Discover and read the best of Twitter Threads about #nurse

Most recents (24)

1/ 🎥🧵 How do we test someone for #delirium in #COVID19 or any ICU? When someone won’t engage it can be a huge red-flag for “quiet” delirium, which predicts 3X ⬆️ #DEATH by 6 mo & acquired #dementia. Watch this movie of me testing pt #1 for delirium.

#MedTwitter #NurseTwitter
2/ What does this mean? He starts out OK but then can’t follow my command to squeeze only on the letter A. Instead, he squeezes when I say the word “squeeze” & doesn’t relax his grip or vary it on different letters. This is inattention & a cardinal feature of #Delirium.
3/ 🎥 Contrast Pt 1 with this Pt 2 video of me doing the same test. This person had delirium on earlier days & is now improving. He gets 8/10 correct responses, which means he’s attentive and not delirious any more. This day he walked & talked for the 1st time!

#Recovery #nurse
Read 7 tweets

Women are sharing ghastly experiences of outpatient #hysteroscopy - invasive surgery with zero anaesthetic - the NHS UK standard practice

This barbaric, inhumane, misogynistic assault against women's rights must end

'My scream sounded unearthly to me, like an animal in terrible pain. Part of my inside was being cut without any anaesthetic. I am 73 years old'
#Hysteroscopy without #anaesthetic
'excruciatingly painful and the gas and air did not really do anything to alleviate the pain'
Read 13 tweets
Things that contributed to my burnout and poor mental well-being as a registered nurse during the pandemic.

🔹Anxiety about me, my own loved ones’ dying

🔹The impact of the heroes narrative

🔹Inadequate/out of date PPE

#Nurse #NHS
🔹Increased workload

🔹Intensity of working in C19 environment

🔹Guilt about not being able to provide high-quality care

🔹Emotional strain from seeing large numbers of patients dying

🔹 Non compliancy of safety measures from other members of the public

#Nurse #NHS
I could extend the list much further.
There’s many factors that have contributed and affected my mental health during the pandemic. #Nurse #NHS
Read 3 tweets
1/🧵#SEPSIS is URGENT. Here it was caught way too late! Sepsis is marked by WBCs (White Blood Cells) either too high OR too low. If someone’s WBC drops from 14k to 6k to 3k WITHOUT antibiotics, that’s a total catastrophe & usually means death is closing in.👇

2/ So hypothetically (& I’m changing details to make this situation unrecognizable to the real patient my comment is based on)…if a month after a knee replacement someone comes in complaining of NEW knee pain and no fever…

#COVID19 #nursetwitter #TipsForNewDocs #nurse
3/ …with a WBC count of 14,000, scans & xrays not showing an abscess, an infected prosthetic joint is still my #1 Dx unless there is a completely obvious other cause of infection. Said another way, this is sepsis due to an infected knee until proven otherwise.
Read 10 tweets
Being a #disabled #nurse is hard - a 🧵 I might delete because this is uncomfortable to share.

I have had #Lupus and several other autoimmune disorders for 20 years and it is frustrating, painful, and at times debilitating.
I don’t talk about my health or what I go through openly because I am afraid that ppl will withhold opportunities or overlook me because I am “sick”. I don't even share how sick I am with most of my family.
I have pretended to be well a lot. Why? Because many nurses and healthcare professionals are ableists. If I don't pretend to be well I am criticized and marginalized. I get treated like a burden when I need accommodations.
Read 12 tweets
1/ 🧵Wisdom in Medicine
What’s going on here? And why it’s key in #COVID19
It’s quite simple: we finally had the #wisdom to ask Mr. D the right question! He and his wife encouraged us to use this picture to teach what we learned.
#PalliativeCare #MedTwitter #NurseTwitter
2/ What we learned was to switch the preposition!
Mr. D was a pre-#COVID patient. On this day, he was taken off the vent after a MONTH. The incessant mantra had been, “What’s the matter WITH Mr. D?” He was surprised when we asked, “What matters TO you, Mr. D?”
3/ He has a tracheostomy, as you can see. We insert this airway through the neck to improve #comfort when someone is on a vent well beyond 10 days. He’s more comfortable because he no longer has a tube in his mouth. We used a program called the #A2Fbundle to reduce his #delirium.
Read 13 tweets
1/ Seemingly endless reports coming in - women's grotesque gynaecological experiences on @NHSuk

