Content That Hygiene Queen Likes

Content That Hygiene Queen Likes

Hygiene Queen, RN (19,148 Views) Guide

Joined Sep 13, '07. Posts: 2,277 (72% Liked) Likes: 7,497

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  • 7:53 am

    While everybody is arguing over what can and cannot be done for her in the AL setting, the raging UTI continues.

    Waiting for her to go into septic shock?

  • 7:50 am

    Sounds like that nurse hasn't had to use critical thinking much in her lifetime. Advocating for your confused patient is not called diagnosing a UTI. It's called critical thinking and good nursing judgement. Get a new order to straight cath the woman to get urine. Is she being treated prophylactically? Get the urine and treat her before this turns into a septic UTI and she comes to my ED with septic shock and dies 2 days later.

  • Feb 9

    I think the general public knows very little accurate information about mental illness. And I think the media (at least in the US) perpetuates this.

  • Feb 9

    Quote from kalevra
    Healthcare is centered on the patient especially in terms of morbidity, mortality and patient satisfaction. Communication breakdown is a common area in the workplace that can result in a lot of conflict and breakdown. I can understand their want to standardize the report/hand-off process in order to make communication more efficient.

    EBP help guide nursing practice in a way to maximize the client experience in the healthcare setting. As a profession, it is important to work together an communicate our needs is an efficient manner so we can improve patient care throughout the healthcare continuum.
    Clearly, you are one of "them" . As a profession, we need to "communicate our needs" for better staffing ratios and less paperwork.

  • Feb 9

    Soap on a rope ....

    Pie plate tied to your waist with string ...

    Nothing they say is the truth ....


    Just the usual prison advice!

    Cheers

  • Feb 9

    Quote from ERnursebyday
    The grand daughter in the room who had just started nursing school says " I just finished ACLS and there only needs to be 3-4 people helping in a code".
    Answer: "Yes, and one should be the DOCTOR!"

  • Feb 9

    I hope I'm not bringing a super zombie thread back to life but I feel like I had to share and represent for some CNA-awkwardness.

    I met this super cute guy in CNA class. He was doing morning classes and I was doing evening, so we really only met because he had to retake one of his skills and we were partnered together. He was practicing finding radial pulse because we had nothing else to do. I thought he was SO cute that my heart was beating super fast, I got super sweaty, I was a mess. In an effort to calm myself down, I made myself much worse. I was trying to hold still and my wrist was twitching. He had to call over the teacher because he couldn't figure out what was a twitch and what to count as pulse. He ended up having to practice on someone else.

    Fast forward to our clinicals. I was feeling super confident and loving the residents. Cuteboy showed up. Apparently he had some scheduling issue and was doing clinicals with me. There was a resident who, if their call light was on, we were warned to bring backup in with us. (either student or CNA) I saw Cuteboy and said "Hey, do you want to go check roomwhatever with me?" I was so ready to prove to him that I wasn't a sweaty, twitchy mess 24/7. He said yes. I knocked and strutted in ahead of him...and immediately slipped on a HUGE BM and twisted my ankle/made a huuuuge mess.

    Fast forward a couple years later...we're engaged. (He's currently taking my 4 year old son bowling with his Grandma, super cute) So I guess the story has a nice end...but...UGH. I pretty much thought I was going to die every time I saw him.

  • Feb 8

    Personally, I wouldn't sweat about this issue.....

    Whenever a patient is being rude or pushing my buttons, I remove myself from the interaction. "Sir, this conversation is over. I'll be happy to return when you are ready to behave in an appropriate manner."

  • Feb 6

    Quote from b52RN
    People who are actually in need of care (hallucinations, delusions, suicidal, DSM diagnoses etc). You know, the ones who aren't trying to prolong their law enforcement notifications, stay out of jail, and get notes claiming they're bipolar so they can claim disability (and no, our doctors don't give it to them).
    Just so you know...some people who "get a note claiming they're bipolar so they can get disability", really are disabled to the point of needing it. And not all of us are malingerers.

  • Feb 5

    Some people post with the intention of receiving replies that coincide with exactly what they want to hear. When that doesn't happen, a few original posters have become defensive and dropped the "I wouldn't want you as my nurse" bomb.

