Jump to content
quazar

quazar

Member Member Nurse
  • Joined:
  • Last Visited:
  • 603

    Content

  • 0

    Articles

  • 9,985

    Visitors

  • 0

    Followers

  • 0

    Points

quazar has 20 years experience.

quazar's Latest Activity

  1. quazar

    Don't touch that Thermostat!

    On my floor it's the opposite problem. The nurse's station and hallways feel like the frozen tundra, and the thermostat is dominated by the ones who are sweating. Our patient rooms have individual thermostats for control, so their comfort is not considered when setting the unit thermostat.
  2. quazar

    Could I have done something differently?

    Nothing WAS wrong, actually. You weren't there. I was. Medicaid is relevant to this conversation because another poster mentioned that medicaid would never tolerate or allow such a situation.
  3. quazar

    Patient abuse, difficult situation

    This is excellent advice. Please take it.
  4. quazar

    Are We Still Holding Back Baby's Head?

    As an L&D nurse who has delivered quite a few babies on the fly over the years, I can honestly and fervently say it is not only barbaric and against all practice guidelines to "hold in" a baby, but my God....if we're talking path of least resistance here, why on earth would I ever prevent a baby from coming? If you've ever pushed with a patient for over 3 hours, you know that having a baby just pop out with little to no work is absolutely fan-freaking-tastic. I'll take it any day of the week over a marathon pushing session.
  5. quazar

    PSA

    OMG that is insane! I'll definitely remember that, wow!!
  6. quazar

    Lying to Patients. Is it for the Best?

    I guess I am guilty of lying to patients if you count lying by omission. In that I don't tell them, "your baby is having xyz decel, which means xyz, which means we need to do xyz intervention." I actually did do that when I was a newer L&D nurse way back in the day, but learned very quickly to not do it because yes, it freaked patients out, to be honest. People have very selective memories in stressful situations, and filter out a lot of what they are hearing when under extreme stress. Labor and birth, for most people, is VERY stressful, and their memories of it are really skewed. If something they perceive as "bad" happens, that sticks in their mind and they grab onto that and focus on it, even years later. The same with something they perceive as exceptionally "good" happening. It stays with them. For this reason, I try to really minimize any sort of stress inducing communications with my patients at the bedside. Especially with a first time mom. My poker face is well honed now, as is my "calm voice," and those things have served me well when the poo is hitting the fan and I am screaming in my head but trying to not freak out the patient. So I guess what I'm saying is, yeah, I kind of lie by omission in that I don't really get into the nitty gritty details of the fhr tracing unless I need to do a major intervention like knee chest, trendelenburg, hold up a cord prolapse, or run for a crash c-section. If the tracing is worsening and I can read the writing on the walls, I will calmly let the patient know bit by bit that there are some concerns, and explain as gently as possible what it happening and try not to scare them. Patients who are scared tend to freeze and fall apart and not cooperate, and that can be dangerous. I have seen it in action at the bedside, and it's awful, and I do my best to avoid that as much as I can while still giving the patient the information they need.
  7. quazar

    Lying to Patients. Is it for the Best?

    I guess I am guilty of lying to patients if you count lying by omission. In that I don't tell them, "your baby is having xyz decel, which means xyz, which means we need to do xyz intervention." I actually did do that when I was a newer L&D nurse way back in the day, but learned very quickly to not do it because yes, it freaked patients out, to be honest. People have very selective memories in stressful situations, and filter out a lot of what they are hearing when under extreme stress. Labor and birth, for most people, is VERY stressful, and their memories of it are really skewed. If something they perceive as "bad" happens, that sticks in their mind and they grab onto that and focus on it, even years later. The same with something they perceive as exceptionally "good" happening. It stays with them. For this reason, I try to really minimize any sort of stress inducing communications with my patients at the bedside. Especially with a first time mom. My poker face is well honed now, as is my "calm voice," and those things have served me well when the poo is hitting the fan and I am screaming in my head but trying to not freak out the patient. So I guess what I'm saying is, yeah, I kind of lie by omission in that I don't really get into the nitty gritty details of the fhr tracing unless I need to do a major intervention like knee chest, trendelenburg, hold up a cord prolapse, or run for a crash c-section. If the tracing is worsening and I can read the writing on the walls, I will calmly let the patient know bit by bit that there are some concerns, and explain as gently as possible what it happening and try not to scare them. Patients who are scared tend to freeze and fall apart and not cooperate, and that can be dangerous. I have seen it in action at the bedside, and it's awful, and I do my best to avoid that as much as I can while still giving the patient the information they need.
  8. quazar

