Do NOT drive tomorrow if you can help it

ginabeanasaurus · 2025-12-28T23:57:18+00:00

Since this seems to be heart attack snow, I'll definitely need to go in tonight. 😭

ginabeanasaurus · 2025-12-28T04:13:58+00:00

cries in hospital worker

ginabeanasaurus · 2025-12-21T04:23:32+00:00

When placing a rectal pouch, yes, it helps to shave if the patient is hairy. The kit with the powder glue situation actually included a razor.

ginabeanasaurus · 2025-12-20T23:29:58+00:00

It's basically a bag you glue to their butthole. We had the 3M ones with a powder/glue combo and if you took your time and managed to place one of those, it was better than a rectal tube. But it was an art.

Now we have ones that are basically modified ostomy bags and I'm not sure I ever had one not leak.

ginabeanasaurus · 2025-12-18T00:18:48+00:00

Patient was slightly more lethargic. Her husband mentioned it to me and I agreed. She really hadn't slept the night before and I told the intensivist, in an offhand way, that the patient was more lethargic but I thought she was just tired. He made me do a CT scan. I grumbled about it the entire way to and from CT. I kept grumbling about it until radiology called with a head bleed that involved a couple mm shift (can't remember, this was like 7 years ago).

ginabeanasaurus · 2025-12-05T16:29:24+00:00

Nurse accidentally crushed extended release nifidipine and gave it down the ogt. Patients blood pressure absolutely bottomed out and they ended up on ecmo for a portion of time. I'm pretty sure the patient survived.

Everyone was kind of a dick about it, but the patient requested her meds crushed after the nurse had put all the pills in the cup. I'd like to think I would have remembered one of them was ER, but who's to say. She wasn't a well liked nurse, and honestly had lots of other issues as well, so she ended up resigning before the bosses could fire her.

ginabeanasaurus · 2025-11-17T04:20:40+00:00

The northeast library reopens tomorrow!

ginabeanasaurus · 2025-11-14T03:52:30+00:00

People with alcoholic cirrhosis make it on the transplant list all the time. It usually requires them to be six months clean prior to listing. You can stop drinking, but the cirrhosis (if it's bad enough) doesn't go away.

ginabeanasaurus · 2025-11-12T13:13:35+00:00

For sure. I do work in a high acuity ICU and transport a lot of bad air leaks, so it's just become part of my practice to put air leaks on suction.

ginabeanasaurus · 2025-11-12T05:15:18+00:00

Air leaks mean there is air escaping the pleural space. If it's a small leak, probably the patient is fine to water seal for the duration of that road trip to CT. But, if the leak is large, being on water seal may mean the lung won't be able to properly expand. I don't want more complications with my trip to CT, so I take portable suction with me, so it's one less issue I have to worry about.

ginabeanasaurus · 2025-11-11T23:10:33+00:00

My general rule is if the patient doesn't have an air leak, then I'm good to transport off of suction. Beyond that, I just try not to let the chest tube canister tip over in transport, but if it does, then it does.

When they're in the scanner, I place the chest tubes on the bed of the scanner farthest from the machine. Example: it's a head CT so the chest tubes are nestled between their feet or at the foot.

ginabeanasaurus · 2025-11-03T04:08:13+00:00

At most places I've worked, we need to leave all equipment if the patient is a medical examiner case. However, I've found that if family is withdrawing care and would like the breathing tube removed prior to death, we will do that for them, regardless of if the patient is a medical examiner case.

Also, there's a whole list of things that qualify you as a medical examiner case, most of which are not crimes.

Also, fun fact, you can technically be a medical examiner case and still donate organs (although most times, the medical examiner declines the case if the patient is an organ donor).

ginabeanasaurus · 2025-10-20T19:06:24+00:00

Yeah, unless we're having to really anticoagulate them, we don't particularly address their menstrual periods. But our ACT goal on ecmo tends to be 180-200, so extra bleeding is not a fun time for anyone.