    I do not take the defensiveness personally. I am simply grateful that my thought processes have evolved in the context that I am willing to be exposed to ideas from those who do not think like me. An online forum is not the hill I wish to die upon.

    On the other hand, some are seeking 'yes'-people, PollyAnna cheerleaders, and head-bobbers to tell them only what they want to hear and nothing more.

  • Feb 5

    I agree with OP in that over the last few years the nursing profession has become more of a liability than ever. Yes it has always been a liability, heck just walking out of your house everyday is a liability, but it has gotten so much WORSE! Let me give you an example.

    In 2010 I moved to OK from NY because finding a job with only an ADN in NY is virtually impossible. I started working for a Level 4 trauma center in a relatively rural area. I was a jack of all trades at this hospital and worked in every department, I gained a lot of valuable experience and was very close to my coworkers. In 2014, the hospital couldn't stay afloat so they sold out to a "for-profit" corporation (we WERE a not-for-profit facility). We saw things change for the worse immediately. We lost 3 of our best Hospitalists because their contracts were up and the corporation was trying to lowball them. They quit and were replaced by some of the scariest doctors on the planet, I wouldn't want these doctors taking care of my plant let alone my family member, but they were willing to work for far less money so the fact that they are incompetent isn't an issue to the corporation. They froze our wages, denied us raises, took away our PTO, did away with pensions, and switched our health insurance to a plan with a $6000 deductible. This caused 90% of our well seasoned veteran nurses to quit and go elsewhere as well. And once again the corporation was probably ecstatic because the nurses who left were making top rate ($35 an hour) so now they could go out and hire new grads as replacements for these veteran nurses, and they only have to pay them $18 an hour! They are making money hand over fist! Next thing they did was tell us "no more overtime!". If we didn't have enough nurses to staff a department, we could call somebody in, as long as it didn't put that person over 80 hours. If you couldn't find a nurse to work that wouldn't put them into overtime, then we had to suck it up and split the extra assignment as best we could.

    Do you not see the potential for disaster here? It's clear as day. You have doctors who got their licenses from a cracker jack box giving orders to new grad nurses who aren't ready to even be on their own yet, taking double and triple assignments that would challenge most of us veteran nurses! And you don't see the liability? Please tell me you're joking. Needless to say, I don't work at this facility anymore. I've worked at 3 different places since I left and it isn't any different anywhere else. The dollar is the bottom line, it's the only thing these corporations care about! But let me tell you what the nail in the coffin was for this particular job. We were short staffed in ICU so everybody had to take a triple assignment. The nurses I was working with had been nurses for less than a year. One of my patients was septic so I was running around crazy trying to stabilize her. One of my other patients was from a nursing home and she had a history of severe COPD and had a trach. She would come in every couple of months and get admitted to ICU for pneumonia, and we always had to put her on the vent. This night she was extremely confused and kept pulling the vent off of her trach, as I'm chasing the other patients' blood pressure, and I had another patient on top of this. Next thing I know I hear one of the nurses scream for me to go into the room of the lady who had the trach. Of course the vent was alarming (again), but when I got into the room the patient was on the floor. She was 100% bedridden and hadn't walked in YEARS! She couldn't even move her legs! AND I had all 4 siderails up! *****?? Anyways, I noticed she was extremely tender in the right hip area. I called the Hospitalist and he came to see her and ordered an x-ray of the hip and a ct scan of the same hip. And because she's an ICU patient guess who had to go to radiology with her? That's right! Me! I hope you haven't forgotten about the other 2 patients I had yet. Anyways, CT scan of the hip was clear. X-ray of the hip was clear. But I noticed something odd in the lower left corner of the hip X-ray. It looked like bone fragments. The radiology tech said "holy crap you're right, let's X-ray her femur." We x-rayed the femur despite that fact that the doctor didn't order one, and sure enough she had a spiral fracture of the femur. We called the Hospitalist and told him to look at the films because she has a fracture. He said "I don't see any fracture." We were like SERIOUSLY???? Then we realized he had only looked at the films of the hip, so we told him to look at the one of the femur. He agreed it was a fracture and told us to consult ortho. The supervisor advised him that ortho was out of town and wasn't going to be back for a week, so we needed to transfer her out. The Hospitalist actually started arguing with the HS about ortho being out of town. Meanwhile, the pt's color is getting white as chalk, and I couldn't get a pedal pulse by Doppler on that foot. We kept calling him back because the patient's condition was worsening! He got sick of us calling him so at 3 am he called the house supervisor to tell her he was signing off on the pt. We were all in utter disbelief. What do we do now? Bring her husband in and have him sign her out AMA and then bring her to the ER? Do we let her sit there until day shift comes and let them deal with it? Maybe we can call her primary physician and give him a run down of what's happening and he can get her transferred. Those were our options. We decided that signing her out and bringing her back in through the ER would not look good at all for the hospital. And the pt wasn't going to make it another 6 hours for day shift to come in. We called her primary doctor (at 3 am) and thankfully he got her transferred and they were able to save her leg.

