I love genuine questions and people putting in the effort to love and understand each other better. If you come at me just wanting to argue I’m going to troll you back. FAFO.

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Joined 1 year ago
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Cake day: June 12th, 2023

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  • I am absolutely awestruck by the amount of bravery and critical thinking under stress that it must have taken to understand that you needed to sign a DNR for your 7 year old. Most parents in your situation would barely be able to add up 2+2, let alone comprehend enough of what the doctor was saying to make that kind of decision.

    I’m also so happy for all of you that you wound up not needing that DNR. I hope she’s adapting well to her life with those limitations, but often children that age have enough neuroplasticity to work it out. She’s also certainly got parents who know how to put their own emotions aside and make sure she gets the care she needs, so under the circumstances she’s got a lot going for her. <3


  • The nurses and nursing assistants all have to wear trackers that track to see if they go near a hand sanitizer station or sink within 30 seconds after entering and 30 seconds before leaving a room. It’s to check for handwashing compliance but in addition to being a narrow and error-prone window it also doesn’t account for other common situations like poking your head into a room to check on someone while on the way to something else and not touching anything or anyone. It creates a situation where you’re better off just breezing through and ignoring a patient calling to you because if you go over there to acknowledge them but don’t have time to set down whatever you’re in the middle of, it’ll hurt your metrics. They might just need a cup of water you could grab and drop off on your way back in the other direction but fuck 'em, admin says you need to make a whole entry and exit ceremony of asking them what they need to keep your numbers up, so they’ll have to wait until you have time for that.



  • And if you’re really dedicated to being a person who saves lives and its a big part of your personal identity, you’d also be risking the lives of the future people you’d be able to help and your identity as a person who saves lives. You can’t help this one person in this specific life threatening situation but there’s other peripartum hemorrhages you could help and many more you could try to keep out of that condition to begin with. But to do that you have to let this one person die despite knowing how to help them too. Absolute shit sandwich.

    I’m working on developing a better work life balance but for the longest time working as a nurse has been the thing I stuck around on ye olde mortal coil for. It’s what was worth sticking around to try and get through all that therapy for. I won’t try to say it’s healthy but if I lost my license I don’t really have a whole lot left to stick around for.



  • On a related note, I’ve been thinking lately about how many older men have gone absolutely batshit on me for suggesting that they may not be able to safely pee standing up anymore. Its so hardwired in some of them that sometimes even bilateral amputees with enough dementia will insist that they need to stand up to pee. I’ve literally pulled back the blankets to show them their missing legs and they look right back up at me and keep yelling at me to get out of the way.

    It’s happened so much at this point that I’m very desensitized to it. They’ll be threatening to kill me and I’m just “ah yes the good ol’ standing piss argument.” It’s practically as developmentally normal as a toddler not being able to share toys or a teenager having an unstable personal identity. Not sure what the female equivalent is, most of the violence I receive from that population seems to relate to trauma / fear related to sexual assault; they have difficulty calmly accepting assistance toileting because they’re worried I’m going to hurt them vs it being less common to be a pride issue with women. Although I suppose the pride just boils down to a fear of being taken advantage of for being weak.

    TLDR; loss of independence is rough and in addition to the driving thing there’s a few other interesting manifestations.



  • Yeah when I got that report and responded all I could think was “this thread is basically incomprehensible. Why are these people arguing poetry vs theoretical physics? It’s like arguing whether or not TMNT is enjoyable based on it not being an accurate depiction of turtle biology???” There is a time and a place to get this heated about the fundamental concepts that define the universe we inhabit but a lemmy post about a Tumblr post that’s written like an overly dramatic fanfiction just ain’t it. The last time I got into an argument that dumb (somewhat coincidentally also on tumblr) was literally over half my life ago!




  • I recently listened to “A Wizards Guide to Defensive Baking” recently and I was NOT expecting YA fantasy fiction to go that hard on the subject of “heroism” being a term used to excuse the phenomenon of pushing people into dangerous jobs way too young to cover for the systemic failures and often outright corruption of existing power structures. I had a good few years experience in Healthcare beforehand but I graduated nursing school mid-covid and that book really spoke to me.

