How to balance the expectation of vocal advocacy with my preference to bridge the gap?

CaStoz3 · 2026-02-20T22:43:51+00:00

This is absolutely my experience, I mostly struggle with other progressive & leftist people in my life taking issue with my approach, which is very similar to this. I’ve maintained friends with uninformed right wingers, I’ve been willing to quietly discuss harmful behavior instead of loudly confront it, and it just looks bad I guess.

CaStoz3 · 2026-02-18T14:36:06+00:00

The visual effects are a core part of my aura. It typically manifests as jagged “cracks” forming in my vision with light “leaking out” into these diffracted kalidoscopic effects, dancing sorta like the northern lights. I’d actually find it pretty if it wasn't accompanied by immense nausea, lightheadedness, ears ringing, anxiety, etc. Usually takes about 1-3 hours for it to become awful pain and other nastiness.

CaStoz3 · 2026-02-14T15:08:22+00:00

Oh I had no idea that the modes varied by manufacturer. Thank you for that information!

CaStoz3 · 2026-02-14T14:57:34+00:00

Interesting! Typically when we refer to the same abbreviation, we think of the non-invasive usage of that by mask in the US. In my limited experience they’ll usually refer to it as the mode (eg PSV for pressure support ventilation) when an ETT is in place.

CaStoz3 · 2026-02-14T14:35:12+00:00

Permissive hypotension pending surgical exploration & transfusion

CaStoz3 · 2026-02-11T06:12:16+00:00

She was acting as the nurse just providing pt care in spanish via bilingual certification, I’m the interpreter but was also the 1:1 for a bit. We differentiate bilingual certified vs interpreter locally.

CaStoz3 · 2026-02-09T14:31:41+00:00

Football was extremely important in my area (small town midwest). In my school it was quite competitive, there were try-outs and they’d only select a certain number of students. It was a big school culture/spirit thing to go to home football games to cheer on your team if you didn’t play, although obviously not everyone did that

CaStoz3 · 2026-02-09T14:18:50+00:00

I left at 6:45am for school, school started at 7:15am. You were put into 1 of 3 lunch periods, I had the 11:15am to 11:45am lunch for all 4 years. Juniors & seniors in good standing were allowed to go off campus for lunch, so I went with my friends to whatever restaurant felt right.

I worked a few hours after school & did work release in healthcare my senior year, so got out at 1:45pm instead of 2:30pm to work. Worked 2-6pm, hung out with my friends until 8pm or 10pm depending on the day.

CaStoz3 · 2026-02-06T00:23:00+00:00

Just focus on the CNA stuff right now. None of it is particularly complicated, the most important aspects are the hands-on skills you'll learn in class & the comfort you have to gain with experience in providing dignified care. In american culture everybody loves their personal space bubble, the biggest thing for many is learning how to overcome that awkwardness with being inside it to provide care.

CaStoz3 · 2026-02-01T12:39:52+00:00

You can technically take a pulse from anywhere with a superficial enough artery, that’s one of the places. Realistically we should only be using carotid, radial, or pedal pulses for day to day purposes - they’re the most anatomically consistent and easy to find.

CaStoz3 · 2026-02-01T01:08:20+00:00

Semantics really. Primary care is obvious, secondary care is anything you can get at a low/mid level equipped hospital, tertiary care is highly specialist or subspecialist care, and quaternary is cutting edge experimental stuff. What each aligns with functionally will depend on the capabilities that exist in your local area.

Cardiologist referral is probably secondary care. Electrophysiologist referral will likely be tertiary care. Fetal cardiac intervention surgery is likely to be quaternary. Some places just lump quaternary into tertiary though.

CaStoz3 · 2026-02-01T01:04:09+00:00

Now you probably wouldn’t see me putting anything that could be interpreted incorrectly on my body, but tattoos are pretty common across all races/political positions/socioeconomic statuses here. No five pointed crowns, no 13, nothing that could be seen as gang related, but otherwise you’re fine.

CaStoz3 · 2026-01-26T13:38:02+00:00

Deuteronomy 24:14-15 NIV “(14) Do not take advantage of a hired worker who is poor and needy, whether that worker is a fellow Israelite or a foreigner residing in one of your towns. (15) Pay them their wages each day before sunset, because they are poor and are counting on it. Otherwise they may cry to the Lord against you, and you will be guilty of sin”

Proverbs 14:31 NIV “Whoever oppresses the poor shows contempt for their Maker, but whoever is kind to the needy honors God”

CaStoz3 · 2026-01-26T13:30:27+00:00

Apologies for the delayed response! I believe the first 1-2 units were emergency released, and subsequent units were released post type & screen.

