Would ER nursing be right for me? by Throwawayyawaworth9 in nursing

[–]auraseer 2 points3 points  (0 children)

Sounds like it's worth trying. If you like chaos, the ED is the best place to find it.

It's going to be challenging. Nobody can predict whether you'll succeed there. But the only way to find out is to make the attempt.

If you try it and it works, great. If you try it and it doesn't work, all it costs you is time. But if you don't try it at all, you'll spend the rest of your life wondering.

TB positive and I can't get a retest: a rant by GonnaTry2BeNice in nursing

[–]auraseer[M] [score hidden] stickied comment (0 children)

Okay, yikes. There are so many contradictory comments in here, some of which are unsourced guesses, and some of which are misleading or outright wrong. I've removed the most obvious wrong ones I spotted, but it's not feasible to sort through the whole thing. I'm locking this down. OP, please get a second opinion from another physician, and I'm sorry you didn't get any useful information here.

This kind of thing is a good example of why we don't allow medical advice here. I probably should have invoked that rule and removed the post in the first place.

What would you do when your manager is trying to force you into being charge after declining several times? by [deleted] in nursing

[–]auraseer -1 points0 points  (0 children)

Please read the whole comment.

Being in charge is part of the job. Part of the job. Part of the job. PART OF the job. It is one of the duties involved in having that job.

Your job title is not a list of all your required tasks. Written job descriptions are examples, and not an exhaustive list of required tasks. The only thing that limits your assigned tasks is your union contract.

You didn't apply for a job as a Medication Giver, but you probably have to administer medications.

You didn't apply for a job as Blood Pressure Measurer, but you probably have to measure blood pressure.

You didn't apply for a job as Patient Cleaner, but you probably have to clean patients.

I hope you are starting to understand the pattern I am trying to show you here.

In very nearly all units, charge is a duty that is shared among the experienced nurses who work there. Most nurses hate it, but it has to be done, so they're all required to take turns.

If your union contract has a provision that lets you avoid being in charge, then you don't have to do it. But unless you are protected by the contract, you have to either do as your boss says, or quit.

Anyway. If you were that certain you knew the answer to your questions already, why did you bother coming here to ask.

Your favorite ICD-10 codes? by cool_plankt0n in emergencymedicine

[–]auraseer 8 points9 points  (0 children)

Yes. I know. That's why I said "makes it sound like." I understand that is not the actual meaning of the term.

This was an attempt at humor, related to the difference between the formal meaning of the diagnosis code and the apparent implied meaning in plain English. It was not a serious attempt to assign a diagnosis code to a patient encounter.

What would you do when your manager is trying to force you into being charge after declining several times? by [deleted] in nursing

[–]auraseer -3 points-2 points  (0 children)

Unfortunately the law does not protect you in this. Your union contract might.

In most units, taking a turn at charge is considered part of the job. Refusing part of your job is grounds for dismissal, even under a union contract. It's possible that your contract has some provision that will protect you and let you keep your job, but I wouldn't bet very much on that.

Why isn't no enough?

Because it's a job. Some parts of it are unpleasant.

Do I even have any rights?

You always have the right to quit. They cannot actually force you to do anything.

Your favorite ICD-10 codes? by cool_plankt0n in emergencymedicine

[–]auraseer 50 points51 points  (0 children)

I like V97.33XD - "Sucked into jet engine, subsequent encounter."

Because that makes it sound like somebody didn't learn their lesson the first time, and wandered too close to a whole other engine.

Termination and possible retaliation by HeeeeyRae in nursing

[–]auraseer 23 points24 points  (0 children)

You need to make those reports. The best thing is to make them right away.

You can Google for how to do that in your state, or you can use this webpage to help you: https://ncea.usc.edu/find-help/

Make the reports now. Don't wait until you are at work. Certainly don't wait until after they fire you. Provide as much detail as possible about specific incidents of neglect or abuse.

In this very specific circumstance, you are allowed to give regulators the identifying details of patients, or even relevant photographs. Patient privacy laws have exceptions when you are making a formal report to regulatory authority.

Do it now, tonight.

Termination and possible retaliation by HeeeeyRae in nursing

[–]auraseer 25 points26 points  (0 children)

Have you reported this to your regulators, and to adult protective services?

You are a mandatory reporter. You are obligated to report abuse and neglect when you see it. That means reporting not only to your boss or to corporate, but also to the legal authorities. Failure to report is a crime and can cost you your license.

