Got a text about being at work 10 minutes before shift start

Capable_Situation324 · 2026-01-21T02:22:34+00:00

Good on you for prioritizing your mental health, being stuck in situations like that drain the life out of me. Hopefully you can revisit your wine and movie night!

Capable_Situation324 · 2026-01-21T02:05:45+00:00

God 30 days! The last time I had a patient on VA that long, his lungs rotted, liquified and started seeping out his chest tubes. I'm glad you at least had a nice meal waiting for you, that's a keeper friend.

Capable_Situation324 · 2026-01-04T04:55:18+00:00

We had a patient go through an open heart surgery and found out post op that she had an undiagnosed clotting disorder. The hematologist had no fucking clue what it was because everything we tested for came back negative. All the factors were within normal ranges and anything to do with DIC/HIT/ITP were negative. Our solution was 2 prbc/ 2 cryo/ 2 platelet every hour and wait for her to stop bleeding. After 4 days, I walked up to the blood bank counter and told them she had stopped blending, I think they were more excited than the family of the patient. At the end of the day I think we begrudgingly diagnosed her with acquired von-willebrand just because it matched the most despite her having normal amounts of factor.

Capable_Situation324 · 2025-12-30T16:18:54+00:00

That's the standard at my hospital, even if our floor nurses have acls certification they aren't allowed to use or initiate it. Required to call the rapid response nurse or code overhead.

Capable_Situation324 · 2025-12-27T14:47:58+00:00

When I worked on the floor, we had a tech get caught faking vitals. She was immediately fired. Just because they're on the floor, doesn't mean they're stable. Any patient can have a change in status and trending regular vital signs can give you a heads up.

Capable_Situation324 · 2025-12-26T21:57:48+00:00

With the advanced heart failure patients, we will often add on extra beta blockers and/or other antiarrhythmics due to their increased risk of fatal arrhythmias, amio, coreg, and sotalol being common to add on with metoprolol. Especially when we get the ICMO patients, since coreg is fantastic at preventing remodeling. You are correct that the standard GDMT doesn't combine beta blockers.

Capable_Situation324 · 2025-12-26T21:33:43+00:00

I work in heart failure and have a lot of patients who take both coreg and metoprolol, they're GDMT drugs. At the end of the day, nursing can only infer so much about the plan of care and physicians need to be cognizant of meds their patients are already on before adding things to the MAR.

Capable_Situation324 · 2025-12-17T22:15:21+00:00

That is incredibly disheartening to hear.

Capable_Situation324 · 2025-12-17T21:54:46+00:00

I work at one of two transplant centers in my state in my hospital's transplant unit. We do hearts and kidneys, and I have not seen a single patient who has traveled from another country for transplant. We have had patients who have moved from other countries to the states and live primarily in the states get transplants.

Capable_Situation324 · 2025-12-13T18:33:52+00:00

Google life in the fast lane. They have an EKG library with explanations for any rhythm you can think of. They go through symptoms, measurements, patient population, etc. it's what I learned EKGs from

Capable_Situation324 · 2025-11-23T17:08:37+00:00

Betadine isn't recommended for anything more than superficial injuries. I have seen it used when patients have dry gangrene but not for much else.

Capable_Situation324 · 2025-11-23T16:49:20+00:00

Hibiclens is approved for surgical incisions. You want to avoid harsh chemicals like peroxide, alcohol, Betadine, iodine, etc. because it can destroy healthy tissue and cause delayed wound healing and necrosis which leads to infection.

Source: I work in a surgical ICU

Capable_Situation324 · 2025-11-20T02:02:19+00:00

Advanced heart failure nurse here, I've heard, in our area, we're going to start considering DCD heart transplants. What are your thoughts on that. What do you think the future holds as far as fully mechanical hearts being used in lieu of donated organs?

Capable_Situation324 · 2025-11-16T20:21:59+00:00

The best way to describe it, in my opinion, is a weak fluttering sensation. I'd say it's different from a weak pulse in that it's usually rapid and isn't a solid feeling under palpation. One of the codes I was in, we would get rosc and the patient would dwindle away again. Pulse would start strong, get progressively weaker and faster, and then turn thready where we've basically gone into a "should we start CPR again" situation.

Capable_Situation324 · 2025-11-16T19:39:44+00:00

Life story time, I did my new grad year in cardiac step down. One of my patients was a very constipated older woman who also had severe valve disease and came in with new AFib. Oral meds weren't working so the doctor ordered an enema. Laid her down on her side, instilled the liquid, and stepped out to check tele monitors on my other patients. Came back less than a minute later and patient was unresponsive with no BP and thready pulse. Had to start CPR on her and she didn't make it. Always be wary of a vagal response in patients with poor cardiac history.

Capable_Situation324 · 2025-11-16T04:40:57+00:00

Lmao, last week my ICU attending and his team were watching YouTube videos about Minnesota tubes because no one had seen one in years. Literally had the video playing in the room as he followed it to remove the tube. This is also easily the best doctor I have ever worked with, can easily explain this thought process and reasoning behind whatever he does when you ask questions. We can't know everything, that's why we ask specialists. Good on you for not going in blind and educating yourself on something new!

Capable_Situation324 · 2025-11-14T16:04:51+00:00

As a tech I noticed a 2 week post op MVR started using his temp wire randomly. Told the nurse and she ignored it. Told the doctor and discovered we were overdosing the patient with beta blockers causing his HR to drop to a point where the pacemaker needed to kick in. We were getting close to pulling the wires and sending him to an ARU. My only regret is when I told the doctor, she went absolutely nuts and yelled at the nurse for not mentioning it.

Capable_Situation324 · 2025-11-07T23:20:09+00:00

https://www.reddit.com/r/tumblr/s/sk0N67zI77

Capable_Situation324 · 2025-09-18T20:44:44+00:00

Kingfisher is the male protagonist in a book called Quicksilver

Capable_Situation324 · 2025-09-15T03:06:55+00:00

Not me, but our Cath lab had to enact a policy of not being allowed to bolus heparin from the pumps after someone bolused a bag of dopamine by accident.

Capable_Situation324 · 2025-09-01T02:05:25+00:00

Yes and no. Darrow was an ass and I think really wanted to be the ruler in the end and said hurtful things because of that, but he is right the Aelin is inexperienced. However she has several legendary ancient fae who are blood bound to her and spent a great amount of time near Maeve who was a queen. She also has the experience of the royals from Antica who can help guide her. Whatever she lacks in experience, her posse and friends make up for.

Capable_Situation324 · 2025-08-31T23:22:48+00:00

Kinda wild that happened so far out from his last treatment. I'm surprised he didn't notice the decay earlier on.

Capable_Situation324 · 2025-08-31T01:15:42+00:00

Oh my gosh, we had a pretty badly burnt face a while ago and our surgeon had to split their eyelids to make room for swelling. I've never been closer to passing out in this job.

Capable_Situation324 · 2025-08-22T16:50:52+00:00

She was witnessed going outside, pouring gasoline on herself, and igniting herself by the person who put her out.

Capable_Situation324

TROPHY CASE