u/Butthole_Surfer_GI

Just like the title says -

Where in this area is your "go-to" for good prime rib?

Doesn't have to be only the 3 locations listed in the title.

Thanks in advance, friends!

Hey all!

Urgent Care RN here with an important announcement - Covid and Flu Season is here and it is virulent!

I commented on a post a little ways back stating that Covid/Flu Season started early this year. In short, it started in mid-August and has only picked up from there.

I fear we are in for a rough next 5-6 months. Maybe longer.

For the past month, we have seen about 5-6 positive covid and/or flu tests a day. Sometimes more. Sometimes less.

Last week, 50% of patients coming in for respiratory related symptoms tested positive for flu or covid.

It is here.

• Get vaccinated.
• Wear a mask (N-95) when out and about and especially in crowded areas.
• Wash your hands before touching your face.
• Cover your sneezes and coughs.
• Buy covid/flu tests from amazon or your local drug store. Test yourself if you feel sick.

Typical symptoms we are seeing are: fever, cough that can range from mild to hacking, sore throat, body/muscles aches, fatigue, upset stomach with/without vomiting, loss of taste/small, confusion/brain fog

Typically, Paxlovid can be prescribed up to 5 days after symptoms have appeared (per my clinicians) - example, you started feeling symptomatic on the 20th, you can get Paxlovid up until the 25th. Anything after 5 days and Paxlovid is much more likely to be ineffective in reducing your symptoms/the duration you are ill.

Now is not the time for your anti-mask / anti-vaccine bullshit.

Please be safe and keep each other safe!

Disclaimer: this is NOT medical advice. I am just an idiot on the internet trying to help. Please seek care with your PCP, an urgent care, or ER if needed.

Wanting these does not make you a NIMBY.

Wanting these does not make you insensitive.

Wanting these does not mean you wish harm on others.

Wanting these things does not make you a "dirty right-winger".

Wanting these things does not mean you are "punching-down".

I'm getting so frustrated we have to pre-emptively type the above before we can express desire for a safe and clean city.

Something - or many things - that we are doing is/are not working.

We should be able to discuss these issues and solutions without people trying to derail the conversation(s).

REPOSTING here because this post was remove by the mods.

EDIT: this is partially a response to the "Judkins Park wtf" post from r / seattle

A rant in the similar vein to the post about anti-vaxxers, I wish we could ban patients who clearly do not follow instructions and then come into the clinic IRATE and ready to fight with any and everyone.

This post was inspired by a mother (it's always the moms, right?) who signed herself up on our "hold my place in line" service instead of her daughter who needed to be seen. It states very clearly on the service that you need to enter the information of the patient needing to be seen, not yourself.

When this mom and daughter gets to the clinic, they are informed of our policy regarding this, they are provided with a written policy, AND a screenshot where it is highlighted that the patient information needs to match the patient who needs to be seen.

What does mom do? She starts screaming at the front desk staff. At the clinic coordinator. At the nurse rooming her (although the nurse did manage to deescalate her a bit).

Apparently this patient is seen in our primary care as well and is just a nightmare to deal with.

Which leads me to my point - why the fuck is she still a patient with the clinic/hospital system?

I know the short answer is money but holy shit grow a fucking backbone, admin!

These people NEED to face consequences like being banned from the clinic or having the cops called on them. Sure, that many not be enough but if we continue to see them, it reinforces the behavior.

And it's not just her.

There was the guy who refused to follow the printed instructions/advice on his after visit summary and then calls the clinic cursing at everyone because he didn't feel better.

There was the woman who was discharged stable after a head injury with instructions to self-monitor her symptoms and return to the clinic or go to the ER if they get worse who called the clinic to complain that no one FROM THE CLINIC had called her to check on her.

There was the mom who wanted a note from the clinician so her COLLEGE-AGED daughter could drop a class she was failing and get a full-refund.

I'm just SO burnt out on these rude ass patients who seemingly never have anyone check their shit.