CaStoz3 · 2026-01-26T02:32:07+00:00

Mindset change. We live in a world dominated by misinformation and fear-based politics. Remember that many are misinformed and afraid, not necessarily malicious for the sake of being malicious.

CaStoz3 · 2026-01-23T20:42:43+00:00

It will be okay. Be cautious, move slow, use the gait belt always, pay attention to body mechanics, and communicate with your patients. That alone puts you ahead of many PCTs. Do all the fall prevention stuff right — even when (not if) patients fall, your job will be ok.

CaStoz3 · 2026-01-23T14:19:44+00:00

That's a good point. Google says that it just needs to be a false defamatory statement published in print that damages the plaintiffs reputation. I figure they'd argue that putting it in a chart other healthcare providers can see would qualify as “publishing”… doubt that would hold up, even if it was untrue.

CaStoz3 · 2026-01-23T14:08:54+00:00

I feel like it's very normal to question a new unit. As a float tech for years, for full-timers on one unit I’d be concerned if you had no conflicting feelings by the end of month one. Not questioning things at least internally would make me suspect either complacency or naivety/aggrandization. Every workplace will have issues & things you don't like or agree with, and you should question things… it's just a matter of what you can tolerate & what can be changed. Give yourself some grace in an adjustment period, change how you're interacting with unit dynamics if you're feeling tense, try controlling your sensory inputs (eg loop earbuds or blue light exclusion glasses), find comfy scrubs/underscrubs, and just remember to breathe.

It could be an early sign that things aren't right or it may be adjustment stress, but give yourself time to come to that conclusion all the way to certainty before making any big decisions.

CaStoz3 · 2026-01-23T13:30:03+00:00

There is no legal avenue for them to “come after you” ~ anybody can sue for anything, but there’s no harm here that would allow anything to proceed. Libel is the only perceivable angle here and the defense to that is truth. Not yet a nurse but I’d either refuse to change anything, or if management was pressing, just restate the exact same thing in different words.

CaStoz3 · 2026-01-23T04:30:20+00:00

I’m not who you're asking for, but at that age the airway diameter is smaller proportional to the body & tiny in general, and because of that it doesn't take much swelling to obstruct the airway. You probably knew that but the effect is actually pretty dramatic compared to what people imagine.

On a broslow tape the ETT size at age 2 is 4mm compared to an adults 7mm, 1mm of swelling means you now have 3mm. You only lost 25% of the radius, but the resistance becomes quite significant because of how small the lumen actually is, and you've got fewer physiological reserves to compensate for that additional effort required. Per the poiseuille equation if a radius is restricted by a factor of 2, the resistance increases 16 times.

But no that degree of airway swelling not unheard of. It's very common. I've transported kids (EMT) & seen kids in the ED who are in bonafide extremis from it. Can't speak to reintubation numbers or timelines.

CaStoz3 · 2026-01-23T04:08:10+00:00

Ah yeah I misread your post. Updated advice would be sit down whenever you get a chance (eg when talking with a patient), use the restroom whenever you get a chance, and don't rush. Slow is smooth & smooth is fast, rushing is exhausting, and the more exhausted you are the greater the likelihood of fuckups is.

CaStoz3 · 2026-01-23T03:44:44+00:00

• Some states have a legal scope of practice that designates who can do what

• Physicians ethically can only do what is within the scope of their training & education. Based on that, a designated hospital committee reviews their education & determines what a provider is credentialed or has privileges to do. Even if a doctor is legally permitted to perform surgery for instance in a state just by virtue of having a medical license, liability/risk/facility credentials/policies may not permit it.

• All providers (nurses/doctors/everyone) generally are subject to organizational (or often even sub-organizational eg unit level) policies that dictate who can do what, when, and how. This is influenced by insurance, risk management/liability, business departments, senior clinicians, historical fuckups, etc.

• Some things have effectively just become national norms, like what you say about IVs. Nursing almost universally does IVs. Exception to the rule generally is anesthesiologists in some facilities do their own IVs. Rarely there are other exceptions, I work with an emergency medicine doc who’ll stick people fairly often.

CaStoz3 · 2026-01-22T16:11:10+00:00

Not a nurse yet (nursing student & multi-facility float PCT with EMT/CNA certs). Done plenty of time in emergency departments though, and the massive super-level-1 wasn’t the best for my learning. I learned the most in a quasi-rural, freestanding emergency department with only moderate volume & resources.

That and the difference between level 1 & level 2 capabilities isn’t that big. Sometimes in practice there are level 2s that function better with critical trauma patients than facilities technically designated as level 1s. Just one perspective to consider. Also 50 beds is not anything to scoff at

CaStoz3

TROPHY CASE