    Somewhat coincidentally iirc it was actually released mid COVID as well, and I imagine had been worked on for years beforehand. So it’s interesting to me that the author picked up on the already existing manifestations of this phenomenon in a way that would speak so well to the epic clusterfuck that ultimately occurred.


  • I was just talking to someone a few hours ago about how sex ed in the US is so bad that a huuuge number of my psychosis patients will tell me they know someone came in to their room and sexually assaulted them overnight because they woke up with a boner or wet vagina. In nursing school they also told us that the average learning level of a US adult (particularly in terms of reading level) is about the fifth grade. My school did sex ed in 6th, so that checks out. In the US its just normal to not know how your genitals work. Especially about the opposite sex and especially when it comes to women’s anatomy, but also just in general. I’ve had multiple men tell me their morning wood is proof of a sexual assault. And you always get shit from police having to file these reports because like yeah obviously we have cameras proving no one did more than poke their head in the room for routine safety checks and this is clearly just a hallucination / delusion but also it’s their right to report it and it’s your job to write it down so like???



  • I’m surprised that particular aspect of the side effect profile comes into play with acute usage.

    Well obvs. It’s basically,“idk which receptor is making them _____ (punch people, refuse to eat or drink, or whatever other immediate harm to themselves / others), but we need it to stop 3 days ago and can figure out the details or a potential cross-taper to something better later.”

    Ah, yes, this happens a lot. No, I don’t work in the medical field at all. I just know things, for reasons.

    Color me fascinated, lol. My guesses are personal experience / reading up on your own treatment or that of a loved one, tangential relation to the field such as clinical research, or just plain personal fascination. Given you linked to a drug that appears to be in trials my first guess is actually the second one. Hadn’t heard of it, and I’m hopeful, but after seeing abilify get approved for acute agitation I’m… skeptical.

    i.e. the psychosis has done so much cumulative damage at this point that you need to fall back to the typicals. That explains why the third-gens are useless.

    Yeah a lot of people don’t realize the damage is additive, both people w/ these disorders and unrelated laypeople who think “talented artist stops taking their meds and continues to be talented but starts creating art with weirder subject matter as their brain boils” is a cool story.

    I’m mostly replying to add though that risperdal also has the distinction of being avaliable as a long-acting injectable, and if you’re trialing oral meds before committing to an LAI, your options are somewhat narrowed. Zyprexa does have an LAI available, but I’ve actually never seen it used and while I can’t tell you why for certain, I do have a guess.

    If you have a patient sick enough that you’re considering an LAI, you don’t want to take benzos off the table for an entire month, especially if it turns out to be inadequate after discharge and they wind up in an ED agitated and unable to report their own med hx and get B52ed and stop breathing. I’ve had a pharmacist tell me considering that interaction is going out of style but a history of that kind of adverse event is difficult for a med to shake. Accutane still has suicidal ideation in adolescents listed as a side effect but I have a strong suspicion that it’s less causation and more correlation with the impact of pizza face on the self and social esteem of a teenager.


  • Dude sometimes we still give thorazine. And tbh ime the 3rd gens don’t do shit for my typical patient. For context also though, I’m essentially providing ICU level care, so when you say the word “symptom control” it’s often referring to like, fists.

    We had a Lady maxxed on Haldol BID one time and she managed to cheek for a week and eventually she just hauled off and rapid fire punched a nurse in the head three times. She legit thought a man was entering through her window every night on a beam of light to forcibly impregnate her and deliver the baby. She kept demanding to see the 50 babies she had up on L&D from the past few months. I’ve actually seen quite a few pregnancy delusions and they’re almost always completely wild psychosis. Another was such an angry manic but high insight enough that when she couldn’t take it anymore she would just come scream at me for the thorazine.

    I’m unsure if you don’t work inpatient psychiatry or you just work somewhere significantly classier than I do. I do work in an inner city area that’s flush with people stuck in a cycle of drugs / homelessness so I’m also not going to tell you that any of this is the best solution, just that it’s the only one avaliable to any of us right now due to shitty government policies.