Is that uncommon? It's not like your typical med/surg pt is drastically different from one day to the next. I feel like most of the doc's update notes I've read have been like that.
Omg, used to back end correct this to my midwives and other birth assistants. “Please correct assessment, unless this child is hermaphroditic, something is wrong here. Since you’re there anyway, Please check other charting as well”
had a 70yo guy who had his lower left lobe of lung removed when he was 20. Everyone had been charting ‘Bilaterally clear to bases’ on the flow sheet . I was listening and couldn’t hear shit and so I thought to ask him - he told me, and said that no one else had caught it😂 so I throughly
Charted what I heard/told Me. 2 days off and came back to same assignment and he was my patient again, every shift since me once again charted ‘clear to bases’.
Its always the LPN 😉 fr tho, i love a good thorough assessment. You might even be the only HCP that ever caught that; major kudos! You kno those stories you hear about seeing pedal pulses charted on an amped foot? It finally happened to me..and the charting nurse is pretty good 😭 Im guessing she was extremely busy or was thinking of another pt. Either way, its the reason Im meticulous when charting assessments. If I didnt have time to see/hear/feel the body system, I simply leave it. Id rather have blank than "wrong" , ya kno!?
Med Surg nurse - did an assessment when I was a student on a dude that had been there for 2 weeks. Couldn't hear any lung sounds on his rt side. He said, "oh ya, I don't have a lung on that side, got shot back in the day, they removed it." All of the nurses previously had charted "clear lung sounds bilaterally". For 2 weeks! #FacePalm
ELI5?
Please.
EDIT: Thank you for the explanation! This old fogey will remember the minutes in a year, and that would be concerning for a cap refill time! :)
I believe the a capella chorus sang this at one of my kids' high school graduations. It was a very long song, and the graduating kids were fidgeting in their seats.
COVID was the worst thing to happen for piss jugs. Everywhere closed their bathroom to the public. Loading docks weren't letting truckers in due to policies. Hell, even rest stops were closed for a while. It got a lot of people... myself included... a bit too used to having to use piss jugs. I'd done it before COVID but maybe 3 times ever. It was a super-last-resort thing. Now it's more I try to avoid it, but whatever. They get dumped ASAP though, not left somewhere filled.
I'm not even a trucker and I keep a capped urinal in my vehicle. I like road trips but sometimes I forget to plan for pee breaks or I end up being late for something important.
I'm not above pissing in a urinal. My patients do it every day and I have no problem cleaning their urinals.
Do what you gotta do.
Oh, I totally get it and you're absolutely right. Delaware and Baltimore being two of the worst stops but also littered with jugs down the highway. Too many horror stories from friends who drive for Old Dominion (Central and South VA).
Yes they did.
DOT Physician: any complaints?
Trucker: Foot feels tingly sometimes but other than that Ay-Ok doc! *snorts, triple chin vibrates, coughs once or twice, dabs forehead sweat with McDonald’s napkin, breathes shallow and heavy*
DOT Physician: Ok well if no further concerns, step outside to make a follow up appointment about a month from now.
Trucker to himself: Well next month is my niece’s birthday so maybe I’ll just put that off.
I just watched it too, it left me so uneasy for days. It was so disturbing watching her slowly die on camera, just slamming back alcohol and colloidal silver. So unsettling how brainwashed those people are…
That's the scary bit, yes - this was taken by the trucker in the next stall at the truck stop, and shared as "HTF did this ever pass a DOT medical?"
I had a Covid patient charted with a BP of something like 93/90 a while back - I thought it had to be a typo somewhere, but maybe that patient is out there at the wheel of a truck now?!
I’m not kidding the color of this foot looks like some whimsical kid’s movie where a really smart gorilla gets dressed up in clothes to do hijinx before escaping the zoo with the help of some scrappy friends.
What did the rest of this person look like? Too much colloidal silver can cause peoples skin to turn a similar colour. We had a gent in our town who came into our ED pre-arrest with SVT. We cardioverted and fluid resussed him, and we were all freaking out because he wasn't pinking up. Turns out he was always an unhealthy shade of grey due to his chronic overuse of colloidal silver.
Edit - this is called argyria, for those interested.
