Nursing interventions for hypothyroidism
Angry patient found my email
2024.05.14 04:44 NicoletteClem Angry patient found my email
I had a patient on my unit a month ago where I work as a charge nurse. High anxiety, borderline delusional, asking for clinically inappropriate interventions. She seems to have an obsession with hating me as we had some interaction (appropriate and professional) when I was charging while she was on the unit. Things like me telling her she couldn’t walk off the unit with her tele/IV pole to go o the ER to have a doctor look at her stubbed toe, which she was requesting an orthopedic surgeon for. That’s just the tip of the iceberg. She of course left a 3 page essay in her Press Ganey survey about how awful our unit is and I am and messaged the president of our hospital on his personal Facebook about it.
A month later and she isn’t letting it go. Now she somehow found my personal email and sent me a long email about how I’m a terrible nurse. Has anyone had an experience like this? What should I be expecting from my leadership about this? And how the heck would she have gotten my personal email?
submitted by NicoletteClem to nursing [link] [comments]
A month later and she isn’t letting it go. Now she somehow found my personal email and sent me a long email about how I’m a terrible nurse. Has anyone had an experience like this? What should I be expecting from my leadership about this? And how the heck would she have gotten my personal email?
2024.05.14 03:27 Significant-Gear-151 Which Cardiac Tech setting seems like the best overall learning experience for a future RN?
Hello!
While looking for different jobs, I saw there were a few different Cardiac Tech positions available at three units/settings, and I'm looking for some insight on which setting might be the best learning experience. My goal is to be a sponge and soak up as much knowledge and experience as possible of different procedures, skills, and cases.
Overall, it looks like position #2 is a smaller unit with more of a focus on basic nursing skills and still gaining some experience with telemetry; however, the other two positions mention Ultrasound IV insertion training and certification in addition to learning about telemetry. I think with #2 being a smaller unit, I might not become as proficient with starting IV's as well which is one of my goals. I would appreciate any tips or insight from anyone who has experience with these different settings!
Position #1) Cath Holding Prep Area (Days)
Responsibilities:
Cardiac Tech helps aid the RNs throughout the prep of our Cardiac Catheterization, Electrophysiology, and Cardiac OR patients. In our department we prep and recover 40 – 50 patients a day. In the pre-op area, the cardiac techs are trained to insert IVs, shave, prep, obtain EKGs, and collect specimens needed to help prepare the patient for their procedure that day. Other opportunities for advancement include Ultrasound IV insertion training and certification and telemetry training if desired.
Position #2) Procedure Recovery Short Stay (Days)
"The Cardiac Procedural Recovery & Short Stay Unit (CPRS) is a 6-8 bed unit that is open 24 hours 7 days a week. The cardiac short stay unit will provide patient care until the patient is discharged or admitted for further observation.
Responsibilities:
The expectations for this role will complete all the patients ADLs, assist with ambulating, and routine care as a Nursing Care PartnePatient Care Tech but with the added competencies of starting PIVs, and assisting nurses in monitoring telemetry. On-the-job training required."
Position #3) Vascular & Interventional Center (Evenings)
Same responsibilities as position #1 but in a different setting - "Cardiac Tech helps aid the RNs throughout the prep of our Cardiac Catheterization, Electrophysiology, and Cardiac OR patients. In our department we prep and recover 40 – 50 patients a day. In the pre-op area, the cardiac techs are trained to insert IVs, shave, prep, obtain EKGs, and collect specimens needed to help prepare the patient for their procedure that day. Other opportunities for advancement include Ultrasound IV insertion training and certification and telemetry training if desired."
TL;DR I'm considering a Cardiac Tech job at three different hospital settings listed above, which setting would potentially provide the best overall learning experience for a future RN?
submitted by Significant-Gear-151 to nursing [link] [comments]
While looking for different jobs, I saw there were a few different Cardiac Tech positions available at three units/settings, and I'm looking for some insight on which setting might be the best learning experience. My goal is to be a sponge and soak up as much knowledge and experience as possible of different procedures, skills, and cases.
Overall, it looks like position #2 is a smaller unit with more of a focus on basic nursing skills and still gaining some experience with telemetry; however, the other two positions mention Ultrasound IV insertion training and certification in addition to learning about telemetry. I think with #2 being a smaller unit, I might not become as proficient with starting IV's as well which is one of my goals. I would appreciate any tips or insight from anyone who has experience with these different settings!
Position #1) Cath Holding Prep Area (Days)
Responsibilities:
Cardiac Tech helps aid the RNs throughout the prep of our Cardiac Catheterization, Electrophysiology, and Cardiac OR patients. In our department we prep and recover 40 – 50 patients a day. In the pre-op area, the cardiac techs are trained to insert IVs, shave, prep, obtain EKGs, and collect specimens needed to help prepare the patient for their procedure that day. Other opportunities for advancement include Ultrasound IV insertion training and certification and telemetry training if desired.
Position #2) Procedure Recovery Short Stay (Days)
"The Cardiac Procedural Recovery & Short Stay Unit (CPRS) is a 6-8 bed unit that is open 24 hours 7 days a week. The cardiac short stay unit will provide patient care until the patient is discharged or admitted for further observation.
Responsibilities:
The expectations for this role will complete all the patients ADLs, assist with ambulating, and routine care as a Nursing Care PartnePatient Care Tech but with the added competencies of starting PIVs, and assisting nurses in monitoring telemetry. On-the-job training required."
Position #3) Vascular & Interventional Center (Evenings)
Same responsibilities as position #1 but in a different setting - "Cardiac Tech helps aid the RNs throughout the prep of our Cardiac Catheterization, Electrophysiology, and Cardiac OR patients. In our department we prep and recover 40 – 50 patients a day. In the pre-op area, the cardiac techs are trained to insert IVs, shave, prep, obtain EKGs, and collect specimens needed to help prepare the patient for their procedure that day. Other opportunities for advancement include Ultrasound IV insertion training and certification and telemetry training if desired."
TL;DR I'm considering a Cardiac Tech job at three different hospital settings listed above, which setting would potentially provide the best overall learning experience for a future RN?
2024.05.14 01:49 Dirtysoulglass Family member [60s, M] 'went feral' after a cervical fusion operation. He is in an induced coma, on a vent, and each day they try to wake him up with the same extreme aggression and disorientation from him- resulting in re-intubation and sedation/drug induced paralysis.
Patient Info: Male, Caucasian, Mid 60s, Unknown Weight (but probably overweight), Cannabis use, Diabetes (I think), previous spine surgery at base of spine with hardware that has cracked, other medications unknown.
Backstory to current situation: He began having balance issues a couple months ago, and started falling more and more frequently. He then showed occasional confusion, like he didnt quite understand what you said to him but still responded in a related way. The confusion would clear up and he would be fine the majority of the time. Zero neck or arm pain, his lower back where his previous surgery was hurt him a lot due to a broken screw and his knees hurt him (previous knee replacement surgery). Went to the ER one night when family made him due to him being very disoriented and confused. Diagnosed at ER with some sort of issue at the base of his skull that was causing these balance and confusion issues. It was relayed to me as some sort of bone spur or restriction that needed intervention ASAP or the next fall could cause serious damage (if his neck is jolted). Cervical fusion surgery was scheduled pretty quickly fusing 4 vertebrae in his neck.
Current Situation: My Family Member (Male, mid 60s) had a cervical fusion surgery at c3-7 (4 vertebrae) about 1 week ago. First day he woke just fine, seemed happy, wanted to sit up and was doing fine. He is discharged, and over the next days he complains of worsening pain between his shoulders either at the very top of his back/base of neck (second hand info). The pain worsens each day for 3 or so days until he is in such a state that he is grunting, groaning, and banging his fists on things because of the pain. This past Friday he started getting almost violent and seemed incredibly disoriented, delirious, and terrified. He could not talk and did not recognize anyone or seem to understand words spoken to him. He was taken by ambulance to the hospital. Once there, he attacked staff (not like him at all) and seemed like a feral animal or a rabid animal. It took 4 people to get him restrained: and they gave him drugs to paralyze him to keep staff safe, restrained him, and sedated him to the point of being on a ventilator. Blood tests came back with only mild THC as anything out of the ordinary. He likely took his entire 30 day pain killer rx from the surgery (bottle was found empty) within a few days HOWEVER the prescription was weak enough that the doctor remarked that the 'drugs he is currently on is stronger than the whole bottle' so unlikely to be an issue. MRI came back fine, all tests they have run have come back fine (aside from blood tests, MRI, and 24hr seizure monitoring test, I do not know if other tests were preformed or what they would be.)
Each day they try to let the sedation wear off and remove the vent to gauge his reaction, and each day it has been the same nearly immediate intense aggression putting staff at risk. He broke restraints. I was told his eyes rolled back into his head where only white showed during one of these wake up attempts, and that when he does gain alertness he looks absolutely terrified and behaves like a cornered prey. So they just sedate/paralyze/intubate again. At this point the plan is to try waking him each day until he stops being aggressive due to tests not showing a diagnosis. He has been given a feeding tube today.
His surgeon's nurse had been contacted today and she said she does not believe this is related to the surgery and she has never heard of a reaction like this. His current doctors (not affiliated with the surgery) have told his mom and sister that 'they have seen this before' but also 'they don't know what this is', which is odd.
Is there anything else that could be going on, and tests that should be preformed, any idea on why this is happening? I cannot stand the idea of him being in terror over and over waking up to being pulled off a vent then put back on, indefinitely.
I apologize for the vague information, but any ideas would be greatly appreciated. Thank you!
submitted by Dirtysoulglass to AskDocs [link] [comments]
Backstory to current situation: He began having balance issues a couple months ago, and started falling more and more frequently. He then showed occasional confusion, like he didnt quite understand what you said to him but still responded in a related way. The confusion would clear up and he would be fine the majority of the time. Zero neck or arm pain, his lower back where his previous surgery was hurt him a lot due to a broken screw and his knees hurt him (previous knee replacement surgery). Went to the ER one night when family made him due to him being very disoriented and confused. Diagnosed at ER with some sort of issue at the base of his skull that was causing these balance and confusion issues. It was relayed to me as some sort of bone spur or restriction that needed intervention ASAP or the next fall could cause serious damage (if his neck is jolted). Cervical fusion surgery was scheduled pretty quickly fusing 4 vertebrae in his neck.
Current Situation: My Family Member (Male, mid 60s) had a cervical fusion surgery at c3-7 (4 vertebrae) about 1 week ago. First day he woke just fine, seemed happy, wanted to sit up and was doing fine. He is discharged, and over the next days he complains of worsening pain between his shoulders either at the very top of his back/base of neck (second hand info). The pain worsens each day for 3 or so days until he is in such a state that he is grunting, groaning, and banging his fists on things because of the pain. This past Friday he started getting almost violent and seemed incredibly disoriented, delirious, and terrified. He could not talk and did not recognize anyone or seem to understand words spoken to him. He was taken by ambulance to the hospital. Once there, he attacked staff (not like him at all) and seemed like a feral animal or a rabid animal. It took 4 people to get him restrained: and they gave him drugs to paralyze him to keep staff safe, restrained him, and sedated him to the point of being on a ventilator. Blood tests came back with only mild THC as anything out of the ordinary. He likely took his entire 30 day pain killer rx from the surgery (bottle was found empty) within a few days HOWEVER the prescription was weak enough that the doctor remarked that the 'drugs he is currently on is stronger than the whole bottle' so unlikely to be an issue. MRI came back fine, all tests they have run have come back fine (aside from blood tests, MRI, and 24hr seizure monitoring test, I do not know if other tests were preformed or what they would be.)
Each day they try to let the sedation wear off and remove the vent to gauge his reaction, and each day it has been the same nearly immediate intense aggression putting staff at risk. He broke restraints. I was told his eyes rolled back into his head where only white showed during one of these wake up attempts, and that when he does gain alertness he looks absolutely terrified and behaves like a cornered prey. So they just sedate/paralyze/intubate again. At this point the plan is to try waking him each day until he stops being aggressive due to tests not showing a diagnosis. He has been given a feeding tube today.
His surgeon's nurse had been contacted today and she said she does not believe this is related to the surgery and she has never heard of a reaction like this. His current doctors (not affiliated with the surgery) have told his mom and sister that 'they have seen this before' but also 'they don't know what this is', which is odd.
Is there anything else that could be going on, and tests that should be preformed, any idea on why this is happening? I cannot stand the idea of him being in terror over and over waking up to being pulled off a vent then put back on, indefinitely.
I apologize for the vague information, but any ideas would be greatly appreciated. Thank you!
2024.05.13 20:53 lexyfield Conceiving after Miscarriage?
Hi friends -
After many months of TTC, all sorts of fertility tracking with Mira, switching to a GF diet (already have been plant-based forever) and countless supplements, - I had gotten a bfp 2 days before my missed period. I only tested early because I was SO incredibly nauseous and my boobs hurt like no other. We were so excited because I have PCOS (no insulin resistance, not overweight, no irregular cycles ever, just some cortisol and testosterone dysregulation with mild hirsutism)and subclinical hypothyroidism (T3 issues) so I always was told my chances would be slim to none.
Of course because of that, my anxiety was elevated and I focused on line progression, a lot. Every little cramp I had made me nervous, despite them being mild. Sadly I watched my lines start to fade over the week and went in yesterday for a quantitative HCG draw after some light brown spotting. I don’t have those results yet. But this morning at just about 5 weeks, I woke up to two negative tests (digital and frer with FMU) coupled with the worst cramps of my life and some period like bleeding.
Ironically, today was my intake call with the OB office, and when I answered and they asked how things were going and I told them how this morning went they responded with “oh I’m so sorry, just go to the ER” and as an ER nurse, I know that’s not really necessary. But I’m annoyed because they didn’t leave me any room to ask questions and also promptly hung up after and cancelled all upcoming appointments per my MyChart notifications. I sat on hold calling back for 45 minutes to try and get connected with someone, but gave up with the long wait.
So I’m pretty sad, to say the least, and feeling really defeated. My question is - how long after a chemical/early miscarriage were you able to conceive? I’m looking at the bright side being that at least my body could do this - since I was told forever I couldn’t. But I can’t help but wonder and hope this wasn’t a one off thing.
submitted by lexyfield to tryingtoconceive [link] [comments]
After many months of TTC, all sorts of fertility tracking with Mira, switching to a GF diet (already have been plant-based forever) and countless supplements, - I had gotten a bfp 2 days before my missed period. I only tested early because I was SO incredibly nauseous and my boobs hurt like no other. We were so excited because I have PCOS (no insulin resistance, not overweight, no irregular cycles ever, just some cortisol and testosterone dysregulation with mild hirsutism)and subclinical hypothyroidism (T3 issues) so I always was told my chances would be slim to none.
