MAISY, RN-ER 9,394 Views
Joined Mar 7, '07.
Posts: 1,115 (55% Liked)
Anything that allows someone to pass in comfort is a good thing....they wouldn't need comfort care if they weren't going to die.
Medications are not given to kill someone-I am not sure where you are working or how this has been presented to you but Morphine and other drips are used to reduce anxiety, allow better oxygenation and help with pain.
There is nothing more unconscionable to me than a family member that wants to wake mom/dad up......it's bad enough that the family is not educated and often doesn't understand, but to have a nurse question this makes me wonder...
It's called concierge medicine....we actually have physicians that charge a flat fee. Like 25K to 50K per year! This covers all visits and ensures that the physician treats them like gold!
Picked Martha Rogers for a presentation to teach for my graduate class....wanted to kill myself!
Actually, finding information (that is understandable and basic) is very difficult on this theorist. Fawcett has a book which breaks down all of the theorists and their framework(which is also very difficult to understand)
Rogers wanted nurses to obtain maximum education, and be able to use all of their skills and abilities in their careers. She was truly a visionary who used pure science (physics) as a basis for many of her theories. A major theme was Energy of self and the Universe.
The few things listed by any RN here doesn't even scratch the surface to understand and explain this theorist. She was before her time and her theories have spawned many others.
Good luck to the OP...
Since we really didn't have a lot of information-I will blame the nursing home.
The admission nurse documented family informed consent and refusal.
An automatic trigger should go off under these circumstances in which the nursing home must has a back up plan that involves: Case management, social worker, PT/OT and administration.
It's sad the patient fell, it's sadder it was due to the family's poor decision making, but saddest yet is that the facility did not respond enmasse to a safety refusal.
PS They probably blamed the nurse.
The OP states that their belief is that healthcare is not a human right.....
A nurse in her early 50's has been injured repeatedly during her career. One day she cannot more.....it is found that she multiple disc injuries which will not allow her to work in her field at the bedside any longer. This nurse has more than 20 years experience in Emergency medicine, but has a Diploma; therefore she is not "qualified" for any other nursing position.
She uses up her time, but can't come back to work.
She can't afford COBRA.
She isn't old enough for Medicare.
She's using a walker.
Is it a human right for her? The person that helped so many others......No one ever thinks of those stuck in the middle. There but for the Grace of GOD.....to those who think healthcare is not a right!
So many areas are cited when discussing healthcare for all; however I see only one. If GOD (or whatever name you use) provided man with the knowledge to heal. IT is our obligation share this knowledge with the masses, it is also our obligation to share the knowledge of prevention, maintenance, and end of life decision making with the masses.
We cannot and should not keep everyone alive. There are many things I do not agree with in the healthcare technology available (especially at end of life and long term vented patients) ; however providing quality services as a country is the bare minimum that the America I believe in should be doing.
I can't even believe this thread is still viable.....
It's been four years since I posted on this thread....
The reality is RUDENESS is not tied to poor people!
ENTITLEMENT seems to run rampant regardless of socioeconomic status!
And, most importantly....when a patient is in the hospital; IT'S NOT ABOUT YOU!
Georgetown's program is online learning; however involves set classroom time-you must be on the webcam and attend the class like all of the on-campus students.
Online learning is hard and in my school there are no papers or tests that can be submitted and subsequently passed without an in-depth understanding of the subject matter. My Adv Patho class was taught by an MD who in her spare time picked up PhD's in immunology and histology. To write any paper in this class I first had to understand by reading tons of information when I was attempting to support a thesis. I say learning is about the faculty, this professor knew everything and had no problem questioning you to death to make sure you did too! Our online discussions were brutal and I cringed when I saw those new to the program as they were not prepared for the type of responses required or expected.
All in all, nursing needs to police itself and its education. To be honest, I am tired of defending myself and my education. When I had no degree I was running technical departments and in charge of million dollar budgets that affected 100s of people and was treated with respect.....I have a BSN and am working on my MSN and feel that people look down on me because I am a nurse.....what is that all about? I am sick of reminding nurses, doctors and having to educate patients that after the 2 minute doctor visit in the hospital-ONLY THE NURSE IS AVAILABLE TO CARE, MONITOR, AND INTERVENE....NO ONE ELSE!!!!!!
