Latest Comments by Jolie

Latest Comments by Jolie

Jolie 23,827 Views

Joined Oct 17, '01. Posts: 9,432 (48% Liked) Likes: 13,238

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  • 3
    dishes, meanmaryjean, and llg like this.

    I'm sorry that you are unhappy with your current situation. You must weigh the pros and cons of breaking your contract, moving to a new area, starting a new job and new life. No one here can possibly know how your current employer will react, how a future employer will receive you or what your tolerance will be for the financial, social or practical aspects of such a change.

    I am a former nurse manager, currently a hiring manager in a different field and the mother of 2 young adults who will soon be making decisions similar to yours. Please accept my input as it is intended: to help you think about your choices and encourage you to think beyond the immediate term.

    First of all, you have a contract. Undoubtedly it spells out the consequences of failing to complete your agreed-upon term of service. I encourage you to read it and be prepared to accept what is written. If you agreed to a monetary payback of $X for leaving after a year, expect to owe your employer that full amount of money. While it is possible that they will choose not to collect, don't count on it. They invested a significant amount of money in your degree and on the job training, and per your contract, they have a right to a portion of that money back if you do not fulfill your obligation. It's nothing personal. It's their responsibility to hire and train your replacement, and that costs money. If you don't have the money or aren't willing to be in-debt to them, then breaking the contract isn't a good idea. Might you be able to find a new job that would be willing to pay your debt as a type of hiring bonus? Possible, but unlikely. Most positions have multiple applicants. It is not likely that a new employer will be so determined to have you on their staff that they would be willing to pay your debt, but should you get a job offer, you can certainly ask.

    Secondly, I am concerned about your statement that you hate the location where you currently live and hate the people there. I assume that you must have had a somewhat favorable impression of your area and your fellow citizens when you accepted and started your current job. Most people don't voluntarily choose to start a life in an area they dislike, and you don't mention a spouse or other circumstances that forced you to locate here. So I encourage you to thoroughly examine what you are looking for in a community and a job, or I am concerned that you will find yourself equally miserable in a new location a year or two from now. I'm glad that you have heard from others who are happy on the west coast, but please don't mistake that for a guarantee that you will also be happy there. I can assure you that it is NOT the longitude and latitude of their home that makes them happy. It is a sum total of family, friends, health, professional challenge, financial comfort, connectedness, independence, educational opportunities, and many other factors that are specific to each individual.

    Lastly, please understand that while sounding chiche, it is absolutely true that the first year (and really two years) out of school are the most difficult for new professionals. Every workplace has its strengths and weaknesses. You acknowledge that there are some good points to yours. Please make sure that you are evaluating it and any other potential employer objectively and candidly. It is easy to see green grass on the other side of the fence. That grass often turns brown upon closer inspection. Might it be possible and worthwhile to focus on gaining everything possible from your current employer while taking a year to plan a move under more positive circumstances?

    Best of luck to you whatever you decide.

  • 4

    Quote from Julius Seizure
    I've never heard of this "safety sensitive" rule where they can refuse to hire you based on any certain (federally legal) prescription that is found in your drug screen (which you may not even take regularly scheduled prior to a shift).

    Does anyone have examples of what kinds of substances would be on a list like that? Or where I could find more info?

    Can you imagine if a Catholic hospital had a policy that they would not hire anyone who used prescription birth control pills?
    There is no single list of "safety-sensitive medications. The drugs of concern to one employer in a given setting may not be an issue for another employer in a different setting. Those that I know to have been reviewed by various employers have included medications with a high likelihood to impair one's level of alertness, reaction time, judgment, etc. Some significant factors that posters may not be considering include whether the individual works alone or with others, whether s/he operates potentially hazardous equipment or drives in the course of employment, whether the employee is solely responsible for the well-being of minor children or dependent adults at work, the strenuousness of physical activity and cognitive demands of the job, and whether the job requires irregular hours or on-call time that could make it impossible to time medications so that they don't interfere with working hours.

    I was recently involved in a situation where a candidate's drug screen indicated use of a prescribed controlled substance. Because of the sensitive nature of the individual's work (which I won't disclose here), the employee was notified that a discussion with his/her healthcare provider was necessary in order to determine fitness for the job. It was the candidate's physician who indicated that the side effects of the medication rendered the candidate capable of the work required and advised not to hire for THAT position, although there were other that were suitable.

    This type of consultation is allowable and appropriate under the ADA, and protects all parties involved: the candidate, the employer and the individuals served by the employee.

