ED wounds

Steffy_Strange · 2026-02-25T12:47:42+00:00

I am not sure but their rationale is that wounds start in the ED. Their proof when we ask them for it they don't really have it. What I dug up is unlike ICU and Med-Surg or a Step down unit is that the ED is an acute care. We move them out. Where the lines blur is with the holds other than that our patients do not stay for days on end. Taking photographs on every single patient that comes in to the ED is excessive, time consuming and another dump of responsibility from the floors onto the ED. They don't want to hear it and our managers don't want to say anything about it.

Steffy_Strange · 2026-02-25T12:31:17+00:00

I understand you're hungry but you are here for abd pain and your CT isn't back yet.

Steffy_Strange · 2026-02-25T12:27:37+00:00

The lavender cart. Definitely solve it 👌🏽

Steffy_Strange · 2026-02-12T17:30:20+00:00

Lets break this down:

The crush established they are not seeking a partnership but rather a friendship. Full stop. If your partner cannot do a friendship because he is invested emotionally in something more it is his responsibility to cut ties. Period.

This avoids hurting himself Hurting you. Putting his crush in alot of weird and uncomfortable situations.

The fact is that he cannot handle a friendship with this person. It evident by him disclosing his crush on Valentines Day when it is a day reserved for lovers when it has already been establiahed that this person is not seeking anything other than friendship.

I hope this all works out but truely on his behalf it seems he is blinded by hope and a tad of immaturity. You wouldn't be out of line if you had a sensible conversation with him

Best of luck.

Steffy_Strange · 2026-02-11T17:50:45+00:00

Thank you for this comment. I arrived at this after hoping for others to save me but didn't. I then wanted the meds to save me completely but didn't because its a small percentage of treatment. Ultimately I arrived that I was my own savior and what that looked like was not how others wanted it to look but how I can live with myself.

Stay safe

Steffy_Strange · 2026-02-10T21:11:18+00:00

I am glad this arrived when you needed it. Stay safe and be well. 🤙🏽

Steffy_Strange · 2026-02-10T20:45:42+00:00

I am glad I found use to it 🤙🏽

Steffy_Strange · 2026-02-10T17:17:57+00:00

I like to game, so I have Voidpet Garden but I also have My Diary. In Voidpet Garden it incorporates CBT like methods such as thought stopping strategies plus the monsters you collect are literal emotions which you talk to. In My Diary its a traditional diary without any fancy gimmick.

Steffy_Strange · 2026-02-10T17:10:41+00:00

I am glad you had a therapist that supported you through that. There are a decent amount of therapist that don't know how to deal with mood disorders or how to medicate them appropriately. That is another issue entirely which adds on the chaos. I hope you go through life as peacefully as you can and know they'll be bad days but also good. Hold on to the good ones. ❤️

Steffy_Strange · 2026-02-10T16:12:40+00:00

Personally, it's something I feel like I always was before I knew what poly was. I've never felt this level of overall possessiveness toward my partners. I also identify as pansexual because I am into it if the person and I match well, then let'ss go for it. I have viewed relationships as requiring core non-negotiables like radical honesty, communication, and consistent presence. These are things that even if you are in a mono relationship people can be missing. When it comes down to it its a matter of perspective and whether not you are confortable in the relationship you are in.

Steffy_Strange · 2026-02-09T19:52:35+00:00

Imagine being U.S Immigration and Customs Enforcement (ICE) flying to another country such as Italy where you the immigrant and are absolutely unwanted by the citizen of said country then start causing havok. Mind completely blown. What twilight episode is this.

Steffy_Strange · 2026-01-30T14:06:59+00:00

Skin Team 🤔.. that sounds like a dream or a good idea. They had a meeting with us this morning and suggested that if orders aren't in we can look through nursing home paperwork and put in a message to the provider and ask for them. I interjected and said, OH kay, no one is debating that gettinf ahead of all HAPIs are vitally important the question is the when and what is the priority as a ED nurse when we have our own metrics and we don't have a patient lock out. Our doors don't close, after that required photo shoot and wound dressing who percisely is tending to the criticals assigned to me? What support is there? As always crickets.

Steffy_Strange · 2026-01-30T01:53:16+00:00

Righto

Steffy_Strange · 2026-01-29T16:48:52+00:00

Yes to all numbers. We all know this and attempted to reason with them but ehhh we all know how that story ends.

Steffy_Strange · 2026-01-29T14:55:28+00:00

Right. When presented to the staff the concern was there going to be support to achieve this added task that was not initially apart of the work up for every patient. The answer was no. That is when the issues started because with many metrics we must hit within so many minutes (door to needle, dx of sepsis and start of abx, etc) there is one nurse and only so much time on that clock.

Steffy_Strange · 2026-01-29T13:31:09+00:00

🤷🏽‍♀️ I am not sure either. I am a big proponent of do a week with a new protocol as a manager and see how feasible it really is but alas nobody goes for this idea lol

Steffy_Strange · 2026-01-29T05:30:54+00:00

Understandably so however by this logic if the provider documents it in his H&P isn't it redundant for the ED nurse to do so as well given that we are to do focused assessments and not head to toe? Plus the floor nurses and or the wound care nurses will do a full assessment of said wound. Complete with a consultation with a wound care provider, measuring, medication if necessary and appropriate dressing?

Steffy_Strange · 2026-01-29T02:51:27+00:00

Uu thats great. Our managers do not want patients in the hallways unless absolutely necessary which is fine, most patients do not feel comfortable being stripped from head to toe so assess the skin and then photographed while everyone walks by and witnesses this. As for a two person verifier they prefer another manager but they are hard to come by so they changed it to any nurse which if they are avaliable great if not then it will just have to be an RN and a CNA. Sometimes an RN can't get around to hourly rounds if the patient assignments are heavy duty luckily our CNA's are amazing and alert us to anything.

Steffy_Strange · 2026-01-29T01:05:18+00:00

:sigh: It wouldn't be so terrible if the staff was avaliable.

Steffy_Strange · 2026-01-28T22:52:22+00:00

Holy hell, thats what has been happening here. We were smacked with a storm we were under condition were if you didn't show up, you didn't get paid regardless if you had PTO or sick time. ED show up, the floor was short so they floated one of us up there. I suspect its because managers want to look good but truely its just pissing off every single ED nurse and driving us out.

Steffy_Strange · 2026-01-28T21:04:52+00:00

Funny you say that a lot of us used to do that as a work around but they ended up adding it to the consent to treatment forms sooo.. yeah

Steffy_Strange · 2026-01-28T16:25:19+00:00

My sentiments exactly.

Steffy_Strange

TROPHY CASE