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Thursday, March 22nd, 2012
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12:16 pm - A non-electric VAC!
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| Saturday, October 1st, 2011
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3:27 pm - Thoughts and opinions welcome
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thatsassylassie
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Dear cynical nurses:
I am in the final year of my BSN program. This term is Leadership/Management outcomes and of course I have a big APA paper to write.
We are to address a healthcare topic with policy, practice and economic implications. It is to be analyzed from a nursing leadership/management perspective. I am thinking of talking about the practice that many hospitals seem to be adopting of mandatory vaccinations for healthcare workers, particularly flu shots. Its seems timely, especially in October.
I come to you to ask if you have any other ideas for topics, as we all seem to have opinions that make us cynical about the healthcare industry. I would love to hear ideas and/or any resources you might have (URLS you can point me to) if applicable.
**Please note, I am in no way asking for help with the work, simply your ideas on pressing topics in healthcare that management can or should be addressing. Thank you in advance!
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(9 comments | comment on this)
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| Monday, September 26th, 2011
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2:39 pm - Hell hath no fury...
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psychofish
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Dear Emergency Department: Please mind where you put your patient belongings. 'Cause hell hath no fury between a woman and her shoes!!! (And her blood pressure!).
Just sayin!
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(3 comments | comment on this)
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| Wednesday, September 21st, 2011
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12:21 pm - Ego is not a dirty word
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amanda_jh66
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I am having many work related issues right now, and i need to vent
Dear Intensivist,
I understand beds are tight, that clearing patients is a bitch BUUUUTTT, I work in the PACU, telling me to BiPap a patient for quite possibly the rest of my shift and or life is not going to work for me. Also saying the nurses are really busy and maybe a bed on the medical ward is better is just plain stupid, it is called INTENSIVE care and HIGH DEPENDANCY for a reason
Dear Orthopedic Reg,
I know you are an Orthopod (Orthogod) but c'mon, you do an operation, you do the op report, you chart meds and orders, it has never been any different, why do you need me to run around after you asking you to do your job?Does it make you feel important? Maybe some mother issues?
Dear Anaesthetist,
Telling me as you stand infront of me that it is your turn to talk ie.flirt with the pretty Cardiologist, cutting my conversation off with her, is not ok! Why is your conversation more important, is it that you are older than me? a doctor? an asshole? I just hope sir, that someone doesn't treat women in your family as badly as you do the women at work.
End of rant
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(comment on this)
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| Sunday, August 28th, 2011
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11:24 am - I'll take five of these in red please.
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| Wednesday, July 20th, 2011
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12:58 am
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rainbowjehan
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I work as a home caregiver right now, which basically means that I do housekeeping and meal prep for my clients as well as transportation assist and meds and such. I also work in a state where burning stuff in a barrel or brick well outside your house is legal.
Two words regarding the client I saw Saturday:
Depends. Bonfire.
I won't lie. It was surprisingly awesome.
current mood:  amused
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(6 comments | comment on this)
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| Tuesday, July 19th, 2011
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2:38 pm - Lung police
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meb21
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Note: I have been unofficially diagnosed with asthma by a nurse practitioner; given that I've had bronchitis twice in the last 5 months, most recently 6 weeks ago, and it required a 12 day Prednisone taper to stop the barking cough, I'd call her diagnosis of "constrictive airway" a fair call.
Lady, if you're going to ask "Do you mind if I smoke?" and I reply "Yes, actually; I have asthma":
DO NOT
-go on about "ooh EVERYONE says that nowadays, it's like an EPIDEMIC". Yes, I stayed up all night with my brothers and sisters on the Asthma Bat-Phone cooking up the SEEKRIT Asthma Conspiracy: "You, meb21! Make sure none of the people in your patients' homes can smoke! It will drive them MAD and we will finally rule the WORLD!"
-say stuff like "Did you hear they're taking that stuff off the market" and make some vague inhaler-type motion with your hand. What is ThatStuff? Should I ask my doctor if ThatStuff(tm) is right for me? Perhaps if you quit the pack a day of that nicotine stuff you're smoking you'd be better off. But I'm a bad nurse, of course, judging you.
-fondle your lighter and pout for the rest of the visit. You're not even my bloody patient! I'm here to see your aunt! Can you hold off of a smoke for 45 minutes while I assess her?? Or go out on the porch!
current mood:  annoyed
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(5 comments | comment on this)
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| Monday, July 4th, 2011
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2:27 pm - Oh, how I love doing home health on a holiday weekend.
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meb21
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I just have to get this out somewhere:
1. Madam, I know that you're fascinated by the Casey Anthony trial and really REALLY want to watch the closing arguments but I really must, must insist on FULL access to the large, open oozing abdominal wound that we've been doing daily dressings on for months now.