Until nurses begin to push publicly their concerns, work realities, what we really do, and how we are treated.....it won't matter what school you go to.....in many people's eyes you are still "just a nurse'...under those circumstances you will never be part of the team or true collaborator(no matter what they say).
In case there are PAs or medical students perusing this site, I will also add that working in a teaching hospital truly opens your eyes to the standards (or lack thereof) by which all are oriented, precepted, or learn. As a nurse in a critical care area we are always urging our residents to "do the right thing" and use "critical thinking". I cannot speak for other disciplines in nursing, but know how to interpret rhythms, labs, and symptoms......so while the intensive learning process is much more than an NP receives....."I am not trying to be a medical doctor, and have no interest in being more than a resource that is sorely needed by the general population." There are many medical doctors today thankful for all of our interventions that assisted, prevented complications or just gave them food for thought. Where are these doctors now? (I would guess that would be all of them)
I don't want your million dollar home, or porsche(whatever)....I just believe people deserve to have someone to depend on and guide them.....Let's face it, a doctor's visit these days is a 5 minute encounter. Give me a NP any day and I will actually have an exam!
Physicians should be grateful, Advance Practice Nurses do not endanger their licenses.....and anyway, everyone wants to be a specialist ....don't they?
Finally, I will leave you some food for thought.......regardless of level of education, nurses are considered the "last line of defense"......it is our responsibility to make sure the patient's meds are correct, withheld if vitals are off, etc.......If I am "responsible" for the doctor's administration errors regardless of the reason and held accountable.....somehow I think, I will probably be more thoughtful when administering Rx, and choosing to refer to specialists because the patient needs it (not because they are a partner)....just saying.
Look for an internship or externship at your local hospitals NOW!!!! Although you will be graduating, this may give you an edge as this is usually 3mos of paid training (not at an RN rate). Normally, this is something you could've done during your summer breaks; it gives you the edge of networking, real work but being precepted during that time.
All students should be doing this if their job market is poor....you need something to distinguish you from others when starting a new profession. Good luck to you.
I know you are in school and they are still preaching about the nursing shortage, but it does not exist in NJ! I know of nurses who can't find work who are experienced much less all of the new graduates who are leaving colleges every semester in search of their "first" nursing job.
In this area, not only are the nurses rushing to complete their BSN (if they already haven't) but they are well into their Graduate Programs for MSN or already have completed MS in Health or some other quick graduate degree. We are stockpiled with BSN nurses. God help anyone who continues to apply for LPN, Diploma, or ASN programs-they can't even get jobs in LTC!
If you'd like some other reasons why a nursing shortage may occur besides the aging RN population, some of these come to mind. Staffing ratios are increasing with nurses dangerously overloaded to the point of breaking or injury. Stress to perform to unrealistic expectations that "we" the public has put on institutions through Hcaps and Press Ganey does not make the job feel "worth it" and at least in the ER makes us truly dislike a lot of patients because of their demands. The Government's pay for performance will create an increasing expectation by management WHICH WILL DEFINITELY cause punitive action to be part of the RN's daily activities (yet non-payment is dependent on care, care is dependent on staffing). Management's failure to realize that while extra staff may initially cost more, prevention of the fall or sentinal event that may occur (and lawsuit) is far less costly.
As you see all of the above is how RN's are undervalued, over-utilized, and beaten until there is no more fight in them or they are physically/mentally damaged beyond compare. This may cause a nursing shortage because no one wants to feel they wasted their time on an education to be dumped on.....that is definitely a reason why nurses are switching careers.
" I wonder if this is something that will change with more prestigious and recognizable schools like Georgetown starting to churn out outline grads?"
