#Nursing assessment

[mdabdurrakib006]

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[artisticdivasworld]

Nursing Quiz

Here is a short quiz covering general nursing skills. See how you do. Answers will be posted at the end, but don’t cheat. Take the test and do your best! Good Luck!! Question 1 A nurse is caring for a patient who just underwent surgery. The patient reports a pain level of 8 on a scale of 1 to 10. Which of the following actions should the nurse take FIRST? A. Administer the prescribed…

[andhumanslovedstories]

I try to answer other people’s call lights if I’m not busy, because if my work is done and I’ve helped out with other people’s work, I can fully commit to slacking off guilt free. And usually what people want is bathroom, snacks, and/or pain meds, all of which are pretty easy to address and if there’s anything too complicated, I can always call the nurse. Anyway, I go answer this call light, and it’s for a patient I don’t know and have never spoken to before. I pop in like “hi can I help you?” as I feel so quietly smug about how Helpful I am being, and the patient goes, “do you know if I’m dying tonight? If I am, I should call my family.”

To be so clear. I was expecting like. a request for a ginger ale. I was not prepared emotionally for a very sick stranger grappling with the angst of potentially imminent death. So I go, “UMMM. I DON’T KNOW. LEMME CHECK WITH YOUR NURSE AND SEE IF SHE KNOWS.” This seemed heinously inadequate in the face of their obvious despair, so I added, “probably not in the next ten minutes if you’re able to sit up and ask, but I can’t make any promises.”

Don’t think that was the ideal follow up sentence. But it didn’t seem to make the patient any sadder than they already were. I used to really live in fear of being the nurse in someone’s anecdote about a wildly inappropriate thing said to them by their nurse. It’s not so much as I’ve gotten over that fear as I’ve accepted that my job thrusts me into a lot of situations where I have to talk about extremely intense topics to the people most intimately affected by those topics, often with no time, no prep, and no information. At this point, I just try my best to ground my inarticulate fumblings in as much genuine care as I can express, and thank God I don’t fuck up worse and more often.

[wr1t3w1tm3]

I did this instead of studying ya'll.

[daily-vocaloid-rock-metal]

Today's entry is #誰かこの痛みに名前をつけてください (#Dare ka Kono Itami ni Namae wo Tsukete Kudasai) -#Someone Please Come up with a Name for this Pain) by CosMo@bousouP featuring Hatsune Miku and Gumi.

It is a denpa digital rock song with a bpm of 219.

The PV was illustrated by CosMo@bousouP

[remyfire]

Okay but it is cute how they just pass him around and assess him as a love language.

[onsomekindofstartrek]

Fucking Christ I had the most irritating argument recently.

So Big Joel put out a teaser for his upcoming video on Irreversible Damage. Now, while Cass Eris has covered this ground pretty thoroughly, I’m definitely glad that a bigger leftist YouTuber, and one as insightful as Henry, is taking a shot at it, just like I was glad to see multiple other video essays on the Somerton scandal. Abigail Shrier continues to be a very vocal fearmonger about trans issues.

In the comments of that video someone was like “yeah it’s unfortunate that this book was transphobic, but her new book, Bad Therapy, is incredible.”

Now, Bad Therapy has already gotten two videos from Cass Eris, so I feel qualified to sum it up as like, exactly her previous book but for mental illnesses she thinks are subclinical, rather than for being transmasc. So basically “overreaching doctors and counselors are using unnecessary therapy to make our children think they’re trans mentally ill.” Fun, right? And obviously fertile ground for her to push TERF ideas in a more subtle way without making the transphobia as obvious as she did in Irreversible Damage.

Now, whatever you think of the thesis “iatrogenic mental illness is a common outcome in teens who undergo school-mandated talk therapy” (it’s probably mostly horseshit,) you probably should find someone else to defend that thesis. You know, besides the woman who previously published a bestselling transphobic screed with a large section on how transness in teenagers can be iatrogenic. I would not like to take her word on anything related to psychiatric treatment of children, actually.

(Especially when she seems to have, as her main concern, the future reproductive capabilities of AFAB children. For Christ sakes, the cover of Irreversible Damage shows a picture of a small girl in 50’s clothing with a circle cut out of the picture roughly where the womb would be. Like Christ, I don’t want to hear anything this woman thinks about children!)

But no, when first Big Joel and then I push back, this person wants to argue like “oh but she’s so right in this new book and I wouldn’t read it and endorse if anyone else were talking about it” and shifting the burden onto me to prove that there’s some other person talking about this issue, and a load of shit like that. I think they think they won, too, because I just had to leave.