    C Section Post-Op Rx

    Okay, that's not "pendulum too far," that's negligence. The first time a c-section mom gets up to go to the bathroom, I don't care if her nurse is busy, then SOMEONE needs to be there to help her, be it an aide or another nurse. She shouldn't be alone. Also, if she developed an incisional hernia IN THE HOSPITAL barely on post op day 1 or 2, that is a huge red flag right there and I'd be calling the dang surgeon. Having had 2 c-sections myself after the age of 30, and a post op hernia after the second one (but it took a few months to happen), I actually DO understand her pain on a visceral level. HOWEVER, the care (or lack thereof) that she received is inexcusable. Something stinks in that hospital. I hope she complained, in writing.
  9. quazar

    C Section Post-Op Rx

    Here, maybe this will help provide clarity. The AAP has a table of medications "usually compatible with breastfeeding" in this PDF. Table 6, starting on page 5. http://pediatrics.aappublications.org/content/pediatrics/108/3/776.full.pdf Here are 2 studies documenting the efficacy of toradol for post op cesarean pain relief, since that has also been called into question: http://www.obstetanesthesia.com/article/S0959-289X(96)80069-0/fulltext http://www.obstetanesthesia.com/article/S0959-289X(07)00017-9/fulltext I'm not sure what your level of bedside obstetric experience is, and why you have such discomfort with toradol, but the research backs up the practice. Don't know what else to tell you here.
  10. quazar

    C Section Post-Op Rx

    The pediatricians, obstetricians, midwives, and lactation consultants I work with all disagree with you, but okay. *shrug* Did you read the research?
  11. quazar

    Just had to Heimlich a kid

    You are awesome!! Kudos for keeping a cool head! When my own CHILD choked I totally froze. It was my husband that did the heimlich. Mommy fail.
  12. quazar

    C Section Post-Op Rx

    I know this probably sounds evil, but it is normal to expect the mother to participate in and perform baby care after a c-section, even 1 or 2 days after. It's part of the care plan, in fact, to get the mother to participate in and take over care of her infant. Many hospitals are moving towards the model where there is no respite/"well baby" nursery, and babies stay with their mothers the entire time they are in hospital, even c-section moms. The nurses don't do all the care of the infant unless there is a medical reason why the mother cannot perform infant care (e.g., a mother on mag sulfate postpartum who is very sick and very lethargic and has no one with her to help).
  13. This is just nuts. The lady KNEW she had the wrong baby, but her husband told her not to say anything so as "not to humiliate the doctor." I simply cannot wrap my brain around such thinking, but it was 1951, and I guess things were VERY different then. Very interesting read, link to the full transcript of the original NPR interview in the story. Mom knew she brought the wrong baby home from the hospital; 43 years later she finally reveals it to her daughter Link to transcript of original interview: Transcript | This American Life
  14. quazar

    Can posting about a friend breach HIPAA?

    OMG Mi Vida Loca!!! That's NUTS. Whoa. So glad you got out of it and how horrible of her to try to throw you under the bus like that.
  15. quazar

    ZDoggMD

    Love him!
  16. quazar

    Gossiping at the workplace

    BTDT, got the t-shirt. Keep your mouth shut and your ears open. Never take sides, never participate. Walk away from the nurses's station when things get heated (suddenly have to pee/check on your patient/stock a room). If you can't walk away, become very engrossed in charting or something else work related. Just always keep your mouth shut and never, ever participate or take a side. Ever. Workplace gossiping is a ubiquitous problem, and yes, it does make you not trust your coworkers and WITH GOOD REASON, in my opinion. The way I let it not bother me is to do what I advised in the first paragraph, and to recognize that I cannot control what other people say behind my back (because I'm sure things have been said) but I can absolutely control whether or not I choose to get caught up in the gossip and drama. When you don't participate, they usually leave you alone.
×

This site uses cookies. By using this site, you consent to the placement of these cookies. Read our Privacy, Cookies, and Terms of Service Policies to learn more.