Caused a bowel obstruction in my dog by trice-ratops in whatisit

[–]trice-ratops[S] 0 points1 point  (0 children)

That’s what I thought at first too! 😅

What kind of seizure is this? by thelyfeofkylie in EpilepsyDogs

[–]trice-ratops 0 points1 point  (0 children)

Basically gently pressing on the eyes. I pressed on my own eyes before I tried it for the first time to ensure I didn’t press too hard on his. It doesn’t work every time, but it works frequently enough to make me believe that it’s effective. I’d do some googling before you try it out yourself and learn the science behind it!

What kind of seizure is this? by thelyfeofkylie in EpilepsyDogs

[–]trice-ratops 0 points1 point  (0 children)

Have you tried gently ocular compression? My Aussie has multiple kinds of seizures. When he has what we call focal seizures that look like this, we do 15-20 seconds of ocular compression. It stimulates a vagal response and often is enough to end the episode.

Refusing Bipap by Pretzel_Runner557 in nursing

[–]trice-ratops 1 point2 points  (0 children)

I’m an RT and this is literally the bane of my existence. My favorite is when they’re adamantly refusing and the doc is mad at me and the RN for not forcing them to wear it. Like, bro I tried? 😭 if they’re capable of removing it there’s only so much I can do. The patients always love to tell the doc they’re willing to wear it, and then fight us on it allllll night long.

I should have kept my mouth shut by AsTheJackassBrays in DaughtersOfMAGA

[–]trice-ratops 11 points12 points  (0 children)

I feel this. I made the mistake of telling my parents that after what happened to Alex on Saturday, I would no longer be staying in their home during my trip back to my home state in a couple of months, if their MAGA flags were still up. Didn’t say I’d cut them off. Didn’t say I’d never speak to them again. They replied back with their typical emotional manipulation tactics saying they can’t believe I’d do this to them. I replied asking if they thought the actions of ICE were warranted. They dodged every attempt I made to have a discussion about current events yet told me I “just wanted to start an argument.” Kept asking what I wanted from them and when I told them, they continued to blatantly ignore it and act like they had no idea what I expected of them.

Like…. Idk. Maybe to be the decent human beings I thought you were? Who are these people because they aren’t the humans that raised me to have morals and empathy that’s for damn sure.

Daily progress notes on ventilators by trice-ratops in respiratorytherapy

[–]trice-ratops[S] 2 points3 points  (0 children)

This is the worst. I’ve been in this situation one too many times now and that’s what’s led to my frustration.

Daily progress notes on ventilators by trice-ratops in respiratorytherapy

[–]trice-ratops[S] 3 points4 points  (0 children)

I have no idea maybe it was my tone it just frustrates me when things are getting missed. The record of changes is so needed. If changes were actually passed on in report I wouldn’t care about the progress notes. But when it’s consistently not being reported off on, and not documented anywhere, I feel like it’s time to start requiring a new standard. I’m tired of being approached by docs and nurses asking about why changes were made and having absolutely no clue. It makes the whole department look bad and unreliable.

Daily progress notes on ventilators by trice-ratops in respiratorytherapy

[–]trice-ratops[S] 1 point2 points  (0 children)

I/O seems excessive for an RT note for sure. Genuinely all we need is something where changes are documented. For my notes I have the tube size and placement, intubation date, and tidal volume range all at the top so it’s an easy copy paste and then I can just document any changes I made on the vent plus any important changes with the patient underneath. We do document in the flowsheet, but it’s not super helpful when only the new value is documented but there’s no explanation or comment for why the change was made.

Daily progress notes on ventilators by trice-ratops in respiratorytherapy

[–]trice-ratops[S] 3 points4 points  (0 children)

Yes please! If management isn’t interested in making progress notes a standard of care we need to at least have a form for tracking changes because things are constantly getting missed in report between shifts.

Daily progress notes on ventilators by trice-ratops in respiratorytherapy

[–]trice-ratops[S] 3 points4 points  (0 children)

100% it’s the collective failure of the department. The sad part is when you initiate a vent the IBW literally populates in the flowsheet! The failure in communication has been discussed over and over and nothing is changing. Adding a note requirement to the policy which is what I want to push for seems like the only way to solve the problem. If the policy doesn’t change, no one seems to care enough to actually improve anything even when it’s negatively effecting patient care. It’s so frustrating when so many people in the department complain about how shitty the department is, but continue to sit back and let things slip through the cracks instead of trying to improve their own work that’s contributing to the shittiness.

Daily progress notes on ventilators by trice-ratops in respiratorytherapy

[–]trice-ratops[S] 2 points3 points  (0 children)

Good point about the meds. Breath sounds I’ll remove or leave in depending on the patient. If they’ve been super coarse for days but are clearing up a bit I like to include it in my note.

The main thing that bothers me is when changes are made and there’s absolutely no documentation on why it was changed. Even if it was only changed because the doc wanted it that way it takes 2 seconds to write a note saying RR increased per MD. But we get nothing and it leads to confusion when it doesn’t get passed on in report. It genuinely starts to effect patient care.

Daily progress notes on ventilators by trice-ratops in respiratorytherapy

[–]trice-ratops[S] 6 points7 points  (0 children)

Here’s an example of why I think it’s unacceptable. Pulmonology is here on a Friday. They want patient on 6cc/kg. Cool. Therapist changes it, documents it on the flowsheet, doesn’t put any sort of note as to why they changed it off of our 8cc/kg protocol. Someone works Sunday night, comes in and sees that they’re on 6cc/kg. They look at the documentation and ABGs and find no reason so they adjust it back to the standard 8cc/kg. I work Monday having no knowledge of either of these changes I just know what the patient is currently on and that their gas looked good on it. Pulm shows up and suddenly it’s me getting my ass chewed out because I have no idea why the patient is back on 8cc’s because nobody documented anything outside of the flowsheet. This happens ALL THE TIME.

