Nurse labs

Content and Tips That Makes You A Better Nurse

2012.11.16 08:54 frankcblazik Content and Tips That Makes You A Better Nurse

A page for helpful tips and resources related to the nursing practice!
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2009.10.18 21:53 davedavedavedavedave Nursing for nurses and by nurses for the care of all.

A place to discuss the topics of concern to the nurses of reddit. All are welcome.
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2013.07.15 23:27 mo_bio_guy Medical Laboratory Science

Medical Lab Scientists Medical Lab Technicians Cytogeneticists Cytotechnologists Histologists Phlebotomists Lab Processors
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2023.06.07 14:00 Ashesbro The Psych Ward- How I came to realize that autism still seems to be so misunderstood (Long read, possible TW)

Sharing my story to spread awareness as well as expressing my frustrations with the mental health care system in my area as an Autistic female. This is only based on my personal experience so please know that I'm aware that not every location/program/person is the same and each person's experience is unique to them. This is a long read so feel free to skip to bottom for TLDR.
I recently spent 3 months in two different hospitals after a breakdown during a mental health crisis. I was eventually transferred from the initial hospital psych ward to another inpatient hospitalization program that was supposedly geared towards helping people with "complex mental health issues." I was told that this was a great program that could help me as they offered therapeutic groups and specialized in mental health conditions such as Autism. During my experiences at BOTH hospitals I was continuously baffled by the lack of knowledge that many of the doctors and nurses had about autism. This post will focus on the Psych Ward experience.
The Psych Ward
Being admitted to a hospital can be very traumatic for anyone but even more so for an Autistic person. From the very beginning I felt shocked by the amount of doctors and nurses (I've met) who seem to lack a lot of knowledge and understanding of autism. Despite explaining that I was autistic, many still didn't understand my stimming/self soothing bvrs (and how they were escalating due to overstimulation). Instead I was heavily medicated/sedated right from the beginning and throughout my experience at both hospitals. (Level of medication depended on severity of stimming/meltdown as well as how uncomfortable it seemed to make others feel).
The psych ward is basically a waiting room/limbo for medication experiments. I felt like a lab rat as they tried to attach different diagnoses to me despite all of those labels tying into the one huge explaination: autism, burnout, trauma, eating disorder, depression/anxiety etc. All these mental health conditions interact, it's all interconnected.
Instead of being able to speak with someone who knows about autism I kept being giving different med cocktails and experienced many side effects.
Examples: -Oh you want to end your existence as you're struggling to function in a capitalistic society where we are slowly destroying our planet? Here let's take a med so you're too numb/tired to notice anymore. - Oh you keep having repetitive thoughts/words? Lets try an antipsychotic for intrusive thoughts. - Anxious and agitated from overstimulation in a place that has people screaming, alarms/phones ringing bright lights and being confined to 2 crowded hallways... Have a med! - Oh ADHD too? Let's up your dose since you're so tired and unable to function as a side effect of all the other meds you're on! - Oh she keeps walking in circles and humming, let's give her that anxiety med again she's agitated. - She keeps sensory seeking through self harm and using it as a coping tool for overstimulation? must still be depressed, let's up her dose! - She's having a public meltdown and is inconsolable! Let's inject her with a sedative to help everyone else feel comfortable and safe. - Still struggling with suicidal ideation and repetitive thoughts, switch the med! Keep her longer!
What helped me during my stay was doing puzzles for hours, but I got extremely triggered over missing pieces or when other people interfered. Having a meltdown over a puzzle was what led me to my first encounter of trying to help a kind nurse understand my autism experience.
This meltdown had confused her but she still wanted to help. After I explained a bit about autism she was so understanding and even asked questions in regards to how she can better help me (or future autistic patients) and further her level of understanding. Later that day she brought me brand new unopened puzzles and wrote on my file that I would be allowed to work on puzzles in my room alone! This accomodation became my new coping skill and hyperfixation.
That particular experience left me inspired and curious to see how familiar other nurses/dr.'s were with the autism spectrum and how it appears differently on an individual basis. Each day/night nurses rotated shifts and we frequently had different nurses who didn't know us yet. I found myself explaining my autism, triggers, and support needs (helpful vs not helpful) to each one of them.
Everytime I had a new nurse my first question would be, "do you know much about autism?". A few of them did know a bit, some would say they knew someone with autism (I even met a nurse who was also autistic which brought me so much comfort!). Often times though nurses would admit they didn't know much about it or only knew what autism looked like in kids. This was pretty shocking to me, how could so many of these professionals in the mental health field not even know much about autism?! Is my brain really that different or hard to understand?
It felt like most of them were familiar with and prepared to "help" with all the other mental health conditions/diagnoses EXCEPT for (something as simple as) autism. (I know autism is complex but so are many of the other conditions!) So many of the healthcare professionals I met seemed to have a very limited understanding of it. Like wait, what medication do we give for that?!
I made an experiment out of my whole hospital experience. I met many student nurses and I asked them if they were learning about autism in school and most of them said "no not really." I told them how beneficial it could be to learn more about it because so many people are autistic including patients like me in the psych ward. Patients that keep getting misdiagnosed and medicated for the wrong things because no one seems to know the signs to look for. If there was more of an understanding of Autism, accomodations could be made rather than constantly medicating and potentially making things worse.
I spent 4 weeks in the Psych Ward and I watched so many patients come and go. The doctor was frustrated because the meds weren't working and she realized I was right about her misdiagnosing me. She finally acknowledged my autism and admitted she didn't know much about it or how to help me. She then referred me to another program that she claimed "specializes in complex mental health issues including Autism". After having to wait in the psych ward for a bed to become available at the other hospital I was finally transferred. I had high hopes of finally finding the help I had been seeking in an environment that was supportive and understanding.
Spoiler alert. The program was not in fact helpful and I strongly disagree that they "specialize" in conditions such as Autism. Spent 2 months there and left feeling frustrated and discouraged about the lack of resources available for autism (in my area).
TDLR- 4 weeks in psych ward. (Many) Health care professionals had very limited understanding of autism. Misdiagnosed, Autism went unacknowledged, stims medicated & misunderstood. Failed med cocktails led to Dr. admitting she didn't know much about autism and couldn't help. Transferred to another hospitalization program that supposedly specialized in Autism. ***spoiler, program wasn't helpful and staff STILL didn't seem to be very knowledgeable about Autism.
Again for emphasis; every location, facility, individual, and experience can vary. This was only my personal experience.
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2023.06.07 12:49 Acceptable_Grape_310 My preceptor is the worse and the doc on the shift is corroborating her story. I have a meeting today. How do I address this?

