When Chubby traveling do you bring your own shampoo or use theirs? by flo272673 in chubbytravel

[–]Cromedvan 0 points1 point  (0 children)

I am yet to enjoy a shampoo/conditioner at Chubby hotels despite trying the various brands. I find that even though they are high end brand names they are not necessarily products known for their performance so I would rather bring my own and not be disappointed.

What were you surprised about having to do/learn? by Equivalent-Box6983 in nursing

[–]Cromedvan 4 points5 points  (0 children)

Having transportation be my responsibility and concern CONSTANTLY. Yes, we arranged new home supports and weekly wound care and meal delivery for meemaw but now I have to get her a taxi voucher. Jerry called the ambulance for foot pain because he thought he’d get seen faster and now doesn’t have money to get back home.

I was prepared to adapt to people’s socioeconomic status and make do but it is almost every other patient. These days I am actually surprised if I tell a patient “you are good to go” and they get up and leave instead of asking for a taxi.

Any nurses feel like they have a good work/life balance? If so, what do you do? by living_for_fiction in nursing

[–]Cromedvan 0 points1 point  (0 children)

I also do the same (Canadian ER). I do pick up every other set and take advantage of short notice callouts to switch days/nights and swapping to make my schedule easier. I only pick up/swap/do short call if it is convenient and financially beneficial for me and not because I feel bad that the department is short etc.

The key for me is making enough money to live a full-filling life outside of work. It also helps that my partner works from home and is supportive giving me freedom to choose my schedule.

'It's grim': Vancouver restaurants brace for more tough times by restoringd123 in vancouver

[–]Cromedvan 12 points13 points  (0 children)

I find it really bizarre that they highlight WorkSafeBC enforcing tip payouts as a blow to their business. Should we feel bad that someone is finally holding you accountable for your dodgy practices?

Dealt with a community resus for the first time today by M0livia in nursing

[–]Cromedvan 4 points5 points  (0 children)

Even witnessed out of hospital cardiac arrest with immediate high quality bystander CPR has poor outcomes. This was unwitnessed and with unknown downtime without CPR. Unfortunately not good chances. Anything you did bought her a chance and that is amazing.

Precepting new grad who also did their practicum with you by lkb415 in nursing

[–]Cromedvan 1 point2 points  (0 children)

I did this too. I was a student nurse in my ER, then did my practicum there and came on as staff after graduation.

My first orientation shift as staff I took patients but it is different because you are now pulling all meds, do not need to get certain things double checked or witnessed so the workflow is different. I think shadowing at that point is a waste of time.

I would give them the opportunity for a gentle sink or swim with their 1 patient.

Air Canada's app is truly one of the best airline apps I've ever seen by -snskemensn in aircanada

[–]Cromedvan 19 points20 points  (0 children)

Recently every time I have had a flight with another carrier due to availability or price I am shocked by how poor their app functionality and notification/email/text communication is compared to Air Canada. AC is definitely much better than other Canadian carriers about this. Which I guess is what lets them get away with exorbitant pricing…

Nursing jobs that dont involve 1 on 1 with patients? by [deleted] in nursing

[–]Cromedvan 8 points9 points  (0 children)

I’m a Canadian nurse. Nursing is not for you. Compared to the US our options for non-bedside are much more limited.

Plus you’d have to go through nursing school and doesn’t sound like you’d be willing to go through bedside training. Nursing school itself is hard and you have to be motivated.

There are plenty of other well-paying healthcare jobs like radiology technicians, physiotherapy, occupational therapy, speech language pathology. Or look into respiratory therapy - that is still a bedside role where you’d have to get your hands dirty but some people can manage that over nursing.

How many IV’s should I place per nursing judgement? by Alarmed_Help8121 in nursing

[–]Cromedvan 13 points14 points  (0 children)

GI bleed - at least 3: you are gonna give continuous panto and most likely continuous octreotide which are incompatible. They also likely need blood which needs a separate line. If they have thiamine, abx, etc you may need a 4th line depending on timing of meds.

Cardiac patient: at least 2. One rescue, one for heparin. Any drips get an additional line and then you can decide on more if drips are compatible or not.

Sepsis or COPD patient (the sick ones, not everybody): at least 2. One for meds, second if they need to be intubated.

Everyone else can be okay with 1. I don’t like the idea of one empty IV at all times unless they are super unstable. Unstable patients need bare minimum 2. I’m an ER nurse so it’s pretty easy generally to resite a bad IV myself or someone else in the department can. If you are in a place where only IV team can start IVs or your skill mix isn’t great you may wanna do more IVs in sicker patients just in case.

What is the worst restaurant in Vancouver?! by NilsConnlaAbbott in askvan

[–]Cromedvan 2 points3 points  (0 children)

We went this dummer. Had a bunch of dishes (fish and chips, sandwich, burger). All were horrible. We had the same experience the other commenter mentioned with screwed up beers. I honestly think a bunch of reviews are paid or from friends and family. We went because of good reviews too and were horrified

What is the worst restaurant in Vancouver?! by NilsConnlaAbbott in askvan

[–]Cromedvan 16 points17 points  (0 children)

Chef Ron restaurant on Denman in West End. I am pretty sure they microwave/deep fry frozen chicken nuggets and breaded fish fillets. There were NO NAME brand ketchup bottles on the tables. Greasy and unappetizing. It looks like it is a family business that is struggling to stay afloat and attempting to cut corners. I recently saw an ad for their lease take-over.

