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Valerie Salva 10,355 Views

Joined Dec 3, '07. Posts: 2,369 (59% Liked) Likes: 4,411

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  • Feb 20 '10

    if you are going to north carolina near new bern there in no amount of money you could be paid to put up with the dangerous situation going on here. it is most likely the same all over the FMC planet. they have cut staff, cut travelers even when they need staff and in one clinic where there was a unknown death, ie: the staff was too overloaded to hear the alarm and a patient died and was found then wheeled into the water room until the paramedics came. there was no attempt to revive because it was too late. the right amount of staff could have saved the life

  • Feb 20 '10

    yes, everything really is the nurse's fault -- there's a whole thread about that. how could you have missed it? really, you should be more up-to-date and astute in your allnurses.com reading.

    ok, i'm joking. really, though, everything is the nurse's fault. or so "they" would have you believe. dietary sent up the wrong tray, it's the nurse's fault. unit secretary didn't answer the phone until it had run 6 times, tell the nurse. the patient wants a drink of water and the tech is standing right outside the room, you should still walk all the way down the hall to where the nurse is doing a sterile dressing change to complain that the patient hasn't gotten her drink of water that she requested four minutes ago.

    and if the cardiologist doesn't like the orders the pulmonologist wrote, it's the nurse's fault. after all, you should have told the pulmonologist what the cardiologist wanted. if the id fellow doesn't like the orders written by the endocrinologist, that's the nurse's fault and if the renal consult hasn't rounded by the time the attending comes in, blame the nurse.

    tell them to work it out like adults, and document, document document. then sit back and laugh because if you work in a teaching hospital, it's the resident's fault.

  • Feb 20 '10

    Quote from jerrylundergard
    thats the crazy part, the cardiologist told me about the lab value and then told me it was my duty to notify the attending to have the attending rectify the sodium. all this instead of the cardiologist just writing some kind of order to deal with it.

    so there was no need to document that the cardiologist was aware cause he was the one complaining to everyone that he told me yesterday and that i didnt have the attending do something!

    when the charge nurse called me this morning she said she didnt see anything in my nursing notes about documenting my call to the attending. i did forget to include a nurse note about the fone call. however, i told her i did call the attending and passed on the info to the night nurse but recieved no call back from attending. this, even though the attending came in and didnt write any orders concerning sodium yesterday and would of presumably looked at lab values. he did order further labs for the following day! i guess i have to document better.
    i am going to disagree with this! you still, imo, should have documented the conversation with the cardiologist. just because he was complaining doesn't mean there was a record of his complaining, or that he noted the lab, and didn't take it upon himself to correct it. if the attending were to approach the cardiologist and ask why he didn't write orders addressing the sodium, the cardiologist could very well turn around and say he didn't know. you just never know what they're going to do, so it needs to be documented, just like your call to the attending. since the lab wasn't considered a critical value, my note would have read something like, attending md (using names, of course) paged per request of cardiologist re: sodium level, no return call received. cardiologist aware of sodium of 149, no orders received. next shift made aware of attempt to inform attending md, etc etc. along those lines. covers all of the events in a quick, concise manner and more importantly, covers you, since it was obviously a sticking point with this arse of a cardiologist.

    i hate when physicians blame the nurse for what other doctors do or don't do. if they have a problem with how someone else manages (or doesn't manage) a patient, they can easily pick up a dang phone and call them themselves, and have a discussion! argh...big babies, they are!

  • Feb 20 '10

    You didn't do anything wrong. The doc was just a jerk. He needed someone to kick around for no reason, and you were handy. Just document any time a physician is paged so you can tell your charge to quit humoring this idiot.

    Q: What's black, 18 inches long, and hangs in front of an a$$hole?
    A: A stethoscope on a cardiologist.

  • Feb 20 '10

    The documentation was the first thing I thought of when I read your OP. I have learned that when I have a conversation with a doctor, I will document what info I gave him/her and what response I got. Even if it seems minor. I write everything I told him/her. I used to think our doc's really backed us up, but that has changed alot in the last year. One nurse was brought before the BON for practicing medicine when she wrote an order the doc gave her as a verbal then denied having given the order. The nurse's documentation saved her.