I am writing this letter to address the events that transpired during the 7 p.m. to 7 a.m. shift on Saturday, May 27th. My preceptor and I were assigned two patients, and while I believe their rooms were 13 and 11, I am currently unable to confirm the exact room numbers as I compose this letter. All incidents occurred before 9 p.m., and I diligently communicated all my actions to my preceptor. We reviewed the charts, lab reports, and medications at the beginning of the shift, following the instructions provided by my dayshift preceptor.
Room 13 housed a patient on ECMO, and when I inquired about it, my colleague advised me not to worry about it and to focus on other tasks. I administered medication to the patient in room 13, informing my colleague beforehand. I was aware that the patient required potassium replacement. While attending to hanging the potassium, I realized I was uncertain about the complete orderset for potassium. In the meantime, the patient in room 11 repeatedly pressed the call light. I updated my colleague on all my actions and informed them that I would quickly address the needs of room 11, with a reminder not to forget to review the labs, even though I had already done so. I entered room 11, where the patient was uncomfortable and restless, requesting pain medication. I reminded him that he was ordered to remain flat due to a procedure, made him comfortable, and administered his medication within 10 minutes of informing my colleague of my location.
Upon returning to room 13, still before 9 p.m., with no tasks overdue or delayed, my colleague barged into the room and loudly exclaimed, "WHAT ARE YOU DOING! WHAT ARE YOU DOING!" This caught me off guard, and I asked them what they meant. They continued to raise their voice, accusing me of "lali-gagging" and implying that I did not want to be there. I attempted to explain that I had communicated every step I took, expressing my confusion. However, they interrupted me, dismissing my attempts by stating that they didn't have time for excuses and that they couldn't teach me to be a nurse as my orientation would end in a few days. At that point, I sought out the charge nurse. I asked two other nurses about their whereabouts, as they weren't at the nursing station; they informed me that the charge nurse was in the room directly across from the physicians' room. Consequently, I waited there to discuss the matter with them. When I finally met with them, they requested that I wait in the breakroom. As I returned to room 13 to collect my notebook and personal belongings, I made it clear to my colleague that I would not tolerate being spoken to in such a manner. Subsequently, I left the unit.
Later, in the breakroom, the charge nurse returned, and I explained the incident to them, elaborating on why I found it impossible to work under such circumstances. I was visibly upset after being yelled at and belittled, but I want to emphasize that I was never the aggressor. Any claims suggesting otherwise are false and likely an attempt to support a co-workefriend whom they have rapport with, which is understandable as it was only my second night on the night shift.
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2023.06.07 10:12 veensalukraysia Any tips for an incoming first year nursing student?

