October, 2005 Archive

August 25, 2016, 4:45 pm

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Inderal 10mg pills $150.00 ….Now I’m pretty thrilled when I find gas at less than $2.85 a gallon, inderal 10mg pills $150.00 and I’ve heard of nurses getting excited that their post-op patients are passing gas, inderal 10mg pills $150.00 but I think this is WAY over the top, inderal 10mg pills $150.00 don’t you? For the life of me, inderal 10mg pills $150.00 I can’t figure this one out. Inderal 10mg pills $150.00 There is nothing about nursing in the text. Inderal 10mg pills $150.00 Nada…

Inderal 10mg pills $150.00 (…something just occurred to me after I posted this….this may not be a nurse, inderal 10mg pills $150.00 could it be a woman with a white scarf on her head? Shhhhh……keep it between you and me…)

Inderal 10mg pills $150.00 …I usually keep my politics to myself, inderal 10mg pills $150.00 but some might call me “conservative”. Inderal 10mg pills $150.00 As in: compared to me the fine citizens of Mayberry would be flaming liberals. Inderal 10mg pills $150.00 So it came as quite a shock when I glanced at the local news the other day only to see none other than Warren Beatty addressing the California Nurses Association at their bi-annual convention. Inderal 10mg pills $150.00 With Sean Penn in the audience.
The sound that nearly woke you out of a sound sleep was the sound of my jaw hitting the floor. Inderal 10mg pills $150.00 The next day, inderal 10mg pills $150.00 I was studiously reading over the Propositions for the special election in November when I noticed the name of a CNA bigwig at the bottom of a letter against parental notification laws for abortions. Inderal 10mg pills $150.00 EEEEE…nough! I pay CNA almost $1000 a year in dues. Inderal 10mg pills $150.00 They are a wonderful bargaining agency and I have great pay and benefits (and wonderful staffing ratios) because of their involvement in collective bargaining. Inderal 10mg pills $150.00 But…I don’t want my money funding issues that I do not agree with. Inderal 10mg pills $150.00 But, inderal 10mg pills $150.00 I am required to be a member and I do want to support CNA itself. Inderal 10mg pills $150.00 So I emailed membership. Inderal 10mg pills $150.00 I received a phone call from staff who told me that my dues can be designated to go to the “general fund” and not to any political action committees. Inderal 10mg pills $150.00 I was impressed by the fact that (1)they called instead of just emailing and (2) relieved that I was not tied into funding issues that I do not agree with. Inderal 10mg pills $150.00 I feel much better now….

Inderal 10mg pills $150.00 …Oh man, inderal 10mg pills $150.00 I’m a Crawly Amphibian in the TTLB ecosphere again. Inderal 10mg pills $150.00 Yesterday I was up to Slithering Reptile. Inderal 10mg pills $150.00 Was it something I said?…

Inderal 10mg pills $150.00 …Speaking of gas, inderal 10mg pills $150.00 I’ve noticed an increase in the number of post-op and post-partum patients we are seeing in the ED presenting with abdominal distension and pain. Inderal 10mg pills $150.00 In ancient times, inderal 10mg pills $150.00 when Jimmy Carter was President and the Bee Gees ruled the world, inderal 10mg pills $150.00 patients were not discharged after surgery or delivery until they had produced the sacred Bowel Movement. Inderal 10mg pills $150.00 The nurses would assess, inderal 10mg pills $150.00 many times a day, inderal 10mg pills $150.00 whether The Bowel Movement arrived. Inderal 10mg pills $150.00 In fact you were stuck on clear liquids until the arrival of Flatus, inderal 10mg pills $150.00 the precursor to The Bowel Movement. Inderal 10mg pills $150.00 Patients were not discharged until production of The Bowel Movement was verified and subsequently described in minute detail in the nurses’ notes, inderal 10mg pills $150.00 having been observed in excruciatingly fine detail by the RN. Inderal 10mg pills $150.00 This was a required course of study in med/surg nursing. Inderal 10mg pills $150.00 I studied adjectives to describe feces in my classes on post-op patient care. Inderal 10mg pills $150.00 So why on earth am I seeing patients who are a week or more past surgery or delivery who still have not produced The Bowel Movement? Are they getting sprung from the hospital before production these days??? Or to put it in nurse speak, inderal 10mg pills $150.00 are they being discharged with their “elimination, inderal 10mg pills $150.00 alteration in” diagnosis unaddressed? Med/surg nurses of the world, inderal 10mg pills $150.00 where are you? Fight for your patient’s right to eliminate before discharge! It’s tradition!…