    Next time I worked I got called into the office. The Hospitalist went to my manager and defamed me in every way possible. He said I didn't "show enough compassion" towards the patient, I was "out of my scope" for doing an X-ray without an order, etc. I plead my case, but needless to say, I was fired. And that is a firsthand account of how much these corporations, hospitals, doctors, managers care about these patients. They tried to go after my nursing license but the board found "no evidence of misconduct". I framed the letter from the BON and hung it on my wall. Time for a career change? Yeah probably. Things are just completely out of control.

  • Feb 3

    Many, many meetings and many, many care plans lol. And you are right...she continues with her manipulations at the new facility. Her PCP told me that she was telling all of the nursing staff in the new facility that she had no earthly idea why we transferred her there. The PCP spoke with the new administrator that very instant and advised that they would no longer treat this patient. It is sad because the facility that she went to is not as "concerned" with providing optimum quality care so she will be able to do as she pleases and most likely will decline to the point where she will never be able to go back home or even to the point of death. I was more concerned with my own thoughts and feelings regarding this patient. Not so much the legal ramifications as my supervisors removed me from the responsibility of searches. I documented everything I said and did with this resident. And I never searched her room without her being in it (gaining her permission first) and a witness being with me. I did manage to work out my stress and also alleviate my feelings of guilt. I just needed to stop trying to be superhuman! I am an excellent nurse and I will always go above and beyond to help those in my care whether they work with me or not.

  • Feb 2

    Quote from LupieNurse
    One of the day medication aides is starting to literally micromanage everything I do and it's driving me insane. I'm so over worked and spread thin. im the only nurse in charge of 50 pt with no medication aide. So yes I may leave a darn medication rapper in the cart because I forgot to put it in the shredder. Or maybe I didn't date the applesauce that I just opened. Well now she's writing emails to the boss lady. I'm just fed up. Getting very depressed and frustrated here. I own up to my mistakes but I keep making them cause they don't staff me adequately. I think I've had it.
    "Medication rapper" is putting quite a funny image in my head. I would probably just look at her and say, "Oh no!" every time she said something petty, but then harassing petty people is fun for me.

  • Feb 2

    Quote from hppygr8ful
    I agree - and most times if I can go into a room somewhat prepared it's easier. I had a patient fire me last night. He actually told me to take my things and go home. On my break I went by the DON's office and jokingly told her I was going home because I had been fired by a patient. She laughed because he had apparently fired several people that day. This particular patient has a form of dementia (not Alzheimer's) and a quirky sense of humor. I cared for him for the rest of the night without incident.

    Hppy
    This happens to me with one of my residents, she fires me all the time when I try to change her dressings. Before sun downing, she loves me, wants me to be her adopted daughter or marry her son, and then a few hours later she yells at me and fires me. She's honestly one of my favorites [emoji4]

    When I gave report to a new CNA about her, I said, "she has dementia and her mood changes at night. Don't take it personally and call me if you need help with her." To the point.

  • Feb 2

    Quote from VivaLasViejas
    I love my Ultrascope. I had a Littman that I couldn't hear much of anything with, then I borrowed a friend's Ultrascope and it was amazing! I bought one with a holographic head and purple tubing, and nobody dared walk off with it because it was the only one of its kind among the nurses.
    I also have the exact Same design on my ultra scope....excellent taste
    I liked littman, I hear no different with ultra scopes. I've had two littmans stolen and one eaten by a dog. They were all master cardiology 3s with my name enscribed.
    my dog hasn't eaten my ultrascope....and neither have the physicians so obviously it deters dogs and docs.


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