    As for the comment on Catholic employers dis-allowing contraception on urine drug screens, I assume you are trying to engage in hyperbole.

  • 0
  • 3

    Quote from NotAllWhoWandeRN
    No, they can't. The purpose of a drug screen is to identify people who are using substances illegally, period, and it was wrong (possibly illegal, but I can't say with 100% certainty) to disclose drug results before they were verified.

    The hospital CAN have a policy that you cannot work under the influence of a controlled substance, but they CANNOT refuse to hire you for taking something you were prescribed while not at work.

    OP, they've done you wrong, but it isn't rude of Pangea to point out that your anxiety and panic (I'm not trying to label you - just using your words) can affect your perceptions of the situation. Employee health isn't who you work with on the unit. The nurse recruiter isn't who you work with on the unit. HR isn't who you work with on the unit. But it will not help to harass people for not getting things fixed quickly enough. You said you wouldn't wait until the next day because the employee who deals with these things was gone for the day? (hard to tell, you said they leave at 3:30 but didn't say when you called) Then you called the recruiter twice in a row then e-mailed? Your fear and frustration are legitimate because they clearly crossed a line, but if your immediate response is panic, you are only increasing their concern that something is wrong, and feeding into any prejudice they may have. If your goal is to keep the job offer, put on a good face for them - even though they don't deserve it - and give them a day, not 15 minutes, to get things fixed.

    If something like this happens again, you may want to simply say to HR (or whoever calls you besides the testing company) that you do not use any drugs illegally and you will contact the testing company to discuss results. Then the testing company will mark you as negative, and all the employer will know is that there was some sort of error.

    You may also want to contact the testing company to file a complaint. Whoever returned the results to your employer without giving time to verify prescriptions is the one who started this mess.
    My post did not address the legality of disclosing the drug screen results prior to verification. Per federal law and the employer's P&P that may very well have been the wrong thing to do.

    But I stand by my assertion that a prescription is not a blanket "OK" for any substance that is detected on a drug screen. There are medications that have the potential to impair a worker, regardless of legitimate medical use, and under those conditions, an employer does not have to hire the individual for that safety-sensitive job. To do so would invite an incident (and avoidable liability) compromising worker and/or client safety and force the employer to address it retroactively by removing the worker from a position s/he never should have been assigned.

    The ADA may come into play in the instance of a worker with a legitimate prescription for a medication with the potential to impair safe job performance. If the worker claims a disability covered by ADA, then additional steps would need to be taken to protect employment rights, but even that is not a "given" that the employee must be hired for a position with significant safety concerns.

  • 4
    LadyFree28, subee, Marisette, and 1 other like this.

    I am not an expert on drug screening policies and procedures, but it is possible that the applicant was positive for a substance that would have been deemed unacceptable regardless of prescription.

    An employer can disallow medications that might potentially impair an individual in a highly sensitive position regardless of prescription.

  • 2
    allsmilesDA and loriangel14 like this.

    If you are certain that you will not attend, simply contact them by the usual means of communication (such as an e-mail to your admissions representative) and state that you appreciate their confidence in you, but you will not be attending.

    I doubt that you will be able to use the drug screen for any other purpose. Any future employer will likely insist on one done under their supervision, but $150 is a small price to pay for avoiding overwhelming student debt, for which I applaud you

    Best of luck to you!

  • 9

    If anyone else addressed this, I missed it.

    You did the right thing by using your critical thinking skills to question a seemingly inappropriate set of orders. I don't believe that it is within your scope of practice as a medication aid to contact the physician for clarification, and certainly not to take a verbal order altering or discontinuing the medication.

    You went as far as you could by calling this to the attention of the nurse, and she met her responsibility by clarifying the order with the physician. You both considered the patient's well being, which is the ultimate goal.

    Those who are running around panicking are doing so because they have a poor understanding of of their legal and professional practice obligations, a poor understanding of the medication in question, or because they know they screwed up and are trying to deflect attention.

    Not your circus.

  • 12
    Moon RN, gaylarn4, TriciaJ, and 9 others like this.

    I lived in this area for 1/2 my life. I'm not surprised in the least. Not only is this institution poorly regarded, so is the hospital system to which it belongs. I never considered working there, and never would, even if it meant greeting customers at Wal-Mart instead. My patient care experiences (had to go there based upon insurance at the time) were abysmal.