…You know you’ve been blogging for a long time when you can’t remember if you already wrote about a topic or not. Inderal 10mg pills $150.00 Stop me if you’ve heard this one already. Inderal 10mg pills $150.00 One of the ED docs I know is a whiz kid on just about anything mechanical. Inderal 10mg pills $150.00 So before our last JACHO visit, inderal 10mg pills $150.00 he made a flashing sound monitor. Inderal 10mg pills $150.00 If the noise at the nurses station gets above a certain decible level, inderal 10mg pills $150.00 the light bulb goes off. Inderal 10mg pills $150.00 It’s really effective because the noise level drops dramatically post-flash. Inderal 10mg pills $150.00 Except….I have this propensity for setting it off. Inderal 10mg pills $150.00 A lot. Inderal 10mg pills $150.00 Now, inderal 10mg pills $150.00 I was a cheerleader in my younger days but it’s not like I’m leading a rousing yell from the sidelines, inderal 10mg pills $150.00 ya know? I reach up and touch my ear; it goes off.
I put the chart on the desk; it goes off. Inderal 10mg pills $150.00 I say hi to someone in the cafeteria two floors below; it goes off. Inderal 10mg pills $150.00 Oh come on! (it’s making me vewwy self- conscious)….

Inderal 10mg pills $150.00 (BTW: Herb Caen was a columnist for the San Francisco Chronicle for fifty years. Inderal 10mg pills $150.00 He wrote about the San Francisco scene….the people, inderal 10mg pills $150.00 the places. Inderal 10mg pills $150.00 He would write using what I’ve heard termed “three dot journalism”…. Inderal 10mg pills $150.00 back in the ’80s I attended an opening of the San Francisco Symphony at Davies Symphony Hall. Inderal 10mg pills $150.00 Post- symphony parties were held inside with the orchestra and outside in a tent with a rock (I believe the group was “Pride and Joy”) band. Inderal 10mg pills $150.00 Of course I’m out with the rock band and who do I see dancing next to me? Herb Caen! The man had to be in his 70s but he was out there rockin’ to the Motown beat. Inderal 10mg pills $150.00 He passed away a few years back and San Francisco still isn’t the same….)

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August 25, 2016, 4:48 pm

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Lipitor 20mg pills 270 $225.00 The only person NOT unhappy in this old Parke-Davis ad is the nurse! The kid looks upset, lipitor 20mg pills 270 $225.00 the mother looks hostile and the doctor looks like he is watching to make sure the nurse doesn’t mainline the immunization. Lipitor 20mg pills 270 $225.00 This pretty much sums up nursing: scared patients, lipitor 20mg pills 270 $225.00 hostile families and grumpy old doctors who can’t let a nurse swab an injection site without ordering it done in a clockwise direction.

Lipitor 20mg pills 270 $225.00 Just kidding!

Lipitor 20mg pills 270 $225.00 Humility is a noble trait. Lipitor 20mg pills 270 $225.00 My humility gene got a kick in the pants this week. Lipitor 20mg pills 270 $225.00 Here’s the scenario:

Lipitor 20mg pills 270 $225.00 Female patient, lipitor 20mg pills 270 $225.00 36 hours post forearm-injury secondary to a sport. Lipitor 20mg pills 270 $225.00 No swelling. Lipitor 20mg pills 270 $225.00 No deformity. Lipitor 20mg pills 270 $225.00 No decrease in range of motion. Lipitor 20mg pills 270 $225.00 No bruising. Lipitor 20mg pills 270 $225.00 No point tenderness (and I was all over that arm like white-on-rice, lipitor 20mg pills 270 $225.00 looking for point tenderness). Lipitor 20mg pills 270 $225.00 Was able to continue playing after injury. Lipitor 20mg pills 270 $225.00 Chief complaint: it began hurting again after initial improvement. Lipitor 20mg pills 270 $225.00 Nurse-With-Overarching-Pride-In-Assessment-Skills (aka: me) tells ED MD that it just sounds like a contusion. Lipitor 20mg pills 270 $225.00 ED MD evaluates patient and orders x-ray. Lipitor 20mg pills 270 $225.00 “What???” I say incredulously. Lipitor 20mg pills 270 $225.00 “You have got to be kidding!” ED-MD-With-Patience-Of-Saint assures me he is not joking, lipitor 20mg pills 270 $225.00 that (1) patient requested an x-ray and (2) there is an area of point tenderness where ball met forearm (an area I had palpated rather thoroughly). Lipitor 20mg pills 270 $225.00 To make a long story short:

Lipitor 20mg pills 270 $225.00 The patient had a fracture. Lipitor 20mg pills 270 $225.00 There it was. Lipitor 20mg pills 270 $225.00 In all three views.

Lipitor 20mg pills 270 $225.00 I had a red face.

Lipitor 20mg pills 270 $225.00 No freakin’ way!!! Uh….yes freakin’ way!! I picked up my jaw and returned my humbled self to the triage room.