Hi all!
I will be joining the first year nursing program this fall. If there any resources I should potentially look out before starting my studies would be great! Would love to hear any tips/advices from upper year nursing students regarding academics, professors, student life, labs, placements would be a definite plus.
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2023.06.07 08:15 coffcat Wondering if I should see endocrinologist

I've had hypothyroidism for about 10 years and have been on levothyroxine 100mcg. Last year my lab came back low T3, this year my lab came back low T3 again and now low calcium too. My dr says she's not changing my medication but to eat a more higher calcium diet. I already eat pretty healthy, greek yogurt, veg/fruit, lean protein and a wide variety of foods, but I can't eat cheese all day too. I guess I could take a higher calcium supplement? I am wondering if I should see a specialist, it makes me nervous that my levels have been low for so long. I tried asking her about it but her nurse just gives me the brush off.
Lab results: FT3 2.07,Free T4 1.2, TSH 1.35, Calcium 8.4mg. My FT3 score was the exact same last year.
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2023.06.07 05:44 MaryNope Dad's Journey Has Come to an End

I wanted to share my dad's story in hopes that it helps someone else. This is going to be long, but I need to get it out and I feel like you guys understand. I've commented a few times, and posted myself once.
Dad's story began months before we knew he was sick with loss of feeling in his hands which he chalked up to be diabetic peripheral neuropathy, vision changes, growing anxiety and sense of doom, and extreme tiredness. He's 68 and has had a quadruple bypass, prostate issues, anemia, afib, you name it. At the end of February he was helping me replace vanities in my bathrooms and could barely walk across Home Depot without needing to stop for a rest. His gait was so slow, he was almost shuffling to walk. He said he had been feeling like "everything took one big step to the left." On March 9th, he woke up and tried to get out of bed but fell on the floor. My stepmom took him to the emergency room where he went in for a CT scan and MRI. They found a plum-sized tumor on the right side of his frontal lobe. Two days later he went in for craniotomy/resection and the tumor was removed almost entirely. He received the GBM diagnosis a day later. Two days after that, he was released to a rehab hospital where he spent five days doing PT ad OT. He was so hopeful, but so sad. He worked his butt off to be able to put on shoes, get dressed, go to the bathroom, bathe, and get in and out of a vehicle so that he could go home. He never regained full mobility and needed help mostly with toileting. He was released ahead of schedule. He was elated and told me to gun it out of the parking lot before "someone realizes they made a mistake and make me go back inside."
The oncologist was encouraging and positive, his tumor was methylated, and all signs indicated he should have plenty of time left. He and my stepmom had just sold their house and bought a new one 200 miles away, so they opted to use American Cancer Society resources to cover an extended stay hotel during his 6 weeks of treatment. He wanted to stay with me, but worried about sharing a bathroom with my 7 year old while taking chemo. The risk of exposure was a concern, plus my house is so small. By this point, he was also not eating much because he said food tasted repulsive. This aversion to food only got worse as he started treatment. My stepmom nagged him constantly to eat. I think it is the one thing she felt like she could control so she fixated on it. After radiation and chemo started, he was constantly exhausted. He slept so much and ate so little. He either had constipation or diarrhea. He told me he was so tired of the constant stress from my stepmom, and feeling like he was going from one issue to the next with no relief. He hated being dependent on others. He started to require help peeing because he couldn't control his stream and would make a mess. The defeat he felt when I had to help him put on his pants and clean up after one of his accidents. He cried so much and seemed so sad and so lost. I assumed we didn't have a lot of time, so I was sure to clear the air on old issues, and I made sure to tell him every day how much he is loved, how much he is appreciated, and how much he matters to our family. My stepmom was showing signs of caregiver burnout and started to act like she resented his needs. I asked her to bring him to my house every day. If she asked for help, I dropped everything to help her. She kept mentioning putting him into a nursing facility, threatening to put him on a feeding tube, and treating him like he was a child who couldn't think for himself. I finally had to tell her that if she didn't start treating him with compassion, she needed to leave. Dad was miserable, but when he was with me we talked, I teased him, he smiled a little. He said how much he appreciated being treated normally because everyone had started treating him differently. I just wanted to make sure that whatever time he had left was filled with the good things in life, that his suffering wasn't made worse. She kept telling him to stop feeling sorry for himself and was annoyed when he cried. He saved his falling apart and grief for when he came to my house. I held him and consoled him. My turn to scare away the monsters after all the support he gave me throughout my life.
