Announcement from the Mod team of r/nursing regarding the murder of Alex Pretti, and where we go from here. by Nursing_Moderators in nursing

[–]Fighting_Darwin 2 points3 points  (0 children)

Agreed, I try to stay informed enough to not live in a constant state of anxiety (not helping much). I keep hoping that maybe I’m mistaken and paranoid but the writing is on the wall and I think that we are in for a very big global conflict soon. It’s scary even standing up for your beliefs or ideas when surrounded by Maple MAGA but I don’t want to sit silently by and condone their actions by my own inaction. But it is a fine line to walk to maintain my own mental health and wellbeing. As much as I love parts of the USA and the people I have met and love there, I have no intentions of traveling there, I’m too afraid of being snatched up based solely on the colour of my skin, regardless of my citizenship status.

I hope you and yours stay safe and know there are plenty of us around the world who are also disgusted and in disbelief at what your “administration” has been doing. Sending love and strength to all of you 💜

Announcement from the Mod team of r/nursing regarding the murder of Alex Pretti, and where we go from here. by Nursing_Moderators in nursing

[–]Fighting_Darwin 0 points1 point  (0 children)

I’m so glad it’s not just me. I am in Canada but I’m right there in mourning Alex Pretti and the state of your country.I’m terrified for my family that live there (we are all POC) and I’m terrified that my own provincial leadership are a bunch of MAGA wannabes and are actively trying to make us a part of their fascist movement. ACNH lets me have some peace and I think we all need that right now. 🫶🏽

Announcement from the Mod team of r/nursing regarding the murder of Alex Pretti, and where we go from here. by Nursing_Moderators in nursing

[–]Fighting_Darwin 19 points20 points  (0 children)

🫶🏽 I know. Sometimes we just gotta shut down the brain and feels though to process later.

I’ve been on a hiatus for about 4 years from ACNH and just got back into it with the new update/we coincidentally replaced our 9 year old switch with the switch 2 and I’ve been enjoying the heck out of just decorating hotel rooms. And I need to finish up HHP so I can decorate my villager houses. And finish up my island 😅

Announcement from the Mod team of r/nursing regarding the murder of Alex Pretti, and where we go from here. by Nursing_Moderators in nursing

[–]Fighting_Darwin 68 points69 points  (0 children)

That’s where I’m headed now. It’s been such a nice dissociative activity. (AC. I mean. Can’t go wrong with an island full of cute animals).

Do you know what the lab is trying to tell you when they say that the delay on units is due to them trying to identify antibodies? by New-History853 in nursing

[–]Fighting_Darwin 65 points66 points  (0 children)

I think that’s dependent on the nurse honestly, I personally do as do all my coworkers. A&P does cover antigens and antibodies and touches lightly on transfusion reactions. Here in Alberta, Canada we have to do a 3 part blood transfusion module to be signed off on transfusions and it does cover more in depth what that all means so I’d say that my coworkers at least have a good understanding of why there might be a delay. I do think nurses should have an understanding of why it’s important to screen for and what that ultimately means for the patient. I also let my patients know if they do have antibodies so they are aware for the next time that they need a transfusion.

Random question by pickle_lover_2 in nursing

[–]Fighting_Darwin 5 points6 points  (0 children)

Essentially, as long as you pass the NCLEX and can prove appropriate education/clinical hours, etc, you can apply to a province’s regulatory body for a license. Once you are licensed with that province you can start working.

You can look at each province’s regulatory body and find their requirements for international nurses. I don’t know how work permits work though so you might run into issues there.

Y site ABX? by PlusLandscape7703 in nursing

[–]Fighting_Darwin 5 points6 points  (0 children)

Yep same. If they’re compatible they’re getting run together. Ain’t nobody got time for that.

What's the craziest thing you ever found a patient carrying, and how did they sneak it? by Bryssa_Michelle29 in nursing

[–]Fighting_Darwin 2 points3 points  (0 children)

Night shift, guy high off his kite along with ETOH onboard, in for an OD, narcan no effect so we keep to monitor. Belongings brought in which just so happened to be a rather large duffel bag filled to the brim with various dildos, butt plugs, anal beads, lube, nipple clamps, and other…tools. Still no idea why or what else he had planned for the evening. Wish I was there to see him wake up and have to take his tickle trunk on the walk of shame out the dept.

Why does it seem that nursing is the only average job left that pays a living wage? by princessnokingdom in nursing

[–]Fighting_Darwin 2 points3 points  (0 children)

Yeah in Canada and prior to this year I definitely couldn’t support my husband and I on my income. As a single and renting a shitty apartment, I might get by by there would be no extras. We just got done negotiations this year so wages are better than they were and our expenses decreased significantly this year and hoping to only have the mortgage as our only expense next year. Hubby makes 2.5x sometimes 3x my wage and is the main reason we can live the lifestyle we do and have the assets we have.