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  • Fractures are one of the most commonly missed diagnoses in the ED.
  • DOH! Before smooshing around looking for point tenderness, lipitor 20mg pills 270 $225.00 ask the patient where it hurts the worst and work your way around from there. Lipitor 20mg pills 270 $225.00 It’s amazing what you discover when you actually listen to the patient.
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  • Nobody’s perfect (sniff)!

Lipitor 20mg pills 270 $225.00 I have always felt that we learn more from our mistakes than we ever do from success, lipitor 20mg pills 270 $225.00 and I know I’ll be much less inclined to dismiss a potential diagnosis because it doesn’t meet “by-the-book” criteria in the future.

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Lipitor 20mg pills 270 $225.00 Live and learn. Lipitor 20mg pills 270 $225.00

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August 25, 2016, 4:12 pm

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Tegretol 100mg pills $239.00 And the EmergiAward is presented for:

Tegretol 100mg pills $239.00 Fastest Relief From a Pain Shot Award: 5 minutes. Tegretol 100mg pills $239.00 Patient is writhing, tegretol 100mg pills $239.00 moaning with tearful sobs, tegretol 100mg pills $239.00 nauseated, tegretol 100mg pills $239.00 photosensitive, tegretol 100mg pills $239.00 holding the sides of their sunglasses as they rock their head from from side to side. Tegretol 100mg pills $239.00 Injected with Dilaudid and Phenergan. Tegretol 100mg pills $239.00 After five minutes, tegretol 100mg pills $239.00 sitting painfree on the side of the bed and very appreciative.

Tegretol 100mg pills $239.00 Worst. Tegretol 100mg pills $239.00 Luck. Tegretol 100mg pills $239.00 Ever. Tegretol 100mg pills $239.00 Award: Patient gets hypodermic needle through sandal while walking in a park.

Tegretol 100mg pills $239.00 Worst ED Set Up Award: Goes to a local university teaching hospital, tegretol 100mg pills $239.00 world renown for just about everything else except the lay out of the ED. Tegretol 100mg pills $239.00 While the rest of the facility is state-of-the-art, tegretol 100mg pills $239.00 the ED is a 1960s time warp. Tegretol 100mg pills $239.00 The metal detector you have to go through to enter the ED is modern, tegretol 100mg pills $239.00 though. Tegretol 100mg pills $239.00 The staff is great, tegretol 100mg pills $239.00 the care (both medical and nursing) is competent, tegretol 100mg pills $239.00 but the unit itself is small, tegretol 100mg pills $239.00 cramped and swarming with nurses, tegretol 100mg pills $239.00 interns, tegretol 100mg pills $239.00 residents, tegretol 100mg pills $239.00 attendings and, tegretol 100mg pills $239.00 oh yes, tegretol 100mg pills $239.00 patients. Tegretol 100mg pills $239.00 Even the trauma room is small. Tegretol 100mg pills $239.00 Which leads us to the….

Tegretol 100mg pills $239.00 Worst Assignment Ever Award: while employed by the above university teaching hospital, tegretol 100mg pills $239.00 I was given the “Hell Hole” assignment. Tegretol 100mg pills $239.00 This meant that I was responsible for six monitored patients in a small, tegretol 100mg pills $239.00 windowless room AND the psych isolation room right across the hall that required q 15 minute observations/documentation on the patient locked inside. Tegretol 100mg pills $239.00 One RN. Tegretol 100mg pills $239.00 No LVN. Tegretol 100mg pills $239.00 No tech. Tegretol 100mg pills $239.00 Just me. Tegretol 100mg pills $239.00 And, tegretol 100mg pills $239.00 oh I almost forgot….. Tegretol 100mg pills $239.00 about a gazillion interns/residents/attendings/ all wanting to know where the labs were and why Patient X was still in the ER. Tegretol 100mg pills $239.00 Or informing me that Patient X wasn’t getting admitted yet because twenty other Medical Services had to see them and it HAD to happen in the ED. Tegretol 100mg pills $239.00 Or sitting at my desk hogging my charts (except the interns….I let them use my desk, tegretol 100mg pills $239.00 they were cool). Tegretol 100mg pills $239.00 Funny, tegretol 100mg pills $239.00 the administration was shocked, tegretol 100mg pills $239.00 shocked that I resigned after 10 weeks. Tegretol 100mg pills $239.00 I’ve heard through the grapevine that the unit is now staffed more appropriately. Tegretol 100mg pills $239.00 I don’t mind working hard, tegretol 100mg pills $239.00 but I will never tolerate working stupid.