Two weeks ago, his oncology team became alarmed at his lab work. His kidney function had rapidly deteriorated and his white and red blood cell counts had dropped. My stepmom insisted on leaving that appointment to take him to their primary care doctor to look at a wound on his foot that had grown. She is blaming the oncology nurses for not alerting her to the labs, or stopping her from leaving. If you couldn't tell, she can be stubborn and controlling. She feels someone should have seen he was dropping into the danger zone for kidney function and blood production long before then. The primary care doctor told her to disregard the sore and go straight to the emergency room. I rushed there to be with them and sat with Dad all night. They immediately stopped the chemo pill and called his oncology/radiology team to notify them. He had two weeks left of treatment and had been looking forward to regaining his energy and sense of taste. We had been making plans for what he wanted to do when he got home. Camping, fishing, etc. In the hospital, he was so confused. He kept grabbing my hand and asking me if he was still alive. He said he felt like he was slipping away and about to go to the other side. I asked what he meant and he said the room we were in was a machine-created construct, that he wanted to sleep, but he didn't want the big sleep. The doctors said his kidney function was slowly improving but his blood counts remained low after two platelet and 7 blood transfusions. His bone marrow had essentially shut down completely. I left for my nephew's high school graduation on Friday. On Sunday morning, my stepmom called and said the doctors didn't think they could do anything else. Dad was not responding to treatment and they couldn't keep him. I said, "it is time to go on Hospice and it is time to bring him home." She made him record a video telling all of us he agreed to go on Hospice. My sister and I drove 200 miles to get to the hospital to sit with him. Now he was rambling and extremely confused, talking constantly, and he had developed the gurgling cough. A nurse asked if we had other siblings and we said yes. "Do they know they need to come see him right away?"
On Monday, May 29th, medical transportation drove Dad 200 miles from the hospital to his home. When they arrived, Dad was more confused and uncomfortable than ever. My stepmom was insisting people wear masks and was fussing around about things that, in retrospect, made no difference, but allowed her to control the situation. We let her do it because everyone copes differently. Dad was set up in the living room and the Hospice nurse came to assess him. He was exhausted and mostly sleeping after getting pain meds. The nurse told us she would be surprised if he lived through the night. She also said that kidney failure may be one of the better ways to die because it isn't painful, you just get more and more loopy as the toxins build up, and then you go peacefully. My aunt arrived and he instantly woke up and started talking. We gathered around him and shared our love, cried with him, held him, told him he was finally home and everything would be ok. He gave each of us little nuggets of personalized love. Called each of us by his nickname for us. It was a beautiful gift to receive that closure. Unfortunately, as the evening wore on he kept talking constantly and became more and more agitated. He said some really crazy stuff. My stepmom gave him more pain and anxiety meds. We sent everyone home to sleep. He didn't stop. She got me up at 1 AM and said she couldn't sleep and couldn't stand the talking and needed to sleep. So I spent the night comforting him, stopping him from pulling out his catheter and trying to get up. The Hospice nurse returned and immediately started morphine, Ativan, and Haldol. He finally slept. He woke up very briefly throughout the day and asked for water. We spent the evening praying with and singing to him. On Wednesday he was completely comatose and the coughing got worse. I whispered to him that I knew there was so much more he wanted to do, but that his body was tired and it was ok for him to go if he wanted to go. The Hospice nurse told us to increase the frequency of meds and told us to prepare. At 10:30 PM, my aunt ran to tell me to come quickly. At 10:40 PM, he took 3 long, deep breaths, and then he was gone.
Weeks ago I asked him what he wanted people to remember about him and pushed record on my phone. He thought for a long time. He cried. He thought some more. And then he said, "I just want people to know they are loved. At no cost to them."
I don't know if this will help anyone. Everyone's case is different. We thought we had more time. I was not in attendance at all of his weekly lab reviews, so I have no idea what was discussed. What I will say is if your loved one was already in poor health, had comorbidities like heart disease and diabetes and anemia before their GBM diagnosis, have a frank discussion with the oncology team about whether or not they are healthy enough for chemo. It might have made a difference for my dad. Get nursing help or Hospice involved early so you can focus on supporting them emotionally while a professional supports their medical needs. My stepmom declared herself his nurse and neglected his emotional needs and downplayed his suffering. He needed support and instead got lectures about crying too much and not eating enough. Please talk to your loved one like they are normal. Don't talk down to them or treat them like they are different, and please make the most of every second you have with them.
Also, f*** glioblastoma.
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2023.06.07 05:11 Ecstatic_Valuable868 chance a wasian girl from TX who really wants to go to USC!