Of course because of that, my anxiety was elevated and I focused on line progression, a lot. Every little cramp I had made me nervous, despite them being mild. Sadly I watched my lines start to fade over the week and went in yesterday for a quantitative HCG draw after some light brown spotting. I don’t have those results yet. But this morning at just about 5 weeks, I woke up to two negative tests (digital and frer with FMU) coupled with the worst cramps of my life and some period like bleeding.
Ironically, today was my intake call with the OB office, and when I answered and they asked how things were going and I told them how this morning went they responded with “oh I’m so sorry, just go to the ER” and as an ER nurse, I know that’s not really necessary. But I’m annoyed because they didn’t leave me any room to ask questions and also promptly hung up after and cancelled all upcoming appointments per my MyChart notifications. I sat on hold calling back for 45 minutes to try and get connected with someone, but gave up with the long wait.
So I’m pretty sad, to say the least, and feeling really defeated. My question is - how long after a chemical/early miscarriage were you able to conceive? I’m looking at the bright side being that at least my body could do this - since I was told forever I couldn’t. But I can’t help but wonder and hope this wasn’t a one off thing.
2024.05.13 20:01 CodyyIRE How would you change/balance DBD?
Hello all, I'm making this post because there has been a lot of discussion over DBD balance and mechanics for as long as i can remember and I'm curios on what people think would improve the game. I'm wondering what balance changes people think would be a good idea whether it be perk changes or complete game-play mechanic changes.
First off all before i give my own opinions i just want to clarify that i know no game will ever be 100% balanced an this post is more of a - what would you do if you had the chance to change something. Feel free to be as creative as you want as this is obviously not something going to happen i just want to hear opinions no matter how out there they are. Have some fun with this :)
So for Killer:
For killer i feel some of the biggest issues are perk usage (some perks have way higher usage all across the board) and balancing the top tiers. Gen regression has always been a big talking point because while gen regression is needed it gets boring to use all the time and play against. What i would do is:
I would also rework/remove all other gen regression perks. This is so killers cant stack more regression on top of the base kit ones added.
I feel like these changes would free up killer build variety and we could spend more time balancing killer power over certain perks being to strong in the hands of certain killers.
For balancing top tiers:
Blight - It's hard to say how strong he is since the recent changes but he is definitely still very strong and with the changes i proposed i guess some nerf would be called for.
Spirit - Rework Mother daughter ring
So for Survivor:
Just like with killer i try to look at what survivor straight up needs in every match and i feel like this has been more challenging than killer for me. Personally i think survivor is in a good spot with some changes possibly making the experience better.
Personally i think gen speeds are too fast with perks so i would Rework/remove all gen speed perks.
So these are just my opinions, i didn't spend a whole lot of time thinking about these and I'm looking forward to seeing some of the replies. And try to be nice to Each other :).
submitted by CodyyIRE to deadbydaylight [link] [comments]
First off all before i give my own opinions i just want to clarify that i know no game will ever be 100% balanced an this post is more of a - what would you do if you had the chance to change something. Feel free to be as creative as you want as this is obviously not something going to happen i just want to hear opinions no matter how out there they are. Have some fun with this :)
So for Killer:
For killer i feel some of the biggest issues are perk usage (some perks have way higher usage all across the board) and balancing the top tiers. Gen regression has always been a big talking point because while gen regression is needed it gets boring to use all the time and play against. What i would do is:
- Base kit Corrupt Intervention
- Base kit Pain Resonance
- Base kit Pop Goes the Weasel
I would also rework/remove all other gen regression perks. This is so killers cant stack more regression on top of the base kit ones added.
I feel like these changes would free up killer build variety and we could spend more time balancing killer power over certain perks being to strong in the hands of certain killers.
For balancing top tiers:
Blight - It's hard to say how strong he is since the recent changes but he is definitely still very strong and with the changes i proposed i guess some nerf would be called for.
- 3 Rushes max
- Increase the duration of each rush
- Blighted Rat base kit.
Spirit - Rework Mother daughter ring
So for Survivor:
Just like with killer i try to look at what survivor straight up needs in every match and i feel like this has been more challenging than killer for me. Personally i think survivor is in a good spot with some changes possibly making the experience better.
- Base kit Decisive Strike
- Base kit Window of Opportunity (maybe give option to disable if some don't enjoy it)
Personally i think gen speeds are too fast with perks so i would Rework/remove all gen speed perks.
So these are just my opinions, i didn't spend a whole lot of time thinking about these and I'm looking forward to seeing some of the replies. And try to be nice to Each other :).
2024.05.13 19:44 A_movable_life Uncle with 2 months or so to live attempted to guilt trip me into resuming contact
When I found this forum about a month ago I was reading the back posts and weeping the whole time.
Background:
I have processed this in therapy, made my peace, and have empathy for the situations that made her who she is.
I don't want to cause her harm, and fortunately I am really bad at relationships, and do not have children. Because it would be very painful if she had grandchildren that she has no access to. My sister and BIL can't have kids. (Details omitted for TW)
I work in the MH field, I'm an Nurse Practitioner. I worked as part of a DBT team. I am not DBT trained or certified but I got really good at boundaries, and sensing manipulation, without having an emotional response.
Before I went NC I would directly and clearly set limits. I stopped her when she would try to split my Sister and I, or gossip about her. There were several times every visit where I would stop her, and explain how I would not engage, did not want to hear, or set a reasonable expectation. Her reply a few times was "Don't analyze me."
Which is amusing because after the last estrangement, I asked her to go to therapy.... never happened.
Current Situation:
My Mother visited my Uncle who is dying of cancer and has by his estimation about 2 months to live.
My Mother sent me a text that I should visit him that she was down there and he does not have much time to live. I forgot I hadn't blocked her number on the new phone.
I have been NC for 9 years other then sending her a 9th Step (AA) letter. I intend to be NC for the rest of her life or mine whichever ends first.
I asked if she was present in the room. She left the morning of him calling me. I said I appreciated him not doing "One of those Ophra type interventions" as it's usually destructive.
I asked about visiting. Everyone has been invited down but me. He says he would like a visit.
He wants me "As a personal favor" to reconcile with her. I should mention he's a retired corporate attorney. Yes it's not amateur hour on either side of the phone. He said she was "Distraught that I would not talk with her."
I said let's address the second item, as you may not want me to visit depending on how I answer.
I would prefer having this conversation in person and to not have this conversation on a 2 sided Cell phone call either.
I said "no."
He pushed back and said this was not normal. I explained how it's more common then you would think both from people I know and also from being in clinical practice for almost 20 years.
He said "I can hear it in your voice that you want to reconcile." (Defining my feelings) I said I am speaking to you in the same tone I use with my patients.
I said that I will not be interacting with her for the rest of our lives. That this was a carefully made and considered decision.
I said we can discuss my reasons if you would like.
He said that was not his concern that it was between my Mother and I.
My mind formulates, "So no matter what happened, there is no reason that would cause you to find estrangement acceptable." Secondly you are implicating that I am being unreasonable, or worse yet cruel.
This goes in circles.
He bounces off a few boundaries, answer stays the same.
I figure I am going to let him know some of the situation. Because he's dying and I don't want him to think I am just being unreasonable and stubborn.
I then explain a little of how our childhood was. The abuse that my mother and I got. I also said I suspect my sister getting other abuse. Left that one hanging out there... Remember this is what I do for a living so that should have significant weight.
The things I did that I regret, and have made amends, as well as going to therapy, stopped drinking, worked the steps, and so forth.
I mentioned my sister goes to Trauma therapy, partially because of me.
Which also puts out there "Has your Sister ever had any therapy for all the stuff she has been through?"
He says "I can hear you are angry at your mother.." (defining feelings again) "
"Help me understand why do you feel that way."
"Based on what you said (above)" I said back, I am not angry at her. I have accepted and made my peace with this situation. I only listed my part in it, and what I have done to become a better person."
Which floats the unsaid question "What is her part in this?"
I said the offer is on the table to talk about this, or not talk about it. That is up to him. If you do want to have this conversation then it needs to be scheduled so I can have my notes.
The offer of a visit is "We shall see, and depends on how I am doing, check back in a week." I know the answer already. I also explained if I visit I will be getting a hotel room and a rental car, and that it's probably better if we do 2-3 hour visits so I don't tire him out.
The unsaid part is I want to be able to leave if I need to immediately, I want to be able to go to daily AA meetings, I want my own space process this coming loss. I
wrote a poem about this situation and read it in at my AA homegroup (The meeting you go to most and help keep it going.) I haven't written a poem since HS writing class. I've been weepy about the whole situation on and off.
I have a letter penned to my cousins, who I am in contact with explaining that he is a father figure in my life, that this is a very painful situation for me anticipating his passing, and that I apologize for not attending major life events in their lives and their children's lives because of this estrangement. That I won't be attending his service because it's the place for my Mother to mourn her last living sibling.
Conclusion:
submitted by A_movable_life to raisedbynarcissists [link] [comments]
Background:
I have processed this in therapy, made my peace, and have empathy for the situations that made her who she is.
I don't want to cause her harm, and fortunately I am really bad at relationships, and do not have children. Because it would be very painful if she had grandchildren that she has no access to. My sister and BIL can't have kids. (Details omitted for TW)
I work in the MH field, I'm an Nurse Practitioner. I worked as part of a DBT team. I am not DBT trained or certified but I got really good at boundaries, and sensing manipulation, without having an emotional response.
Before I went NC I would directly and clearly set limits. I stopped her when she would try to split my Sister and I, or gossip about her. There were several times every visit where I would stop her, and explain how I would not engage, did not want to hear, or set a reasonable expectation. Her reply a few times was "Don't analyze me."
Which is amusing because after the last estrangement, I asked her to go to therapy.... never happened.
Current Situation:
My Mother visited my Uncle who is dying of cancer and has by his estimation about 2 months to live.
My Mother sent me a text that I should visit him that she was down there and he does not have much time to live. I forgot I hadn't blocked her number on the new phone.
I have been NC for 9 years other then sending her a 9th Step (AA) letter. I intend to be NC for the rest of her life or mine whichever ends first.
I asked if she was present in the room. She left the morning of him calling me. I said I appreciated him not doing "One of those Ophra type interventions" as it's usually destructive.
I asked about visiting. Everyone has been invited down but me. He says he would like a visit.
He wants me "As a personal favor" to reconcile with her. I should mention he's a retired corporate attorney. Yes it's not amateur hour on either side of the phone. He said she was "Distraught that I would not talk with her."
I said let's address the second item, as you may not want me to visit depending on how I answer.
I would prefer having this conversation in person and to not have this conversation on a 2 sided Cell phone call either.
I said "no."
He pushed back and said this was not normal. I explained how it's more common then you would think both from people I know and also from being in clinical practice for almost 20 years.
He said "I can hear it in your voice that you want to reconcile." (Defining my feelings) I said I am speaking to you in the same tone I use with my patients.
I said that I will not be interacting with her for the rest of our lives. That this was a carefully made and considered decision.
I said we can discuss my reasons if you would like.
He said that was not his concern that it was between my Mother and I.
My mind formulates, "So no matter what happened, there is no reason that would cause you to find estrangement acceptable." Secondly you are implicating that I am being unreasonable, or worse yet cruel.
This goes in circles.
He bounces off a few boundaries, answer stays the same.
I figure I am going to let him know some of the situation. Because he's dying and I don't want him to think I am just being unreasonable and stubborn.
I then explain a little of how our childhood was. The abuse that my mother and I got. I also said I suspect my sister getting other abuse. Left that one hanging out there... Remember this is what I do for a living so that should have significant weight.
The things I did that I regret, and have made amends, as well as going to therapy, stopped drinking, worked the steps, and so forth.
I mentioned my sister goes to Trauma therapy, partially because of me.
Which also puts out there "Has your Sister ever had any therapy for all the stuff she has been through?"
He says "I can hear you are angry at your mother.." (defining feelings again) "
"Help me understand why do you feel that way."
"Based on what you said (above)" I said back, I am not angry at her. I have accepted and made my peace with this situation. I only listed my part in it, and what I have done to become a better person."
Which floats the unsaid question "What is her part in this?"
I said the offer is on the table to talk about this, or not talk about it. That is up to him. If you do want to have this conversation then it needs to be scheduled so I can have my notes.
The offer of a visit is "We shall see, and depends on how I am doing, check back in a week." I know the answer already. I also explained if I visit I will be getting a hotel room and a rental car, and that it's probably better if we do 2-3 hour visits so I don't tire him out.
The unsaid part is I want to be able to leave if I need to immediately, I want to be able to go to daily AA meetings, I want my own space process this coming loss. I
wrote a poem about this situation and read it in at my AA homegroup (The meeting you go to most and help keep it going.) I haven't written a poem since HS writing class. I've been weepy about the whole situation on and off.
I have a letter penned to my cousins, who I am in contact with explaining that he is a father figure in my life, that this is a very painful situation for me anticipating his passing, and that I apologize for not attending major life events in their lives and their children's lives because of this estrangement. That I won't be attending his service because it's the place for my Mother to mourn her last living sibling.
Conclusion:
- That firstly he feels that there is nothing that would justify estrangement.
- That my Mother probably said she has no insight into why I estranged her.
- Based on #2 I am guessing that she has had no therapy. A good therapist would turn that around and use certain questions to help her develop insight.
- That he feels I am angry and I want to reconcile.
- Defining my feelings is a huge red flag for me.
- I bet he didn't expect me to be calm, collected and give a rational and consistent dialogue.
- Having to hear about his Sister's home life probably hurts. The fact that he probably had no clue until my father passed, he has a lot of guilt.
- He's formally trained and skilled in negotiation tactics.
- He's dying so he has a huge ability to guilt me.
- I gave him the option to understand, that I would visit if asked, that I would limit exposure, and that we did not have to address this, or we can look at photos and tell stories, etc. What is not on the table is reconciliation with my Mother.
2024.05.13 17:27 adondshilt Nursing Ideas and PICOT for Evidence-Based Practice
 | Nurses play a crucial role in driving evidence-based practice (EBP) in healthcare. Here's how you can combine nursing ideas with PICOT (Population, Intervention, Comparison, Outcome, Time) to formulate research questions and improve patient care: submitted by adondshilt to Compliant_papers [link] [comments] https://preview.redd.it/4kre9luap70d1.png?width=700&format=png&auto=webp&s=a4af01325b75cfda59662d87a2d57b7bf593660d Nursing Ideas:
Additional Tips:
|
2024.05.13 16:51 misanthrope247 Please help! Input on real world health assessment needed
I am a frustrated nursing instructor who hates the way health assessment is taught in our program. Tons of focus on PRECISE technique without teaching when and why an assessment actually matters. For example, second year students can perfectly demonstrate how to assess pupil response but none can tell you when it makes sense to do this or what an abnormal response even means. Heart sounds are also a big deal with a lot of time spent on landmarking for those. Are full heart sounds something done routinely (like Q shift) in your practice? If yes- what type of unit is it? I worked acute internal medicine and it just was not something we did routinely. Of course we often assessed apical Hpulse deficit [esp in pts with a fib]. I can easily rationalize when doing an apical makes sense vs not to students.