    Like some other posters, I wonder why nurses didn't simply walk out or sit down and refuse to participate, especially given the hospital's well-known and long-standing poor reputation. I know I will ruffle some feathers with this comment, but so be it. Adult professionals who refuse to set (and enforce) limits invite poor treatment by others, and don't have much credibility when complaining after the fact. This was NOT an urgent patient care or critical staffing situation. Nor does it seem to have been a new-employee training session, which might explain some staff members' reluctance to speak up. This "inservice" appears to have been geared towards nurses of all levels of experience and seniority. Shame on them for not refusing to participate right there and then, especially given that they are unionized. What good is union representation if it does not empower employees to object to obvious wrongs in the moment?

  • 3
    jrt4, LadyFree28, and poppycat like this.

    I encourage you to consider that providing supplemental oxygen in and of itself will not reduce the baby's work of breathing.

    Grunting, retracting and nasal flaring are all indicators that an infant is working too hard to move air in and out of the lungs. While the oxygen saturation may temporarily hold in the "OK" range of 93-95%, the baby is likely to decompensate and supplemental oxygen alone won't be sufficient to rescue the baby at that point.

    The least invasive means of supporting a baby who is working hard to breathe is prone positioning with the head of bed elevated. Bracing the sternum and ribcage against a firm mattress lessens the work of breathing, and may buy you time to set up a high flow cannula or CPAP at the bedside. It is best to intervene with these measures before the baby is completely exhausted and needs intubation and ventilation.

  • 3

    Quote from Farawyn
    They do. They are magic.
    On the fainter or the lice? Maybe we're on to something

  • 5

    Tell them they can have their ammonia inhalers when they stop ostracizing kids from school for a single nit.

    You'll need them for the increased incidence of fainting

    Honestly, I've never used one. Do they really work?

  • 4

    What do your state and school district allow to be dispensed without a provider's order and/or parental consent? Makes no sense to keep anything on hand in a classroom that might lead to compliance issues with the regulations that guide your practice as well as policy and procedure.

    Vinyl gloves. Soap. Water. Bandaids. Maybe individual packets of petroleum jelly.

    Anything else will probably cause more trouble than it's worth.

  • 4

    Re: other countries' immigration you know how easy it was for me to get into [insert Central American country here] last month? I literally walked up to the customs guy, handed him $10 and my passport. He asked me what I do for a living, not that it mattered much. He handed me my passport and my stamped tourist card back and said, "Welcome to our country." The tourist card had a space for passport number and nationality, neither of which did he bother to fill in. 90-day tourist cards and permanent residency are not the same thing, I get it. But try getting to the US that easily - and legally - from Mexico or Central America. They are way more generous to us than we are to them, and it's not like they have good reason to be. We have a lot of Mexican/Central American blood on our hands.[/QUOTE]

    I believe you are missing a simple and obvious point. The Central American country you visited didn't welcome you with open arms out of generosity. They warmly welcomed you because it was to their economic advantage to do so. They didn't check your profession or desired length of stay because it was all irrelevant to them. Regardless of your reason for visiting (business, personal, voluntourism, even nefarious activities), your visit left their country better off financially.

    The same can not be said for most crossing the borders into our country. That doesn't mean that we should refuse entry to all, but it does mean that we must be judicious in planning and pacing immigration so that we can absorb those who enter our country in a manner that betters their lives without overburdening our citizens and legal immigrants and visitors.

    You discuss the possibility of our citizens someday being financially disadvantaged and seeking refuge in other countries. I daresay that if/when Americans are perceived to be a financial detriment, your Central American welcome would be far less generous.

    I don't mean that as a slam on another nation. I fully understand there are necessary limitations in the care and protection of one's own citizens.

  • 1
    Tweety likes this.

    Quote from Tweety
    Other posters have disputed that 650 number. I mean seriously, if I heard that I would immediately "use an internet search engine" for some backup like I do with all outrageous claims.

    Thanks, Tweety. That is exactly what I did.

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  • 0

    Quote from libbyliberal
    Where did you hear that?
    171,109 people participated in the 2016 Iowa Democratic caucus. Some precincts ran out of ballots.
    I stand corrected. EACH of the major Democrat candidates managed to get approximately 700 votes in the Iowa Caucus. The actual total was 1406 votes statewide, with Martin O'Malley receiving 8, Bernie 697 and Hillary 701.

    The Democrat vote total fell short of the Republican last place finisher, Rick Santorum, who received 1783 votes.

    This information has been broadcast by local news outlets, but not to my knowledge, by national media. I find that curious.

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