia versed / propofol

    offlabel replied to ffliper27's topic in PACU

    A runny nosed 25 year old pgy 1 resident whose voice has barely changed can take out my grandma's appendix but a new grad nurse can't work in the

  18. The Silent Victims of Human Trafficking

    offlabel replied to lorimadden's topic in General Nursing

    Abortion clinic workers, especially, are in a vital and unique position to help these girls. Please know the signs and assist these desperate victims of abuse. Vital topic. Thanks for putting a...

  19. Calibrating CVP/ART/etc

    offlabel replied to nurs1ng's topic in MICU, SICU

    Don't take my word for it. Try it for

  20. Dobutamine Drips at home

    offlabel replied to ash12345's topic in Home Health

    Your agency should have a specific policy for the care of patient's getting dobutamine or milrinone at home. Furthermore, it should have specific instructions for teaching the patient's family or home...

  21. Did Your NP School GPA Matter?

    offlabel replied to NerdsRUs's topic in Advanced Practice

    Well, you know what they called the guy that graduated last in his class in NP

  22. lasix and kidney injury

    offlabel replied to lmarti10's topic in Critical Care

    Not to be a pill, but a quick google search will get you exactly what you're looking for that isn't anonymous and possibly

  23. Lumpy abdomen following vag delivery?

    offlabel replied to counterpoints's topic in Ob/Gyn

    You felt

  24. G1PO INDUCTIONS

    offlabel replied to Surfandnurse's topic in Ob/Gyn

    Very frustrating indeed. Nothing like placing a labor epidural in the patient you describe at 10 am knowing full well that at some time after midnight, the pager well be going off for a hurry up...

  25. I Should Be in Jail

    offlabel replied to allnurses's topic in General Nursing

    Very well written, poignant. Insightful. The last line was anti climactic though. This piece doesn't reduce to me thinking about when I may have been provoked to violence or even the self control of...