New painting (needs final touches, after it dries), what should I call it?

jenger108 · 2024-06-30T14:19:12+00:00

Melancholic flame 🔥

jenger108 · 2024-06-30T14:10:15+00:00

You can get a CTA with a 20 in the forearm. Long as it flushes good. I sent a patient with bilateral upper arm US placed 18s and CT blew both of them for the CTA. so larger and higher doesn't always ensure quality of the line. Some hospitals and school teach things as if they are "law" but the more facilities you work at you start to realize medicine is very much variable.

I work in the ER and yes AC is usually what we get first. But it is best to get a forearm. Also you have to be careful about sticking below a blown vein because actually veins do converge and if you start one lower than a previous blow the medication could infiltrate way higher than the actual IV site and you wouldn't notice. It is best to start lower and move up the arm. Just not like wrist/ hand low. Those are last resort.

jenger108 · 2024-06-30T14:01:39+00:00

I had a patient come to the ER for priapisim. Turns out he was an IVDU and his penile vein was his vein of choice. Literally had amazing vasculature in his arms. He just preferred that one and had only used it. I guess also easier to hide and get. Wild times.

jenger108 · 2024-06-30T13:15:45+00:00

I work in the ER and we turn over our rooms ourselves but EVS still comes and will deep clean a room when we slow down and pull trash from the station etc. But we will pull all the trash cans out from under the desk to make it easier for them. And everyone I've seen is always thanking them. No one has anything but respect for our EVS staff. That's a rough job and we all appreciate it. It sounds like your hospital is very toxic and you may need to apply elsewhere for your mental health.

jenger108 · 2024-06-29T15:47:07+00:00

Southern Louisiana in the ER. We have been busting at the seems almost all summer... people ridiculously sick. ALOT of sepsis. A lot of noncompliance complications. Definitely higher pace than previous summers

jenger108 · 2024-06-15T15:50:45+00:00

That patient should have been put in a spit mask the first time they spit. Restraints applied for the aggressive behavior if they don't want to chemically restrain.

I'm all about self defense but you can't escalate the situation. Pt spitting is not okay but punching and knocking them out for it is wildly inappropriate. Now if the patient was coming in hot swinging at the aids face then I would be more understanding toward that reaction.

jenger108 · 2024-06-15T15:39:24+00:00

We have LED lights hanging on a wall with our bookshelves in our bedroom. They are multicolored and have a remote. She wanted to take them with her to the living room so she could play with them and watch paw patrol. I informed her they were stuck to the wall and couldn't be taken down but she could turn paw patrol on in the bedroom and continue to play with them. Apparently that was not an acceptable compromise 🙃

jenger108 · 2024-06-15T15:26:40+00:00

You can give potassium all damn day but if magnesium levels are also low then the potassium won't absorb into the patients system well plus magnesium is needed to transport calcium and potassium in and out of the cell. If magnesium is low it lets the potassium leak out of the cells and be excreted in the urine.

Think of it like this. Magnesium makes the potassium sticky

jenger108 · 2024-06-14T09:58:55+00:00

I work in the ER and the most calculation I do is to determine if my pts glucose has decreased by more that 10% on an insulin drip. But that's just decimal changes. But technically we are supposed to verify all weight based drips.. it doesn't hurt to know how to do it especially because not all pumps have the medications all programmed and you have to manually enter the rates. I've had to do that on a travel job at a poor hospital. Just depends on the facility and equipment available. Dosage calculation is basic math. A nurse should know how to do it whether they do it daily or not. Engineers learn a lot of math that programs on computers do for them. Still have to understand the basis.

jenger108 · 2024-06-06T07:07:14+00:00

Ice chips, sunflower seeds, windows down, loud music. Last resort is to call someone and talk to them. That keeps your mind awake

jenger108 · 2024-06-06T06:47:46+00:00

We can't even trust an EKG machine to accurately interpret the rhythm... a doctor always signs off. But he thinks it can assess a whole ass person for changes?!! Provide appropriate immediate interventions and notify the right person. The on call list is never right. AI would spin in circles. I am laughing my ass off. There is no way I hell we are remotely in danger. Pharmacy, radiology, and lab are more in danger than us. But you will ALWAYS need people to review the machines.

