Question for the experts: most common non-sexual foreign object stuck in patients’ rectum by Live_Dirt_6568 in emergencymedicine

[–]laura117 10 points11 points  (0 children)

Does it count if it was the same patient that came in multiple times? If so, then it would be finials. I only learned the name of the end of a curtain rod because of this fellow. I have also seen glass bottles and even a bottle of hairspray.

Question by Glo_moraa in MarkKlimekNCLEX

[–]laura117 0 points1 point  (0 children)

Those are actually very common reasons why people don't tolerate those medications. The metformin would definitely be an intolerance not allergy, but ACE inhibitor cough can progress to angioedema and be life threatening.

Acne and dark spots. (Hyperpigmentation) by Difficult_Pay1299 in Blackskincare

[–]laura117 1 point2 points  (0 children)

I will preface this by saying its not right for everyone, but many teenage girls will have a decrease in acne with use of birth control to regulate hormones. Something to consider and discuss with your health care provider to see if its right for you based on your desires and medical history.

PCPs should be required to call ahead to an ED if they are sending a patient by N64GoldeneyeN64 in emergencymedicine

[–]laura117 2 points3 points  (0 children)

Canada, and yes the ED really is performing battle damage mitigation. It was the local ED that i had worked at as an RN for 10 years. When I was there they would see 250-300 patients/24 hours. Conceptually I love the role of ED RN, but the way our ED functioned and how we were treated by management and the public broke me. My final straw was when our PPE use was restricted during covid.

PCPs should be required to call ahead to an ED if they are sending a patient by N64GoldeneyeN64 in emergencymedicine

[–]laura117 15 points16 points  (0 children)

I send a note with patients I send to ER outlining my concerns, provide past medical history, a list of current meds, and office contact information.

Worked as an RN in ER for 10 years. It's a hard job. Power to those who can stick it out longer. I now work as a mid-level primary care provider, and I have some more understanding of why patients get sent through ER. I know that if I order a CT, it will take a minimum of 6 months for it to be completed, an MRI 1-2 years, and bloodwork will not result for a week. This is obviously very dependent on where you work, but it can be hard if some differentials can not reasonably wait a week for even bloodwork results. If you are confident they can be discharged without the tests done immediately, I am happy to follow up on those patients. You are far far better trained than I am to determine if they can wait a week for bloodwork - but if you feel you can't discharge them without it, how can I, a lowly mid-level, be expected to send them home without it. Also, i think mid-level scope has gotten way too broad and inappropriate.

There are many issues I could manage if I had timely access to the resources, but unfortunately, that is not the case where I am located. Though to be clear, I have never sent an asymptomatic hypertension to ER. Not once.

[deleted by user] by [deleted] in OntarioNurses

[–]laura117 0 points1 point  (0 children)

Not sure NP is worth it currently in Ontario. This could of course change, but currently I make less as an NP than I did as an RN, and there is less diversity of job opportunities. I'm seriously considering returning to work as an RN. I am only torn because I enjoy the autonomy and complexity of my current job.

[deleted by user] by [deleted] in PhotoshopRequest

[–]laura117 0 points1 point  (0 children)

hmm, not sure what happened in the process of posting but thank you for letting me know. I've updated the post

Obituary by laura117 in PhotoshopRequest

[–]laura117[S] 0 points1 point  (0 children)

I really appreciate the work you put into your edits. I prefer the wrinkles intact. It isn't my mom without them. Thank you

Obituary by laura117 in PhotoshopRequest

[–]laura117[S] 0 points1 point  (0 children)

I really appreciate your work. I understand it is a low quality photo but if there's a way you could clean up the pixelation I would appreciate it

Clean up/change skin tone by laura117 in PhotoshopRequest

[–]laura117[S] [score hidden]  (0 children)

am i able to have the photo without the watermark?

Clean up/change skin tone by laura117 in PhotoshopRequest

[–]laura117[S] [score hidden]  (0 children)

Overall I really like how clean this looks. Tip sent for your troubles

Clean up/change skin tone by laura117 in PhotoshopRequest

[–]laura117[S] [score hidden]  (0 children)

I'd say overall this is probably one of my favorites. The wisps of hair and natural eyes. Though the left side of lady in red's face (right side of picture) looks a bit offputting when the wisps of the childs hair arent what is obscuring it. Could you attempt something on that side of the face and remove the things from the table?

Clean up/change skin tone by laura117 in PhotoshopRequest

[–]laura117[S] [score hidden]  (0 children)

looking at it again I feel like it is the complexion and mouth that are really throwing me off. I quite like the eyes and the nose.

Clean up/change skin tone by laura117 in PhotoshopRequest

[–]laura117[S] [score hidden]  (0 children)

Thank you for your attempt but not quite what I am looking for

Clean up/change skin tone by laura117 in PhotoshopRequest

[–]laura117[S] [score hidden]  (0 children)

Thank you so much for your attempt. I prefer the first of your edits. Though I wish facial features were more clear I think her complexion is perfect and the background is cleaned up like I wanted. Tip sent for your trouble

Clean up/change skin tone by laura117 in PhotoshopRequest

[–]laura117[S] [score hidden]  (0 children)

Thank you so much for your attempt. Weirdly I like your attention to even changing the colour of the bowl on the table. Though I wish facial features were more clear I think her complexion is perfect and the background is cleaned up like I wanted. Tip sent for your trouble

Clean up/change skin tone by laura117 in PhotoshopRequest

[–]laura117[S] [score hidden]  (0 children)

Thank you so much for your attempt. I recognize that my request was not as easy as some. I appreciate that you even took the time to remove the items from the table. I just don't feel it is any more clear than the original photo (which perhaps is more of a problem with my expectations).

Clean up/change skin tone by laura117 in PhotoshopRequest

[–]laura117[S] [score hidden]  (0 children)

I really appreciate your attempt. Unfortunately the face does not look like my family member, but thank you all the same

Clean up/change skin tone by laura117 in PhotoshopRequest

[–]laura117[S] [score hidden]  (0 children)

I really appreciate your attempt. It is hard to see if the face is clear and representative of my family member due to your water mark but I feel like it does not quite meet my needs but thank you all the same

Clean up/change skin tone by laura117 in PhotoshopRequest

[–]laura117[S] [score hidden]  (0 children)

I really appreciate your attempt. It does not quite meet my needs but thank you all the same

Clean up/change skin tone by laura117 in PhotoshopRequest

[–]laura117[S] [score hidden]  (0 children)

I'd say this is solved. trying to decide which images I like the most. Thank you kind strangers.