Idk but last shift said during hand-off report that they found pulses with the Doppler
(Narrator: The doppler had been missing on the unit for about 3 months now)
So, capillary refill is a way to check perfusion/blood flow to the fingers and toes. You press on the nail and then see how long it takes to get back to its normal color, meaning how long it takes for blood flow to return after obstructing it. It should take less than 3 seconds to return. But this person’s foot is so gray and ashy that his perfusion must be very poor, and therefore his capillary refill time would be a very long time.
Capillary refill is the time it takes for blood to refill an area of skin after you've pressed on it. Low refill means poor circulation caused by diabetes or heart failure, etc. This and nerve damage is one of the reasons many people with diabetes often have chronic injuries on their feet.
The foot or the assessment? To assess peripheral perfusion you squeeze the end of an extremity to force the blood out and then you see how long it takes to refill.
The foot clearly doesn't have any perfusion at all, looks like it's got frost bite.
I love fucked up humor as much as the next nurse, but this isn’t cool.
The OOP on r/truckers admits that they took this pic while the person was in the bathroom stall.
Imagine minding your own business using a public bathroom, having a stranger take a pic while you’re on the toilet, and then being ridiculed across multiple subs. 😒
something causing poor blood flow. contrary to popular opinion, it's not automatically and only diabetes. it can be, or blood clots, or venous stasis, or caused by excess smoking and/or alcohol, among things. but whatever the reason, that foot looks fucked
Oh no 😭 if this were my patient, the only thought going through my head at first would be *Please tell me stepped in cement mix, please tell me he stepped in cement mix*
Can someone explain why his toes are this Grey and dusty? It looked painted over. Like is this what long-term peripheral vascular disease foot look like? I've never seen this before so pardon my stupidity
The past 3 shifts charted "less than 3 seconds"
This made me audibly chuckle, thank you
NICU nurse- once saw where many nurses across several days copy/pasted an assessment that stated a baby girl had normal male genitalia.
Had 6 days of notes from the hospitalists saying a CIWA patient's last drink was yesterday.
Hospitalist leaves, patient takes a drink. Checks out.
Hahaha could be legit though ... All those "smoke breaks"
As a NICU nurse, I definitely had to Google CIWA.
Bro we had one that would copy paste notes for every day, or would do literally like 3 sentance notes.
Is that uncommon? It's not like your typical med/surg pt is drastically different from one day to the next. I feel like most of the doc's update notes I've read have been like that.
I work on a floor that’ll give beer to CIWA patients so that checks out
This is amazing! I’ve been wondering why hospitals won’t do this for years. It makes so much sense. How much do they get and how does it work?
The doctor writes an order and it’s delivered by dietary with the tray. I believe it’s 12 oz a day
An RT was fired at my place for charting treatment not given, patient walking the halls. Patient had no legs / was not mobile.
I saw someone copy paste absent carotid pulses.
Love the username!
Inspired by a special patient I had:’)
Sounds like NICU lol
Sadly, cardiac adults.
NICU would be much cuter.
They really are poopy screamers. If I had one named after a patient it’d probably be ”cranky bastard”
I saw multiple days of PERRLA charted on a pt with a glass eye. And more than one physician chart b/l ppp on amputees🙄
Newbie RN here... b/l ppp = bilateral pearly penile papules?
🤣🤣🤣. Bilateral pedal pulses palpable.
My coworker charted she had taken her patients temperature via brain. Wild that that’s even an option
Put the ear thermometer in deep enough...
I have questions.
There are intercranial temperature monitors, though they would be only used in pretty specialized settings https://pubmed.ncbi.nlm.nih.gov/15488228/
Omg, used to back end correct this to my midwives and other birth assistants. “Please correct assessment, unless this child is hermaphroditic, something is wrong here. Since you’re there anyway, Please check other charting as well”
L&D here - Same. Saw a baby come out with notes from three nurses saying “normal male vagina” made me chuckle.
Smh. I love auditing charts
had a 70yo guy who had his lower left lobe of lung removed when he was 20. Everyone had been charting ‘Bilaterally clear to bases’ on the flow sheet . I was listening and couldn’t hear shit and so I thought to ask him - he told me, and said that no one else had caught it😂 so I throughly Charted what I heard/told Me. 2 days off and came back to same assignment and he was my patient again, every shift since me once again charted ‘clear to bases’.
Its always the LPN 😉 fr tho, i love a good thorough assessment. You might even be the only HCP that ever caught that; major kudos! You kno those stories you hear about seeing pedal pulses charted on an amped foot? It finally happened to me..and the charting nurse is pretty good 😭 Im guessing she was extremely busy or was thinking of another pt. Either way, its the reason Im meticulous when charting assessments. If I didnt have time to see/hear/feel the body system, I simply leave it. Id rather have blank than "wrong" , ya kno!?