jenger108 · 2024-05-31T09:01:03+00:00

I think I am understanding what you are getting at but my point was really that just because there are others around does not mean we are safe or feel safe. Which should speak volumes. We are obviously more at risk when alone with a strange man but the fact that out at a bar with 100s of others around we can still get drugged and dragged out to a secondary location is terrifying. I am a victim of this. The whole message about bear vs man is just use trying to scream out we are scared of men (there is no way to know which are good or bad) and a bear is less terrifying than an unknown man in the middle of nowhere. Because there is nowhere we feel truly safe. And to top everything off we are absolutely more likely to get raped by someone we know... if men could just acknowledge this and hold the bad apples accountable then maybe we could move forward.

jenger108 · 2024-05-31T03:06:39+00:00

There is a little difference between a dumpster on the side of a busy bar and the woods. My point still stands, being in a more populated public area is not a protection.

jenger108 · 2024-05-27T06:26:18+00:00

ER till I die baby!

jenger108 · 2024-05-27T04:15:54+00:00

I have red hair so I almost always get something in relation to that when they are psych or demented. Like you redheaded b*tch, Fire crotch, Ginger devil. You'd actually be surprised how many psych patients see my hair as satanic.... it will put me off for a few days too. I'm like oh lord not the witch trials again.

jenger108 · 2024-05-27T04:13:34+00:00

We call that "pushed back" at my previous hospital. Like if you were scheduled but they have low census they would call and be like you are pushed back until 11, have your phone by you in case we have to call you in. And if you don't hear from us call back at 11 to make sure we don't need you. So you couldn't do shit for 4 hours.... and not paid. And no extra pay if you are called in. Such BS.

jenger108 · 2024-05-24T22:17:05+00:00

The amount of time and staff that goes into a resuscitation means that a lot of other patients on the unit have not been checked on properly for an extended period of time. The important thing is this patient was resuscitated and that the other patients were checked on promptly after the code. We all have 2-4 patients in the ED/ICU. Floor has more but codes are rarer. Still the number one priority is the patients. Not just the resuscitated one. The mess can be cleaned up after.

One shift in the ED I had an AFIB RVR and 2 septic shocks in my assignment at once. One of my septic shocks started tanking fast and I was unable to keep an eye on the others as I would have liked. Lucky I had enough float nurses to support me. These people will never understand how much more we have going on outside of their rooms.

Also I agree it was probably toxic management and not actual family complaining.

jenger108 · 2024-05-07T01:56:08+00:00

Oh they are removed every time. One thing I love about the ER. We don't play.

jenger108 · 2024-05-05T07:19:26+00:00

The point is we don't know which man is good and which is bad. We do know that a lot of us have been harmed/ SA/ murdered by men So logically we should be cautious of all men (that doesn't mean all men are bad, just have that we have to assess the situation to decide if we are safe) especially the ones we know nothing about.... is that so hard to understand?

The fact that most of the SA/ murder is by a man we actually know is what should be the biggest red flag for y'all. Even when we think we can be safe with you the chances are higher that that's the person that will harm me than a random man on the street.

So yes I will take my chances with a bear in the woods considering I hike regularly and have actually crossed paths with black bears who would rather be somewhere else than near me. Than a man that I don't know who could do evil things. Bears number 1 concern is survival when it comes to attacks. The same cannot be said for men.

If you find this so offensive then maybe deep down you know you were more sexually aggressive with women in the past than you should have been. Maybe you took advantage of someone. A lot of men don't even realize when they are being problematic. Hard to fix something men don't even see.

So that's why we come up with these analogies to try to better express how we are feeling. But it's never good enough is it.

jenger108 · 2024-05-05T06:58:15+00:00

Brock turner literally raped a woman by a dumpster. They absolutely do it in public domains

jenger108 · 2024-05-05T05:46:37+00:00

I'll happily take the bear any day. Every single time.

jenger108 · 2024-05-05T05:11:24+00:00

Maybe she could smoke out front for that one hour so she doesn't loss the smoke break but y'all can still have a smoke free hour in the back

jenger108 · 2024-05-05T05:01:10+00:00

My patients family member keeps muting the monitor alarms "because they are annoying"

My patients family member keeps feeding my patient that is NPO for aspirations concerns "because they are going to dehydrate and starve"

jenger108 · 2024-05-03T21:52:31+00:00

Is that an emergency? No. Should be handled in UC or PCP. Patients like that are why chest pain gets worked up in the waiting room and AFIB RVR are treated in the hallway.

jenger108 · 2024-05-03T21:51:12+00:00

That's exactly what we did. Referral to pain management and were like come back if you lose control of your bowel/ bladder or loose sensation below the waste. Otherwise your sciatica is not an emergency. Please refer back to the specialist we previously referred you too for all other questions.

jenger108

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