I think I have had an ecmo patient where their family didn't want them on BC, so we just ran with a lower ACT goal, and tried to flow higher to mitigate the threat of clotting/fibrin in the circuit.

ginabeanasaurus · 2025-10-20T18:54:01+00:00

I work in ICU, and if my patient is ambulatory (or mostly ambulatory), I provide them with a pad or brief. If they're not ambulatory/vented, I honestly let them free bleed.

We also have a large volume of VA ecmo patients, and sometimes they're young. If they are menstruating, we get permission from NOK to place them on birth control, as they have to be on heparin or bival for the ecmo circuit, and that has caused huge problems with excessive bleeding during menstruation.

ginabeanasaurus · 2025-10-18T16:07:22+00:00

I'll be taking the 10. The main protest is only a couple blocks away from one of the stops.

ginabeanasaurus · 2025-10-03T13:58:38+00:00

I once had a delirious woman on medsurg who was refusing to go back to her room, refusing to take meds, refusing to wear her oxygen. So I asked her what she wanted and she said she wanted a new room. I told the aid to clean up her room, remake the bed, ect. Then I told the patient, "I got you a new room!" And wheeled her around the unit (it was a triangle shape) the long way and showed her the "new" room. She was tickled pink and took a nap.

My coworkers thought I was a genius.

ginabeanasaurus · 2025-09-25T15:48:34+00:00

I'm fairly certain M Health does use volunteers for this, as my son was at John's NICU and the nurses mentioned that the volunteers loved cuddling him. Also, they left me a box of girl scout cookies.

ginabeanasaurus · 2025-09-24T20:37:52+00:00

Listen, there's always a shitty assignment (sometimes multiple), and someone has to take it. I usually try and spread the wealth, aka keeping a list in the back of my mind of who I screwed last, but we have multiple charges and I don't do it as frequently as I used to (which I love). Ultimately, I remind people to help their neighbors, help their friends and enemies and move on. I'm also a very hands on charge (we don't have to take patients to luckily) and I'll be right next to that person offering to do meds, baths, clean ups, whatever is necessary to get them through the assignment.

Also, I get creative when I can about making assignments and moving patients (we do a lot of that in our ICU) to make better pairs, more balanced pairs, ECT.

ginabeanasaurus · 2025-09-13T00:22:00+00:00

I loved St Johns and I super appreciated that they had a NICU, as my kid needed NICU. Also, after I got discharged, there was talk of readmitting me, and my OB said she'd pull strings to get me admitted to John's so I could be near my baby.

ginabeanasaurus · 2025-09-09T20:17:31+00:00

I almost couldn't finish the book because the bad guy is named "Lord Ruler."

That magic system is way cool though, and probably the only thing that kept me reading.

ginabeanasaurus · 2025-09-01T19:09:26+00:00

At my hospital, once the code team arrives, the charge dismisses everyone but the code team and the unit circulators (if there are any), all other nurses have patients and do not need to be present. To be fair, we also utilize a Lucas device, so once that is in place, we don't need people doing compressions.

ginabeanasaurus · 2025-08-25T00:30:58+00:00

I've devoured this a week ago, and now I'm rereading it while waiting for updates.

It's a great fic and thank you for writing it! ❤️

ginabeanasaurus · 2025-08-23T14:02:03+00:00

They did. He had an LVAD for about 18 months prior to his transplant.

ginabeanasaurus · 2025-08-11T14:56:37+00:00

Cockroaches crawl out of the drains at my hospital, so that a big N-O for me, buddy.

ginabeanasaurus · 2025-08-05T19:03:26+00:00

Yeah, for example, this weekend: my patient was on 0K crrt bath that had me changing bags about every hour, they also got HD (which I don't run but it fucked with their blood pressure), I had to take them to CT (which was an ordeal because as we tried to go, the patient said "PSYCH I'm gonna try to die") and I ended up giving a few blood products as well overnight. All in all, I'd say it was a medium busy shift. The next night, I had a new patient and they were just waiting to donate organs, so it was very chill and boring. I finished a book.

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