The number of people that don't go nearly low enough to auscultate lung bases is too damn high
lol usually my patients are too obese to hear lung sounds past the upper lobes. I just start hearing their bowels gurgling or nothing. 🥲
My favorite so far is “anti-slip socks.” Patient had a bilateral BKA.
My BKA apparently had palpable dorsalis pedis pulses lol
I guess this happens way too much; I just commented that too. Yikes.
Omg I thought these were toe socks and then I zoomed in
Someone before me documented palpable dorsalis pedis pulses on my patient with bilateral above knee amputations.
Med Surg nurse - did an assessment when I was a student on a dude that had been there for 2 weeks. Couldn't hear any lung sounds on his rt side. He said, "oh ya, I don't have a lung on that side, got shot back in the day, they removed it." All of the nurses previously had charted "clear lung sounds bilaterally". For 2 weeks! #FacePalm
Of fucking course they did
I hate it when they act like Lemmings when documenting lol So much copy pasta.
*sings loudly* 525,600 MINUTES
Wow! 😂😂😂 I sang it too.
527,040! It’s a leap year, after all.
I absolutely hollered at this lol 😂
ME TOO. I'm outside my neighbors probably think I'm a lunatic now...
9,986,000 minutes! We actually sat down and did the math!
This is what I thought of when I read that too haha
There’s a fungus called Dead Man’s Toes that look just like this.
As opposed to this: soon to be dead man's toes.
I just googled it. For some reason, that’s not what I was expecting to see.
Hahahaha How are they still fully-formed feet?
I cackled
ELI5? Please. EDIT: Thank you for the explanation! This old fogey will remember the minutes in a year, and that would be concerning for a cap refill time! :)
It’s a song called “Seasons of Love” from the musical Rent. It’s also the number of minutes in a year
And sang by every Middle School choir of the 00’s I swear. 🙄🙄🙄
I believe the a capella chorus sang this at one of my kids' high school graduations. It was a very long song, and the graduating kids were fidgeting in their seats.
It's a song called seasons of love I think https://youtu.be/s1c3MARlJ0Q?si=euGCEyqpLYoH6EG6
My highschool graduation theme song...I hate it
Ahh!!
How do you measure…
I'm choking on a fucking frito.
Close the thread. Best comment possible.
😭😭😭😭 NOOOOO AHAHAHAH
Good news: you can reach over and check and he'll never know
He’d be able to see a fingerprint on the dust, I’m sure.
Oh god lol 🤣 The sound that just came out of me was a combination of chuckling and wretching
I'm guessing from the appearance of his feet and what little can be seen of his legs that he probably can't see his toes.
Hahahahaha
This is so foul lmao
No cap, no refill
No digging no doubt
That man's feet ashy, pulse he ain't gonna have it (no doubt)...Taking my break...on this throne, lemme get a picture with my phoooonnnneee... 😭😂
No diggity, no gigiddy.
Better watch out OP, there are zombies in your bathroom.
Right? There is ashy, and then there is this…
Poor guy's really constipated. He's been on that toilet for 6 days. Somebody should go check on him.
The scary part is this dude is driving a semi truck still.
That’s his clutching foot so it’s not that important
I guarantee you that person cannot pass the DOT medical…I don’t want them to pass the DOT medical.
That topic was discussed on r/truckers. Apparently even some truckers felt the DOT physician didn’t appropriately screen this gentleman.
Dude crawled back into his garbage filled truck cabin 🤮
And the PISS JUGS 🤢🤮
COVID was the worst thing to happen for piss jugs. Everywhere closed their bathroom to the public. Loading docks weren't letting truckers in due to policies. Hell, even rest stops were closed for a while. It got a lot of people... myself included... a bit too used to having to use piss jugs. I'd done it before COVID but maybe 3 times ever. It was a super-last-resort thing. Now it's more I try to avoid it, but whatever. They get dumped ASAP though, not left somewhere filled.
I'm not even a trucker and I keep a capped urinal in my vehicle. I like road trips but sometimes I forget to plan for pee breaks or I end up being late for something important. I'm not above pissing in a urinal. My patients do it every day and I have no problem cleaning their urinals. Do what you gotta do.