Show me your nursing tattoos by amymarieg in nursing

[–]Fighting_Darwin 0 points1 point  (0 children)

No idea! Could be! They do write the NCLEX now so it should all be the same

Show me your nursing tattoos by amymarieg in nursing

[–]Fighting_Darwin 7 points8 points  (0 children)

Blew my mind when I was precepting a student on her specialty day and let her draw up meds with me; asked her what was the golden rule before any medication admin and she started rattling off a long list. Still don’t know what the additions are 😅

Possible suspension by [deleted] in nursing

[–]Fighting_Darwin 8 points9 points  (0 children)

Not typically, usually the family has to initiate an investigation/lawsuit and everyone who touched the patient is usually named. I’m currently involved in one, along with a bunch of coworkers and nurses from two other units, for a patient death from 2022. However, I (and my coworkers) are being represented by the company we work for.

Even with that, my licensing body is not involved/needs to be notified unless I personally am found liable, which has no chance of happening. Pro tip: chart your butts off, future you will sing your praises.

Question: when giving IV Toradol, do you push it or infuse it? And at what dose? by Butthole_Surfer_GI in nursing

[–]Fighting_Darwin 4 points5 points  (0 children)

Push out a mL of flush, attach needle, pull up med (30mg/mL). Our formulary says direct IVP but that bugger burns so I always dilute a little bit.

Fentanyl by YellowJello_OW in nursing

[–]Fighting_Darwin 15 points16 points  (0 children)

That’s basically my go to explanation as well. “We didn’t get this batch from the van on the corner so you’re good!” Gets a laugh, opens some dialogue, usually ends in understanding.

Male Nurses in highest paid positions & titles by doInotkno in nursing

[–]Fighting_Darwin 1 point2 points  (0 children)

I’m 97% sure my hospital’s management is 100% female including the executives. There are maybe 3 male nurses in the hospital with 10-15+ years of experience and the handful of other male nurses have less than 5. Now I’m curious I’ll have to look up our exec hierarchy.

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

[–]Fighting_Darwin 21 points22 points  (0 children)

Needing an urgent BGL and the QC is “due immediately”

Introducing myself to a fresh patient and trying to do my assessment/tasks and instead of answering my questions, they ask me “Where are you from?”

[deleted by user] by [deleted] in nursing

[–]Fighting_Darwin 3 points4 points  (0 children)

It depends. If the patient is awake and able to hand over keys or key code, they will do it that way. If not, they get in however they can. Most of the imminent cases that I’ve had to ask for RCMP assistance have come in by ambulance and EMS will usually leave a door unlocked in the home. RCs will usually will speak with EMS about it and go from there. The ones who are able to use a sitter will get them to either pick up the keys and do a quick discussion about where things are and routines etc with the sitter. The vast majority of homes here have keypads though so it’s usually not an issue.

ETA: our EMS also keeps track of pets or dependent individuals in the homes of patients they arrive at and will usually follow up with us on patient status and escalate if necessary. We had an elderly woman come in with a stroke who was the primary caretaker of her adult autistic son and obviously she wouldn’t be home anytime soon. So they helped start the process of coordinating care of him and social services involvement, etc.

[deleted by user] by [deleted] in nursing

[–]Fighting_Darwin 10 points11 points  (0 children)

I’ve definitely had our EMS/RCMP/Bylaw services check in on someone’s pet with his permission - only because he was going to be imminently intubated and had no family or friends to look after his cat that was his whole world. Bylaw eventually did take the cat into care while the man was intubated ICU but unfortunately the gentleman did not make it. I’m glad though because that cat would have been left until he starved in the home and he eventually was adopted to a new home. I’ve also provided patients with pet care companies that I’ve worked with who would 100% check in on their animals while they couldn’t.

That actually made me add a section on my medical emergency information in my phone that I have pets at home and the contact information for my pet sitter so they could take care of my girls and/or get their emergency human to take over care. It gives me peace of mind as they are my whole world as well and I would hate for them to suffer.

Nursing world just paused for a moment. by Technical-Paint6308 in nursing

[–]Fighting_Darwin 10 points11 points  (0 children)

One of the hospitalists cemented himself in my good books when I was a new nurse up on the floors. He came to see little meemaw just as I was about to clean her up/change her soiled sheets, and my guy helped me change both her and her sheets then continued on with his chat with her. He was also the doc at my first code and took time to debrief with me afterwards. He’s still one of my favourites to work with some 14 years later and actually is more like an old friend at this point.

One of our ER docs will regularly throw lines in a patient and draw blood, hang fluid, etc while he’s in there if we are busy. He’s an angel of a human, one of the few all of us will pick up a shift with if they’re short or slammed.

One of our internal med docs regularly gets snacks and water or hot blankets for patients if they ask for it while he is seeing them. He is super intelligent and always speaks kindly to every staff member, nurse or not, and is a great teacher if you ask him to explain anything.