I am so tired of this fucking administration and their anti-vaxx and anti-science bullshit.

If you're a nurse and you support this administration and/or this anti-vaxx bullshit, get the fuck out of the profession.

That's it. That's the post.

I am just so fucking tired of this administration and their anti-science, anti-vaxx, anti-medication bullshit.

Part of this is that I want to hear/read your thoughts and part of this is because I just want to vent/commiserate.

Hi all! You've seen my posts before about flu and covid.

I wanted to spread a PSA for y'all that strep throat seems to be particularly prevalent right now. I base this entirely on the fact that we tested about 30 people in the last 2 days and about 30% of those tested came back positive on their rapid strep tests.

I know it may not sound like a lot, but this is a huge number of patients when compared to how many people we tests for strep/how many rapid tests are positive.

Remember, just because you have a sore throat DOES NOT mean you have strep - it's more likely to be related to a cold or the flu. Or just a random sore throat caused by some virus.

Strep throat is caused by a bacteria and does not typically present with a cough/runny nose.

The most common symptoms that I hear from patients who end up testing positive either on rapid test in clinic or their throat culture are:

it came on suddenly, it really hurts to swallow, they have noticed that their tonsils are enlarged/enflamed, they report an earache/headache along with their sore throat. Nausea/vomiting in younger children.

Of course there are more symptoms but those are the ones that seem most common.

As of the writing of this post, I have not been able to find any AT-HOME strep tests. If anyone knows where to buy, please share that information and I can edit the post.

EDIT: There are NO FDA approved at-home tests currently on the market at this time.

If you have any of the above symptoms, please go to an urgent care to be tested. This will involve a strep test where the back of your throat is swabbed (warning, it will probably make you gag), a discussion/exam with the clinician, and possibly the swab being sent to the lab to see if it grows bacteria - this is the typical process at my clinic and it may look different at others.

Depending on the results of your rapid swab and the discussion/evaluation by the clinician, you may be prescribed antibiotics - I have seen patients test negative on the swab but be prescribed antibiotics anyway because the clinician took one look at them and their tonsils/throat and knew/highly suspected it was strep.

Sometimes you don't get antibiotics UNTIL we get the results of your culture back. Which could take 1-3 days.

If you test negative, the treatment is supportive: ibuprofen to help with pain, Tylenol to help reduce fever, staying well hydrated, getting lots of rest.

Sometimes I have seen the clinicians prescribe viscous lidocaine which helps to numb the throat and relieve pain so you can swallow.

Strep throat is spread by droplets in much the same way cold/flu is. In terms of prevention - WASH YOUR HANDS often, avoid touching your face and eyes, cover your sneeze/cough, wear a mask, avoid sharing utensils/glasses/toothbrushes.

Typically, persons being treated for strep (with antibiotics) are considered less contagious after 24 hours (after starting the antibiotic) and can often return to school/work if they are fever-free without using medication to reduce said fever. Of course, check with your school/workplace for their actual policy.

DISCLAIMER: nothing in this post is intended to replace medical advice from a practicing clinician and should NOT be used to make any healthcare decision. I am just an idiot who enjoys surfing buttholes in my spare time.

I consider it part of my job to raise public awareness.

Stay happy and healthy! And please be nice to/patient with the clinic staff!

EDIT: since this is gaining more traction I wanted to be very clear that anyone wanting to bring their anti-mask/anti-vaxx/anti-science shit can fuck RIGHT OFF.

Hi all! You've seen my posts before about flu and covid.

I wanted to spread a PSA for y'all that strep throat seems to be particularly prevalent right now. I base this entirely on the fact that we tested about 30 people in the last 2 days and about 30% of those tested came back positive on their rapid strep tests.

I know it may not sound like a lot, but this is a huge number of patients when compared to how many people we tests for strep/how many rapid tests are positive.

Remember, just because you have a sore throat DOES NOT mean you have strep - it's more likely to be related to a cold or the flu. Or just a random sore throat caused by some virus.