I reviewed an older post on this sub related to the topic of heart sounds but it seemed like people were mixing together the laying of a stethoscope on a chest for ANY reason with actually assessing for heart murmurs/extra sounds. There is a big difference between assessing for rhythm and rate and assessing for SOUNDS. So, in what situations would a new grad be expected to do full heart sounds every shift? What changes are you looking for from shift to shift? Is hearing an S3 really more sensitive for fluid excess in a pt with HF than daily wt/BNP or other assessments? If we already know a pt has a valve disorder like regurg or stenosis...are we able to pick up an acute change to that diagnosis that would require acute intervention? I want to be able to explain when taking the time to assess full heart sounds matters and when it doesn't in real life for a new grad nurse. HELP!
submitted by misanthrope247 to nursing [link] [comments]
I reviewed an older post on this sub related to the topic of heart sounds but it seemed like people were mixing together the laying of a stethoscope on a chest for ANY reason with actually assessing for heart murmurs/extra sounds. There is a big difference between assessing for rhythm and rate and assessing for SOUNDS. So, in what situations would a new grad be expected to do full heart sounds every shift? What changes are you looking for from shift to shift? Is hearing an S3 really more sensitive for fluid excess in a pt with HF than daily wt/BNP or other assessments? If we already know a pt has a valve disorder like regurg or stenosis...are we able to pick up an acute change to that diagnosis that would require acute intervention? I want to be able to explain when taking the time to assess full heart sounds matters and when it doesn't in real life for a new grad nurse. HELP!
2024.05.13 16:49 Lavendersunshin3 My husband is making STIMS all about him
So my husband has a history of having something ‘feel wrong’ when things start moving along in this process. Last time, it was in January, the literal day of our ivf consult, he ended up in the ER because he felt like he couldn’t poop. After dozens of labs, scans and tests, the doctors told him nothing was wrong, gave him some laxatives and sent us home.
Now, fast forward to 5 months later, I’m on day 7 of STIMS and this fcking dude is starting on this bowel problem again. He is already on stimulant laxatives. I told him we can’t do this right now, and he said it’s not his fault he can’t go number 2 and is starting to hint towards medical intervention again…..for a phantom bowel problem. (I can also hear him going #2 in the early mornings.)
He’s going to make me lose it. All he needs to do is be the man of the home for two weeks but seeing me go through this meant he had to go through something too. I’m so stressed out over him and wish I could do it alone lol. Anyone else have a husband start to go weird during IVF?
Edit: Thank you to those who responded with helpful comments! No, I’m not leaving my husband and yes, I’m sure he’s someone I want to have kids with. No, he doesn’t have cancer and I’ve always been more than supportive of his medical endeavors, including back in January when instead of the nurse, I physically held the enema inside of him until he went to the bathroom.
We talked and chopped it up to anxiety which as many commented is a totally normal emotion to have during this process on both ends (lol). I understand my tone above was angry and frustrated, I appreciate those who validated my feelings as I felt them and brought some light to my eyes at the same time. Good luck to everyone on their journey’s here 🤍
submitted by Lavendersunshin3 to IVF [link] [comments]
Now, fast forward to 5 months later, I’m on day 7 of STIMS and this fcking dude is starting on this bowel problem again. He is already on stimulant laxatives. I told him we can’t do this right now, and he said it’s not his fault he can’t go number 2 and is starting to hint towards medical intervention again…..for a phantom bowel problem. (I can also hear him going #2 in the early mornings.)
He’s going to make me lose it. All he needs to do is be the man of the home for two weeks but seeing me go through this meant he had to go through something too. I’m so stressed out over him and wish I could do it alone lol. Anyone else have a husband start to go weird during IVF?
Edit: Thank you to those who responded with helpful comments! No, I’m not leaving my husband and yes, I’m sure he’s someone I want to have kids with. No, he doesn’t have cancer and I’ve always been more than supportive of his medical endeavors, including back in January when instead of the nurse, I physically held the enema inside of him until he went to the bathroom.
We talked and chopped it up to anxiety which as many commented is a totally normal emotion to have during this process on both ends (lol). I understand my tone above was angry and frustrated, I appreciate those who validated my feelings as I felt them and brought some light to my eyes at the same time. Good luck to everyone on their journey’s here 🤍
2024.05.13 16:47 misanthrope247 REAL WORLD purpose of assessing heart sounds every shift?
I am a frustrated nursing instructor who hates the way health assessment is taught in our program. Tons of focus on PRECISE technique without teaching when and why an assessment actually matters. For example, second year students can perfectly demonstrate how to assess pupil response but none can tell you when it makes sense to do this or what an abnormal response even means 😒. Heart sounds are also a big deal with a lot of time spent on landmarking for those. Are full heart sounds something done routinely (like Q shift) in your practice? If yes- what type of unit is it? I worked acute internal medicine and it just was not something we did routinely. Of course we often assessed apical Hpulse deficit [esp in pts with a fib]. I can easily rationalize when doing an apical makes sense vs not to students.
I reviewed an older post on this sub related to the topic of heart sounds but it seemed like people were mixing together the laying of a stethoscope on a chest for ANY reason with actually assessing for heart murmurs/extra sounds. There is a big difference between assessing for rhythm and rate and assessing for SOUNDS. So, in what situations would a new grad be expected to do full heart sounds every shift? What changes are you looking for from shift to shift? Is hearing an S3 really more sensitive for fluid excess in a pt with HF than daily wt/BNP or other assessments? If we already know a pt has a valve disorder like regurg or stenosis...are we able to pick up an acute change to that diagnosis that would require acute intervention? I want to be able to explain when taking the time to assess full heart sounds matters and when it doesn't in real life for a new grad nurse. HELP!
submitted by misanthrope247 to nursing [link] [comments]
I reviewed an older post on this sub related to the topic of heart sounds but it seemed like people were mixing together the laying of a stethoscope on a chest for ANY reason with actually assessing for heart murmurs/extra sounds. There is a big difference between assessing for rhythm and rate and assessing for SOUNDS. So, in what situations would a new grad be expected to do full heart sounds every shift? What changes are you looking for from shift to shift? Is hearing an S3 really more sensitive for fluid excess in a pt with HF than daily wt/BNP or other assessments? If we already know a pt has a valve disorder like regurg or stenosis...are we able to pick up an acute change to that diagnosis that would require acute intervention? I want to be able to explain when taking the time to assess full heart sounds matters and when it doesn't in real life for a new grad nurse. HELP!
2024.05.13 16:37 paeyongs being an adhd-er in a medical field is so difficult
i'm a nursing student, and just a few days before i got diagnosed with adhd, i had a rotation in one of the most difficult wards to rotate to. my clinical instructor gets frustrated at me most times because of how slow i do things and that "my interventions are too compartmentalized", so i do things once at a time. i also get pressured how i still have a lot of things to do for my patient while my groupmates were already endorsing and were done for the day. there are also other sources of frustration such as things that are supposed to be "common sense" ending up not being so common to me.
i've always thought that it's a me problem (well, it is), until my doctor brought up that i might be misdiagnosed with bipolar 2 and that i have adhd and depression instead. we talked about executive dysfunction and all that and everything makes so much sense. kinda sad how it's diagnosed late and how gender plays a role and as my doctor said, how i was "bright" as a child so no one suspects it.
currently i am all piled up in tons of paperwork from the previous rotations and i am so close to failing this class because i just can't keep up with the pace and for some reason when something makes me anxious or i don't have a heavy motivation to do something, i truly can't do it. seriously crawling my way to the end of the semester and i pray that i don't fail this class.
submitted by paeyongs to ADHD [link] [comments]
i've always thought that it's a me problem (well, it is), until my doctor brought up that i might be misdiagnosed with bipolar 2 and that i have adhd and depression instead. we talked about executive dysfunction and all that and everything makes so much sense. kinda sad how it's diagnosed late and how gender plays a role and as my doctor said, how i was "bright" as a child so no one suspects it.
currently i am all piled up in tons of paperwork from the previous rotations and i am so close to failing this class because i just can't keep up with the pace and for some reason when something makes me anxious or i don't have a heavy motivation to do something, i truly can't do it. seriously crawling my way to the end of the semester and i pray that i don't fail this class.
2024.05.13 08:50 Huge_Contribution689 Really really struggling with my in laws and I (20F)feel so guilty for my baby and fiancé (25M)what should I do!?
Ok this is just a bit of a rant to get stuff off my chest probably won’t have everything in it cause i feel like I could write a whole novel if I really got into it 😅😭
So basically I’ve (20F)been with my partner(25M) for just over two years now and we have 2 kids together (I know very fast the first was a happy accident who passed away shortly after her birth and the second was intentional as I knew by then this was the man I wanted to spend the rest of my life with) ever since we first started dating his mum hasn’t liked me never really gave a reason she’s just one of those people that assumes she doesn’t like you until you prove her otherwise and that basically means just bowing down to everything she wants and doing everything the exact same way she does things. Now I’m not a confrontational or argumentative person I can’t stand conflict however I’m also autistic and am incapable of doing some things the ways she does them really stupid stuff like how I do the washing or something would cause her to start complaining to her son about me and this was a constant thing it obviously got quite tiring and annoying but we just dealt with it and got on with life.
Now while I was pregnant with our first child my partners mum reported me to social services (cps for any Americans) saying I wouldn’t be capable of looking after our baby that I’d said I wasn’t gonna feed her and such (complete lies btw) all of this came completely out of nowhere no conversation about any concerns had ever been raised by her to either of us. So we dealt with the low and behold the social worker we were assigned had no concerns didn’t intervene in anyway and only stuck around because to be able to sign us off she had to see us physically interact with the baby so she had to be born but we’d already been told she was ready to sign us off immediately after the birth as there was absolutely no need for them to be involved based on all their observations of watching us prepare for a new baby and me already having set up some help with a family nurse to make sure I knew everything I needed to to look after our little girl (I’m a rather young mum and autistic so🤷♀️) anyway as I mentioned she passed away a few days after me and my partner decided we could do with getting away and having time to ourselves to process (we were living with his parents at the time) and his sister and mum were very unhappy about hay because we’d said we didn’t want our daughter to be disturbed any more and she was to be left to rest now and we will all say our final goodbyes at her funeral. His sister started saying we were abandoning her and just cause we don’t care about her doesn’t mean the rest of the family don’t care and saying she was all alone in a cold dark box in a freezer and such with no one that cares for her his mother kicked me out of her house it was all very traumatic during an already incredibly traumatic time.
Eventually things got left tho and I moved past it all for my partners sake I got pregnant again and we were trying to plan and build for our future we got our own place together finally when I was around 5 months pregnant or so and we were getting the place ready for our second child. His family even came round and helped us with a few bits things were a bit tense but they were better and they were getting into the friendly realm.
Baby was born and first time we took him to see fiancés family his mum ignored him the whole time and had to be convinced to even hold him. Obviously I was offended on behalf of my child but I didn’t say anything to them and we went round again to see everyone and this time everything was fine and friendly and no issues.
I started struggling and fiancés family were asked to help with the baby while we sorted me support out (I was diagnosed with ppd) and when support was out in place we reached out to sort out going to collect our baby and bring him home at which time we were told if we came anywhere near him police would be called and social services had already been called on us by them and we weren’t getting him back.
A lot happened and it was very back and forth and messy and confusing I can try and explain if anyone’s interested but basically we were advised to go and get him straight away and that he’d been abducted basically I called fiancés mum a nasty name ( don’t know if I can swear on here?) police came he had to stay there overnight due to the time (11:30 at night) and we collected him the next day.
Social have stayed involved a little while this time just to monitor that I am engaging with perinatal help and just to make sure theres nothing we need from them but they have also said there is no concern from them and no intervention they feel is necessary that ppd is a very normal thing and I am doing all the right things to cope and get better from it.
Since all that’s happened I have been very reluctant for baby to be away from me I have been having flash back off losing our daughter and nightmares of him never coming home. I asked if contact with fiancés family could happen with me present for the meantime while I work with perinatal help to deal with my paranoid thinking and if it could happen in a neutral location AKA a public place again until I work through my feelings with professional help. That was refused and they said they’d just not see baby at all that I was being controlling and they “weren’t gonna play my game” and I’d have to explain to him when he grew up why there was a whole family he never saw and it was all my fault. All this was putting a lot of strain on my fiancé as well and was really upsetting him so I backed down and allowed fiancé to take baby to see everyone without me even tho I was very afraid.
We then planned to go out for the day with the family and I came along as well and fiancés mum and sister didn’t come anywhere near baby didn’t try and interact with him at all and completely blanked him all because I was there. Now they had been trying to convince fiancé to go on holiday with them with baby and reluctantly said I could come along as well and yer couldn’t be civil for one afternoon with me around and essentially took it out on my baby (thankfully he’s still too young to understand of remember any of this) so fiancé and I agreed holiday with them really isn’t a good idea.
They are now going crazy saying I control fiancé that he doesn’t have a back bone that I’m abusing him? That they’ve gotten used to the thought that they will never see baby (no ones every said that) and that they basically don’t care now and as long as I’m around they want nothing to do with baby or fiancé.
I’m feeling so so bad for both my boys I’m devastated I’ve come between fiancé and his family and I’m so upset baby isn’t going to grow up knowing his aunt or cousins or his grandparents from that side. I’ve been struggling thinking that all this would be better if I took myself out of the equation that fiancé and baby would be better off as I wouldn’t be coming between them and family but I know that’s my ppd talking I just really needed to get it all off my chest to a bunch of random strangers who don’t know me or anyone else and have no biases
Sorry for how long this is
submitted by Huge_Contribution689 to JUSTNOMIL [link] [comments]
So basically I’ve (20F)been with my partner(25M) for just over two years now and we have 2 kids together (I know very fast the first was a happy accident who passed away shortly after her birth and the second was intentional as I knew by then this was the man I wanted to spend the rest of my life with) ever since we first started dating his mum hasn’t liked me never really gave a reason she’s just one of those people that assumes she doesn’t like you until you prove her otherwise and that basically means just bowing down to everything she wants and doing everything the exact same way she does things. Now I’m not a confrontational or argumentative person I can’t stand conflict however I’m also autistic and am incapable of doing some things the ways she does them really stupid stuff like how I do the washing or something would cause her to start complaining to her son about me and this was a constant thing it obviously got quite tiring and annoying but we just dealt with it and got on with life.