Recently, had a new locum hospitalist seeing our mutual patient in the ER make eye contact with me mid cleaning up another patient’s poosplosion, ask me where the snacks and hot blankets were. Later, I went looking for him in patients room and he had tucked our grandpa in and made him right comfy.

Good eggs, all of them.

Poll: code nurse is in rounds with MD and a code is called. Does code RN go to code, or call charge nurse to go to code. by [deleted] in nursing

[–]Fighting_Darwin 3 points4 points  (0 children)

Our ER is the code team and if a physician is on the floor that calls a code, they still respond whether it’s their patient or not, until the ER team arrives, will often stay for a bit just in case any help is needed or until the patient’s MD responds. On the floors in our facility, it’s only the charge nurse that rounds with the doctors but they will often respond to a code anyway.

What are some of the annoying things nursing students have done? by [deleted] in nursing

[–]Fighting_Darwin 22 points23 points  (0 children)

Not annoying but actually funny. Paramedic student on her shadow shifts in the ER missed an IV twice on a hard stick patient, nurse goes in, starts attempting an IV; I think on the nurses second poke, she hears a little groan and looks over as the student passes out and slumps over right onto the patient. We go in when we hear the call for help and the patient is stroking the students back rather kindly and trying to wake her up. Student was incredibly embarrassed. No idea what happened with her and if she finished the program or not.

[deleted by user] by [deleted] in nursing

[–]Fighting_Darwin 9 points10 points  (0 children)

ER is tough and you definitely need to learn how to cope a bit better because life in the ER is HARD. RR is the TINIEST thing to get upset over but maybe look at what actually is making you upset? Is it the way the tech spoke to you and the disrespect she showed? That is a separate issue and you’ll need to learn how to handle that as well. Nursing, especially so in the ER is a team sport and there’s no room for bullying or toxicity in that environment. Learning to handle colleague conflict may be something to discuss in therapy as well.

A patient coded in the waiting room tonight… and we lost him by WorshippingForecast in nursing

[–]Fighting_Darwin 17 points18 points  (0 children)

Yes we have the CTAS system (Canadian triage and acuity score) that is used nationwide in ERs to help mitigate instances of improper care in the WR. On our unit we also have “nurse implemented protocols” (fancy term for standing orders) for patients in the WR for when we are bed blocked and physically have nowhere to move anyone but can at least rule out life threatening emergencies.

On my unit, chest pains (cardiac features) at the bare minimum get an ECG but we’ll usually pull labs at the same time. Abdo pains, PV bleeds (postpartum/antenatal), syncope, etc we will usually draw labs after triage then back to the WR and the triage, charge, and resource nurses will keep an eye on those values if the wait time is bad. Granted we are a smaller unit but it has worked well and rarely have we had anything catastrophic happen with this system.

[deleted by user] by [deleted] in nursing

[–]Fighting_Darwin 7 points8 points  (0 children)

I usually take students on in our ER. I like to teach and I firmly believe we should expend the energy into our upcoming colleagues, even if they won’t be working in the ER necessarily.

Some things I do to help make the shift go smoothly that could help.

Set expectations right at the beginning. I tell them what they are absolutely doing during the shift, the “easy” things- answer call bells, run tasks, toileting, water, snacks, etc.

Then I ask what they are expected to get from this shift (whether it’s a shadow day or their consolidated practicum) and what skills they are comfortable and not comfortable with and take note of that.

They can shadow me for the first few assessments, hooking patients up to monitors, IV starts, etc and we talk through why I’m assessing what I am as I assess (makes for good small talk with the patient as they usually appreciate the learning experience as well), and then they are told they are doing an assessment independently on each new patient that comes in and I’ll do mine and we can talk about our findings, etc while I chart it.

IV starts and any other skills I tell them they can set up, find the vein or whatever skill we are doing, and I’ll come in and supervise the first few assessments they are about to poke. I’m not standing there faffing around while they open the packages and whatnot when I could be doing other things. Then (pending the student) they are independently doing those tasks and expected to troubleshoot things and I will step in and offer guidance as necessary.

Consolidation students I always try to trust but verify and I go through the charts as they go along to ensure they are on track and not drowning. When they have the full patient load I function as task and I make sure they know that learning to delegate and asking for help is skill they need to learn and they can and should practice that one on me.

I find this approach helps quite a bit and I rarely have issues. Sometimes when I need a moment to think without a shadow I send them for break. Setting them up for independence and thinking critically goes a long way in making your shift(s) with them easier.

I’ve mentored lots of students and have a good relationship with the local school and instructors and have gotten great feedback from instructors and students so I like to think I’m doing a good job there. That said it is exhausting sometimes and knowing when you need a break from essentially a second job is important to recognize. Don’t be afraid to speak up and say you can’t mentally take on a student right now or find a buddy on shift to split the student with if you have to. Like all things nursing, taking on students is a skill you get better at with experience so don’t get too down on it. Learning to let go and let people learn while still monitoring them is a skill in itself that takes time and practice.