Lied to, minimised, dismissed, mocked, belittled, scorned by health care professionals

Refusal to believe women's first hand authoritative accounts of how these procedures TRULY feel

Failure to see women as needing or having any right to pain management

Callous, total lack of empathy, refusal to respond to women's pain
'Was told I was being “dramatic” by female doctor & nurse'

'Last time I spoke to female GP she basically told me as a woman I should expect this'

'I had a hysteroscopy and the male consultant was furious I had the anesthetic when he told me I didn't need it'
Read 9 tweets
1/🧵#COVID19 Compassion

Our patient wants to live 3 days to see his grandson graduate. He has #COVID19 pneumonia & is extremely short of breath. He’s chosen NOT to go on a ventilator & is on 100% O2 HiFlow Canula. He’s afraid of tight-fitting a bipap mask.

2/ The intern said, “I never saw a patient whose respiratory rate was twice his oxygen saturation!” Yep, last night his O2 sats dropped to 30% and he was breathing 60 times a minute! By morning he was 85% sat and RR was 28. Better but tenuous.

#TipsForNewDocs #MedStudentTwitter
3/ All of this raises some complicated ethical + treatment questions that I’d like to cover. We addressed this on rounds several times this week & at times it got a bit heated. His #nurse said she noticed herself flushed, mad, and heart rate >130…why?
Read 13 tweets
On #InternationalNursesDay, 25-yr-old @Dulichandyadav1, a nursing officer at #AIIMS, shared this poem with me. Posting with permission:)

"Naa rukenge naa thakenge, khud se yeh vaada hai/chaahe saans ke iss yudh mein ho daav par saanse humaari"

Thank you for your service :) Image
A thank you is not enough. Last yr, I reported on the plight of nurses in #Delhi hospitals -- bad quality #PPE, extreme working hours, less pay, and many fell sick. Sharing some stories here:…
Anursing officer at a private hospital, said, “Health workers have been put in the line of fire without adequate gear”.

Read 16 tweets
If #HealthCare positions itself as public priority number one during a #pandemic, then it goes without saying #nurses in fact perform a critical and central role in delivering said #health care. #NursesWeek2021 #NursesWeek #NursesDay #NursesMonth #Nursing #NurseTwitter #Nurse
By not only advocating for #HealthPromotion in general, but by also educating #patients directly and the public at large of the preventive measures necessary to avoid illness and injury, it's not an exaggeration to call #nurses out as #noble..
...or, at the very least their selfless #professional #nursing pursuits can be considered as such. Conjoined with providing actual #MedicalCare AND assisting with #rehabilitation AND providing emotional & psychological #support AND...
Read 5 tweets
1/ 🧵A picture is worth 1,000 words 👁 #COVID19:

This 🎥 shows a clear example of what can happen to a person’s body w #COVID. His wife asked me to show it on twitter & urges everyone to get #vaccinate

(w/ consent of pt & wife)

#MedTwitter #NurseTwitter #CriticalCare
2/ You’ll notice his eyes are swollen shut. (Written perm to show). This is not fluid. It’s AIR from inside his chest leaking out his lungs 🫁 through muscles & skin to his neck & into his face. He is AWAKE & communicating but had ICU #delirium earlier.

#MedStudentTwitter #Nurse
3/ Look at his chest CT. See the “L” lungs w #Covid pneumonia/#ARDS & also AIR leaking out under his skin. Now go back to 1st tweet & watch 🎥 again. This is called “barotrauma” & happens when the 🫁s get too stiff and pop. Difficult situation. We’re hoping he can heal!

Read 5 tweets
1/ End of Life in #COVID19...
yesterday I was removing life support from a patient, according to his wishes as stated by his wife, to convert the goals of care to comfort measures only. I took some time in the room alone with him & considered...
@pallipulm #palliativecare
2/ just for a moment all the very difficult & also excellent things that happened in my own life that no one else understood. Then I looked at my patient & realized he had just as many highs & lows that only he knew. Here was an infinite treasure of a person...
#MedTwitter #Nurse
3/ and the actions I was about to take would allow his life to come to a peaceful natural end. I committed to do everything I could for him to make sure he didn’t suffer as he sauntered out of life. What a privilege & honor to be allowed to enter into the miracle of him...
Read 7 tweets
Extra-Bad Blood🩸Vessel Dz in #COVID19:

1. Immunogenic HITT (heparin-ind thrombocytopenia & thrombosis) NOT from heparin but #Covid itself. Bilateral arterial clots.

