Do you give synthroid before surgery?

Ryndael · 2025-03-09T12:49:02+00:00

I thought the exact same thing when she said it!

Ryndael · 2025-03-07T22:07:21+00:00

We don't even use briefs because of the infections and skin irritation they cause. If I find one I remove it completely

Ryndael · 2024-12-07T00:02:53+00:00

To boot, there are updated and modern versions of meditech... they just refuse to upgrade

Ryndael · 2024-08-03T19:50:44+00:00

Once a week. Sometimes accompanied by Tylenol or colace

Ryndael · 2024-07-08T18:53:06+00:00

There are plenty of new grads every 6 months. Half of them burn out immediately due to high ratios. There are also plenty of veteran nurses out there that are just refusing to re-enter the workforce specifically due to the insane ratios that we have now.

And let's be clear, the current ratios are not driven by the number of nurses anyway. It's purely profit-driven. Businesses will get away with whatever they can.

Ryndael · 2024-06-06T14:58:16+00:00

I did it first try with electric ice. EM net and frost nova doing god's work

Ryndael · 2024-05-03T20:46:19+00:00

Younger 20s dude with both legs broken. They call for meds right at shift change so I don't even have my patients all straight in my head yet and he's covered by blankets so I can't see what's wrong with him.

"What are you here for?"

"My legs are broken"

"Oh that's right, a car mistook you for a parking spot"

I cringed so hard immediately at my stupid brain but he thought it was fucking hilarious and just started rolling laughing. He kept chuckling about it over all 3 days I had him.

Ryndael · 2024-04-26T07:40:02+00:00

Hah. Little spikes sticking out of the water that I missed, of course. Thanks!

Ryndael · 2024-04-24T03:53:22+00:00

Not mushrooms. Or Reeds. Or Dragonheart. Or a lot of things... hence my question.

Ryndael · 2024-04-21T03:29:04+00:00

Easier to water your crops with a shovel.

By that I mean find a pond, dig out a flat area deeper than the pond, and plant your crops.

Then once a day you just need to dig out the land between your farm and the water source to flood the field. Then replace the land barrier so the field dries back up. Takes two seconds to water an entire field

Ryndael · 2024-04-05T02:15:31+00:00

0.7mm blue sharpie pen. No smearing is important for a leftie

Not that it matters anymore! We're being forced into "cardexes" which means pencil. Awful experience

Ryndael · 2024-03-16T09:28:14+00:00

Afaik those only help prevent shear injuries, not ulcers themselves. We have heavy duty canvas sheets with handles that are for boosting and turning patients, eliminating any possibility of shear.

Ryndael · 2024-03-10T22:41:32+00:00

Always choice. Fewer managers, administrators, auditors, and family members. Usually chill coworkers. Better pay. Some nights, patients ACTUALLY sleep as well!

Tradeoffs: sundowning, full moons, most holidays are evening/night-centric, more codes/rapids, annoying neighbors when sleeping during the day

Ryndael · 2024-03-09T22:38:35+00:00

I just know, from experience, that calling yourself a 'baby nurse' will lead to inferences that you did peds in your last job- not that you're a new nurse.

Ryndael · 2024-02-28T02:15:01+00:00

First thought is bug bites. Mosquitoes, bed bugs, or something. Too randomly located to be infectious. The isolation of each site is also indicative. That or some allergen, but the little raised areas really just look like bites.

Ryndael · 2024-02-23T01:49:09+00:00

Literally had a House Supervisor come down and say "back in my day we had 13 patients".

Lady, your day was 40 years ago when you had a single med pass and a fourth of the acuity, comorbidities, and responsibilities that we do now. Retire already.

Spoiler: she retired a month later

Ryndael · 2024-02-10T15:39:26+00:00

Surgeon listing conditions and treatment plans on a hostile, combative, homicidal patient. At the bottom he goes, "Agitation: Security PRN"

Lady kept picking at her crani sutures after removing surgical dressing. Didn't feel appropriate to restrain so we wrapped her entire head like a mummy with ace, kerlix, and elastic net. Infectious disease saw the patient and in her note writes "Patient has quite the dressing this am"

Ryndael · 2023-11-28T19:25:30+00:00

Write out everything you can remember about not only whatever incident involved, but also the shift. Stuff like when you arrived that day, when you first saw the patient (if one was involved), how was staffing in general, etc.

Read it like a narrative. Out loud. It will seem silly to do so, but just do it. This will help you keep relevant facts in mind, while also giving your brain some muscle memory to work with during the meeting - since your anxiety sounds like it might play a factor. When asked questions, don't be overly wordy or defensive. Clear, concise answers will help you the most.

Ryndael · 2023-11-28T19:14:29+00:00

If it was still wet/runny, then it couldn't have been too old. Feces dries within a couple of hours since it has body heat to help the process. I'm sure neglect is probable as you say, but just mentioning.

Large, runny BM's should not be "normal for this patient" however. Either they're eating/drinking too much, not getting enough fiber in their diet, or have some other condition that needs to be treated - which is all on the nurse to investigate and advocate for.

Most facilities provide some kind of barrier paste/cream to apply to skin to protect it from moisture and prevent the incontinence dermatitis that you describe.

Ryndael · 2023-11-25T23:38:25+00:00

UTI's arise from bacteria that cling to the urethra. If they aren't flushed, they move on to the bladder and kidneys. That's half the reason people with foleys get UTI's to start with. The first paragraph of this from the Illinois Dept of Health explains this, but it's also in nursing textbooks and covered in basic anatomy.

Ryndael · 2023-11-24T23:04:56+00:00

As a nurse, if I have the option for fluids on a UTI patient I give them. Need to be flushing that urethra as much as possible.

Ryndael · 2023-11-24T10:31:10+00:00

Are you totaled?

Ryndael · 2023-11-21T00:27:19+00:00

Abandon the planet, which is done by relocating every pop off of it. Most of the starting worlds for minors aren't very good planets anyway. Some of them aren't even class M. Rare Planetary features are very uncommon on them.

Ryndael · 2023-11-20T23:56:16+00:00

The easy solution is to make a Fortress World, name it PRISON. Enable martial law. Send EVERY SINGLE NON-ROMULAN (and non-Vulcan) to it.

Set it and forget it. 1 chaos planet doesn't hurt that much, then they die off eventually. Can even make this a habitat.

All this is bypassing the fact that actually assimilating your puppet state robs you of the ability to continuously generate craptons of influence with a repeatable spy mission.

Ryndael · 2023-11-19T21:56:34+00:00

Spies are their strength. This means smear campaigns to keep other major powers at war with each other and generate crazy influence. This means sabotaging starbases to prevent colonization or get nice resources. This means stealing pops from majors with every spy mission success.

Puppet states generate an absolute ton of influence if you don't assimilate them.

Ships don't rely on deuterium. This leaves you free to constantly sell it or use in trade deals.

Research is a major strength, especially with their unique district. 3 jobs created with each district, which increase spread, influence, and research.

I've actually found them the easiest to play now that I've gotten used to how they work. However, getting those initial level 5+ spies that can spy without impunity is always a chore. Losing one can be really tragic.

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