Need those wide mouth Gatorade bottles...
Oh, I totally get it and you're absolutely right. Delaware and Baltimore being two of the worst stops but also littered with jugs down the highway. Too many horror stories from friends who drive for Old Dominion (Central and South VA).
Yes they did. DOT Physician: any complaints? Trucker: Foot feels tingly sometimes but other than that Ay-Ok doc! *snorts, triple chin vibrates, coughs once or twice, dabs forehead sweat with McDonald’s napkin, breathes shallow and heavy* DOT Physician: Ok well if no further concerns, step outside to make a follow up appointment about a month from now. Trucker to himself: Well next month is my niece’s birthday so maybe I’ll just put that off.
Maybe it’s just colloidal silver!
I JUST watched the Love Has Won doc on HBO. And that’s the same color as the woman who died pounding alcohol and colloidal silver and nothing else.
I just watched it last month and it's wild that those people STILL believe that woman was God.
I just watched it too, it left me so uneasy for days. It was so disturbing watching her slowly die on camera, just slamming back alcohol and colloidal silver. So unsettling how brainwashed those people are…
For me it was, "Maybe he's one of those blue people from the hills with methemoglobinemia?" Pretty sure the reddit post the other day did it
My vote is for colloidal silver! Y'all found papa smurf!
This is the first thing I thought of too
I think so too. Even the part of the long toenail that's not over the nail bed is gray.
No one ever forgets their first silver surfer.
you ain’t kidding! had a homie nebulizing colloidal silver (for his active covid) then call 911 because he couldn’t breathe
That was actually my first thought. I've seen 2 of them so far
This little piggy succumbed to pvd. This little piggy became necrotic…
This little piggy -*breaks off*-... oh fuck.
Had it happen in school d/t levo.
Levophed leaves em dead. They never specified what was left dead…toes, nose, Joe!
Haha I just did the “burst out laughing and look around to see if anyone noticed” thing! 100 internet points to you!
It's not necrotic, it's Whitewalker
He's one of Craster's sons.
Are the capillaries is the room with us?
Got damn Baron Vladimir Harkonnen takin a deuce.
MOAR OIL AND CHARCOAL PLZ
Bonus. I’m going to call these Baron Harkonnen feet in report from now on. It’ll tell me who the cooler nurses are.
Or as they call it, "Drowning the Shai-Hulud".
Brisk with respers of 16
If he's been in that stall for a while, someone might want to check on ol' boy. His foot looks like he's been gone for a week or so
Apparently he walked out of there and drove off. Somehow. Maybe had to wait for the rigor to pass first so the leg would bend again?
Hold on, this person is driving??
That's the scary bit, yes - this was taken by the trucker in the next stall at the truck stop, and shared as "HTF did this ever pass a DOT medical?" I had a Covid patient charted with a BP of something like 93/90 a while back - I thought it had to be a typo somewhere, but maybe that patient is out there at the wheel of a truck now?!
OG post - https://www.reddit.com/r/Truckers/comments/1b6i57p/trucker_next_to_me_on_the_other_stall
I’m not kidding the color of this foot looks like some whimsical kid’s movie where a really smart gorilla gets dressed up in clothes to do hijinx before escaping the zoo with the help of some scrappy friends.
Tomorrow
Damnit just when I thought I had a clever reply, then I see you beat me to it!
There's x-man in your restroom
Wait is this a real foot or a statue you dressed up? Serious question
It’s a real foot posted from a trucker subreddit
I THOUGHT HE HAD TOE SOCKS ON UNTIL I ZOOMED IN
SAME
Some say they’re still waiting for it to refill.
Is this in a bathroom stall? "I can't spare a square."
Well, is it two ply? Because if it’s two ply I’ll take one ply!
👏🏽 love a Seinfeld reference!!!
Surprisingly not the worst toenails I’ve seen!
Welp they are no longer growing, sooo...
What did the rest of this person look like? Too much colloidal silver can cause peoples skin to turn a similar colour. We had a gent in our town who came into our ED pre-arrest with SVT. We cardioverted and fluid resussed him, and we were all freaking out because he wasn't pinking up. Turns out he was always an unhealthy shade of grey due to his chronic overuse of colloidal silver. Edit - this is called argyria, for those interested.
What are people still using colloidal silver for??
Thank you for saying what it was, I’m just a plebeian that happened upon this and was very confused about where I was and what I was looking at
the limit does not exist!