And the thing is… would you do this for anything else? “Oh this person is a young earth creationist, but we’re talking about embryology, not evolution, so I suppose we can trust them. And who else is talking about embryology? It’s your job to show me someone else talking in this way about the subject and maybe then I’ll consider not endorsing the obvious evangelical Christian grifter.”

No! Fuck no! She’s invested in the idea that parents need to protect their children specifically from devious healthcare providers to protect them from “being convinced they’re trans,” so a second book on the topic of healthcare providers causing mental illness in children is going to be biased at best, even if it doesn’t mention trans issues directly. How are you this dense?

[nerdgirlnarrates]

I know it’s very early in residency both for me to have this opinion and to be judgmental about it, but my god progress notes should contain a real assessment. It sucks on crosscover to not have a good idea of why a team is doing the things they’re doing and then to have to make decisions about a patient I barely know with little information. Here’s an example: Mr. A is being treated for cellulitis. He is also getting a very thorough workup for osteomyelitis for reasons I can’t discern—is it his clinical picture? Is it some risk factor I’m unaware of? The imaging so far has been negative, so I’m not sure why it’s still being pursued. Then I’m paged that he’s having excruciating pain. I’m not sure how suspicious to be for underlying osteo—was the team very concerned and just waiting for a change in his picture, or was the additional workup CYA medicine? Should I give Tylenol or would it be better not to mask a fever so we can see if the antibiotics are working while we wait for the remaining imaging to be read? I’m sure an even slightly more experienced resident would not be fazed by this, but I honestly find it very frustrating. Like at least tip me off at signout as to what you’re thinking. But since you can’t anticipate every question I’ll be asked or everything that will come up, it’s probably best to write a good assessment. I’m only asking for a sentence or two on what you’re thinking. It really really really does help me understand where the patient is at. In conclusion, this shit is of the devil:

Mr. A is a 50 y/o M with PMHx of HTN, BPH admitted for cellulitis.

#cellulitis

- doxycycline 100 mg PO BID

- negative XR

- negative US

- MRI pending

[faggling]

I love taking care of people omggg 😍😍😍

[longlegsnamjoon420]

Got a strong feeling none of these schools I applied to are going to call me but the cardiac floor job is def gonna call me. Siiiiighhhhhhh

[thelegendofmrrager]

I can't really complain cuz I'm getting paid to sit on my ass most days but like... the burnout from not having expectations for each work day is insane. Waking up like "hmm... am I gonna get two clients back to back at the tail end of my shift and have to work them thru the process simultaneously or am I going to sit and stare at a screen doing nothing for damn near 9 hours?"

[fernsfabulousfloweringfacility]

i did a tihng

[dollfairy]

It's really hard to get over the childhood wound of "no one believes me or listens to me so I can't trust anyone or go to anyone for support and therefore have to handle everything myself" when that shit is still happening to me as an adult in my 30s lol

[er-cryptid]

[alucardsinep]

doctorpilled appointmentmaxxer

[responsiblelemon]

8pm: Patient's blood pressure is high in the 170s. He has been anxious and up and down to the bathroom frequently. I decide to give him a little time to calm down and recheck.

9pm: Patient has calmed down and is resting in bed. Blood pressure is now in the 180s. I page the doctor, who says she isn't concerned and puts in orders for IV meds if it goes up above 190.

11pm: Blood pressure is now in the 190s. I give IV labetalol.

12am: Blood pressure is still in the 190s. I give IV hydralazine.

1am: Blood pressure is still in the 190s and now he has a severe throbbing headache and a sudden onset episode of nausea. I can't give any more blood pressure meds. I page the doctor and tell her the patients BP readings and symptoms. She tells me to give more labetalol, I tell her I can't give more meds on this floor and if she wants more, the patient will have to transfer. Doctor says we'll just wait until the morning and consult the hospitalist.

2am: I have told my charge nurse about this and she has reached out to a couple other resource nurses we have for backup. Charge nurse pages the doctor herself and tells her we need transfer orders to get this patient to a higher level of care because he is extremely hypertensive and symptomatic and not responding to medication. Doctor grumbles but puts in the transfer orders.

3am: I take the patient downstairs where he can get stronger blood pressure meds and closer monitoring than I am able to do on my floor.

New nurses: if something doesn't feel right, if the doctor doesn't respond the way you think they should, follow your gut and ask for help. And always, always chart to cover your ass!