u/dopaminegtt

I'm curious about this because I'm an older nurse (12 years in). How often do you write a nursing note?

When you page a provider to the bedside to assess a patient for a concern you have, do you write a note summarizing the encounter? ie, "dr smith at bedside at 1330 in response to page at 1315." Drain with 100cc bloody output in one hour, previously straw colored. Per MD continue plan of care, if output becomes more than 200cc/2 hours notify team. At this time vitals are WNL, pt resting in bed, A+Ox4 with no complaints.

Or for example if a patient seems like they have a behavior issue (rudeness, risk of violence, noncompliance with instruction" do you write a note (A SOAP note - subjective, objective, assessment, plan)?

I spent some time auditing charts and most newer nurses don't write nursing notes, but I feel like they help paint a picture in a way charting by exception does not. I don't want to over chart, but I also know my memory isn't what it used to be and the cases in the news right now with documentation being ripped to shreds I know I need to be able to paint a bigger picture.

What do you do in your practice?

Hi all, I have a few bags from portland leather and they have all been very good quality, even the seconds pieces I have purchased and grab bag items have been great. I am really happy with the quality and pricing. My ONLY complaints is I wish the bags were lined in a light color so it was easier to find your items.

Are there any buy/sell/trade forums or website that has resellers? I know this sub doesn't allow buying or selling, but if anyone knows of a place please dm me.

Any suggestions on what to do with grab bag pieces you aren't into to? My SIL and both get grab bags and normally swap with each other, but she recently got some pieces we both dislike.

Thanks in advance!

Has anyone experienced this? The nurse wasn't very informative when she called to give me instructions (fast from 8pm until my appointment time at 630. Water is ok until 0400, then strict NPO.) I don't know if I should bring anything with me, Ive heard it's several hours long. The only things they suggested I bring were a phone charger and a jacket because it's cold.

Did they test make you sick? I'm worried it's going to make me vomit or give abdominal pain.

When you're having a hard time getting nutrition do you swell up? I had a rough few days and my feet swelled up. I'm not sure what's going on. I've never had this problem before except when I was super pregnant. I've read protein malnutrition can cause this and my albumin was at the very bottom of normal on July's labs.

Does this happen to anyone else?

Has anyone had an iron infusion? my ferritin in 2.5

When you precept experienced RNs do you start from the basics? I told her I was going to start at the beginning to make sure we have a solid foundation. Like our work flow, flushing and zeroing all your lines, checking your alarm limits immediately when you enter the room. Trying to make sure we have good habits in place.

I also feel like I may be explaining too much pathophysiology to her, but I'm not sure. I'm an RN with >10 yr experience but don't normally precept. They give me a new grad every few years. Any advice on precepting a nurse coming from acute care to step down?

Do you know what I mean? Mentioning that you are an employee, or having someone pull a favor to get you in to an earlier appointment. Would you do this? I need to see heme-onc and my PCP put in a stat order for a private oncology group - I have called on four separate occasions and not been able to make an appointment, left voice mails, etc. I'm worried that if this is how hard it is to get an appointment that it's going to be a night mare to work with them.

My assistant nurse manager has some pull at the cancer center associated with the hospital we work at (she used to work in onc) and gave me a recommendation and said that I should mention I'm a nurse across the street. She said if I have trouble she will make some phone calls.

Is this weird? I've had my dr friends call me in abx for a uti before, but never had someone pull strings for appointments.

Just trying to figure out what's going on while I wait for my heme appointment. My hgb is 8, wbc 2.2, anc 1100. Labs in Jan were normal. I do have sjogrens syndrome (I take plaqunil), celiac and gastroparesis, gerd (no ulcers). Have not had a colonoscopy or followed up with gyn yet.

Hello ladies and gents, I'm responsible for stocking our menstrual products drawer for staff at work. I'm asking for your advice on what you'd like to see. I have tampons in a variety of absorbencies, size 3 pads with wings, panty liners, wipes, midol single dose packs.

No one has had any complaints but I was hoping you could give me some feed back. Should I get smaller pads? I also need recs for the least crappy cheapest products because buying tampax and always is getting expensive for our budget.

I am looking for a heme-onc (blood and cancer doctor) in the heights. My dr is sending a referral to one she chose randomly because I need to get in asap, but I'd like to have a list in case I don't like this guy.

Anyone have a doctor with a good bedside manner, who listens to your concerns and not just looks at the numbers, and actually has some common sense? Seems like that's hard to come by these days. (sorry this is all over the place, I'm low key freaking out I have to see an oncologist stat)

my hgb is 8 something down from 10 something in january, and iron is 5, ferritin is 19 (cutoff for low normal 16). My B12 was fine but I take a B complex due to thiamine deficiency and at the urging of my GI (also extra D due to deficiency and extra thiamine).

I can't stomach oral iron products or much red med, my diet as you all probably know is garbage and probably deficient in everything. I also have celiac disease which means my body doesn't absorb iron well.

I didn't have any bleeding ulcers but do have a moderate size hiatal hernia that could be bleeding? I am in perimenopause and have heavy-ish periods at times but they've always been this way and my hgb has been stable around 11 most of my life. I have symptoms of anemia: tachycardia when I don't take my betablocker (for anxiety), am short of breath, fatigued, and bruise easily.

I put in a mychart message to my PCP, who did not order the labs, about the hgb of 8some thing, and iron of 5 (they can see all labs through epic), and asked if I needed to schedule and appointment or call the ordering physician. They responded that they would call right away and got me in the next morning at 9.