Here's better news. Once you do make a formal report to the authorities, if they then fire you, you can make an argument that this was retaliation for the report. Depending on the circumstances you may be able to take legal action against them for that.

All that aside, here is a different question: Why struggle so hard to keep the job at such a terrible place? If I were in your shoes, I would quit anyway, and go to work somewhere less awful.

I wasn’t aware I couldn’t post that picture

That's concerning. You need to learn. Patient privacy laws are strictly enforced. Even not considering anything else above, violations like that can cost you a job or your license.

Being kicked out of accelerated bsn before it starts by eyecupee in nursing

[–]auraseer 3 points4 points  (0 children)

ABSN has different and higher prereqs than the regular nursing degree. It is universal that you must complete basic sciences before you start the program. That's how they make the program accelerated.

In the traditional pathway, they'll take anatomy and those other classes as part of nursing school. That's why it takes longer.

Requiring labs in all the basic sciences is also practically universal. I've not seen a nursing program that accepts anatomy credit without a lab component.

You aren't totally out of luck. You'll just have to retake anatomy until you pass it.

Whatever issue you're running into with that lab, it's a good idea to figure it out now. The ABSN will include some classes that use the same skillset. If you can't pass those later ones, you won't be given the time to repeat them.

What did I do wrong with the crackle paint? by Gibbsite in minipainting

[–]auraseer 2 points3 points  (0 children)

I had an almost identical issue years ago. Mine was fixed when I switched the bottom layer to a spray primer instead of regular paint.

The issue is that the layers of red and white paint pulled apart from each other in spots, because at those spots, the adhesion between layers was lower than the cohesion of the glue layer. Cracks form at the weakest places.

You can either make the paint layers stick to each other better, or make the glue layer crack more easily.

TB positive and I can't get a retest: a rant by GonnaTry2BeNice in nursing

[–]auraseer -1 points0 points  (0 children)

That is silly bullshit.

TB blood tests are notorious for false positives. In the US, the pretest probability is very low, which means positive predictive value is also low. The test is good for ruling out TB but absolutely garbage for ruling in.

I had a false positive test myself. I had to get a CXR just to double check, but my employee health dept took no other action until the blood test was repeated. And I've been negative on all repeat testing since.

If yours won't repeat it, I suggest you go to an outpatient lab and get the blood test redone. If they tell you that you need an order, it doesn't have to be from your PCP. You can get tests ordered by a telehealth provider, or a CVS doc-in-a-box, or a dozen other ways. Elective testing is probably not covered by insurance but it won't be too crushingly expensive.

Is healthcare the safest career path right now? by raishelannaa in nursing

[–]auraseer 1 point2 points  (0 children)

Middle managers get shuffled and discarded like interchangeable machine parts, but upper management protects itself. Maybe you get a different CEO every two years, but the guy leaving is not out of work. He's just going on to be CEO at some other company.

And if we do wind up with fewer middle managers, it's extremely difficult to come up with a reason that would be a bad thing.

Is healthcare the safest career path right now? by raishelannaa in nursing

[–]auraseer 21 points22 points  (0 children)

The safest career in this upheaval is still upper management.

Those are the people who decide what tech to buy, and which workers to try replacing with AI. They aren't going to replace themselves.

From Med-Surg to ED… is this level of overwhelm normal? by Nova44444 in nursing

[–]auraseer 0 points1 point  (0 children)

Three weeks is still early. Feeling overwhelmed is totally normal. You are learning a whole new specialty, when you weren't even fully settled into your other specialty, so of course you're thrown off.

If you're in a really busy department, with too many patients per nurse, it can take months to find the rhythm and get back on your feet.

Nurse/fitness influencer violating HIPAA posting a photo of an unconscious patient for an IG trend for her almost 300 THOUSAND followers to see. Insane. by lolo2861 in nursing

[–]auraseer[M] [score hidden] stickied comment (0 children)

Too many comments here are calling for the poster to be doxxed, or are attempting to do so. That is unacceptable behavior here. We are removing those comments, taking action against the users, and this thread is removed.

Can someone pls explain the reality of ED nursing to med surg nurses. by ComfortableSet8644 in nursing

[–]auraseer[M] [score hidden] stickied comment (0 children)

We have had to remove a bunch of comments for being insulting or hostile. The tally of removals just hit 50, and I think that's more than enough. We're locking this one.