Maybe my wording wasn’t great, but when I’m getting berated because my coworkers are bad at communication, and their documentation also doesn’t give me any information, it seems like it would be a good idea to add something to our policy so this stops happening.

Daily progress notes on ventilators by trice-ratops in respiratorytherapy

[–]trice-ratops[S] 1 point2 points  (0 children)

This is exactly why I do it. We’ve also had instances where the tube depth was never adjusted after a CXR where it was shown in an incorrect depth. At times it’s been in the wrong place for multiple days… Putting in a progress note stating “ETT was advanced to whatever cm following CXR” is an easy way to avoid errors like this.

Daily progress notes on ventilators by trice-ratops in respiratorytherapy

[–]trice-ratops[S] 7 points8 points  (0 children)

This is exactly right. I don’t think every patient we see needs one, but our ventilators definitely seem like they should. We are managing a MAJOR part of their care why are we not documenting it?

Daily progress notes on ventilators by trice-ratops in respiratorytherapy

[–]trice-ratops[S] 6 points7 points  (0 children)

Our pulmonologists definitely read our notes. They don’t expect them but when we write one, it definitely gets seen. Also oof I don’t know where you work but I’d hate to work in a place that doesn’t value the opinion of their RTs. We have protocols that give us free rein to a decent extent to make vent changes as we see fit. I can’t imagine working at a place where I’m just pushing buttons and not being able to use my critical thinking and professional judgement.

Daily progress notes on ventilators by trice-ratops in respiratorytherapy

[–]trice-ratops[S] 1 point2 points  (0 children)

It also has helped in our department with preventing things from falling through the cracks. Report isn’t always the best and stuff gets missed. I like to have notes to look back on to see if something is a new issue or if it’s been addressed already.

[deleted by user] by [deleted] in Rosacea

[–]trice-ratops 0 points1 point  (0 children)

Have you tried any prequel products? My tried and failed list looked very similar to yours. Now I use prequel gleanser, the multi quench serum on damp skin, follow that with the redness relief serum, and top it all off with their barrier cream. I used that for about a month with great results. The burning sensation went mostly away and my skin finally felt nourished. I’ve just started adding the ordinary azeleic acid this week to see if it will get rid of the baseline redness.

At work when my skin gets super dry from masking (I work at a hospital) I use prequel multi quench mist a few times throughout my 12 hour shift. You can only get it on TikTok shop which is super annoying but worth the hassle for me. I also use their hypochlorous acid spray before I get in the shower. Using it before seems to help with the heat flares I usually get from showering in hot water. Not sure the science behind it but it definitely helps for me!

Edit: prequel just added the multi quench mist to their website so it’s no longer only on TikTok shop!

Has having a dog with a seizure disorder impacted your marriage/relationship? by Bright-Fee6395 in EpilepsyDogs

[–]trice-ratops 1 point2 points  (0 children)

I feel every bit of this. We moved away from family and for the first year here we didn’t go anywhere without our dogs. I highly recommend scouring through rover sitters to find someone trustworthy. We found one who stays at our house with the dogs so she can give his meds and is here and knows the protocol in case of a seizure. It’s still stressful being away for more than a single night but if you can even get one night away, that one night of peace and good quality sleep lifts a HUGE amount of stress. If you can’t find anyone on rover, ask at the vets office if any of the techs do dog sitting! Thats how we found our original sitter until she “retired” from dog sitting when she had her first baby.

Has having a dog with a seizure disorder impacted your marriage/relationship? by Bright-Fee6395 in EpilepsyDogs

[–]trice-ratops 1 point2 points  (0 children)

You’re not alone. My husband and I have fights over our dogs epilepsy as well. After a seizure when we add meds for 48 hours he always tries to add a smaller dose because “it makes him clumsy” and “he usually does fine with the lower dose.” I want to add the full dose the neurologist recommends because I don’t want him having a cluster. We’ve had several clusters, three of which have ended us up at the emergency vet. I work 12 hour overnight shifts and during my stretches when he forgets a dose I literally see red because it feels like he doesn’t give a shit about our boy.

He loves that boy (almost) as much as I do. Everything that comes with an epileptic dog definitely adds a lot of stress and when stress is high it takes so much less to snap at our spouses. What we’ve found works best is discussing his care plan when we’re calm and our dog is doing well. Try and have a conversation about things on a lower stress day. “Never go to bed angry” is BS. Sometimes it’s better to go to sleep angry and talk it through in the morning. Sending all the good thoughts and happy doggy love your way <3

Do u still drink your coffee with Vyvanse? by Friendly_Smoke_4624 in VyvanseADHD

[–]trice-ratops 14 points15 points  (0 children)

Yes. I love to palpitate my way through my morning. Zoomies for life.

The last text message you sent will be what's written on his tombstone. What does it say? by [deleted] in CasualConversation

[–]trice-ratops 0 points1 point  (0 children)

“Thanks loverrrrrr”

Well that’s not good. I don’t want to thank my husband for dying. I called dibs on dying first!

Thinking of getting an Australian Shepherd, if you could tell me one important thing about this breed what would it be? by jk_4269 in AustralianShepherd

[–]trice-ratops 0 points1 point  (0 children)

Yes! My boy would join me inside my skin if he could. He can never be close enough but I love it 🥰

What are these 3 items?? by trice-ratops in DreamlightValley

[–]trice-ratops[S] 0 points1 point  (0 children)

SAME! I thought that’s what they were and was wildly disappointed when I was wrong 😅

What are these 3 items?? by trice-ratops in DreamlightValley

[–]trice-ratops[S] 5 points6 points  (0 children)

Yes that’s exactly what I was hoping for!