As someone who has taken graduate level classes at a private college, I can say without a doubt my classes have been some of the hardest I have ever encountered during this past year. All of my professors are either MDs, PhDs or a mixture of both! I have considered switching from local college program to Georgetown just because of the "name" and the fact that they will take my credits previously earned. Truthfully, clinical placements matter and should be the basis for evaluating an NP and their training. Another factor which has is never accounted for is that most nurses have been nurses for awhile. I am an ER nurse, am able to work independently, identify illness quickly and have the critical thinking skills necessary to see "sick" as opposed to "not sick". Perhaps NP programs should require "5" years of nursing experience as opposed to just one based on the lack of clinical experiences and sites provided that match PA schools......perhaps, entry requirements should be stricter and apply to everyone. Perhaps, Nursing should just get it together!
Another factor to be considered should be the school rankings. My ASN was obtained from a top community college whose initial entry of 144 students during my initial year, ended with 52 graduating (some of those 1 time repeaters who did not start with me). My BSN was in an onsite/hybrid program whose graduation rate again was <50% and whose standards were sky high. My current graduate program is at this same institution and had a requirement of 3.5 GPA or higher in addition to the standard requirements.
I don't believe in the C=RN, I don't believe in good enough. The patient deserves nurses of a higher quality who put in the effort required to be good at their jobs, part of this is performing well through "hands on", the "written word", and ability to "find the answer" and to know when the answer is you cannot fix the problem and the patient must be referred. (A problem with many GP's too!)
Online schools aren't the problem.....lack of standards throughout the system that makes graduating from them is!
Also work on a non-smoking campus; have smoked in my life-but was always cognizant of others and did not smoke around non-smokers. Glad I haven't smoked for a very looooooong time.
That being said.....
Smoking and so many other things are bad.....
Discrimination exists and goes on behind closed doors and blatantly......people hire people; therefore they hire what is comfortable for them or what they "value" in an employee.
Everyone's outside is on display: fat, ugly, short, tall, tattooed, pierced, ethnic, whatever......I can guarentee anyone who is less than average in someone's view will not get the job. We've all heard it "appearances are everything!" While this is subjective crap, people are hired on it; not their qualifications. How many have seen articles in which salary is tied with height, age, looks.....what do any of these things have to do with getting the job done? Apparently a lot, because we Americans tend to value these things; therefore we make these people the more successful ones!
As for smoking, bad for you....bad for those around you.....stinks....causes health problems.....not necessary to life. Raises insurance rates.....employer's market, employer rules.
We currently have all kinds of programs for wellness, know your numbers, etc etc....waiting for the other shoe to drop and make it mandatory. Then, all of the nurses who are so stressed and take bp meds, antidepressants, anxiety meds, muscle relaxants, heart meds for inevitable SVT (ER) know a bunch......will all be looking for new jobs. Then we'll have medically induced ageism whose medical symptoms are probably entirely contributable to their jobs!
Write him up, but don't you think blood vitals are your responsibility?
Ancillary staff answer to you....plain and simple. Write him up as many times as it takes; refuse him as your staff member; report him to patient safety or risk management.
That attitude, behavior and his actions are dangerous in any unit much less a critical care area.
Sorry, there is no rehabilitation for this one....he's got to go! His attitude will not change and he will bring everyone else down. Management's tune will change with continued complaints.....just stick to your guns.
I'd like to believe it was just who they know, but it's obvious when I look at the new hires in my ER and they are all young with BSN's to boot!
If you have a younger person, they are still so unsure of themselves: they don't question authority, they don't fight back, they are molded the way management wants, they have no other life to compare nursing to, and the lists go on......
Despite what the nursing profession says about nursing; the truth is that it is just easier to have people shake their heads yes and either make it or not......then, have opinions based on experience, voice those opinions, formulate other options, etc, etc......
Employer's market, they will do what they want......this is the time to hone one's skills and bide your time for the "wheel to turn again"
I will give the difference between my older self interviewing someone and our NM 20's-my questions who are you, why do you want to be here, what kind of experience clinical and people---HERS do you call out sick, how much energy do you have, do you have a problem with OT?
See any differences? BTW, my hires stick....just saying.
To the OP, you will find something....you have to be persistant with recruiters....the expectation that because you are the best qualified they will call is not how nursing apparently works....in this case, the squeaky wheel gets job.
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