Now while I was pregnant with our first child my partners mum reported me to social services (cps for any Americans) saying I wouldn’t be capable of looking after our baby that I’d said I wasn’t gonna feed her and such (complete lies btw) all of this came completely out of nowhere no conversation about any concerns had ever been raised by her to either of us. So we dealt with the low and behold the social worker we were assigned had no concerns didn’t intervene in anyway and only stuck around because to be able to sign us off she had to see us physically interact with the baby so she had to be born but we’d already been told she was ready to sign us off immediately after the birth as there was absolutely no need for them to be involved based on all their observations of watching us prepare for a new baby and me already having set up some help with a family nurse to make sure I knew everything I needed to to look after our little girl (I’m a rather young mum and autistic so🤷♀️) anyway as I mentioned she passed away a few days after me and my partner decided we could do with getting away and having time to ourselves to process (we were living with his parents at the time) and his sister and mum were very unhappy about hay because we’d said we didn’t want our daughter to be disturbed any more and she was to be left to rest now and we will all say our final goodbyes at her funeral. His sister started saying we were abandoning her and just cause we don’t care about her doesn’t mean the rest of the family don’t care and saying she was all alone in a cold dark box in a freezer and such with no one that cares for her his mother kicked me out of her house it was all very traumatic during an already incredibly traumatic time.
Eventually things got left tho and I moved past it all for my partners sake I got pregnant again and we were trying to plan and build for our future we got our own place together finally when I was around 5 months pregnant or so and we were getting the place ready for our second child. His family even came round and helped us with a few bits things were a bit tense but they were better and they were getting into the friendly realm.
Baby was born and first time we took him to see fiancés family his mum ignored him the whole time and had to be convinced to even hold him. Obviously I was offended on behalf of my child but I didn’t say anything to them and we went round again to see everyone and this time everything was fine and friendly and no issues.
I started struggling and fiancés family were asked to help with the baby while we sorted me support out (I was diagnosed with ppd) and when support was out in place we reached out to sort out going to collect our baby and bring him home at which time we were told if we came anywhere near him police would be called and social services had already been called on us by them and we weren’t getting him back.
A lot happened and it was very back and forth and messy and confusing I can try and explain if anyone’s interested but basically we were advised to go and get him straight away and that he’d been abducted basically I called fiancés mum a nasty name ( don’t know if I can swear on here?) police came he had to stay there overnight due to the time (11:30 at night) and we collected him the next day.
Social have stayed involved a little while this time just to monitor that I am engaging with perinatal help and just to make sure theres nothing we need from them but they have also said there is no concern from them and no intervention they feel is necessary that ppd is a very normal thing and I am doing all the right things to cope and get better from it.
Since all that’s happened I have been very reluctant for baby to be away from me I have been having flash back off losing our daughter and nightmares of him never coming home. I asked if contact with fiancés family could happen with me present for the meantime while I work with perinatal help to deal with my paranoid thinking and if it could happen in a neutral location AKA a public place again until I work through my feelings with professional help. That was refused and they said they’d just not see baby at all that I was being controlling and they “weren’t gonna play my game” and I’d have to explain to him when he grew up why there was a whole family he never saw and it was all my fault. All this was putting a lot of strain on my fiancé as well and was really upsetting him so I backed down and allowed fiancé to take baby to see everyone without me even tho I was very afraid.
We then planned to go out for the day with the family and I came along as well and fiancés mum and sister didn’t come anywhere near baby didn’t try and interact with him at all and completely blanked him all because I was there. Now they had been trying to convince fiancé to go on holiday with them with baby and reluctantly said I could come along as well and yer couldn’t be civil for one afternoon with me around and essentially took it out on my baby (thankfully he’s still too young to understand of remember any of this) so fiancé and I agreed holiday with them really isn’t a good idea.
They are now going crazy saying I control fiancé that he doesn’t have a back bone that I’m abusing him? That they’ve gotten used to the thought that they will never see baby (no ones every said that) and that they basically don’t care now and as long as I’m around they want nothing to do with baby or fiancé.
I’m feeling so so bad for both my boys I’m devastated I’ve come between fiancé and his family and I’m so upset baby isn’t going to grow up knowing his aunt or cousins or his grandparents from that side. I’ve been struggling thinking that all this would be better if I took myself out of the equation that fiancé and baby would be better off as I wouldn’t be coming between them and family but I know that’s my ppd talking I just really needed to get it all off my chest to a bunch of random strangers who don’t know me or anyone else and have no biases
Sorry for how long this is
2024.05.13 08:46 Huge_Contribution689 Really really struggling with my in laws and I (20F)feel so guilty for my baby and fiancé (25M)what should I do!?
Ok this is just a bit of a rant to get stuff off my chest probably won’t have everything in it cause i feel like I could write a whole novel if I really got into it 😅😭
So basically I’ve (20F)been with my partner(25M) for just over two years now and we have 2 kids together (I know very fast the first was a happy accident who passed away shortly after her birth and the second was intentional as I knew by then this was the man I wanted to spend the rest of my life with) ever since we first started dating his mum hasn’t liked me never really gave a reason she’s just one of those people that assumes she doesn’t like you until you prove her otherwise and that basically means just bowing down to everything she wants and doing everything the exact same way she does things. Now I’m not a confrontational or argumentative person I can’t stand conflict however I’m also autistic and am incapable of doing some things the ways she does them really stupid stuff like how I do the washing or something would cause her to start complaining to her son about me and this was a constant thing it obviously got quite tiring and annoying but we just dealt with it and got on with life.
Now while I was pregnant with our first child my partners mum reported me to social services (cps for any Americans) saying I wouldn’t be capable of looking after our baby that I’d said I wasn’t gonna feed her and such (complete lies btw) all of this came completely out of nowhere no conversation about any concerns had ever been raised by her to either of us. So we dealt with the low and behold the social worker we were assigned had no concerns didn’t intervene in anyway and only stuck around because to be able to sign us off she had to see us physically interact with the baby so she had to be born but we’d already been told she was ready to sign us off immediately after the birth as there was absolutely no need for them to be involved based on all their observations of watching us prepare for a new baby and me already having set up some help with a family nurse to make sure I knew everything I needed to to look after our little girl (I’m a rather young mum and autistic so🤷♀️) anyway as I mentioned she passed away a few days after me and my partner decided we could do with getting away and having time to ourselves to process (we were living with his parents at the time) and his sister and mum were very unhappy about hay because we’d said we didn’t want our daughter to be disturbed any more and she was to be left to rest now and we will all say our final goodbyes at her funeral. His sister started saying we were abandoning her and just cause we don’t care about her doesn’t mean the rest of the family don’t care and saying she was all alone in a cold dark box in a freezer and such with no one that cares for her his mother kicked me out of her house it was all very traumatic during an already incredibly traumatic time.
Eventually things got left tho and I moved past it all for my partners sake I got pregnant again and we were trying to plan and build for our future we got our own place together finally when I was around 5 months pregnant or so and we were getting the place ready for our second child. His family even came round and helped us with a few bits things were a bit tense but they were better and they were getting into the friendly realm.
Baby was born and first time we took him to see fiancés family his mum ignored him the whole time and had to be convinced to even hold him. Obviously I was offended on behalf of my child but I didn’t say anything to them and we went round again to see everyone and this time everything was fine and friendly and no issues.
I started struggling and fiancés family were asked to help with the baby while we sorted me support out (I was diagnosed with ppd) and when support was out in place we reached out to sort out going to collect our baby and bring him home at which time we were told if we came anywhere near him police would be called and social services had already been called on us by them and we weren’t getting him back.
A lot happened and it was very back and forth and messy and confusing I can try and explain if anyone’s interested but basically we were advised to go and get him straight away and that he’d been abducted basically I called fiancés mum a nasty name ( don’t know if I can swear on here?) police came he had to stay there overnight due to the time (11:30 at night) and we collected him the next day.
Social have stayed involved a little while this time just to monitor that I am engaging with perinatal help and just to make sure theres nothing we need from them but they have also said there is no concern from them and no intervention they feel is necessary that ppd is a very normal thing and I am doing all the right things to cope and get better from it.
Since all that’s happened I have been very reluctant for baby to be away from me I have been having flash back off losing our daughter and nightmares of him never coming home. I asked if contact with fiancés family could happen with me present for the meantime while I work with perinatal help to deal with my paranoid thinking and if it could happen in a neutral location AKA a public place again until I work through my feelings with professional help. That was refused and they said they’d just not see baby at all that I was being controlling and they “weren’t gonna play my game” and I’d have to explain to him when he grew up why there was a whole family he never saw and it was all my fault. All this was putting a lot of strain on my fiancé as well and was really upsetting him so I backed down and allowed fiancé to take baby to see everyone without me even tho I was very afraid.
We then planned to go out for the day with the family and I came along as well and fiancés mum and sister didn’t come anywhere near baby didn’t try and interact with him at all and completely blanked him all because I was there. Now they had been trying to convince fiancé to go on holiday with them with baby and reluctantly said I could come along as well and yer couldn’t be civil for one afternoon with me around and essentially took it out on my baby (thankfully he’s still too young to understand of remember any of this) so fiancé and I agreed holiday with them really isn’t a good idea.
They are now going crazy saying I control fiancé that he doesn’t have a back bone that I’m abusing him? That they’ve gotten used to the thought that they will never see baby (no ones every said that) and that they basically don’t care now and as long as I’m around they want nothing to do with baby or fiancé.
I’m feeling so so bad for both my boys I’m devastated I’ve come between fiancé and his family and I’m so upset baby isn’t going to grow up knowing his aunt or cousins or his grandparents from that side. I’ve been struggling thinking that all this would be better if I took myself out of the equation that fiancé and baby would be better off as I wouldn’t be coming between them and family but I know that’s my ppd talking I just really needed to get it all off my chest to a bunch of random strangers who don’t know me or anyone else and have no biases
Sorry for how long this is
submitted by Huge_Contribution689 to u/Huge_Contribution689 [link] [comments]
So basically I’ve (20F)been with my partner(25M) for just over two years now and we have 2 kids together (I know very fast the first was a happy accident who passed away shortly after her birth and the second was intentional as I knew by then this was the man I wanted to spend the rest of my life with) ever since we first started dating his mum hasn’t liked me never really gave a reason she’s just one of those people that assumes she doesn’t like you until you prove her otherwise and that basically means just bowing down to everything she wants and doing everything the exact same way she does things. Now I’m not a confrontational or argumentative person I can’t stand conflict however I’m also autistic and am incapable of doing some things the ways she does them really stupid stuff like how I do the washing or something would cause her to start complaining to her son about me and this was a constant thing it obviously got quite tiring and annoying but we just dealt with it and got on with life.
Now while I was pregnant with our first child my partners mum reported me to social services (cps for any Americans) saying I wouldn’t be capable of looking after our baby that I’d said I wasn’t gonna feed her and such (complete lies btw) all of this came completely out of nowhere no conversation about any concerns had ever been raised by her to either of us. So we dealt with the low and behold the social worker we were assigned had no concerns didn’t intervene in anyway and only stuck around because to be able to sign us off she had to see us physically interact with the baby so she had to be born but we’d already been told she was ready to sign us off immediately after the birth as there was absolutely no need for them to be involved based on all their observations of watching us prepare for a new baby and me already having set up some help with a family nurse to make sure I knew everything I needed to to look after our little girl (I’m a rather young mum and autistic so🤷♀️) anyway as I mentioned she passed away a few days after me and my partner decided we could do with getting away and having time to ourselves to process (we were living with his parents at the time) and his sister and mum were very unhappy about hay because we’d said we didn’t want our daughter to be disturbed any more and she was to be left to rest now and we will all say our final goodbyes at her funeral. His sister started saying we were abandoning her and just cause we don’t care about her doesn’t mean the rest of the family don’t care and saying she was all alone in a cold dark box in a freezer and such with no one that cares for her his mother kicked me out of her house it was all very traumatic during an already incredibly traumatic time.
Eventually things got left tho and I moved past it all for my partners sake I got pregnant again and we were trying to plan and build for our future we got our own place together finally when I was around 5 months pregnant or so and we were getting the place ready for our second child. His family even came round and helped us with a few bits things were a bit tense but they were better and they were getting into the friendly realm.
Baby was born and first time we took him to see fiancés family his mum ignored him the whole time and had to be convinced to even hold him. Obviously I was offended on behalf of my child but I didn’t say anything to them and we went round again to see everyone and this time everything was fine and friendly and no issues.
I started struggling and fiancés family were asked to help with the baby while we sorted me support out (I was diagnosed with ppd) and when support was out in place we reached out to sort out going to collect our baby and bring him home at which time we were told if we came anywhere near him police would be called and social services had already been called on us by them and we weren’t getting him back.
A lot happened and it was very back and forth and messy and confusing I can try and explain if anyone’s interested but basically we were advised to go and get him straight away and that he’d been abducted basically I called fiancés mum a nasty name ( don’t know if I can swear on here?) police came he had to stay there overnight due to the time (11:30 at night) and we collected him the next day.
Social have stayed involved a little while this time just to monitor that I am engaging with perinatal help and just to make sure theres nothing we need from them but they have also said there is no concern from them and no intervention they feel is necessary that ppd is a very normal thing and I am doing all the right things to cope and get better from it.
Since all that’s happened I have been very reluctant for baby to be away from me I have been having flash back off losing our daughter and nightmares of him never coming home. I asked if contact with fiancés family could happen with me present for the meantime while I work with perinatal help to deal with my paranoid thinking and if it could happen in a neutral location AKA a public place again until I work through my feelings with professional help. That was refused and they said they’d just not see baby at all that I was being controlling and they “weren’t gonna play my game” and I’d have to explain to him when he grew up why there was a whole family he never saw and it was all my fault. All this was putting a lot of strain on my fiancé as well and was really upsetting him so I backed down and allowed fiancé to take baby to see everyone without me even tho I was very afraid.
We then planned to go out for the day with the family and I came along as well and fiancés mum and sister didn’t come anywhere near baby didn’t try and interact with him at all and completely blanked him all because I was there. Now they had been trying to convince fiancé to go on holiday with them with baby and reluctantly said I could come along as well and yer couldn’t be civil for one afternoon with me around and essentially took it out on my baby (thankfully he’s still too young to understand of remember any of this) so fiancé and I agreed holiday with them really isn’t a good idea.
They are now going crazy saying I control fiancé that he doesn’t have a back bone that I’m abusing him? That they’ve gotten used to the thought that they will never see baby (no ones every said that) and that they basically don’t care now and as long as I’m around they want nothing to do with baby or fiancé.
I’m feeling so so bad for both my boys I’m devastated I’ve come between fiancé and his family and I’m so upset baby isn’t going to grow up knowing his aunt or cousins or his grandparents from that side. I’ve been struggling thinking that all this would be better if I took myself out of the equation that fiancé and baby would be better off as I wouldn’t be coming between them and family but I know that’s my ppd talking I just really needed to get it all off my chest to a bunch of random strangers who don’t know me or anyone else and have no biases
Sorry for how long this is
2024.05.13 08:41 Huge_Contribution689 Really really struggling with my in laws and I (20F)feel so guilty for my baby and fiancé (25M)what should I do!?