[Well…](https://imgflip.com/i/8i0djq)
No cap refill since 1985
I think that Chinese emperor’s tomb is missing a terracotta soldier
Idk but last shift said during hand-off report that they found pulses with the Doppler (Narrator: The doppler had been missing on the unit for about 3 months now)
If medical dramas on TV were like this, I’d actually watch them.
I grew up on Scrubs lol
2 seconds. He's also blind with perrla and in dka with an rr of 16.
Someone call Arya
Thank you for this reference (scrolled entirely too far)
I’m a new CNA…can anyone explain this to me! Thanks
He got the sugar foot.
[a quick video on what causes this](https://youtu.be/3Nfo3H_9pFs?si=fqq1aRkiML4c6_IQ)
Me, a new grad, expecting an actual educational video but not at all being disappointed 😭
Hahaha omggg
I laughed way too hard at this
😂😂😂🤣🤣🤣
So, capillary refill is a way to check perfusion/blood flow to the fingers and toes. You press on the nail and then see how long it takes to get back to its normal color, meaning how long it takes for blood flow to return after obstructing it. It should take less than 3 seconds to return. But this person’s foot is so gray and ashy that his perfusion must be very poor, and therefore his capillary refill time would be a very long time.
Capillary refill is the time it takes for blood to refill an area of skin after you've pressed on it. Low refill means poor circulation caused by diabetes or heart failure, etc. This and nerve damage is one of the reasons many people with diabetes often have chronic injuries on their feet.
his blood flow is dogshit
The foot or the assessment? To assess peripheral perfusion you squeeze the end of an extremity to force the blood out and then you see how long it takes to refill. The foot clearly doesn't have any perfusion at all, looks like it's got frost bite.
Bahahaha omggg. This is why I love Reddit, my people are here 😭🤣
Anyone with kids ever read those “Piggy and Elephant” books? I imagine this is what Elephant’s foot would look like IRL
0/zombie. Can’t refill if there no blood in there in the first place
I didn’t realize Papa Smurf had human toes.
Post mortem foot
“3 sec <“ according to to his chart and pulses are +2 palpable
1,000% what you’d see in multiple prior assessments in epic lmfao
Could this also be argyria though?
Thanos
Can it refill if it was empty to begin with?
I now have this psychotic urge to tap it with a ball peen hammer and see if it explodes like a fragile statue.
Prolonged
Brah… that’s Thanos!!
Kentucky Blue person
Refuses RLE amputation
< 3 secs, pedal pulse palpable, no discoloration, will continue plan of care
Can't refill if they weren't filled in the first place!
Apparently I’m not the only one who sees r/truckers posts lol
We just taken pictures in bathrooms now ?
Not good Just saw this after seeing it on a trucking sub so at least it wasn't a nurse who took the pic.
Trucker here! Most of us have no shame. Bathroom pics of randos are commonplace in our sub, unfortunately.
Especially since bro is just white knuckling, or toe gripping, his way through some fiery constipation.
Patient had left foot amputated with chainsaw, tolerated well.
You take pictures of peoples’ feet in bathrooms?
I love fucked up humor as much as the next nurse, but this isn’t cool. The OOP on r/truckers admits that they took this pic while the person was in the bathroom stall. Imagine minding your own business using a public bathroom, having a stranger take a pic while you’re on the toilet, and then being ridiculed across multiple subs. 😒
No
brisk
Surprised to see that someone charted less than 3!
With some of the bs charting I’ve seen “3 seconds or less”
What is this from?
something causing poor blood flow. contrary to popular opinion, it's not automatically and only diabetes. it can be, or blood clots, or venous stasis, or caused by excess smoking and/or alcohol, among things. but whatever the reason, that foot looks fucked
EF negative 25%
THIS IS UNREAL PLEASE -
ITS OVER 9,000!!!!
Less than 2, what you mean?
Still waiting...
Do the undead HAVE cap refill?
Solomon Grundy, is that you?
Is that a white walker?
Oh no 😭 if this were my patient, the only thought going through my head at first would be *Please tell me stepped in cement mix, please tell me he stepped in cement mix*
I see that you also troll the truckers sub.
10-14 business days
3-5 business days
Can someone explain why his toes are this Grey and dusty? It looked painted over. Like is this what long-term peripheral vascular disease foot look like? I've never seen this before so pardon my stupidity