2. Words you never want to hear from a patient: "Let's get this wound vac done so I can get back to playing with my chainsaw."
3. You, sir, if you are indeed harassing my patient because she is gay, and I ever catch you, I'll call the cops on you so fast your head will spin.
current mood:  hot
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(4 comments | comment on this)
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| Monday, June 6th, 2011
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8:09 am - keeping the census up
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catseurat
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I work in a subacute rehab, and it's a slow time of year. We have to call the DON or ADON before sending any patient out to the ER, since we can supposedly treat most things in-house.
So last night I have my guy with stage IV cancer with mets, gtube, fairly non-communicative, very supportive family - who wants him to live forever. Hence the FULL CODE status. So he starts to get loopy, combative, O2 sats in the toilet, won't keep the O2 on, develops +4 edema to all extremeties, BP 70/30, and the family is insisting we send him out. So we do.
And I call the DON to let her know, and all she hears is "FULL CODE" and tells me we should have treated him here (sure, I'll push some lasix to get rid of the edema AND the BP), and then says, "and if he codes, well, then you could send him out."
I'm trying to think how I would chart that so the family's lawyers treat me kindly as they remove my license.
*facepalm*
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(6 comments | comment on this)
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| Saturday, May 28th, 2011
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12:03 pm - Thanks, Sherlock Holmes.
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meb21
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Urologist to my Grandfather: "I think your problem is that you've got an old bladder."
My uncle (present at the appointment) to the Urologist: "Doctor, he's 91 years old. He didn't just get an old bladder overnight."
I told my dad to recommend to Grandpa to get a second opinion. Flomax doesn't fix everything, Doc.
current mood: awake
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(3 comments | comment on this)
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| Thursday, April 28th, 2011
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9:16 pm - Supply rants
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tudorpot
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Dear Supply department,
Thanks for the note telling me the dressings I ordered to cover Mr. X's wound are back ordered. Two weeks should be ok, I am using sections of the cardboard box the supplies were shipped in as a substitute until you can get your act together.
no luv
Dear Funding Agency,
See above. That is why you need to let our office keep some supplies on hand.
no luv
Dear Supervisor,
I'm having a great deal of trouble reconciling your actions. Three months ago I witnessed you refusing to re-use perfectly good and unused large envelopes that are included in each patient chart due to concerns about infection. Ditto AA Batteries. I am still trying to figure out how the unused batteries for IV pumps would be an infection control hazard: if some patient decides to stick an AA battery in any orifice - natural or created by one of our less than skillful surgeons, that is not going to be his major problem. Heck - it might help.
Now I read that unused medical supplies that previously were only good enough to send to Haiti, if they come from 'clean' homes can be used to stock our supply closet.
puzzled,
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(5 comments | comment on this)
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9:00 pm - Note to Corporate peeps
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tudorpot
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Nurses don't need to hear about all the money you spent wasted on doing the perfectly bleeding obvious. Also, when you hold a meeting, provide something other than sweet baked goods and perhaps a cold drink or a cup of coffee. BTW We are the ones who actually bring the $$$$ into the company. Without the nurses, no care gets done and no revenue flows in. Raising mileage/km rates from 32 cents a km to 39C, don't expect a standing ovation, it's still far below what other employees in the province get. You guys are support, we are front line. Remember that.
Oh, and short stay chart that has a 13 page assessment is not an improvement.
current mood: cynical
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(1 comment | comment on this)
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| Saturday, April 16th, 2011
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6:34 am - True Horror Tales
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nokomarie
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I get this weird feeling that most people don't understand the experience of being a nurse in a small nursing home or small, non-acute, hospital could be true. It seems quaint and scarcely possible.
But I started nursing back in '96 after years of being a pharmacy tech through all of the eighties and went through being told that 100 gloves per aide was generous and that the non-ambulatory demented patients should be given diapers made of bed pads. They wanted the women to have slips on and would check them by means of flipping up their skirts in the hallways. Things have really come a long way.
I realize that most on this site are hospital nurses and I, myself specialize in re-hab but please give thought to where your patients who don't come out with A+ Marks go without contempt. Where do these poster children for elder abuse go? They oftentimes get loving care and if too many tests are ordered and too many calls to the doc for non-acute symptoms are logged, it is because the family and those nurses are fighting for those that are under their care. No-one is much more out of touch than a man with kidney failure, necrotic syndrome, an above the knee amputation and a will/belief that he will go home because some coward of a doctor/nurse/someone/anyone told him that he would.
In a way the old way was better for those without hope of a cure. But keeping up with the times must be something else. I put out $200 a year on gloves for sure and I buy in bulk. None of us, I think, have a handle on how much healthcare really costs.
So, let's do some horror stories. I have plenty so I will wait. Let's hear about when the system fails us.
