Guiniack

PhD crit care nrsg. Quilting since a kid. Gotta have dogs. Have lived from North to South, East to West in the US. Now in California.

[Guiniack @guiniack]

@panagis21 Listen to Dr. Glaucomflecken’s (Dr. Will Flanary) story about his cardiac arrest & Lady Glaucomflecken’s (Kristin Flanary PhD) successful resus of him, despite her having to learn CPR on the fly from the 911 operator & perform it for 10”. He got thru it with no neuro deficits.

[Guiniack @guiniack]

@JaymetheRN @EmilyPetro22 A year ago my sister had a documented rupt’d disc. Her doc gave her oxy x10 days…then she had to get another script every 10 days for >2 months! She saw pain mgt and they didn’t want to change anything, which meant she had to do copay every 10 days. It was ridiculous!

[Guiniack @guiniack]

@JaymetheRN @EmilyPetro22 For a while (don’t know abt now) in MN pharms monitored MDs and # of opioid RXs. If MD was not a pain mgt MD, pharm would report them to the state if they felt MD wrote too many, not knowing the pt’s hx or rationale for use. MDs backed off writing adeq pain meds.

[Guiniack @guiniack]

@PlantMamaRN @scrubsandsauv Tizanidine is much better than flexeril and it’s for spine-mediated spasms, such as you’re most likely experiencing

[Guiniack @guiniack]

@KrimeeraPharma @MoarSahitoPTI Careful in giving low doses in bradycardia, though, cuz some pts will further brady down

[Guiniack @guiniack]

@JaymetheRN I tell pts they have X amt of energy and they can either use that to fight pain or to heal. It’s their choice and I’ll respect it but the best thing would be to take meds to fight pain so they can use their energy to heal.

[Guiniack @guiniack]

@plastic_baggy17 If you weren’t a No Code before…

[Guiniack @guiniack]

@ThePhDPlace @godwin_france I don’t want to sound like a snob but when I say I have a doctorate, why do ppl equate that with a DNP? I worked hard for my physiological based clinically relevant nursing PhD. Don’t equate my dissertation with a capstone project. It’s like calling me an LPN, not an RN.

[Guiniack @guiniack]

@EmilyPetro22 @RNSuperHero When I was in a weird teaching ICU in the South, the anesth had a bad habit of giving K+ based on uo during heart ORs. Till a code in the ICU with a monitor strip of widening QRSs…idiot! He and the surgeon tried to blame the code on the pt’s age, till I showed him the strip!

[Guiniack @guiniack]

@RNSuperHero In the 80s I worked in a high acuity ICU (8 RNs:12 pts) & we were covered for repeat labs, common sense labs like K+ after diuresis, & labs we felt the pt needed. The residents expected results when we called with issues so we cut down wasted time. We didn’t abuse that privilege

[Guiniack @guiniack]

@RNSuperHero Part of our job is teaching residents how to run codes and so by watching us and seeing us be calm and seeing our approach, they learn how to best run codes on their own. Good for them thanking you for taking charge, BTW, rather than trying to bulldoze and bullshit through.

[Guiniack @guiniack]

@ross_prager In the 80s, I worked in a very high acuity ICU. If we weren't sure if a pt were dry or wet we gave them a MS challenge. Essentially, we gave them 4mg MS IV & watched the effect on BP. If it dropped, they needed fluids. If their BP stayed ~same, lasix! Either way the pt gets a nap

[Guiniack @guiniack]

@deb2nine @DoomScroling @RockyMountViews Out of network is all on the mom. The insurance company will put as much of the costs on the mom as it can. I've been licensed as an RN in 9 states since 81, and I've heard my pts complain ever since DRGs came into practice.

[Guiniack @guiniack]

@inspiredzone @BethOCo46384149 @drquinngyn Until their wife/dgtr/DIL/granddgtr has an ectopic pregnancy/pPROM/etc and there's not enough time to med flight her out to another state...

[Guiniack @guiniack]

@Prolife_Sam @TerriBecause He's not saying that. But a study showed only 6.7% of 74 babies born in this situation (PROM, born before 25 gestational age) survived. IV antibx, Mg++, & labor suppressants just aren't enough. Save mom! The premie, if it survives, will have sequelae for which it won't thank you.

[Guiniack @guiniack]

@nancyshively @nursekelsey @ClaudetteGGibs1 Want to see underpaid? Try TEACHING nursing!!! Bedside nursing in CA pays fantastic (ICU nocs, $100k).

[Guiniack @guiniack]

@medic2RN_RJC I'm so sorry. It doesn't matter he was in hospice, we all hope for a calm, eupneic passing. RSV is not nice. For those reading this, pls vax if applicable and especially educate the older folks around you that it's not just dangerous to kids (I'll get off my soapbox now).

[Guiniack @guiniack]

@covie_93 Exactly!! Regardless of your political affiliations, VOTE!! And vote locally, those are more important than many ppl realize.

[Guiniack @guiniack]

@marypatf @dustysgirl1434 @EM_RESUS Been an ICU RN since '81, licensed in 8 states, and pharmacy wasn't part of the code team... anywhere. I worked in primarily teaching hospitals.

[Guiniack @guiniack]

@camcath And his wife. She has an 11 m/o and a 1 m/o, to say nothing of being freshly pp herself. Now she's dealing with grief and hopefully no one else got the flu.

[Guiniack @guiniack]

Just read re: 27 y/o dad of 3 otherwise healthy died of flu in TN. No vax. Went to ER with c/o SOB, dropping sats, pain on breathing. IDK if they did CXR, but he was sent home. Came back with worsening sats/SOB. Got tubed, paralyzed, died. 2 kids under a year. Damn shame.