Ok this is just a bit of a rant to get stuff off my chest probably won’t have everything in it cause i feel like I could write a whole novel if I really got into it 😅😭
So basically I’ve (20F)been with my partner(25M) for just over two years now and we have 2 kids together (I know very fast the first was a happy accident who passed away shortly after her birth and the second was intentional as I knew by then this was the man I wanted to spend the rest of my life with) ever since we first started dating his mum hasn’t liked me never really gave a reason she’s just one of those people that assumes she doesn’t like you until you prove her otherwise and that basically means just bowing down to everything she wants and doing everything the exact same way she does things. Now I’m not a confrontational or argumentative person I can’t stand conflict however I’m also autistic and am incapable of doing some things the ways she does them really stupid stuff like how I do the washing or something would cause her to start complaining to her son about me and this was a constant thing it obviously got quite tiring and annoying but we just dealt with it and got on with life.
Now while I was pregnant with our first child my partners mum reported me to social services (cps for any Americans) saying I wouldn’t be capable of looking after our baby that I’d said I wasn’t gonna feed her and such (complete lies btw) all of this came completely out of nowhere no conversation about any concerns had ever been raised by her to either of us. So we dealt with the low and behold the social worker we were assigned had no concerns didn’t intervene in anyway and only stuck around because to be able to sign us off she had to see us physically interact with the baby so she had to be born but we’d already been told she was ready to sign us off immediately after the birth as there was absolutely no need for them to be involved based on all their observations of watching us prepare for a new baby and me already having set up some help with a family nurse to make sure I knew everything I needed to to look after our little girl (I’m a rather young mum and autistic so🤷♀️) anyway as I mentioned she passed away a few days after me and my partner decided we could do with getting away and having time to ourselves to process (we were living with his parents at the time) and his sister and mum were very unhappy about hay because we’d said we didn’t want our daughter to be disturbed any more and she was to be left to rest now and we will all say our final goodbyes at her funeral. His sister started saying we were abandoning her and just cause we don’t care about her doesn’t mean the rest of the family don’t care and saying she was all alone in a cold dark box in a freezer and such with no one that cares for her his mother kicked me out of her house it was all very traumatic during an already incredibly traumatic time.
Eventually things got left tho and I moved past it all for my partners sake I got pregnant again and we were trying to plan and build for our future we got our own place together finally when I was around 5 months pregnant or so and we were getting the place ready for our second child. His family even came round and helped us with a few bits things were a bit tense but they were better and they were getting into the friendly realm.
Baby was born and first time we took him to see fiancés family his mum ignored him the whole time and had to be convinced to even hold him. Obviously I was offended on behalf of my child but I didn’t say anything to them and we went round again to see everyone and this time everything was fine and friendly and no issues.
I started struggling and fiancés family were asked to help with the baby while we sorted me support out (I was diagnosed with ppd) and when support was out in place we reached out to sort out going to collect our baby and bring him home at which time we were told if we came anywhere near him police would be called and social services had already been called on us by them and we weren’t getting him back.
A lot happened and it was very back and forth and messy and confusing I can try and explain if anyone’s interested but basically we were advised to go and get him straight away and that he’d been abducted basically I called fiancés mum a nasty name ( don’t know if I can swear on here?) police came he had to stay there overnight due to the time (11:30 at night) and we collected him the next day.
Social have stayed involved a little while this time just to monitor that I am engaging with perinatal help and just to make sure theres nothing we need from them but they have also said there is no concern from them and no intervention they feel is necessary that ppd is a very normal thing and I am doing all the right things to cope and get better from it.
Since all that’s happened I have been very reluctant for baby to be away from me I have been having flash back off losing our daughter and nightmares of him never coming home. I asked if contact with fiancés family could happen with me present for the meantime while I work with perinatal help to deal with my paranoid thinking and if it could happen in a neutral location AKA a public place again until I work through my feelings with professional help. That was refused and they said they’d just not see baby at all that I was being controlling and they “weren’t gonna play my game” and I’d have to explain to him when he grew up why there was a whole family he never saw and it was all my fault. All this was putting a lot of strain on my fiancé as well and was really upsetting him so I backed down and allowed fiancé to take baby to see everyone without me even tho I was very afraid.
We then planned to go out for the day with the family and I came along as well and fiancés mum and sister didn’t come anywhere near baby didn’t try and interact with him at all and completely blanked him all because I was there. Now they had been trying to convince fiancé to go on holiday with them with baby and reluctantly said I could come along as well and yer couldn’t be civil for one afternoon with me around and essentially took it out on my baby (thankfully he’s still too young to understand of remember any of this) so fiancé and I agreed holiday with them really isn’t a good idea.
They are now going crazy saying I control fiancé that he doesn’t have a back bone that I’m abusing him? That they’ve gotten used to the thought that they will never see baby (no ones every said that) and that they basically don’t care now and as long as I’m around they want nothing to do with baby or fiancé.
I’m feeling so so bad for both my boys I’m devastated I’ve come between fiancé and his family and I’m so upset baby isn’t going to grow up knowing his aunt or cousins or his grandparents from that side. I’ve been struggling thinking that all this would be better if I took myself out of the equation that fiancé and baby would be better off as I wouldn’t be coming between them and family but I know that’s my ppd talking I just really needed to get it all off my chest to a bunch of random strangers who don’t know me or anyone else and have no biases
Sorry for how long this is
submitted by Huge_Contribution689 to relationship_advice [link] [comments]
So basically I’ve (20F)been with my partner(25M) for just over two years now and we have 2 kids together (I know very fast the first was a happy accident who passed away shortly after her birth and the second was intentional as I knew by then this was the man I wanted to spend the rest of my life with) ever since we first started dating his mum hasn’t liked me never really gave a reason she’s just one of those people that assumes she doesn’t like you until you prove her otherwise and that basically means just bowing down to everything she wants and doing everything the exact same way she does things. Now I’m not a confrontational or argumentative person I can’t stand conflict however I’m also autistic and am incapable of doing some things the ways she does them really stupid stuff like how I do the washing or something would cause her to start complaining to her son about me and this was a constant thing it obviously got quite tiring and annoying but we just dealt with it and got on with life.
Now while I was pregnant with our first child my partners mum reported me to social services (cps for any Americans) saying I wouldn’t be capable of looking after our baby that I’d said I wasn’t gonna feed her and such (complete lies btw) all of this came completely out of nowhere no conversation about any concerns had ever been raised by her to either of us. So we dealt with the low and behold the social worker we were assigned had no concerns didn’t intervene in anyway and only stuck around because to be able to sign us off she had to see us physically interact with the baby so she had to be born but we’d already been told she was ready to sign us off immediately after the birth as there was absolutely no need for them to be involved based on all their observations of watching us prepare for a new baby and me already having set up some help with a family nurse to make sure I knew everything I needed to to look after our little girl (I’m a rather young mum and autistic so🤷♀️) anyway as I mentioned she passed away a few days after me and my partner decided we could do with getting away and having time to ourselves to process (we were living with his parents at the time) and his sister and mum were very unhappy about hay because we’d said we didn’t want our daughter to be disturbed any more and she was to be left to rest now and we will all say our final goodbyes at her funeral. His sister started saying we were abandoning her and just cause we don’t care about her doesn’t mean the rest of the family don’t care and saying she was all alone in a cold dark box in a freezer and such with no one that cares for her his mother kicked me out of her house it was all very traumatic during an already incredibly traumatic time.
Eventually things got left tho and I moved past it all for my partners sake I got pregnant again and we were trying to plan and build for our future we got our own place together finally when I was around 5 months pregnant or so and we were getting the place ready for our second child. His family even came round and helped us with a few bits things were a bit tense but they were better and they were getting into the friendly realm.
Baby was born and first time we took him to see fiancés family his mum ignored him the whole time and had to be convinced to even hold him. Obviously I was offended on behalf of my child but I didn’t say anything to them and we went round again to see everyone and this time everything was fine and friendly and no issues.
I started struggling and fiancés family were asked to help with the baby while we sorted me support out (I was diagnosed with ppd) and when support was out in place we reached out to sort out going to collect our baby and bring him home at which time we were told if we came anywhere near him police would be called and social services had already been called on us by them and we weren’t getting him back.
A lot happened and it was very back and forth and messy and confusing I can try and explain if anyone’s interested but basically we were advised to go and get him straight away and that he’d been abducted basically I called fiancés mum a nasty name ( don’t know if I can swear on here?) police came he had to stay there overnight due to the time (11:30 at night) and we collected him the next day.
Social have stayed involved a little while this time just to monitor that I am engaging with perinatal help and just to make sure theres nothing we need from them but they have also said there is no concern from them and no intervention they feel is necessary that ppd is a very normal thing and I am doing all the right things to cope and get better from it.
Since all that’s happened I have been very reluctant for baby to be away from me I have been having flash back off losing our daughter and nightmares of him never coming home. I asked if contact with fiancés family could happen with me present for the meantime while I work with perinatal help to deal with my paranoid thinking and if it could happen in a neutral location AKA a public place again until I work through my feelings with professional help. That was refused and they said they’d just not see baby at all that I was being controlling and they “weren’t gonna play my game” and I’d have to explain to him when he grew up why there was a whole family he never saw and it was all my fault. All this was putting a lot of strain on my fiancé as well and was really upsetting him so I backed down and allowed fiancé to take baby to see everyone without me even tho I was very afraid.
We then planned to go out for the day with the family and I came along as well and fiancés mum and sister didn’t come anywhere near baby didn’t try and interact with him at all and completely blanked him all because I was there. Now they had been trying to convince fiancé to go on holiday with them with baby and reluctantly said I could come along as well and yer couldn’t be civil for one afternoon with me around and essentially took it out on my baby (thankfully he’s still too young to understand of remember any of this) so fiancé and I agreed holiday with them really isn’t a good idea.
They are now going crazy saying I control fiancé that he doesn’t have a back bone that I’m abusing him? That they’ve gotten used to the thought that they will never see baby (no ones every said that) and that they basically don’t care now and as long as I’m around they want nothing to do with baby or fiancé.
I’m feeling so so bad for both my boys I’m devastated I’ve come between fiancé and his family and I’m so upset baby isn’t going to grow up knowing his aunt or cousins or his grandparents from that side. I’ve been struggling thinking that all this would be better if I took myself out of the equation that fiancé and baby would be better off as I wouldn’t be coming between them and family but I know that’s my ppd talking I just really needed to get it all off my chest to a bunch of random strangers who don’t know me or anyone else and have no biases
Sorry for how long this is
2024.05.12 01:55 Herban_Myth Florida Gov. Ron DeSantis signs another 20 bills into law. Here’s what to expect (Credit: Anthony Talcott)
 | Published by Anthony TalcottFlorida Gov. Ron DeSantis on Friday signed another 20 bills into law that cover a variety of issues, including insurance, medical payments and sexual assault evidence.The new laws signed on Friday include: HB 215 — Risk Retention GroupsHouse Bill 215 lets motor vehicle coverage issued by a risk retention group (RRG) satisfy financial requirements under the state’s motor vehicle law.RRGs are a type of liability insurance company owned by its members. They usually let businesses with similar insurance needs pool their risks under state and federal laws. The law goes into effect on July 1. HB 287 — TransportationHouse Bill 287 addresses several issues related to transportation in the state, primarily as it relates to FDOT and the DHSMV.For example, the law limits the amount of fuel tax revenues and motor vehicle license-related fees that can be spent on public transit projects. Other changes include the following: Requires the DHSMV to annually review major traffic law changes each year so that driving course content can be modified accordingly Motor vehicles used for the performance of work on an FDOT road/bridge project must be registered in compliance with state standards Amends provisions related to funding a fire station along the Alligator Alley toll road Amends provisions that a property owner’s right of first refusal for property that FDOT acquired but later determined is no longer needed for a transportation facility The law goes into effect on July 1. HB 437 — Anchoring Limitation AreasHouse Bill 437 expands on parts of Biscayne Bay in Miami-Dade County, which are designated as anchoring limitation areas.“Anchoring” refers to when boaters seek and use a safe harbor on a public waterway for an indefinite period using an anchor. Previously, Florida law designated certain areas that are densely populated with narrow waterways as “anchoring limitation areas.” When in these areas, people are prohibited from anchoring between a half-hour after sunset and a half-hour before sunrise. This law designates sections of Biscayne Bay between Palm Island and State Road A1A; and between San Marino Island and Di Lido Island as anchoring limitation areas. The law goes into effect on July 1. HB 935 — Home Health Care ServicesHouse Bill 935 allows Medicaid to pay for home health services.According to Legislative analysts, this will be allowed if ordered by advanced practice registered nurses or physician assistants. The law goes into effect on July 1. HB 1065 — Substance Abuse TreatmentHouse Bill 1065 amends requirements for substance abuse treatment policies.For starters, the law prohibits a “recovery residence” — used in the treatment of substance abuse — from denying access solely on the basis that a person has been prescribed federally approved medication for the treatment of a substance abuse disorder. In addition, the law increases the number of residents whom a recovery residence administrator may actively manage at a given time from 100 to 150. The law also increases the timeframe for a certified recovery residence to find a new administrator if one is removed from 30 days to 90 days. The law goes into effect on July 1. HB 1083 — Permanency for ChildrenHouse Bill 1083 seeks to create a more efficient, less costly adoption process.According to analysts, the law streamlines the adoption process for orphaned children so long as they already know the prospective guardian. In addition, this law expands the criteria for Post-Secondary Education and Support (PESS), Aftercare, and Extended Guardianship and Adoption Assistance Programs, which aim to make it easier for those ages 18 - 23 to receive benefits as they transition out of foster care. The law also expands eligibility for adoption incentives and increases the award amounts. The law goes into effect on July 1. HB 1335 — Department of Business and Professional RegulationHouse Bill 1335 makes various changes regarding the DBPR and its policies.Applicants and licensees will be required to create and maintain an online account to communicate with the DBPR if they’re part of the tobacco, nicotine, alcohol, CPA, or elevator industries. Furthermore, the law removes certain requirements and provisions for practices like barbers, cosmetologists, pilots, specialty electrical contractors and asbestos abatement professionals. The law goes into effect on July 1. HB 1503 — Citizens Property InsuranceHouse Bill 1503 makes certain changes to Citizens Property Insurance, including:Surplus Lines: Surplus line insurers meeting state standards may take out policies from Citizens issued on homes that aren’t primary residences or homesteaded properties. Flood Coverage: Citizens policyholders who must purchase flood insurance for coverage eligibility are required to buy only dwelling coverage for a flood loss — rather than dwelling and contents coverage. This rule took effect upon the bill’s signing. Combining Accounts: The law eliminates unnecessary statutory language now that Citizens has combined the Personal Lines Account, Commercial Lines Account and Coastal Account. Operations