So of course I guess I'm looking at either getting a blood transfusion (I am currently on my period so hgb will continue to drop), or at least maybe iron infusions? I am a nurse, but we don't transfuse until a minimum of 7, 6.3 if asymptomatic with signs of adequate perfusion so I am not expecting a transfusion but I don't know this doctor well.

Has anyone had iron infusions? I only know of the allergic reaction risk, any other side effects?

Like a neighborhood only HOA pool (not a backyard pool)? We have to move to that side of town from the heights and I'm looking at neighborhoods and not liking it. Send help.

Eta nothing against public pools other than the hours suck and they're always crowded and often not free in surrounding communities like Houston. Pasadena and Baytown even have public water parks, and la porte a wave pool and that's cool. I just like the convenience of having a pool close by that's less crowded with better hours,. especially if I'm already paying an HOA.

(ETA or surrounding area, I'm trying to be halfwayish between the shipchannel and med center. Wish east end/ edo were in the budget but none of those homes meet our needs)

I'm just curious because I recently heard of a 22 weeker being admitted. My niece was born at barely 25 weeks after a placental abruption and is now 12 with many developmental delays and challenges in her life. She is the sweetest girl and I'm so glad she's with us.

I am not a NICU mom, or a NICU nurse, just a concerned Aunt (and trauma RN) that was up there every day and saw the saw the heroic efforts of the nurses and staff. These babies struggle so much, and our technology is getting so advanced. Is there a point where it is unethical to pursue life prolonging measures when the quality of life is so uncertain? My niece is doing fairly well now and can eat on her own and doesn't use oxygen anymore, but does require assistance with ADLs and other basic tasks. I can't imagine being a parent in that position, but have been thinking about this a lot, especially as our reproductive rights laws change.

Just wondering how many of us had HG when pregnant. I had HG in my last pregnancy 10+ years ago. I started with gastroparesis symptoms about a year and a half ago and official dx about 9 months ago. With HG I got though the misery knowing that it'd go away with delivery (and the feeling it was "worth it" from medical professionals kind of shaming me). There's no end in sight with GP. I think I'm good and then bam, flare for no good reason.

I was recently given the opportunity to work in an interim leadership role in quality directly under my department direction (not my manager, but my management did have to sign off on it). I worked with education, quality, infection prevention and several special tasks forces. I was in the role for four months.

Unfortunately, due to scheduling conflicts on my end I asked to go back to the unit so I could work 3 12s instead of 5 8s. Kids have a lot of orthodontics appointments, and I have chronic illness requiring many doctor appointments as well as therapies so I was having to take a lot of time off. I didn't want to apply for intermittent FMLA because this was only an interim role.

I learned a lot and had a good experience. I was wondering if it would be appropriate to write my director a card thanking her for the opportunity and confidence in my to do the job. I'd also like to give her a small item, like a candle in a scent she likes (she has a candle warmer in her office).

I'm not sure if this would be appropriate, I'm not trying to earn brownie points but I do geniunely appreciate the opportunity, and I'm not trying to commit career suicide here and would eventually like to go into leadership or education. Ultimately, I am happy with my choice to return to bedside but don't want to burn any bridges (I left on good terms after explaining my situation). I'm new to the world of leadership interactions and mainly just interact with my manager and ANM.

I have been struggling and on liquids and purees for a while. finally ready to try solids again. I'm really sad about the foods I can't eat but I made a meatloaf with ground beef and shredded, peeled zucchini. I made glazed carrots and creamed spinach, and brown gravy.

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Y'all I ate a pretty normal portion and kept it down! I'm super stoked. And my gravy is great, can't wait to eat mashed potatoes.

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No one understands how exciting this is.

I'm supposed to take b complex and vitamin D because I have b1 and b12 and d deficiency. Does anyone have any advice on tolerating these? They make me so sick

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I'm supposed to take iron too (hemoglobin is 8) but I can't stomach it at all.

I'm so tired of finding things I can eat. Protein drinks make me vomit now. I get nauseous when I look at foods I've gotten sick on. Immense stomach pain makes me not want to put anything in my stomach. I'm just exhausted. I'm supposed to eat 6x a day and I can't do it. I've lost 20lbs in 2 months here. I don't like purees and I have oab so subsisting on liquids makes me really uncomfortable

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What are your go to foods?

I'm struggling guys. I had an egd back in may for esophageal dilation. Around that same time I got a new job and have been under so much stress. Since then, I lost 20 lbs in two months because I'm not able to eat because of the nausea. I'm back on liquids but fill up so fast and hate feeling bloated.

I also recently got diagnosed with celiac disease (after being strictly gluten free for four years, I did a months long gluten challenge that made me pretty sick) so I'm off gluten again now but still feeling super bad. I hate purees and protein drinks (so burned out!) so if you have any safe foods please share them, nothing sounds good. After having vomited my safe foods, I now feel put off them.

I'm weak, I have vitamin deficiencies and am anemic. I'm not underweight yet as I started off over weight. I've been diagnosed for about 6 months but have had symptoms for about 18 months.

I just need hope this will abate soon. I quit my job Friday, and asked to go back to my old job, so hopefully the reduced stress will help.

eta more info: I have reglan but hate it, and would prefer to not eat than take it. They think I have GP because of an autoimmune disease (sjogren's syndrome) that caused nerve damage. I don't necessarily have constant nausea but any time I eat anything (and now strong smells effect me too) I get sick and that has me associating food with suffering

I'm a critical care nurse with 12 years experience and recently had the opportunity to step away from bedside. Today, I asked for my old job back and got it. I didn't like being away from bedside. Has anyone stepped away and come back?

Do you plan on working the floor until you retire?