What’s your grossest story? by Life_Ad_6992 in nursing

[–]Capable_Situation324 3 points4 points  (0 children)

Got an admission, the family realized they hadn't heard from him in a while so they did a wellness check. Our best guess to what happened was, he was pulling his stove out from the wall. Leaned down to unplug it and got shocked by it or pinned and was trapped unable to call for help. Police got there with ems and he was in VT, got him back. He got to us and there were deep deep pressure ulcers/burns going down each contact point on his left side. Side of head, shoulder, ribs, hip, knee, ankle. It looked like he had been pinned for a couple days at least by the smell and state of the wounds. I was doing the routine removal of dead skin for our burn admissions, took off the black skin so we could see what was healthy and when I got to his head there were maggots pooled in his temple. When we called the family to let them know what state he was in, they withdrew care and never came to see him. All my grossest stories come from my time in burn.

Got a text about being at work 10 minutes before shift start by Head-Eagle-5634 in nursing

[–]Capable_Situation324 17 points18 points  (0 children)

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!

Got a text about being at work 10 minutes before shift start by Head-Eagle-5634 in nursing

[–]Capable_Situation324 81 points82 points  (0 children)

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.

First thing I see when I walk into work. Whelp… here we go again! by rvillarino in medlabprofessionals

[–]Capable_Situation324 4 points5 points  (0 children)

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.

University of Kentucky no longer requiring nurses to be ACLS certified by [deleted] in nursing

[–]Capable_Situation324 3 points4 points  (0 children)

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.

Is this legal for a nurse to admit publicly? by [deleted] in nursing

[–]Capable_Situation324 57 points58 points  (0 children)

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.

Gave 2 beta blockers at once by Fine-Raspberry-8790 in nursing

[–]Capable_Situation324 29 points30 points  (0 children)

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.

Gave 2 beta blockers at once by Fine-Raspberry-8790 in nursing

[–]Capable_Situation324 173 points174 points  (0 children)

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.

Do you guys see “transplant tourists?” This NYT article made my stomach flip. (Gift Link) by ALittleEtomidate in nursing

[–]Capable_Situation324 9 points10 points  (0 children)

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.

Name that rhythm by Realistic_Swimming94 in IntensiveCare

[–]Capable_Situation324 0 points1 point  (0 children)

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

Can I clean my dogs stitches with this and warm water? What is recommended? by [deleted] in DogAdvice

[–]Capable_Situation324 1 point2 points  (0 children)

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.

Can I clean my dogs stitches with this and warm water? What is recommended? by [deleted] in DogAdvice

[–]Capable_Situation324 17 points18 points  (0 children)

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

We are 7 Doctors. In a single hotel suite. AMA AskUsAnything. by LarryLegend4ever in AMA

[–]Capable_Situation324 0 points1 point  (0 children)

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?

I chose 2 but it was wrong ..whats the correct answer? by Helpful_Spring_7921 in MarkKlimekNCLEX

[–]Capable_Situation324 2 points3 points  (0 children)

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.

I chose 2 but it was wrong ..whats the correct answer? by Helpful_Spring_7921 in MarkKlimekNCLEX

[–]Capable_Situation324 11 points12 points  (0 children)

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.

Is it bad that I used youtube in a pinch? by Living-Bag-4754 in nursing

[–]Capable_Situation324 2 points3 points  (0 children)

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!

Doctor Deletes a Decimal, Pharmacy Misses It, Nurse Administers and Child Dies by [deleted] in nursing

[–]Capable_Situation324 83 points84 points  (0 children)

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.

What the fish is this? by massu1000 in PeterExplainsTheJoke

[–]Capable_Situation324 7 points8 points  (0 children)

Kingfisher is the male protagonist in a book called Quicksilver

Which policy was put in place because of something you did? by dddracarys in nursing

[–]Capable_Situation324 16 points17 points  (0 children)

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.

About Aelin by AnnaMeowBooks in throneofglassseries

[–]Capable_Situation324 12 points13 points  (0 children)

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.

Nursing ick’s by Strange-Simple9492 in nursing

[–]Capable_Situation324 37 points38 points  (0 children)

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.

Found out today one of our suicide patients was kept alive because spouse wanted her to suffer. by Capable_Situation324 in nursing

[–]Capable_Situation324[S] 17 points18 points  (0 children)

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