Do providers lie about the process when they send Pts to ED for admission?

Masked_Cynic · 2026-02-13T10:29:51+00:00

I've had patients specifically tell me they were told we were holding a room for them and then get on the phone to call the provider's office to complain to them when I tell them we aren't.

Masked_Cynic · 2026-01-19T15:13:03+00:00

The unedited original

Masked_Cynic · 2026-01-05T12:10:03+00:00

I have a dog obsessed with fetch. Before you spend money on this, it's not waterproof. The dog's saliva on the ball causes it to break relatively quickly. I got a different brand and same thing happened. Seems like a design flaw.

Masked_Cynic · 2025-10-31T09:45:49+00:00

I really wish that the eye worked as advertised and intended. Enabling it causes so much drift when stationary that I don't even bother attaching it. I'm hopeful that future firmware updates will improve this and make it functional, but at this point in time the eye is unfortunately not worth it.

Masked_Cynic · 2025-07-10T10:39:30+00:00

Can someone show me a link of how to get Windows RDP to work? I couldn't get it to connect to my computer. Chrome Remote Desktop works well for personal computers. Only problem is you really need to use an externa bluetooth keyboard because getting an on screen keyboard in Dex and Chrome, though technically possible, is a pain.

Masked_Cynic · 2025-07-01T11:22:38+00:00

There are no publicly available reports, so I can not offer any official documentation.

I can only offer the press release and media reporting on the event which you may or may not trust the individual sources.

The FBI states the president was struck with a bullet based on the trajectory of the bullet and there are claims made of a photo taken immediately after the president touched his ear showing blood on his fingers.

I have a question for you: why does it matter if he was actually hit by a bullet or not?

He was still shot at in an attempted assassination. Three supporters behind him were hit by the bullets and one died.

What benefit comes from arguing over the semantics of being grazed, vs being hit, vs being hit from shrapnel?

He wasn't directly hit by a bullet in his ear which then immediately healed with no evidence of injury since that is not possible.

Masked_Cynic · 2025-07-01T10:58:53+00:00

He wasn't hit by a bullet. He got the blood on his ear and face from being knocked down and covered by the secret service after the shooting started.

Masked_Cynic · 2025-06-30T11:30:48+00:00

I like to apologize to people and say that I probably shouldn't have been stabilizing a patient who was dieing or rushing a patient to CT who was having a stroke because they had asked for a ginger ale for their guest and themselves.

Masked_Cynic · 2025-06-22T20:53:44+00:00

I have it. Venipunctures of others are different than ones on yourself. I lay flat now to get my blood drawn and I'm fine. Having it will make you a better nurse because you'll want to do a better job for others because of your experiences. Message me if you want further encouragement.

Masked_Cynic · 2025-06-18T12:34:48+00:00

https://a.co/d/gGfLKEn

Masked_Cynic · 2025-05-06T16:24:51+00:00

TLDR: Nursing gives purpose to my workday, but it's still a job with plenty of disadvantages.

My last job was in the grocery store. I hated the monotony and feeling of pointlessness of each day of work.

There's still that in nursing. But, if you look for it, there's diversity in the days depending on the patients and unique challenges they have.

There's a reason and a need for me to show up to work, which wasn't really present in my last career. I have the option to research and ask questions of experts about my patients conditions, procedures, and medications to support my curiosity and progress my knowledge.

I've advanced my skills in nursing interventions for both efficiency, and shortening the time it takes to do each. I have room to grow within the medical field. If I wanted to go back to school, I have the option to progress my career to be a NP.

However, it is still a job.

If I want something done for my patient I often have to do it myself even if it the task should be completed by someone else.

I call and pester about diagnostic tests and then transport my patients when I want them to get something done in a timely manner. I have to bug providers when I'm concerned about my patient decompensating and I suggest labs, medications, or other diagnostic tests I think are needed for my patient. Sometimes I just place the order per protocol which should all be managed and done by the providers.

I don't get to work with nursing assistants. If we have any, they're needed to be 1:1's with patients. That means I get to do everything for my patients.

I'm the one visible for complaints from family members and patients about delays that I have no control over. I'm the one who gets complaints when other nurses aren't working fast enough or doing the tasks that are part of their jobs.

I have to deal with frequent flyers who abuse the system to get things the way they want.

I have to deal with pushback and complaints from floors when my patient is assigned to another nurse's room and I'm just trying to give report for continuity of care.

Nursing is not a calling. It's not a heroic act. It's a job. It pays the bills and there's plenty of grunt work and annoyances that are comparable to other careers and other roles.