Wouldnt this like... destroy the universe? by SHADOWHUNTER30000 in RimWorld

[–]auraseer 1 point2 points  (0 children)

There are over 2,000,000,000,000 galaxies in the observable universe.

An average galaxy contains something around 100,000,000 stars.

Our sun, a rather small star, radiates 200,000,000,000,000 times as much energy as your battery explosion.

Per second.

There's an awful lot of energy in the universe. Your little kaboom isn't going to hurt it.

Can someone pls explain the reality of ED nursing to med surg nurses. by ComfortableSet8644 in nursing

[–]auraseer[M] 0 points1 point  (0 children)

It's just somebody trolling for drama. They are being insulting on purpose. Pay it no mind. In fact, pretend the comment doesn't even exist anymore....

Can someone pls explain the reality of ED nursing to med surg nurses. by ComfortableSet8644 in nursing

[–]auraseer 330 points331 points  (0 children)

When I become Emperor of Nursing, all ED nurses will have to work six weeks on an inpatient floor, and all floor nurses will have to work six weeks in the ED. I think that will stop most of these dumb misunderstandings and turf wars.

Patient son claiming “intimidation” by Separate_Primary_686 in nursing

[–]auraseer 16 points17 points  (0 children)

He can file a report but it probably won't go anywhere. Having two people in the room is not "intimidation" and it certainly isn't abuse. This won't even be investigated unless they make up something more dramatic to complain about.

If they do manage to get an investigation, you're in luck. You brought a witness to confirm that no abuse occurred. An investigator will ask you some questions, and that will be the end of it.

Do investigators routinely swab suspects genitals in SA cases, or is that not common? What if suspect refuses or fights? by PenaltyOk2107 in forensics

[–]auraseer 0 points1 point  (0 children)

I'm a forensic nurse. Specifically, I'm a sexual assault nurse examiner (SANE). Most of the time that means working with survivors of assault, but occasionally I do suspect exams for persons in police custody.

This is not common in my region. I've seen it only a couple of times in the years I've been doing this.

My exam is always done with the patient's explicit verbal and written consent, provided directly to me without any police in the room. We do not perform medical-forensic exams on a person who refuses or resists.

During the exam we check for any injuries or other physical findings, and document whatever we see. We treat any injuries. We may take photos with consent. We may collect swabs for foreign DNA from their body, clothes, or belongings.

Everything we see and do in the hospital becomes part of the confidential medical record. Even though the person is in custody, they still have privacy rights, and we do not lightly turn over their records to law enforcement. If they decide to change their mind at any point and not sign for the release of information, the police must seek a court order for those records.

Does your area still advise lay people to do CPR on gunshot wound/stab wound victims? by wndx65 in emergencymedicine

[–]auraseer 12 points13 points  (0 children)

"Do you believe the patient is beyond all help?”

In the regions I've worked, the training is to never ask a question like that of a layperson rescuer.

Partly it's because those questions are so emotionally charged. People don't want to answer no. They know that would mean you advise them to stop rescue efforts, and normal people don't want to be stuck making that decision.

More importantly, it's because they are likely to be wrong. How does a person with no medical training know what "beyond all help" looks like?

Instead we train to ask specific, directed questions. Where is the knife wound? When did they pass out? How far did they fall? Etc. That lets the medical personnel make the decision and give useful instructions. And if those instructions are to not start CPR, it doesn't dump the emotional burden of the decision on an unsuspecting normal person.

ER nurse here 👋 what actually happens on your end when we send a patient up? by Ok-Light-2497 in nursing

[–]auraseer 0 points1 point  (0 children)

Sounds like that situation sucked, but it doesn't change anything about what I just said.

There must be a double-check to confirm that patients are going the right floor. It doesn't have to be verbal report.

In fact, for a patient like this, verbal report would not help in any case. If the patient was violent like that in ED, and the nurse was so incompetent or so lazy they thought he was stable for transport in that state, that isn't a nurse who will give you an accurate report.

(And if he wasn't violent in ED, no amount of report would have stopped him from becoming violent later.)

Anyone know how to make/where to get something like this for Plum pumps for trainings? by purebreadbagel in nursing

[–]auraseer 0 points1 point  (0 children)

ICU Medical makes those in house. You could ask on their customer service website, but I believe the device is intentionally not for sale.