and Management: Citizens’ executive director may appoint a designee to act as the agency head, and Citizens can share information with the NICB to help fight insurance fraud. This law goes into effect on July 1. HB 1561 — Office Liposuction SurgeriesHouse Bill 1561 involves more restrictions on physicians offering liposuction services out of their offices.Currently, physicians are required to register their offices with the Department of Health if they’re performing liposuction procedures under certain conditions. Under this law, they will have to register regardless of whether the fat is temporarily or permanently removed. Furthermore, fines are increased to $5,000 each time a physician performs such a procedure in an office that isn’t registered with the DOH. Previously, the fine was set at $5,000 per day, so the change will allow the DOH to go after physicians who violate the law several times within the same day. The law went into effect upon being signed. HB 1557 — Department of Environmental ProtectionHouse Bill 1557 makes several changes involving the DEP, including:Requires each water management district (WMD) to develop rules by the end of 2025 to promote the reuse of reclaimed water Expands the types of projects undertaken by local governments that can be awarded funding by the Resilient Florida Grant Program. Requires the DEP to work on maintaining data on rising sea levels and statewide flood vulnerability The law goes into effect on July 1. HB 1611 — Insurance ChangesHouse Bill 1611 makes several changes to the state’s insurance rules, including:Data Reporting: Property insurers must report information to the OIR on a monthly basis rather than a quarterly one. Data must be reported based on ZIP code instead of county. Public Housing Authority: The maximum per-loss occurrence amount that a PHA self-insurance fund may retain is changed from $350,000 to an amount that the fund can withstand, so long as it meets sustainability criteria. Cancellation Prohibition: Surplus lines insurers’ ability to cancel or non-renew personal and commercial lines residential insurance polices because of unrepaired damage after a hurricane or wind-loss following a declared emergency is restricted. Hurricane Modeling: Insurers using the average of at least two models in their rate filing must use the same average model throughout the state. If using a weighted average instead, insurers must justify their decision with the OIR. Citizens Property Insurance: This law eliminates a provision that lets Citizens charge up to 50% above the established rate for policyholders whose coverage was provided by an insurer who was determined to be “unsound.” Roof Inspections: Roofing contractors are added to the list of authorized inspectors whom an insurer can approve to inspect a roof. This law goes into effect on July 1. HB 7089 — Transparency in Health and Human ServicesHouse Bill 7089 sets standards for medical billing to increase price transparency.First, the law requires hospitals to publish the costs of 300 or more “shoppable services” or provide an online resource that meets federal guidelines. In addition, hospitals will be required to set up an internal process for patient billing disputes. “Hospitals and (Ambulatory Surgical Centers) must disclose when an insured patient’s cost-sharing amount exceeds a non-insured person’s cash price or pay a maximum fine of $500 per incident,” the Legislative analysis reads. “The bill requires hospitals and ASCs to provide each patient with an estimate and requires health plans to provide an advanced explanation of benefits on certain timelines.” Alongside these rules, the law prohibits hospitals from filing an “extraordinary collection action” for medical debt, and a three-year statute of limitation period for medical debt collection will be implemented on the day that the hospital refers the debt to a third party. The law also exempts up to $10,000 of a debtor’s property from garnishment or other legal actions by a hospital to recover medical debt. The law goes into effect on July 1. SB 168 — Congenital Cytomegalovirus ScreeningsSenate Bill 168 amends state statutes regarding newborn health screening requirements.Under this law, all newborns born under 35 weeks and requiring cardiac care in a hospital with neonatal intensive care services must be tested for Cytomegalovirus (CMV). CMB is a common virus, though a healthy immune system typically keeps it from making people sick. However, some babies with a congenital CMV infection can have health problems that are apparent at birth and which can result in death. The law also requires that CMV screening and medically necessary follow-up reevaluations that lead to a diagnosis are covered for Medicaid patients. In addition, children diagnosed with CMV must be referred to a primary care physician and the Children’s Medical Services Early Intervention Program for management of the condition. The law goes into effect on July 1. SB 186 — Neurodegenerative DiseasesSenate Bill 186 requires the state’s Surgeon General to establish a policy committee for progressive supranuclear palsy and other neurodegenerative diseases.The committee is aimed at identifying the impact of these diseases on Floridians while providing recommendations to improve awareness, detection and outcomes. Members of the committee must be appointed by Sept. 1, and the initial meeting must be held by Oct. 1. The law goes into effect on July 1. SB 364 — Public Service Commission RulesSenate Bill 364 amends state statutes regarding rulemaking by the Public Service Commission.Under this law, rules about the Florida Public Service Regulatory Trust Fund and assessment fees charged to Florida utilities can be adopted by the PSC without being subject to potential ratification under state law. The law went into effect upon being signed. SB 366 — Gas Safety Law of 1967Senate Bill 366 revises the maximum civil penalties for violating Florida’s Gas Safety Law of 1967.Under SB 366, maximum penalties are increased from $25,000 to $266,015 for each violation for each day that a violation persists. This can reach over $2.6 million in total for any related series of violations. The law goes into effect on July 1. SB 532 — SecuritiesSenate Bill 532 amends the Securities and Investor Protection Act.Many of the changes are aimed at improving investor protection through the Securities Guaranty Fund and providing more opportunities for investment within the state. According to Legislative analysts, the changes were recommended by a Florida task force that was aimed at increasing the ability of small businesses in the state to raise capital. There were also several small changes regarding business financing provisions that were made to be consistent with recent federal rules. The law goes into effect on Oct. 1. SB 764 — Retention of Sexual Offense EvidenceSenate Bill 764 amends state statutes to specify the standards for storing sexual assault evidence kits (SAKs).SAKs must be retained for a minimum of 50 years if they are collected from alleged victims who: do not report the sexual offense to law enforcement during the forensic physical exam do not ask to have the evidence tested In addition, the medical facility or certified rape crisis center that collected the SAK must transfer the kit to the FDLE within 30 days of collection. The FDLE must then store the evidence anonymously with a documented chain of custody. The law goes into effect on July 1. SB 998 — Liquefied Petroleum GasSenate Bill 998 makes several changes regarding liquefied petroleum (LP) gas.Many of these changes are regulatory and aimed at ensuring proper handling and storage of LP. The law goes into effect on July 1. SB 1380 — Disability Transportation ServicesSenate Bill 1380 involves special transportation services geared for those with disabilities.The law revises the duties of FDOT regarding requirements in its grants and agreements with firms that provide paratransit services. For example, the law requires that such providers: offer both pre-booking and on-demand service to paratransit service users establish reasonable time periods between a trip request and arrival, best practices for limiting travel times, and transparency about service quality offer specific technology-based ride booking and vehicle tracking services in accessible formats provide training to each paratransit driver for the professional development of staff providing direct services The law goes into effect on July 1. |
2024.05.11 23:37 ole_Dick_Lemon BCBA in peds psych
Hello all!
TLDR; are BCBAs trained in psychiatric conditions. And how to work together for a common goal when I feel the BCBA is stepping out of her scope of practice and in to mine as a nurse.
First post here, and I had a specific question I wanted some guidance on. I am a nurse working on a pediatric inpatient psychiatric unit working specifically with kids with autism or developmental delays. The hospital has recently hired on a new BCBA who I believe is practicing above her scope of competence. I am not sure how much education BCBAs get specifically in psychiatric conditions or the diagnosis and treatment of such disorders. I think a lot of what she is doing is good, but these kiddos often have co-occurring diagnoses and I don’t think she’s taking these psychiatric diagnoses in to account when making her behavior plans and interventions. She is also instructing nurses on things that a definitely NOT in her scope of practice. Such as administering of emergency medications and seclusion and restraint. Which is occasionally necessary to prevent serious Injury to patient peers and staff. This new BCBA is good at her job, but she tends to shut down her staff who have good ideas (no idea is good unless it’s hers). And completely dismisses staff when they bring up things that have worked for a specific patient for a specific behavior in the past. She can be difficult to work with in that regard. I don’t really know how to professionally tell her “stay out of my lane” 😅
submitted by ole_Dick_Lemon to ABA [link] [comments]
TLDR; are BCBAs trained in psychiatric conditions. And how to work together for a common goal when I feel the BCBA is stepping out of her scope of practice and in to mine as a nurse.
First post here, and I had a specific question I wanted some guidance on. I am a nurse working on a pediatric inpatient psychiatric unit working specifically with kids with autism or developmental delays. The hospital has recently hired on a new BCBA who I believe is practicing above her scope of competence. I am not sure how much education BCBAs get specifically in psychiatric conditions or the diagnosis and treatment of such disorders. I think a lot of what she is doing is good, but these kiddos often have co-occurring diagnoses and I don’t think she’s taking these psychiatric diagnoses in to account when making her behavior plans and interventions. She is also instructing nurses on things that a definitely NOT in her scope of practice. Such as administering of emergency medications and seclusion and restraint. Which is occasionally necessary to prevent serious Injury to patient peers and staff. This new BCBA is good at her job, but she tends to shut down her staff who have good ideas (no idea is good unless it’s hers). And completely dismisses staff when they bring up things that have worked for a specific patient for a specific behavior in the past. She can be difficult to work with in that regard. I don’t really know how to professionally tell her “stay out of my lane” 😅
2024.05.11 23:02 No-Caterpillar-8060 Landlord and Mold (AZ)
Hi all,
I’ve been in a messy situation with our property management company for the last bit. We’ve had reoccurring mold issues with a litany of other things. Long story short, the LL refused to break our lease sans penalty even though they failed to rectify the mold situation in under 10 days, per AZ law. I have a toddler in the home, which is why I’m even considering going to court. As far as I understand, we are legally in the clear to walk away from our lease, as the company has already voided it with their noncompliance.
Do we have a leg to stand on with this? I’ve copied a draft of an email detailing everything out that we will be sending to a lawyer officially and to the local LL office. We literally just want our lease done and our deposit back. They offered us a single night in a hotel and to finish the work in 3 days. However, an ozone treatment alone takes 7 and they have to remove several walls, a shower, and the toilet to start to rectify this.
We have all our work orders, medical documents and bills, and photos of the home assembled and ready to go.
All this to say, besides addressing our lawyer with this and praying, what next? We’re staying with family ATM and we are no longer in the home to limit the exposure. I figured I would ask here because I’m going out of my mind and I needed some loose answers.
—-EMAIL DRAFT——
(PROPERTY MANAGERS),
We tried to reach _____ on 5/10/2024 via phone and were not able to get through.
After learning that breaking our lease on the grounds of mold hazards was denied, we want to reach out again to detail the severity of the safety and environmental issues in the home we rent from (property company).
Over the last year, beginning one month after move-in, our daughter has had asphyxiating episodes severe enough that her lips turn blue. After the first incident, we immediately took her to the ER, where an EKG and several tests on her lungs were conducted. As all tests came back clear, we were advised the issue may be environmental. Since that consultation, our daughter experiences persistent hives all over her body, some the size of a hand. Treatments for various skin diseases have been unsuccessful. She had a full allergy panel run this week, which came back negative. She has been placed on antibiotics, steroids, and homeopathic remedies, all of which failed to stop the hives and the chronic congestion and ear infections. After several rounds of failed tests and treatments, pediatricians and nurses have supported the initial assessment of environmental causes.
The hives and blue lips only stop when we are outside of the home. I left home last month with my daughter. All issues resolved immediately and for the entire two weeks we were out of the home. Upon our return, the issues, including hives and breathing episodes, immediately returned. Our pediatrician will be examining her again next week to confirm environmental causes. We all have persistent congestion, headaches, and fatigue.
We conducted an air quality test on 05/09/2024, which confirmed the presence of mold in the home, further corroborating that the home is causing our daughter’s illness.
We have worked to bring attention to the mold issue from the time of the move-in consult, which at the time was only visible in the shower area. A formal work order was processed for the base of the shower on 03/22/2023 for “discoloration,” and it was not completed until 05/09/2023. That is 48 days between the request and completion of the work order. The moldy caulk replacement request was submitted 04/17/2023 and completed 05/17/2023, coming to 30 days for remediation. The request to repair drywall, which was soft-to-touch, was submitted 04/17/2023, and was not completed until 06/21/2023, which is 65 days between request and completion. We deep clean the bathrooms weekly, dry the showers thoroughly after every use, and open windows and run fans to provide proper ventilation. The repair provided by (property company) was insufficient to prevent mold recurrence.
On May 10, 2024, the mold remediation technician confirmed extensive water damage and mold growth in both bathrooms upstairs. He confirmed that several walls, the shower, and the toilet would all have to be removed and replaced. This consultation came 6 days after it was scheduled, which was an additional 10 days after we submitted the work order, coming to 16 days from notification to consultation, and nearly double the legal requirement of 10 days from notification to remediation.
Unfortunately, mold remediation is not the only repair in our home that we have waited unreasonably long for. Persistent issues include:
-Oven: When the gas technician arrived at the home to turn on utilities, the technician refused to connect the gas line, as the stovetop ignition took an extended amount of time to light. He provided a paper warning notifying us of the hazard. When (property company) was notified, it took 7 work orders from 2/8/2023 to 3/24/2023 (44 days) to receive a replacement oven.
-Dryer Vent: Upon move-in, the dryer vent was clogged and we were cautioned not to plug in our dryer, as this was a fire hazard. (property company) was notified on 2/7/2023 of the issue. Work orders were repeatedly canceled for this issue. 4 work orders were placed before a technician was sent on 3/24/2023 (45 days). This was improperly completed, and the issue persisted. We paid for a Samsung technician to come to our home to verify the dryer was functional, and he confirmed again the dryer vent was the issue. 08/15/2023 (189 days) another work order was submitted, and these orders were canceled, nearly daily. (A property company technician) would show up to our house, only to let us know the work order was not approved repeatedly. After speaking to the head of maintenance and several property managers, the work order was pushed through on 09/07/2023 (212 days). The dryer vent remains a persistent issue to the point that we clear it weekly.
-Windows: 6 windows in the home do not remain open. It became a safety issue when our 21-month-old daughter began to pull at them and they started slamming shut. I notified (property company) on 2/27/2024. The work orders are open as of 5/10/2024 (93 days), with only three windows repaired. Nearly all the windows in the home had missing or damaged screens upon move in, which we documented.
We cannot trust that (property company) will complete the mold remediation within 3 days, as quoted to us 5/10/2024, due to the history detailed above. One night in a hotel will neither safely accommodate us until the remediation of the hazardous mold issue, nor repair the damage done over the last 15 months to the health of us and our daughter.
Similarly, we cannot trust that the damage will not continue upon our return to the property, given the track record for repairs stated above.
We as tenants have performed our due diligence both to request reasonable repairs through (property company) and to exhaust every avenue of medical intervention for our daughter. Every step of the way we have acted in good faith and have not only maintained the property, but increased its condition. Since we have video of our initial walk through, two days before move-in, we’d be happy to invite you in to show the positive difference we have made on the property. Furthermore, you’ll be welcome to see the extent of the hazardous mold situation first hand.
We are reasonably requesting a termination of our lease agreement, sans penalty, and the return of our security deposit for now. We are within our legal right to request this, as we are well outside of the state-mandated, ten-day timeline for total remediation. (See Arizona Landlord and Tenancy Act, A.R.S. 33-1324 and A.R.S 33-1361, which specify the mold must be remediated by the landlord within ten days of formal notice by the tenant, or the tenant reserves the right to terminate the lease without penalty).