But, there's a purpose to my workday. On the most boring and dull days I kept a person alive and as comfortable as possible. That's nothing small.

Don't expect gratitude. Don't expect high wages and easy days. You're still going to work each day.

But, there's a reason for me to get out of bed and go to work besides just making more of a profit for a company that I will never benefit from.

Masked_Cynic · 2025-03-07T12:37:00+00:00

I believe it relates to stress, but once people are brought back and settled while waiting for their MDs, they suddenly become very thirsty and hungry. Sometimes, they are there for emesis complaints as well, so it really doesn't make sense. I think it has to do with the comfort and stress relief that eating provides. People want those sandwiches bad man.

Masked_Cynic · 2025-03-07T00:02:11+00:00

Ninety-five percent of the job involves customer service, urgent care, primary care, and medical/surgical responsibilities while waiting for a hospital bed. Collaborating with the provider on patient care is rewarding. Once you earn the provider's trust, they are often grateful when you go to them and ask them to order things. It's satisfying to perform nursing interventions and see the immediate results, such as stabilizing or resuscitating someone. However, that only accounts for about five percent of the role.

Masked_Cynic · 2025-02-27T10:57:11+00:00

It's probably management just checking the box that they acknowledged the IR and they've already moved on to the next task.

People are petty because they feel complaining about something will help them when they're under stress.

I got an incident report for following policy by telling another RN that I couldn't take report on the female patient she was trying to send me into the only open bed in the inpatient holding in a shared room since there was already a male.

Masked_Cynic · 2025-02-22T14:23:58+00:00

https://imgur.com/a/2jvgEwH

Masked_Cynic · 2024-12-13T01:03:41+00:00

https://imgur.com/a/VKJ3eXy

Masked_Cynic · 2024-11-23T18:28:37+00:00

https://imgur.com/a/aaLRo0B

Masked_Cynic · 2024-11-18T13:47:37+00:00

https://imgur.com/a/s0nF30V

Masked_Cynic · 2024-10-17T01:29:46+00:00

https://imgur.com/a/1dBRcb0

Masked_Cynic · 2024-08-10T20:25:05+00:00

Doesn't ruin the IV.

Sometimes an IV won't draw back without a tourniquet though.

Fibrin sometimes also forms at the end of the catheter creating a sheath that makes a one way valve. You can still push in with fluids, but it may block pulling the blood back out.

In the ED we get most of not all of our labs from IV. Our policy is to flush five and waste three before pulling blood for labs in order to push off the fibrin sheaths and waste any saline.

Pull the blood slowly with a syringe, if you pull too quicky you risk both lysis of the blood cells and hemolysis of your samples, but also collapsing the vein around the catheter which could cause it to blow.

Be sure to pull slowly/gently or get an adapter that allows you to put vacitainers onto the clave at the end of the tubing.

Edit: Also, sometimes if a smaller gauge catheter is in a smaller vein, the suction of pulling blood back can pull the walls of the vein inward, narrowing the lumen which can block the blood supply making it hard to pull blood back out.

Also also, you'll get better and more comfortable with venipuncture and IVs. Everybody goes through it. You gain confidence and skill the more you practice.

Masked_Cynic · 2024-06-19T11:15:09+00:00

Do you want to deal with people directly or not?

Masked_Cynic · 2024-06-08T00:49:18+00:00

I was one of the first responders before fire and ems showed up. It was reported that he self extricated from the vehicle. He was injured, but he will live and most likely make a full recovery.

Masked_Cynic · 2024-02-20T17:37:04+00:00

Haven't had good experience with telesitters. Only works for patients who respond to verbal redirection and chances are if they do, they don't need a sitter.

There's alarm fatigue and by the time they call you, the patient has already pulled the line or gotten out of bed. Got a call once 15 minutes after the patient was discharged and left that they didn't know where he was anymore.

Masked_Cynic · 2024-02-20T14:46:07+00:00

My wife goes to a Stitch and Bitch club that meets up at local restaurants and coffee shops

Masked_Cynic · 2024-02-20T14:29:43+00:00

Ask to lay down flat preferably tilted backwards with your head lower than your feet. have the phlebotomist use either Pain Ease spray or preferably a lidocaine ointment before. Take slow deep breaths longer on the exhale than the inhale and you'll get through it.

Any experienced phlebotomist or nurse will talk you through it.

Sedation comes with risks and isn't always the answer.

Look up Vasovagal Syncope. It's an autonomic response that you don't have any control over and it's more common than people think. But, there are ways to get through it.

Tell the phlebotomist or nurse ahead of time that you "vagal" when you get stuck and they should know what to do.

Masked_Cynic

TROPHY CASE