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(8 comments | comment on this)
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| Wednesday, April 13th, 2011
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8:17 pm - Susan G. Komen 3-Day For the Cure: Help Needed
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| Wednesday, March 2nd, 2011
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9:15 am - Nicotine-Free Hiring
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sistrmoon
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My question is: if you're going to start testing for nicotine and excluding applicants based on positive results, are you also going to exclude overweight or sedentary applicants, those who drink on their nights off, those who participate in high risk activities? After all, they should know better and be a better example for clients! I'm a non-smoker(and an Onc nurse), but this seems a bit over the line. Smoking is still legal.
St. Francis Hospital's Hiring Policy goes Nicotine-Free
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(19 comments | comment on this)
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| Saturday, February 19th, 2011
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5:21 pm - Refusal
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colleenie02
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I am ER nurse. I have been an RN for 4 years in inpatient and outpatient settings. I am also 2 years through FNP school. I am one year out from having my masters.
Here is a copy of an email I just sent my manager.
Hi XXXXXXXXX-
I have a question. Sometimes I find myself being asked to do things that I think are medically inappropriate because they have low medical utility and are going to be painful and distressing to a patient. I'll address my concerns with the provider who will still order this done to the patient. (ie, sticking a 99 year old hospice patient 4+ times for a larger bore IV for a blood transfusion, forcing a highly anxious 8 year old boy to recieve a phenergan suppository for typical gastroenteritis when the father was agreeable to let him go home and just continue to puke and he screams and cries "Dad please don't let them do this to me!", straight cathing a muslim 19 year old female who has been here for 35 minutes with run of the mill abd pain because she can't pee and the provider wants a UA for signout which by the way I did refuse to do)
If I refuse to do something that is not life-threatening to a patient but is in my (almost master's educated) opinion unnecessary, futile, or traumatic to a patient, will I get in trouble?
Colleen
Does anyone have any knowledge or experience with this?
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(17 comments | comment on this)
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| Tuesday, December 7th, 2010
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7:33 pm - Home health vs hospice
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retrophoto
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Okay, most of my experience in home based care is hospice, but this company I am working for does things WAY different...are these things typical in conventional home health?
The nurses have been trained that if there is some kind of health issue going on, like elevated blood pressure or blood sugars to either tell them to make an appt with their doctor, or pass it on to the DON to follow up with the doc. Or call 911 if warranted.
When you do a home health admission, do you not have to verify orders/meds with an MD like every other healthcare facility/agency on the planet? If they only get CNA services do they still need to get MD orders to verify meds?
Don't care conferences have to be held every 14 days, even if the only disciplines offered are nursing, cna and Pt/OT?
In home health are you supposed to basically, not address anything that isn't related to your skilled nursing need?
Have you ever seen a home health agency that sets up regular times for all visits for CNAs and nurses, and actually put those times on the plan of care?
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(5 comments | comment on this)
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| Saturday, November 27th, 2010
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12:14 am - Dear NFJ taking up space in my room.
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joeydiablo
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We have sent your urine to the lab and received a negative hematuria result. We are sending you home now as you are here for the same thing you were last week. No you are not getting any prescriptions. No the ER doc is not coming back to see you.
The fact that you went to the bathroom after you were notified of this and brought back a cup of pink colored liquid just to show that you 'know you are bleeding' and 'not crazy' and 'not here looking for pain medication' does not impress anyone. It is your 16th visit to this ER this year. 16 emergencies? Uh huh.
You can cry all you want. It is clear that the reason you are crying is that you are not getting a prescription for narcs. Also because we are on to you. Have a nice day and please find someone else to play hide and go drug seek with.
The sad part is this is every freaking day it seems like.
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(1 comment | comment on this)
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| Wednesday, November 24th, 2010
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5:58 pm - A Visit
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yesdog
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Today, I visited one of my former ICU patients at an assisted living facility. He introduced me to everyone as "the girl I spent a couple of nights with". He is an amazing man for 93 years young.
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(1 comment | comment on this)
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12:23 am - LPN school?
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tribulation
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I'm thinking of going for LPN certification and I have a few questions.
- Does it really take a year? How rigorous is the training, a lot of advanced math and science? I'm willing to work hard, just wondering. Math is not my strong suit.
- I've heard stuff about LPNs being fazed out and underpaid so I should just go for RN certification which I can attain in two years with an Associate's. True/false?
- I have pretty major social anxiety issues. How badly do you think this would affect my abilities to be a nurse?
- Know of any cheap, certified schools in the DC area (Montgomery County/DC)?
Thanks!
x-posted to ![[info]](http://l-stat.livejournal.com/img/community.gif?v=92.1) poor_skills and maybe some other places, idk.
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(14 comments | comment on this)
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