2. TSS (toxic shock synd) + #COVID - nightmarish clotting in legs/arms = like burns

#MedTwitter #Nurse #Vaxx
1/ Since others asked, our diagnosis of “spontaneous immunogenic HITT” was made by positive HIT ELISA (an immunoassay) showing the presence of anti-PF4 IgG antibodies even though he had not been (past or present) on heparin. This in setting of #COVID19.
2/ He also had an abnormal functional assay of platelet-activating capacity of PF4/heparin-Ab complexes, though there are slight differences in results of his assay vs. typical HIT. He now has 2 problems (#COVID & HIT) causing potentially life-threatening arterial thrombosis.
Read 4 tweets
1/ Do data support pt trial off sedation for “SAT” when pt is comfortable on current dose? Yes
Shared w permission:
“Dr. Ely, yesterday our ICU #nurses went over #A2Fbundle in Epic for implementation. Do you recommend SAT at RASS Goal of RASS -1 to +1?
#medtwitter #criticalcare
2/ Excellent #Nurse added:

“We are currently not doing SAT (Spontaneous Awakening Trial) but keeping pt’s RASS -1 to +1.  Just want to make sure we are interpreting #A2Fbundle correctly.”
#medstudenttwitter #COVID19 #pandemic
3/ my Answers:

Great questions. I don’t think +1 (anxiety) is ever a good goal but 0 to -1 is a 👍 default target RASS if we acknowledge there are times when sedation target should acceptably be set as deep as -3/-4 in bad #ARDS or -5 transiently when pt requires paralytics.
Read 8 tweets
My latest for @TPostMillennial

🩺 Joe Biden's new EO denies patients in pain the medication they need💊… #chrnoicpain #drugs #biden #politics #health #medicine #MedTwitter #healthcare #Budget2021 #environment #OTD #quoteoftheday #SuperBowl
The genie for the far-left🧞‍♂️
otherwise known as President Biden

leads the executive gov agencies & the DEA to gamify pain medicine in order to "stop" the opioid crisis

Making it harder for your family to get help when you need it

#drugs #health #journalism #politics @JoeBiden
Biden allows DEA & others to radically expand unconstitutional powers & eliminate patient privacy like HIPPA

Making it so there is nothing in health
gov won't know about U🕵️… #health #drugs #opioidcrisis #opioids #medtwitter #biden #dea #LawEnforcement
Read 13 tweets
Daily Bookmarks to GAVNet 01/01/2021…
Beyond Climate War: Writings on Deep Adaptation to societal collapse…

#SystemsChange #adaptation #ClimateChange #conflict
“Those of Us Who Don’t Die Are Going to Quit”: A Crush of Patients, Dwindling Supplies and the Nurse Who Lost Hope — ProPublica…

#supplies #hope #patients #nurse #COVID19
Read 10 tweets
Thread 👇

After completing a comprehensive analysis of four years of tweets from 44 of the top 50 schools of nursing, I have some advice for schools of nursing:

Use hashtags that other people are using, too.

~90% of the hashtags used by 44 schools of nursing between 9/2018 and 12/2020 were used ten or fewer times across 57,306 tweets.

Around ~50% were used only ONCE.

The vast majority of hashtags used by top-ranked schools of nursing are about..... {drumroll, please}.......

nursing and schools of nursing.

Read 11 tweets
#USA 🇺🇸💉🦠

As the #US rolls out the #Pfizer#BioNTech vaccine, let’s have a look... how’s your state doing? Share a 📷 or a thought/perspective as we battle back against the #coronavirus / #covid19? Thread.

