u/anon567126

Hi all! I finally got accepted after two agonizing cycles and wanted to find out if there are any other SRNAs who have chronic conditions and how you manage them. I have MS, which requires 2 infusions per year of a specialty medication.

Is anyone else out there on a specialty med that requires pre auth and how do you manage this with not working or with the school’s insurance? Should I just look at the marketplace? I’m not married and don’t have a partner so I don’t have someone else’s benefits to use. For context the school I’m going to be going to is in Florida.

TIA

If anyone has any stories of hope, where your partner finally overcame their issues and changed for the better, would you be able to share them please?

I finally ended things with my partner of 4 and a half years because of his depression. Don’t get me wrong, he’s a great guy, but I just couldn’t take it anymore and it’s been sucking the life out of me. He can’t set any achievable realistic goals, doesn’t hold up to his word, and will just close himself off when feeling depressed.

He builds up good habits but then ultimately falls down into the same pattern. I commend people who are able to have relationships with people like this and make it work, but I don’t have it in me anymore. I would love to experience a relationship with a mentally healthy person for once.

For those of you who have broken up, does it get better? Did your partner eventually get help and become a much better version of themselves or is it all just a temporary band aid until the next depressive wave comes?

I don’t know if I made the right decision but also didn’t want to hear someone threatening to off themselves after an argument we had.

Hello, I’m traveling to Newport next weekend for a little getaway. My hotel is not in the immediate downtown area so I’ll probably have to drive to where the activities are. Could you tell me what the parking is like? I’m also going with a dog as I see the town is pretty dog friendly. Lastly, should I just make reservations for all the restaurants I want to go to or can I wing it?
TIA

Hello all, I am really freaking out and typing this through tears. My question is, has anyone ever had a situation where they got an infusion before the med had been approved by insurance? My appt is tomorrow and the infusion center just called me to say they still don’t have approval. Because of an issue with labs from my last infusion, my doctor doesn’t think I can afford to have a lapse in time for medication.

Can I just get the med, get the bill, and square it with insurance afterwards? I’m also apart of the copay program if that means anything.

I was the nurse who coded a patient yesterday, 78M, ESRD, severely septic w bacteremia. Initial code blue on the floor for him when he was hypoxic, he was still satting in the 40s on HFNC. I had him in the icu maxed on pressers, when the doc got an a line in, pressures were 40s-60s over 20. We thought it was venous. Sent an ABG, totally arterial. HR was still 75 at this time, (he had a pacemaker).

He didn’t code again with me until later on in the shift when I couldn’t feel a pulse and my pressures were taking while I was on the holy trinity of pressors and maxed. My question is, why do you think he didn’t code when his pressures were in the 40s when we placed an arterial line? Does a pacemaker help prevent the patient from arresting? If that’s what happened the first time why didn’t it help him the second?

I’m just feeling confused and we didn’t have a debrief after so it left me w a lot of questions.

FWIW, we also gave a crap ton of bicarb pushes throughout the shift. PH was still 6.8 on a bicarb drip at 200cc/hr.

TIA.

I need help with what kind of mental disorder this could be. A 30M goes through periods of feeling depressed and low, feeling like a loser, but then picks up good habits again, like reading, meditating, and journaling and starts to feel better. Slow starts to his morning help, taking time to be in nature, fresh air, going for walks. But all it takes is one day of falling off track for him to start feeling hopeless again. One day of not doing laundry, one day of getting home from work at 8pm and falling right asleep instead of doing chores, which then causes him to flake on plans because he just wants to be alone.

He can’t commit to things, if he makes plans on a Wednesday for a Sunday, he will likely be bailing. He has been seeing a Neurologist who prescribed him Wellbutrin and Addy, for depression and ADHD, but to me this seems like it could be bipolar? I’ve been telling him for months now that these meds are not working for him, and that there are psych meds out there that can actually make you feel better and that there is no point in taking these if you’re gonna feel like garbage still.

Any insight?

Disclaimer: I’m a nurse but not in the field of psych at all so these are just my assumptions.

Hi all. I went to my neurologist today and got some not so favorable news. My scans are stable thankfully, but my B cell and NFL levels have increased slightly after being 0 for the last couple of years. My neurologist is worried that it could be my body mitigating the ocrevus and told me if my repeat testing is still elevated, I might need to switch to briumvi.

I have been on ocrevus for 8 years now and switching to a new drug scares me particularly because I’m just worried about how my body will react to this change. I also feel like ocrevus is so glorified that I feel like what I may be switching to is no longer “the best”.

Has anyone had any experience with this medication or switching from ocrevus to briumvi? Why did you do it? What was your experience?

I would love to hear anything positive right now. Feeling so sad and devastated cause I really thought I had a good handle on this God damn disease.

Looking for a dog boarding facility in Nassau for three days for my baby girl. Recommendations and non recommended places are welcome.