Here is my statistics. I am a rising senior and I would truly love to have some advice on my application. Thank you so much! :)) I apologize for how long this is
DemographicsGender: FemaleRace/Ethnicity: 1/2 White, 1/2 Asian 💀 (Both parents are immigrants but completed grad school in the US), so I am 2nd generation for college
Residence: US
Type of School: Competitive Public (Apart of STEM Magnet Program w/ around 70 selected students out of a class of 750 and features STEM classes w/ diff teachers and EC requirements)
Hooks: None 💀💀
Income: around 300-400kIntended Major: Biochemistry or Molecular Bio 😍🌿AcademicsGPA: 3.97UW (One 89 Freshman yr💀) 5.1 Weighted
Note: AP/College courses worth 6.0 at my schoolRank: 31/750, expect to go to at least 26/27 when SEM2 Junior yr updates# of Honors/AP/Dual Enrollment (all 4 yrs): 16 + 1 self study APSenior Year Course Load: AP Calc BC, AP Bio, AP Gov/AP Econ, AP Lit,
Standardized TestingSAT: N/A
ACT: 35 (35 W, 35 S, 34 R, 34 M) , technically 34.5 LMAO but they round so yay
My first attempt I got a 32, will not submit unless required.
AP: All 5s so far (freshman & sophomore yr) (AP Psych, AP World History, AP Comp Sci Principle, AP Human Geo)Extracurriculars/Activities (Not in proper order yet)
  1. Nonprofit (Co-founder) (10-12)
Hosted hackathons with pretty high turnouts (500 submissions/10k in sponsor prizes), set up a tutoring network, donated over $1k to reduce healthcare disparities in Afghanistan. Hosted medical camps and had professors from CMU/NYU come out and talk to students via zoom.
  1. Intern at local med school (11/12)
Helped assist with virology research. Helped Edit research papers, set up laboratory equipment, and shadow various processes
  1. Intern at local Emergency Room (10,11,12)
shadowed numerous doctors and nurses. Wrote detailed case studies to understand medical symptoms. Assisted basic needs, vitals/giving towels
  1. Vice President, National Honor Society (11/12)
Helped manage/ provide volunteer opportunities in student led organization to over 200 upperclassmen. A pretty big deal at my school.
5) Founder, president of Chem Olympiad Club (11.12)
Hosted meetings to prepare for the test. Covered a variety of subjects including Ochem. Although 3 of us were close, none of us advanced unfortunately. Plan to expand more next year. Overall I had fun with this club and it fueled my love for chem.
  1. Vice President/Marketing Lead of Red Cross Club (11,12)
Helped created volunteer opportunities, held a blood drive, managed members in fulfilling service hours, led meetings alongside the founder.
7) President of Public Health Club (11,12)
- Created with my friend, we addressed current issues, donated sanitary supplies to local shelters and clinics. Wrote cards to ICU patients. Had healthcare professionals speak to a group of students on education required/overall aspects of job.
8) Secretary of Science Honor Society (11/12)Managed volunteer hours, meeting hours, help create sign-ins for meetings as well as communicating when meetings will occur.
9) Student created Business Club, member (10,11,12)
Hands-on collaboration with local businesses. Help with marketing, inventory management. Worked with a laboratory and a nonprofit. Helped advertise events to targeted demographic
10) Independent Research (10)
Placed at regionals, districts, and advanced in state as a finalist of about 800 kids in TX
I wont get too into it but it was related to biochem and tested whether a substance could alter the DNA of a strain of ecoli in a lab setting.