As the quoted mold remediation costs over $2,000, we are unable to fix it on our own within the bounds of the law. Arizona law dictates repairs must be 1/2 a month’s rent or less than $300 for a tenant to pay for and invoice the property owner. Otherwise, we would have conducted repairs properly a year ago.
We would prefer to resolve this matter peacefully and conclude this chapter of our lives. If you would like to further discuss this matter, please reach out to (myself and husband). We are requesting all communication be through email at this point.
If we are unable to reach an agreement on our lease, our lawyer is prepared to reach out and handle the case moving forward.
submitted by No-Caterpillar-8060 to legaladvice [link] [comments]
I’ve been in a messy situation with our property management company for the last bit. We’ve had reoccurring mold issues with a litany of other things. Long story short, the LL refused to break our lease sans penalty even though they failed to rectify the mold situation in under 10 days, per AZ law. I have a toddler in the home, which is why I’m even considering going to court. As far as I understand, we are legally in the clear to walk away from our lease, as the company has already voided it with their noncompliance.
Do we have a leg to stand on with this? I’ve copied a draft of an email detailing everything out that we will be sending to a lawyer officially and to the local LL office. We literally just want our lease done and our deposit back. They offered us a single night in a hotel and to finish the work in 3 days. However, an ozone treatment alone takes 7 and they have to remove several walls, a shower, and the toilet to start to rectify this.
We have all our work orders, medical documents and bills, and photos of the home assembled and ready to go.
All this to say, besides addressing our lawyer with this and praying, what next? We’re staying with family ATM and we are no longer in the home to limit the exposure. I figured I would ask here because I’m going out of my mind and I needed some loose answers.
—-EMAIL DRAFT——
(PROPERTY MANAGERS),
We tried to reach _____ on 5/10/2024 via phone and were not able to get through.
After learning that breaking our lease on the grounds of mold hazards was denied, we want to reach out again to detail the severity of the safety and environmental issues in the home we rent from (property company).
Over the last year, beginning one month after move-in, our daughter has had asphyxiating episodes severe enough that her lips turn blue. After the first incident, we immediately took her to the ER, where an EKG and several tests on her lungs were conducted. As all tests came back clear, we were advised the issue may be environmental. Since that consultation, our daughter experiences persistent hives all over her body, some the size of a hand. Treatments for various skin diseases have been unsuccessful. She had a full allergy panel run this week, which came back negative. She has been placed on antibiotics, steroids, and homeopathic remedies, all of which failed to stop the hives and the chronic congestion and ear infections. After several rounds of failed tests and treatments, pediatricians and nurses have supported the initial assessment of environmental causes.
The hives and blue lips only stop when we are outside of the home. I left home last month with my daughter. All issues resolved immediately and for the entire two weeks we were out of the home. Upon our return, the issues, including hives and breathing episodes, immediately returned. Our pediatrician will be examining her again next week to confirm environmental causes. We all have persistent congestion, headaches, and fatigue.
We conducted an air quality test on 05/09/2024, which confirmed the presence of mold in the home, further corroborating that the home is causing our daughter’s illness.
We have worked to bring attention to the mold issue from the time of the move-in consult, which at the time was only visible in the shower area. A formal work order was processed for the base of the shower on 03/22/2023 for “discoloration,” and it was not completed until 05/09/2023. That is 48 days between the request and completion of the work order. The moldy caulk replacement request was submitted 04/17/2023 and completed 05/17/2023, coming to 30 days for remediation. The request to repair drywall, which was soft-to-touch, was submitted 04/17/2023, and was not completed until 06/21/2023, which is 65 days between request and completion. We deep clean the bathrooms weekly, dry the showers thoroughly after every use, and open windows and run fans to provide proper ventilation. The repair provided by (property company) was insufficient to prevent mold recurrence.
On May 10, 2024, the mold remediation technician confirmed extensive water damage and mold growth in both bathrooms upstairs. He confirmed that several walls, the shower, and the toilet would all have to be removed and replaced. This consultation came 6 days after it was scheduled, which was an additional 10 days after we submitted the work order, coming to 16 days from notification to consultation, and nearly double the legal requirement of 10 days from notification to remediation.
Unfortunately, mold remediation is not the only repair in our home that we have waited unreasonably long for. Persistent issues include:
-Oven: When the gas technician arrived at the home to turn on utilities, the technician refused to connect the gas line, as the stovetop ignition took an extended amount of time to light. He provided a paper warning notifying us of the hazard. When (property company) was notified, it took 7 work orders from 2/8/2023 to 3/24/2023 (44 days) to receive a replacement oven.
-Dryer Vent: Upon move-in, the dryer vent was clogged and we were cautioned not to plug in our dryer, as this was a fire hazard. (property company) was notified on 2/7/2023 of the issue. Work orders were repeatedly canceled for this issue. 4 work orders were placed before a technician was sent on 3/24/2023 (45 days). This was improperly completed, and the issue persisted. We paid for a Samsung technician to come to our home to verify the dryer was functional, and he confirmed again the dryer vent was the issue. 08/15/2023 (189 days) another work order was submitted, and these orders were canceled, nearly daily. (A property company technician) would show up to our house, only to let us know the work order was not approved repeatedly. After speaking to the head of maintenance and several property managers, the work order was pushed through on 09/07/2023 (212 days). The dryer vent remains a persistent issue to the point that we clear it weekly.
-Windows: 6 windows in the home do not remain open. It became a safety issue when our 21-month-old daughter began to pull at them and they started slamming shut. I notified (property company) on 2/27/2024. The work orders are open as of 5/10/2024 (93 days), with only three windows repaired. Nearly all the windows in the home had missing or damaged screens upon move in, which we documented.
We cannot trust that (property company) will complete the mold remediation within 3 days, as quoted to us 5/10/2024, due to the history detailed above. One night in a hotel will neither safely accommodate us until the remediation of the hazardous mold issue, nor repair the damage done over the last 15 months to the health of us and our daughter.
Similarly, we cannot trust that the damage will not continue upon our return to the property, given the track record for repairs stated above.
We as tenants have performed our due diligence both to request reasonable repairs through (property company) and to exhaust every avenue of medical intervention for our daughter. Every step of the way we have acted in good faith and have not only maintained the property, but increased its condition. Since we have video of our initial walk through, two days before move-in, we’d be happy to invite you in to show the positive difference we have made on the property. Furthermore, you’ll be welcome to see the extent of the hazardous mold situation first hand.
We are reasonably requesting a termination of our lease agreement, sans penalty, and the return of our security deposit for now. We are within our legal right to request this, as we are well outside of the state-mandated, ten-day timeline for total remediation. (See Arizona Landlord and Tenancy Act, A.R.S. 33-1324 and A.R.S 33-1361, which specify the mold must be remediated by the landlord within ten days of formal notice by the tenant, or the tenant reserves the right to terminate the lease without penalty).
As the quoted mold remediation costs over $2,000, we are unable to fix it on our own within the bounds of the law. Arizona law dictates repairs must be 1/2 a month’s rent or less than $300 for a tenant to pay for and invoice the property owner. Otherwise, we would have conducted repairs properly a year ago.
We would prefer to resolve this matter peacefully and conclude this chapter of our lives. If you would like to further discuss this matter, please reach out to (myself and husband). We are requesting all communication be through email at this point.
If we are unable to reach an agreement on our lease, our lawyer is prepared to reach out and handle the case moving forward.
2024.05.11 13:53 SquishiCorgi Bloodwork results
Hi everyone, hoping someone can help me understand my bloodwork results. I was born with hypothyroidism and I currently do not have a doctor as he retired and have to advocate for myself now. I am in Canada and have access to nurse practitioners through a virtual care website. I was advised my TSH levels were too high by an NP from bloodwork results from July 2023 and they increased my dose to 100mcg from 75mcg on April 10. Here are my results from my bloodwork from April 22:
T4 Free 19.3 12.0-23.0 (pmol/L) Final TSH 3.51 0.35-4.2 (mU/L)
I've tried looking online for resources to understand my results but have been overwhelmed and wanted to reach out to you all who also may be in a similar situation as me.
submitted by SquishiCorgi to Hypothyroidism [link] [comments]
T4 Free 19.3 12.0-23.0 (pmol/L) Final TSH 3.51 0.35-4.2 (mU/L)
I've tried looking online for resources to understand my results but have been overwhelmed and wanted to reach out to you all who also may be in a similar situation as me.
2024.05.11 12:01 stronglikebear80 Weird Missed Childhood Signs?
I was talking to my Mom the other day about how things are going with medication and how things are improving. The subject of childhood came up and I asked her if she remembered any encounters with medical professionals or school that make sense now I'm diagnosed.
One of the things that came up was how when I was about 8 or 9 I was sent for several hearing tests as they were concerned I wasn't hearing properly and it was affecting my learning. The results were always that my hearing was fine and I just wasn't paying attention! I remember feeling frustrated because I was TRYING but I just seemed to miss things a lot. Eventually the school nurse told my mom that she thought I had "nervous hearing loss" and that was that. No follow up or explanation, just one more thing to add to the evidence that I was a "neurotic female" lol. Got to love the early 80s approach. I shouldn't be surprised I suppose, I was really badly bullied all through school and had nearly zero intervention from school for that. It was much easier to find the faults in me I suppose! My parents did try to get help for me but were up against GPs who said "children don't get depressed" or insinuated that they weren't bringing me up right!
It's interesting uncovering all the little signs that were always there. I don't rail against it because this was years before ADHD was recognised widely let alone in girls. But I do feel let down and I will always be sad for that little girl who went through so much. No wonder I blocked out a lot and masked for so long.
submitted by stronglikebear80 to ADHDUK [link] [comments]
One of the things that came up was how when I was about 8 or 9 I was sent for several hearing tests as they were concerned I wasn't hearing properly and it was affecting my learning. The results were always that my hearing was fine and I just wasn't paying attention! I remember feeling frustrated because I was TRYING but I just seemed to miss things a lot. Eventually the school nurse told my mom that she thought I had "nervous hearing loss" and that was that. No follow up or explanation, just one more thing to add to the evidence that I was a "neurotic female" lol. Got to love the early 80s approach. I shouldn't be surprised I suppose, I was really badly bullied all through school and had nearly zero intervention from school for that. It was much easier to find the faults in me I suppose! My parents did try to get help for me but were up against GPs who said "children don't get depressed" or insinuated that they weren't bringing me up right!
It's interesting uncovering all the little signs that were always there. I don't rail against it because this was years before ADHD was recognised widely let alone in girls. But I do feel let down and I will always be sad for that little girl who went through so much. No wonder I blocked out a lot and masked for so long.
2024.05.11 05:06 xxxrio Most disheartening shift I've ever had
I used to love intensive care, but due to staffing shortages, my unit has adapted a "beggars can't be choosers" attitude. Practice expectations have changed and every time concerns are brought up, were told we're in unprecedented times, or it is what it is, or do with what you have, etc...
Came in for a day shift and got report from night nurse that the pts GCS had declined from what day shift stated yesterday. MDs were not made aware overnight as the nurse did not make the connection regarding change in pt status. Pt also had a potassium level that needed to be shifted, which the results had shown up about an hour before TOA. Nurse told me, "I should've paid more attention."...nurse was reading a book when I walked in for report. Pt was also pan cultured overnight and received orders for tazo, which were signed off as given on Epic.
When I walked to assess my pt this morning, he was unrousable...no sedation whatsoever. Tazo still full in the mini bag and was never administered. Ended up with a STAT head CT which showed pt had stroked. Usually, I'd have more grace for people - mistakes happen. But this is a nurse who previously asked to come off orientation early because she had been a trauma nurse for 20+ years and that she's an NP. Our unit provides orientation for 2 months for nurses with experience, and 3 months if they're new graduates, with the option to extend. So this wasn't from a lack of education. Red flags started showing during her first week of working independently when she said that she didn't know how to assess a GCS.
Anyway, I filed a safety incident report today...got asked by my manager and educator to redact my report. Not the first time this nurse's practice has been reported, she's got a lengthy list of reports filed against her. (Mind you, were also at a unionized hospital). At this point... I don't really know who the institution is protecting anymore. It feels like a slap on the face.
EDIT: Management took down mine and my charge nurses safety incident reports regarding the situation. We looked at our accounts and both our files have been deleted. My only trace of evidence of it was a confirmation with my reference number and that it has been submitted. The charge nurse was told that it was inappropriate for her to file an SIR on behalf of me (I was sent to CT, then MRI then back to CT throughout the day with a pt who was incredibly labile through transport and required interventions along the way). My charge wanted to file on behalf of me because she knew I was busy and didn't want me to stay late. I also had a 2:1 ratio beginning of my shift, until shit went down and my other pt was reassigned to another nurse. I was approached by my manager after the first CT that I needed to file an SIR on my own - so I did. Apparently while I was in MRI/CTA my manager and educator started looking for me to also ask me to redact my statement. I didn't come back to the unit until 1800 and by then, they were both gone. I wasn't even personally asked to redact my statement - IT WAS JUST DELETED. I had just asked the union for advice and was told not to redact it, when I went to review my account, it was gone.
TL;DR - filed a safety incident report that led to a critical problem, which involved a historically lazy/incompetent nurse. Was asked to redact my file, refused to do so with the advice of the union, management deleted my file anyway.
submitted by xxxrio to nursing [link] [comments]
Came in for a day shift and got report from night nurse that the pts GCS had declined from what day shift stated yesterday. MDs were not made aware overnight as the nurse did not make the connection regarding change in pt status. Pt also had a potassium level that needed to be shifted, which the results had shown up about an hour before TOA. Nurse told me, "I should've paid more attention."...nurse was reading a book when I walked in for report. Pt was also pan cultured overnight and received orders for tazo, which were signed off as given on Epic.
When I walked to assess my pt this morning, he was unrousable...no sedation whatsoever. Tazo still full in the mini bag and was never administered. Ended up with a STAT head CT which showed pt had stroked. Usually, I'd have more grace for people - mistakes happen. But this is a nurse who previously asked to come off orientation early because she had been a trauma nurse for 20+ years and that she's an NP. Our unit provides orientation for 2 months for nurses with experience, and 3 months if they're new graduates, with the option to extend. So this wasn't from a lack of education. Red flags started showing during her first week of working independently when she said that she didn't know how to assess a GCS.
Anyway, I filed a safety incident report today...got asked by my manager and educator to redact my report. Not the first time this nurse's practice has been reported, she's got a lengthy list of reports filed against her. (Mind you, were also at a unionized hospital). At this point... I don't really know who the institution is protecting anymore. It feels like a slap on the face.