As the title says, I was sitting outside today and saw my neighbors chihuahua fall from a second floor balcony, it’s like an 8 foot drop, I still heard it hit the ground and she yelled “shit”. I guess he’s small enough to have slipped through th railing. My jaw fell to the floor. The dog was twitching and not moving. He only yelled out one little weak cry and that was it. It took her what felt like forever to get to him and even then she didn’t seem to be distraught or anything. She then picked him up and carried him inside like a football, again he didn’t seem to be moving. And she was out on the balcony again holding him, but like, not really assessing him or seeming concerned.

I kinda forgot about it as the day went on but just remembered now as I’m going to bed and it’s bothering me so much. I have a dog who I love so much and she’s allowed out on the balcony but thankfully is too big to go through the railings. I still watch her though. I just love my dog so much that I would be an absolute mess God forbid I was in that position and the lack of calmness expressed is bothering me. I really hope the dog is okay. I didn’t see anything else since then.

Hi all. Can someone please explain PSV to me like I’m 5? On my unit, when we are doing SBTs to prep for extubation, the patient gets put on PSV, but it’s also referred to as CPAP by most of the providers on my unit. They’ll say something like “CPAP 10 over 6”. Can you explain the 10/6 thing? I know one is PEEP but the other is ??? Just feeling really confused rn and want to understand why this mode helps a patient be independent as well as what the hell it means.

TIA

[NY] I recently put in a reasonable accommodation request through my employer to work and earlier shift due to a medical necessity. It was granted, however, rumors have been swirling as to why I was switched shifts and somehow my business about my diagnosis has gotten out there.

I’m feeling super violated, and my question now is what should I do?

I want to talk to my manager first and confront her about what I’ve been hearing (being that management and HR are the only ones who know about the condition and reasons for the accommodation), but I also want to file a complaint.

My question HR people, what should I do? Should I talk to her AND file the complaint, or just file the complaint? For reference I am a nurse at a major hospital system in NY.

Hi all!

I’ll keep this short and sweet. So my mom lent a friend $17,000 recently and he has just paid her back in cash. We’re trying to find a way to allocate the money into investments and are trying to do so with avoiding as many tax penalties as possible.

We’ve already decided that she will open and max out a Roth IRA (she’s 68), but we don’t know where to put the rest. Is this the right move? Can you recommend anything else?

For context we are in New York, she already has a 401k which she doesn’t take withdrawals from from her previous employer. She also gets about 26k in social security income yearly.

TIA

To keep a long story short my (28F) boyfriend (30M) has been struggling with depression for a very long time since he was a teenager. He ended up falling into bad habits like p*rn addiction and we*d but has since overcome them which I am very proud of.

The problem is we have been together for 4 years now, and from those 4 years, the last 2 have been incredibly difficult with his depression. He went to school for physical therapy, which if you didn’t know does not have a high ROI for the amount of student loans required. Because of this, he works 7 days a week. The first four days are ten hour shifts, and the last three are 8 hours and 2 6 hours. We try to make time for each other but it’s very difficult because during the week he is so tired that he just comes home and sleeps. This leads to him feeling like crap on the weekend, not cleaning his apartment, and feeling like he needs time for himself since all he did during the week was go straight to bed.

I don’t know what to do. The first two years of our relationship was wonderful because he was in school and worked part time doing some odd jobs but he had strict rigor and was able to have time for everything including us.

We get along well for the most part, I love him and he is my best friend, but I am out of options. He takes adder*ll and bupropion which were prescribed by a neurologist and not a proper psychiatrist and I have been begging him to see one for months now to get this re-evaluated. The problem is he kind of self diagnosed himself saying that he has ADHD and depression, and the doctor went with it.

I’m no psychiatrist but aren’t these meds made to work by giving you the energy boost that you need? It seems like it doesn’t work for him. Because of this we’ve broken up off and on, he’ll feel better for a little bit, we’ll get back together, and then we are back at square one. I decided I’m going to stop answering him completely and not feed into this cycle anymore. He says he loves me but is it wrong to use that as leverage? My ultimatum is going to be to speak to a real psychiatrist or go to therapy. Or I’m going bye bye.

I would really love some feedback, any medication recommendations, and if this sounds familiar to anyone who has gone through a similar situation. I am at a loss. I truly do love who he is when he isn’t depressed, but idk how to help him.

TLDR: F28 with a M30 boyfriend who feels good when he is in a routine for two weeks but one thing will throw him off into a depressive state. What to do?

Hi all!

I am precepting a new grad nurse and we were going over what happens during codes. We touched on ambu bags and “bagging” a patient that’s vented during a code. My question is, how would you best explain in depth why we choose to bag someone vs just keep them on a vent? I want to make sure she fully understands when it’s appropriate and when it’s not.

TIA