Strep throat is caused by bacteria and does not typically present with a cough/runny nose.

The most common symptoms that I hear from patients who end up testing positive either on rapid test in clinic or their throat culture are:

it came on suddenly, it really hurts to swallow, they have noticed that their tonsils are enlarged/enflamed, they report an earache/headache along with their sore throat. Nausea/vomiting in younger children.
EDIT: if you have a sore throat (even a "mild" one) and a fever, please consider getting tested.

Of course there are more symptoms but those are the ones that seem most common.

As of the writing of this post, I have not been able to find any AT-HOME strep tests. If anyone knows where to buy, please share that information and I can edit the post.

EDIT: There are NO FDA approved at-home tests currently on the market at this time.

If you have any of the above symptoms, please go to an urgent care to be tested. This will involve a strep test where the back of your throat is swabbed (warning, it will probably make you gag), a discussion/exam with the clinician, and possibly the swab being sent to the lab to see if it grows bacteria - this is the typical process at my clinic and it may look different at others.

Depending on the results of your rapid swab and the discussion/evaluation by the clinician, you may be prescribed antibiotics - I have seen patients test negative on the swab but be prescribed antibiotics anyway because the clinician took one look at them and their tonsils/throat and knew/highly suspected it was strep.

Sometimes you don't get antibiotics UNTIL we get the results of your culture back. Which could take 1-3 days.

If you test negative, the treatment is supportive: ibuprofen to help with pain, Tylenol to help reduce fever, staying well hydrated, getting lots of rest.

Sometimes I have seen the clinicians prescribe viscous lidocaine which helps to numb the throat and relieve pain so you can swallow.

Strep throat is spread by droplets in much the same way cold/flu is. In terms of prevention - WASH YOUR HANDS often, avoid touching your face and eyes, cover your sneeze/cough, wear a mask, avoid sharing utensils/glasses/toothbrushes.

Typically, persons being treated for strep (with antibiotics) are considered less contagious after 24 hours (after starting the antibiotic) and can often return to school/work if they are fever-free without using medication to reduce said fever. Of course, check with your school/workplace for their actual policy.

DISCLAIMER: nothing in this post is intended to replace medical advice from a practicing clinician and should NOT be used to make any healthcare decision. I am just an idiot who enjoys surfing buttholes in my spare time.

I consider it part of my job to raise public awareness.

Stay happy and healthy! And please be nice to/patient with the clinic staff!

EDIT: since this is gaining more traction I wanted to be very clear that anyone wanting to bring their anti-mask/anti-vaxx/anti-science shit can fuck RIGHT OFF.

Hi y'all!

I am an RN at an outpatient urgent care clinic that does frequent blood draws and I have a few questions. For background, we have a sysmex and i-STAT machines in clinic so we can preform our own CBC, CHEM-8, TROP. Everything else gets drawn, centrifuged (as needed) and sent out.

We send out routine and "STAT" labs - STAT gets picked up faster and resulted faster.

I've looked all around our lab area and noticed we do not have any "no-additive" tubes.

A few weeks ago, one of our providers ordered a STAT BNP. I drew it and handed it to one of the MAs to process. She told me she was going to centrifuge and separate the plasma from the cells, per the requisition instructions - although I'm not sure if it needed to be done before being sent to the main lab.

My question for y'all is this: if needing to separate plasma from cells, what is the preferred container for the separated plasma? Since we don't have "no additive" tubes, would a sterile syringe be ok? Would a separate EDTA tube be preferred?

Went there for the first time a few days ago.

15 bucks to spend one hour with friendly kitties and kittens.

Friendly staff.

Just wanted to give them a shoutout.

My family didn't even wish me luck when I told them I was taking the class. Maybe it's not the most "impressive" of classes to take/pass, but I am proud of myself.

41 people being monitored for Hantavirus

Just keeping y'all informed :)

I see y'all. I love interacting with y'all. Y'all are doing a good job.

That's the post.