EDIT: Management took down mine and my charge nurses safety incident reports regarding the situation. We looked at our accounts and both our files have been deleted. My only trace of evidence of it was a confirmation with my reference number and that it has been submitted. The charge nurse was told that it was inappropriate for her to file an SIR on behalf of me (I was sent to CT, then MRI then back to CT throughout the day with a pt who was incredibly labile through transport and required interventions along the way). My charge wanted to file on behalf of me because she knew I was busy and didn't want me to stay late. I also had a 2:1 ratio beginning of my shift, until shit went down and my other pt was reassigned to another nurse. I was approached by my manager after the first CT that I needed to file an SIR on my own - so I did. Apparently while I was in MRI/CTA my manager and educator started looking for me to also ask me to redact my statement. I didn't come back to the unit until 1800 and by then, they were both gone. I wasn't even personally asked to redact my statement - IT WAS JUST DELETED. I had just asked the union for advice and was told not to redact it, when I went to review my account, it was gone.
TL;DR - filed a safety incident report that led to a critical problem, which involved a historically lazy/incompetent nurse. Was asked to redact my file, refused to do so with the advice of the union, management deleted my file anyway.
2024.05.11 02:45 ConsumedBoy Pulmonary Kaposi Sarcoma
I wanted to share my story on about my experience with Ward 86 at UCSF in San Francisco. It was at one point the epicenter for HIV/AIDS research and treatment.
About 12 years ago at a now renamed extension program called Magnet in the Castro I asked for the relatively new drug Truvada to act as a HIV/AIDs preventive measure and was told it was not for me and maybe I should practice monogamy as I was in a relationship.
About 10 years ago I contracted HIV from a partner who said he was positive undetectable but was not. I got sick and a friend took me to get tested at a clinic in San Francisco and I tested negative on the rapid test. I’m not sure why but they called my parents who were listed as my emergency contacts and said it was very important I came back to the clinic to discuss some test results. My parents knew before I did.
The quick test failed to show I actually was positive just caught early. I began treatment of 3 different drugs that immediately made me sick. I had trouble staying on them, as certain time I started and stopped and started I woukd get sick. I sought therapy and tried all kinds of things to stay on my pills but it was difficult. I liked to live in the denial I was sick and felt better off the pills.
I lived in a 3 story walk up and noticed I was starting to get out of breath at the top of TD stairs. It got so bad I would collapse on the floor trying to catch my breath. I went made an appointment with ward 86 and saw my nurse practitioner. She first said I was probably asthmatic, gave me a prescription for albuterol. It didn’t really work so I went back in and she told me I wasn’t using it enough.
I began to get worse. I couldn’t walk a block without stopping and sitting down and catching my breath. I was 29 years old. Over the next 10 months I went back in to ward 86 several times complaining of shortness of breath. I was diagnosed anxiety disorder and was offered SSRI medication and refused. My nurse practitioner pulled out a plastic device and had me blow into it and it showed I had the lung capacity of a 60 year old. She diagnosed me, at 29 years old, with COPD. I hadn’t smoked in years. She was then going to prescribe me with another inhaler. A steroid. I’m fairly certain that would have killed me. Without knowing why, I had a gut feeling that this was wrong and I said I wanted another option. The first inhaler didn’t work I didn’t see how another one would.
10 months and I can’t walk to the end of the hall in my apartment without gasping for breath. I develop a cough so bad each time I start coughing I’m ending up on the floor. I start reading study after study, I have no medical training and look up every other word in a medical dictionary trying to find out what is happening to me. I can hardly get out of bed and read studies all day. I came across a study about a young man with the same issues I was having. The same test results, it was me, he died shortly after medical intervention. In the shower I run my hands over my clavicle and feel a lump. I immediate calm my nurse practitioner and tell her I need to come in, that I know what I have. I diagnosed myself with pulmonary kaposi sarcoma. She says only a trained doctor could feel lymph nodes in that area. I go in and see a doctor and she feels the lymph nodes on my clavicle. They send me to dermatology where I’m told there is no way I have pulmonary KS. I have a single lesion on my abdomen and they run tests, It’s KS. They set up the necessary tests needed before I can do a bronchoscopy. Finally, my bronchoscopy comes, I’m told I have scarring indicating I have pulmonary KS. One of my lungs is collapsed.
I’m sent to oncology. My oncologist tells me she’s not sure why I’m there . She looks at notes from ward 86 where there is no mention of my diagnosis as it was determined at the adjoining hospital and the systems are separate. She says I’m fine. I ask her if there’s anyway way I can build my immune system so I don’t get more sick. She says “I don’t know … maybe drink green tea?” And laughs .
I call my NP she says I’m definitely very sick and I definitely need to go back to oncology. My oncologist looks for notes but the doctors who did my bronchoscopy failed to leave any notes. They have to contact them and from memory they submit notes.
At my appointment I am told I need to start chemotherapy. Orientation is set. I go and then treatment is scheduled. I keep reading studies . I find a study with men my age, my genetic background, who are positive and have pulmonary KS. The study shows that there is no benefit from chemotherapy. That the survival rate is the same. I don’t go to my chemo appointment. Or any other appointments. My NP submits her resignation. I keep taking my pills . And one day I notice my breathing is getting better. It improves. Not all the way but I can walk places I can get out of bed. I finally go back to ward 86. I’m told I have a new doctor, They tell me that looking over my treatment they thought it was perfectly normal course of action and that my NP hadn’t done anything wrong. My NP also relayed a message to me from the office saying that she hoped that my experience didn’t prevent me from coming back to ward 86.
I feel as though I was in a machine and I was not getting care tailored to me. My breathing issue is permanent as the damage is permanent. There’s no getting better. I realize my part in all of this.
submitted by ConsumedBoy to hivaids [link] [comments]
About 12 years ago at a now renamed extension program called Magnet in the Castro I asked for the relatively new drug Truvada to act as a HIV/AIDs preventive measure and was told it was not for me and maybe I should practice monogamy as I was in a relationship.
About 10 years ago I contracted HIV from a partner who said he was positive undetectable but was not. I got sick and a friend took me to get tested at a clinic in San Francisco and I tested negative on the rapid test. I’m not sure why but they called my parents who were listed as my emergency contacts and said it was very important I came back to the clinic to discuss some test results. My parents knew before I did.
The quick test failed to show I actually was positive just caught early. I began treatment of 3 different drugs that immediately made me sick. I had trouble staying on them, as certain time I started and stopped and started I woukd get sick. I sought therapy and tried all kinds of things to stay on my pills but it was difficult. I liked to live in the denial I was sick and felt better off the pills.
I lived in a 3 story walk up and noticed I was starting to get out of breath at the top of TD stairs. It got so bad I would collapse on the floor trying to catch my breath. I went made an appointment with ward 86 and saw my nurse practitioner. She first said I was probably asthmatic, gave me a prescription for albuterol. It didn’t really work so I went back in and she told me I wasn’t using it enough.
I began to get worse. I couldn’t walk a block without stopping and sitting down and catching my breath. I was 29 years old. Over the next 10 months I went back in to ward 86 several times complaining of shortness of breath. I was diagnosed anxiety disorder and was offered SSRI medication and refused. My nurse practitioner pulled out a plastic device and had me blow into it and it showed I had the lung capacity of a 60 year old. She diagnosed me, at 29 years old, with COPD. I hadn’t smoked in years. She was then going to prescribe me with another inhaler. A steroid. I’m fairly certain that would have killed me. Without knowing why, I had a gut feeling that this was wrong and I said I wanted another option. The first inhaler didn’t work I didn’t see how another one would.
10 months and I can’t walk to the end of the hall in my apartment without gasping for breath. I develop a cough so bad each time I start coughing I’m ending up on the floor. I start reading study after study, I have no medical training and look up every other word in a medical dictionary trying to find out what is happening to me. I can hardly get out of bed and read studies all day. I came across a study about a young man with the same issues I was having. The same test results, it was me, he died shortly after medical intervention. In the shower I run my hands over my clavicle and feel a lump. I immediate calm my nurse practitioner and tell her I need to come in, that I know what I have. I diagnosed myself with pulmonary kaposi sarcoma. She says only a trained doctor could feel lymph nodes in that area. I go in and see a doctor and she feels the lymph nodes on my clavicle. They send me to dermatology where I’m told there is no way I have pulmonary KS. I have a single lesion on my abdomen and they run tests, It’s KS. They set up the necessary tests needed before I can do a bronchoscopy. Finally, my bronchoscopy comes, I’m told I have scarring indicating I have pulmonary KS. One of my lungs is collapsed.
I’m sent to oncology. My oncologist tells me she’s not sure why I’m there . She looks at notes from ward 86 where there is no mention of my diagnosis as it was determined at the adjoining hospital and the systems are separate. She says I’m fine. I ask her if there’s anyway way I can build my immune system so I don’t get more sick. She says “I don’t know … maybe drink green tea?” And laughs .
I call my NP she says I’m definitely very sick and I definitely need to go back to oncology. My oncologist looks for notes but the doctors who did my bronchoscopy failed to leave any notes. They have to contact them and from memory they submit notes.
At my appointment I am told I need to start chemotherapy. Orientation is set. I go and then treatment is scheduled. I keep reading studies . I find a study with men my age, my genetic background, who are positive and have pulmonary KS. The study shows that there is no benefit from chemotherapy. That the survival rate is the same. I don’t go to my chemo appointment. Or any other appointments. My NP submits her resignation. I keep taking my pills . And one day I notice my breathing is getting better. It improves. Not all the way but I can walk places I can get out of bed. I finally go back to ward 86. I’m told I have a new doctor, They tell me that looking over my treatment they thought it was perfectly normal course of action and that my NP hadn’t done anything wrong. My NP also relayed a message to me from the office saying that she hoped that my experience didn’t prevent me from coming back to ward 86.
I feel as though I was in a machine and I was not getting care tailored to me. My breathing issue is permanent as the damage is permanent. There’s no getting better. I realize my part in all of this.
2024.05.11 00:40 10384748285853758482 “Nurse is why we can’t have good things”
You've likely seen people claim this. Maybe you even believe it. On this episode of Mythbusters, I'm breaking down why this claim is wrong.
"Nurse is why (weaker) killers can't be buffed." Nurse existing does not magically prevent BHVR from directly buffing a weaker killer's base kit or add-ons. Nurse existing has not stopped BHVR from doing things like changing the time it takes to finish a gen, adding base regression to kicks, reducing basic attack cooldown, and speeding up default pallet breaks. The last two have no impact on Nurse while helping weaker M1 killers.
"Nurse is why we can't have good killer perks."/"Nurse is why killer perks can't be buffed to be better on other killers." * BHVR: Releases Barbecue & Chili, Call of Brine, Corrupt Intervention, Deadlock, Discordance, Eruption, Friends 'til the End, Grim Embrace, Devour Hope, Face the Darkness, Pentimento, Plaything, Ruin, Undying, I'm All Ears, Infectious Fright, Lethal Pursuer, Make Your Choice, Merciless Storm, No Way Out, Nowhere to Hide, Pop Goes the Weasel, Save the Best for Last, Floods of Rage, Pain Resonance, Starstruck, Surge, Terminus, Thanatophobia, Thrilling Tremors, Ultimate Weapon * Also BHVR: Buffs Dead Man's Switch, Eruption, Gearhead, Retribution, Lethal Pursuer, No Way Out, Overcharge, Gift of Pain, Starstruck (during PTB)
"Nurse got perks/a lot of the perks named above nerfed." Legion and Plague likely got Thanatophobia nerfed. Knight and Skull Merchant likely got regression nerfed. Regression perks like old Eruption were nerfed for being overpowered. Regression perks were also nerfed for being too strong when 4-stacked. BHVR has also made generators take longer to complete and added base regression to kicks. BHVR nerfs perks for all sorts of reasons, including pick rate.
"Awakened Awareness was nerfed because of Nurse." Yes and no. Nurse was a reason, but not the sole reason. Awakened Awareness paired with Starstruck was extremely strong on both Nurse and Spirit, two killers that both utilized basic attacks and had extremely fast map traversal. Awakened Awareness by itself was also very good as info for Nurse, Blight, and Spirit, the top 3 killers in the game, while being niche at best on all but a few other killers. BHVR nerfed Awakened Awareness because the perk was good on the best killers while being irrelevant on others except for a niche build on a few killers.
"Nurse's Blink Attack had to be changed to M2 because Exposed perks were overpowered on her." * BHVR: Releases Make Your Choice, Haunted Ground, Starstruck * Also BHVR: Buffs Starstruck's duration mid-PTB * Also BHVR: Doesn't change No One Escapes Death for almost 4 years * Also BHVR: Doesn't change Nurse's Blink Attack for almost 7 years
submitted by 10384748285853758482 to deadbydaylight [link] [comments]
"Nurse is why (weaker) killers can't be buffed." Nurse existing does not magically prevent BHVR from directly buffing a weaker killer's base kit or add-ons. Nurse existing has not stopped BHVR from doing things like changing the time it takes to finish a gen, adding base regression to kicks, reducing basic attack cooldown, and speeding up default pallet breaks. The last two have no impact on Nurse while helping weaker M1 killers.
"Nurse is why we can't have good killer perks."/"Nurse is why killer perks can't be buffed to be better on other killers." * BHVR: Releases Barbecue & Chili, Call of Brine, Corrupt Intervention, Deadlock, Discordance, Eruption, Friends 'til the End, Grim Embrace, Devour Hope, Face the Darkness, Pentimento, Plaything, Ruin, Undying, I'm All Ears, Infectious Fright, Lethal Pursuer, Make Your Choice, Merciless Storm, No Way Out, Nowhere to Hide, Pop Goes the Weasel, Save the Best for Last, Floods of Rage, Pain Resonance, Starstruck, Surge, Terminus, Thanatophobia, Thrilling Tremors, Ultimate Weapon * Also BHVR: Buffs Dead Man's Switch, Eruption, Gearhead, Retribution, Lethal Pursuer, No Way Out, Overcharge, Gift of Pain, Starstruck (during PTB)
"Nurse got perks/a lot of the perks named above nerfed." Legion and Plague likely got Thanatophobia nerfed. Knight and Skull Merchant likely got regression nerfed. Regression perks like old Eruption were nerfed for being overpowered. Regression perks were also nerfed for being too strong when 4-stacked. BHVR has also made generators take longer to complete and added base regression to kicks. BHVR nerfs perks for all sorts of reasons, including pick rate.
"Awakened Awareness was nerfed because of Nurse." Yes and no. Nurse was a reason, but not the sole reason. Awakened Awareness paired with Starstruck was extremely strong on both Nurse and Spirit, two killers that both utilized basic attacks and had extremely fast map traversal. Awakened Awareness by itself was also very good as info for Nurse, Blight, and Spirit, the top 3 killers in the game, while being niche at best on all but a few other killers. BHVR nerfed Awakened Awareness because the perk was good on the best killers while being irrelevant on others except for a niche build on a few killers.
"Nurse's Blink Attack had to be changed to M2 because Exposed perks were overpowered on her." * BHVR: Releases Make Your Choice, Haunted Ground, Starstruck * Also BHVR: Buffs Starstruck's duration mid-PTB * Also BHVR: Doesn't change No One Escapes Death for almost 4 years * Also BHVR: Doesn't change Nurse's Blink Attack for almost 7 years