First up. New York. Image
#USA 🇺🇸💉🦠 #Illinois

Doug Meyer, 38 respiratory therapist, airway manager @OSFHealthCare @PeoriaIllinois is among the 1st #Illinois healthcare workers to receive the #COVID19Vaccine. Ht @BlueRoomStream

#USA 🇺🇸💉🦠 #RhodeIsland

A Latino doctor, Dr. Christian Arbelaez, was the 1st person in Rhode Island to get the #COVID19 vaccine. Now he wants to be an example for his community.… @DanMcGowan reports. Image
Read 58 tweets
1/ ICU #diaries for Good #Death:
Especially at EOL, ICU #Diary is part of #A2Fbundle. My pt w/ home-hospice told me details recorded in #ICU by #nurse allowed her to decipher cryptic #delirium memories she was struggling with.

#medtwitter #meded
2/ Then she told me of hours spent reading big-hearted comments others had written in her ICU diary, making her realize how much her life meant to others. It was a priceless gift to her at a critical juncture in what had a time of deep poverty in her life. #PalliativeCare
3/ ICU Diaries give family members at bedside a practical way of helping w/ loved one’s care & can help channel their worries in a focused way.
#criticalcare #pulmcc
Read 7 tweets
Martha Curley now discussing year of the #nurse and inspiring the future work force: what a year 2020 has been for nurses.

Without nursing staff the response to the #COVID19 pandemic would have failed

They are the key part of healthcare.

Prof. Curley now describes the role of the #nurse in #research - and feels the priority should be going back to make sure our health care settings are designed to help and heal and comfort patients

We should not be harming patients by being in the hospital

To achieve nursing research we need to create a platform that allows this!

We are lucky @SotonChildHosp #PedsICU that we have @Katystearn1Katy @donnaaust1n @UHS_PICResearch @RDsouthampton @southamptonCRF who support nursing research - & teaching how to do it! #EPCCS20
Read 4 tweets
1/ When I play the #criticalcare movie 🎥 of me as an intern or resident back in my head, I see myself as much too robotic 🤖 with my patients, as if plugging in kitchen appliances.

#medtwitter #meded #tipsfornewdocs #medstudenttwitter #nurse #pulmcc #COVID19
2/ The nurse would slip a Foley catheter up his urethra into his bladder. I’d go to the stockroom to get all the materials to slide a plastic endotracheal tube down his trachea to become command-central for his breathing on the ventilator.
3/ Next, I’d methodically place a Swan-Ganz catheter by serial insertion of a needle first, then a wire through the needle, next a dilator over the wire, and finally the catheter itself down into his great vessels and heart. And start the ‘pressors.
Read 6 tweets
For #London psychic reading client: You expected me to be shocked that covid19 is rampant throughout your community. I'm not shocked. I'm more surprised that people believe the conspiracy theorists and then get violently ill. Why are people so complacent during a pandemic? #Nurse
cont. for #London psychic reading client: If you work on the theory, that one third of population can be falsely covertly influenced, what happened to the other two thirds of the population? This is all about giving a damn about others well being. Look at the world. #compassion
cont. for #London psychic reading client: Never mind aliens looking down on us and trying to work out how selfish the human race has become. This is more about psychological conditioning and how this is being used on public to help those in power. Do they care about human life?
Read 3 tweets

It might be hard to work in the ED as a new nurse but it is possible and the way to gain grounds and become stable is to know the following:

Thread 📜
Please RETWEET 🙏🏽 ImageImageImage
Thread continued.

1. ASK A LOT OF QUESTIONS: Ask as many questions as possible, no matter how stupid u think they are. Questions ranging from where the bp machines are kept to how to perform sepsis protocol etc. If you have not asked up to 10,000 questions like me, please do.
2. OBSERVE WHAT OLDER NURSES ARE DOING: Yes. Just watch what the older nurses are doing, note the pattern and techniques.

3. SEEK ADVICE: when confused or in doubt, seek the advise of your nurse in charge, a senior nurse or your mentor on things that get you confused.
Read 5 tweets
Watching this is quite emotional. I first met Katie in 2001. She's battled with the health system to be understood and properly cared for the entire time. I remember the dissmisal from so many HCPs 'it's all in her imagination'.…
Listening to people and taking them seriously is so hugely important. It changes lives because we really understand and people get the right support and treatment.
Katie chose to embark on training towards becoming a #nurse. She's a #nursingassociate
#teamCNO @CNOEngland
p.s I would have tagged Katie but I can’t blummin find her!
Katie ... jump in!
Read 3 tweets

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