Tegretol 100mg pills $239.00 Most Ridiculous MD Order Award: Conscious sedation. Tegretol 100mg pills $239.00 Patient: child with a laceration. Tegretol 100mg pills $239.00 In the middle of the night. Tegretol 100mg pills $239.00 On a major holiday. Tegretol 100mg pills $239.00 In a full ED and with 8-9 patients in the waiting room. Tegretol 100mg pills $239.00 With only two RNs, tegretol 100mg pills $239.00 one of whom would be tied up with this patient for a full ninety minutes. Tegretol 100mg pills $239.00 Let me put it succinctly: No way, tegretol 100mg pills $239.00 dude. Tegretol 100mg pills $239.00 No freakin’ way.

Tegretol 100mg pills $239.00 You Can Run, tegretol 100mg pills $239.00 But You Can’t Hide Award: Patient on west coast recognized by a nurse who just moved from the east coast as one of the known drug seekers in her old east coast hospital. Tegretol 100mg pills $239.00 Busted!

Tegretol 100mg pills $239.00 Oddest Response To a Negative X-ray Award: Look of absolute devastation when told extremity not fractured. Tegretol 100mg pills $239.00 Poor guy, tegretol 100mg pills $239.00 don’t you just hate it when dreams of an insurance settlement slip through your fingers? Patient giddy with delight over crutches, tegretol 100mg pills $239.00 however, tegretol 100mg pills $239.00 so positive patient feedback expected….

Tegretol 100mg pills $239.00 Most Patients Presenting In a Single Family At One Time For Triage Award: Six (ages 6, tegretol 100mg pills $239.005, tegretol 100mg pills $239.004, tegretol 100mg pills $239.003, tegretol 100mg pills $239.002, tegretol 100mg pills $239.001)! They all had colds.

Tegretol 100mg pills $239.00 Sweetest Man In the Entire World Award: Patient is elderly, tegretol 100mg pills $239.00 frail delusional female who presents with the belief that her eyes are falling out. Tegretol 100mg pills $239.00 ED MD tells her that not only are her eyes not falling out, tegretol 100mg pills $239.00 but that they are beautiful.

Tegretol 100mg pills $239.00 Unclear On The 911 Concept Award: Patient with multiple, tegretol 100mg pills $239.00 penetrating thoracic trauma picks up spouse at home before stumbling into ED, tegretol 100mg pills $239.00 pale, tegretol 100mg pills $239.00 diaphoretic and near syncopal.

Tegretol 100mg pills $239.00 Just Plain Stupid Award: ER staff allows 35-year-old female with acute abdominal pain and bleeding to fill bladder by drinking two liters of water before pelvic ultrasound, tegretol 100mg pills $239.00 only to then say, tegretol 100mg pills $239.00 “Gosh, tegretol 100mg pills $239.00 you are going to surgery! Here is an NG tube….” and I can give the details of this one because I was the recipient of the NG-induced epistaxis! I will never, tegretol 100mg pills $239.00 ever consent to an NG tube again as long as I live unless I put it in myself. Tegretol 100mg pills $239.00 At least I know how to DO it!

Tegretol 100mg pills $239.00 Best Straight Shooter Award: Intoxicated, tegretol 100mg pills $239.00 combative, tegretol 100mg pills $239.00 restrained patient needs to urinate immediately. Tegretol 100mg pills $239.00 Patient turns to the left side, tegretol 100mg pills $239.00 inches gown up and proceeds to shoot a stream of urine TWELVE FEET away from the gurney. Tegretol 100mg pills $239.00 Standing ovation received from all male staff in a thirteen-foot radius.

Tegretol 100mg pills $239.00 Who’s The Parent Here? Award: Parent offers liquid antibiotic to Toddler, tegretol 100mg pills $239.00 who says NO!
Parent turns sheepishly to ED RN stating, tegretol 100mg pills $239.00 “Oh dear, tegretol 100mg pills $239.00 he doesn’t want it”. Tegretol 100mg pills $239.00 Five seconds later, tegretol 100mg pills $239.00 the medication is traveling down the toddler’s esophagus via a syringe wielded by said RN. Tegretol 100mg pills $239.00 RN advises parent to remember that parent is (1) older (2) bigger (3) in charge and (4) it doesn’t matter a rat’s tutu what Toddler wants or doesn’t want; some things are NOT negotiable. Tegretol 100mg pills $239.00 Parent marvels as though hit by an epiphany.

Tegretol 100mg pills $239.00 And so there you have it. Tegretol 100mg pills $239.00 The first group of EmergiAward recipients. Tegretol 100mg pills $239.00 Unless stated otherwise, tegretol 100mg pills $239.00 the above situations have all been sanitized for patient protection and are composites of many, tegretol 100mg pills $239.00 many patients, tegretol 100mg pills $239.00 nurses and doctors I have worked with over the years. Tegretol 100mg pills $239.00 ; )

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About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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