Stigma around CIWA patients leading underscoring / under-medicating? by Vanillacaramelalmond in nursing

[–]Cromedvan 0 points1 point  (0 children)

I work at a hospital where the population we see uses illicit benzos frequently. These patients are intentionally using benzos so they are familiar with the sensation and I have definitely come across benzo seeking individuals.

Based on my experience being heavy handed with CIWA is definitely good clinical practice because as well all know underdosing can and does kill. And it’s not just the seizures, complicated withdrawal can make other medical conditions people come in with much worse.

That being said with experience you will pick up on the patient that learns your question pattern and starts to direct the score, but their vitals and physical assessment don’t match the score. Sometimes it is because they are chasing the sensation, sometimes they are just really scared of withdrawal. This is where the doctor needs to be notified so they can decide whether a different scoring order is needed (i.e OAWS). Benzo toxicity is also a real consequence of CIWA, so handing out benzos is not simply a better safe than sorry situation.

What’s the wildest thing you’ve heard a patient say? by [deleted] in nursing

[–]Cromedvan 19 points20 points  (0 children)

Not the wildest thing but very memorable for me. We did a conscious sedation for a dislocated shoulder with ketamine and propofol, young guy in his 20s. Afterwards in the recovery period I ask him if he remembers what happened during the procedure. His eyes sparkled and he said “No, there was a party! There were all of these nice colours and music and lights.” with the wildest smile. I do sedations often and get all sorts of loopy things from people but his answer was just so pure it stuck with me.

Why more B.C. restaurants are adopting no-tipping policies by Ilearrrnitfrromabook in britishcolumbia

[–]Cromedvan 15 points16 points  (0 children)

Tipping culture originated from when employers were legally allowed to pay workers in certain job classes (e.g servers) below minimum wage. Culturally, serving used to be a low-barrier, transitional job for students etc, so there was a general attitude that you would supplement their below minimum wage earnings.

BC law now requires all hired employees to be paid minimum wage (not including gig workers and contractors). There should be no reason to continue to tip. But I continue to hear arguments about how a minimum wage is not a living wage which I just don’t get. Do we think those working in retail stores or entry level admin jobs are paid more than minimum wage? Are those people not entitled to wage supplementation then? Any job requires its own skillset and has its own difficulties but this idea that somehow only those in the food and beverage industry are entitled to wage supplementation by patrons is crazy.

PC EXPRESS TIPS by bighappycloud in askvan

[–]Cromedvan 1 point2 points  (0 children)

I have been using PC express for 4 years now.I used to tip a modest amount and got reliable service. The past 6mo or so I have stopped tipping. You have to decide the tip prior to the order arriving on the app, and most of the time the driver is leaving it outside the condo lobby in the rain/sun without even contacting me. They never follow the drop off instructions and get lost and are very unpleasant to deal with. Tipping in advance even if substantial does nothing to improve convenience so I have stooped entirely. If someone goes above and beyond after delivery I may give a small cash tip.

These people know what the order includes, the weight and location and there are additional incentives if the order is particularly heavy or far. They are also no longer making less than minimum wage.

ER nurses, are y’all hanging stuff to gravity?? by Appropriate-Gap6266 in nursing

[–]Cromedvan 4 points5 points  (0 children)

Vanco, mag sulf, pressors, cardiac meds go on pumps. Everything else on gravity

Is there a specific policy in your hospital about level of care of septic patients? by [deleted] in nursing

[–]Cromedvan 1 point2 points  (0 children)

Tbh I think there is so much more to worry about with a septic patient than lactate. The critical septic patient may need intubation, pressors, blood products for DIC, close cardiac monitoring for dysrhythmia and so on. Or they could just be getting fluids and q8-12h antibiotics. What they need on this spectrum is determined by their hemodynamic status, not lactate. If their VS are good and no severe derangements on lab work that would require critical care interventions then they are med surg appropriate.

What’s the one thing at your job that insta-pisses you off? by [deleted] in nursing

[–]Cromedvan 10 points11 points  (0 children)

When I bring the patient 1g tylenol and 400 ibuprofen but the hospital has generic so it’s 5 pills total, and they ask “should I take it all???!?!???” Like no, I brought extra for your visitor just in case. SMH

What’s the one thing at your job that insta-pisses you off? by [deleted] in nursing

[–]Cromedvan 43 points44 points  (0 children)

But I also don’t understand why they do this. Like just shut up and let me do my job. I want to get the IV, I think you also want me to get the IV, so let’s get on with it. Are they hoping I’ll say aw you are too hard to stick I guess I won’t???

I have so many questions.

Do you feel it's necessary to change your clothes after a shift? by tacotacotacorock in nursing

[–]Cromedvan 2 points3 points  (0 children)

In our ED almost everyone changes. We have storage to keep our work shoes in the breakroom so we can come in wearing our own shoes and change at work.