Awards/Honors
- State finalist in Science Fair
- 3rd place in regionals (Science Fair)
- Presidential service gold award x 2
- AP Scholar w/ distinction
- John Locke Essay comp, special awardLetters of Recommendation8.5/10: AP Chem Teacher: Pretty close with her, made the club & had her for two years. She is older and sometimes forgets what class period I am in but knows me as a student. We hugged on last day of school and I wrote her a very long card on how she inspired me to do pre-med and I frequently came during free blocks to review tests.
9/10: AP History, also NHS founder (I am VP), will def be working alongside him for a while. Also a lit major and I heard he writers bomb LORs. The only thing is I was pretty quiet in his class lol.


EssaysI currently have a rough draft but idk if I want to trauma dump because every time I talk about it, it brings a lot of emotion. It's basically about the process of overcoming my mother being diagnosed with cancer and being told she had months to live. She was constantly in surgery/therapies. Thankfully, she is fine now, but it was a pretty low point in my life leading up to freshman year of HS. I also want to focus on how the event impacted my values/future goals/personality without it being a sob story if that makes sense.
Where I am ApplyingTexasI am currently auto-admit for UT (top 6% of my class)
Rice University
A&M (Safety)

CaliforniaUSC (EA) My DREAM school since I was like 10 😍😍😍
All the UCs (UC Irvine, UCLA, UC Berkeley...)
Santa Clara Uni
MA: Boston Uni, Tufts, Northeastern, Boston College
Other Schools: UVA/UNC Chapel Hill, Umich, WashU, Notre Dame, CMU, NYU, Georgetown
Ivys: Cornell, Dartmouth, Brown, & UPenn (I do not expect to get in)


Reflection
I would love if someone could humble me and also lmk where they could see me getting into. Again, any advice to improve my odds and responses are highly appreciated. Also if anyone has any recs on where I should ED to maximize chances that would be great.
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