    But on this instance of yours, I would blow it off as a learning experience. Relax.

  • Feb 20 '10

    One facility I worked in a couple years ago had a sex offender as a resident whose crime was molestation of female children...his own granddaughter being just one of his victims at the age of 6. He came to that facility from jail due to decline in health. He stayed in his room mostly and kept quiet. But one day a CNA came to me and told me I needed to come to the dining room NOW. When I got down there, I noticed he was trying to get a little girl that had come in to sing for church to sit in his lap. He was offering her candy. I immediately grabbed the little girl and carried her back to the church people and escorted him to his room. I immediately notified my DON and the administrator and had to chart a book on him. The whole situation made me very uncomfortable to say the very least.

    I think personally, that there should be some kind of LTC for inmates that are too frail to be in a jail's general population. I don't think inmates should be in a regular LTC....just my personal opinion.

    Blessings, Michelle

  • Feb 20 '10

    Quote from vivacious1healer
    Here is an example of what happens when sex offenders are admitted to a nursing home. Makes me shudder....

    http://www.chicagotribune.com/health...,7127371.story
    Thank you for this article. What stood out to me was the fact that often authorities cannot prosecute cases of rape because the victim, who may be suffering a cognitive impairment or mental illness, is unable or unwilling to proceed with the case.

    I also found it utterly shameful that one of the biggest causal factors of sexual violence between residents in LTC is a lack of sufficient staffing. But no----corporate has to keep its costs down and its revenues high---even if it's a non-profit facility.

    Don't people in LTC, either for rehab, mental illness or for the rest of their lives, deserve the BEST care we can give rather than the WORST?

  • Feb 20 '10

    In states that have civil commitments for sexual offenders, a person may hit the street free again up to seven years after their offense.

    At that time their age or disability status may qualify them for nursing home care.

    The medical facility (or housing for that matter) that is not doing due diligence in preventing these individuals from taking residence are subjecting their clients and employees to a credible risk.

    In most cases, court records and registers can be searched at no cost. Efforts that are free, versus litigation; its costs and publicity, make this a simple decision.

  • Feb 20 '10

    Here is an example of what happens when sex offenders are admitted to a nursing home. Makes me shudder....

    http://www.chicagotribune.com/health...,7127371.story

  • Feb 20 '10

    Well, coming from a hospital that has a black list (do not admit under ANY circumstance) I can't say that we won't do something like that. From what I understand, the black list contains names of patients who, in the past, has been documented to have sexually assaulted either staff or other patients on a previous admission to the psychiatric unit. These people can come into the hospital saying that they are actively suicidal and I've seen the psychiatrist throw them out. The exchange between patient and psychiatry:

    Patient: "If I walk out this door, I'm going to kill myself..."
    Doctor: "You're not getting admitted. Good bye."

  • Feb 20 '10

    Sounds like a good idea, but even more important to look closely into the background of the workers, judging from a lot of media publicity over the years. A CNA I once worked with recently got a nice sentence in the state pen for his underage girl preference. He was like that when I knew him. I guess the management, who knew about him, thought he wouldn't bother the LOL.

  • Feb 20 '10

    I'm single with no children, so I definitely prefer 12-hour shifts which enable me to have more days off during the week. The $26 hourly pay rate adds up to $52,000 per year for a person who works a full-time 40 hour work week, and just slightly less for someone who works 36 hours per week. Also, it looks as if you will have every weekend off if you select the 12-hour shift job at the SNF. It looks like a good deal on the surface.

    If you've got children, want to be with them during the evening hours, and don't mind coming to work 5 days per week, then the home care job might work out for you.

  • Feb 20 '10

    I had the unfortunate experience of working for HCA in a management capacity for a time and I could tell you horror stories about what I saw and had to put up with in order to get care for patients. Because they are a for profit organization their focus is $$$$$$$$$$$$$$$, period. They will do anything they can get away with to keep non paying patients out of their facilities and they do not care if they get fined or sued because "that is what we have lawyers for". It is the most unethical organization and I would never be a patient there or work there. I can't even start to describe to you the things that they tried to get me to make the nurses do that were in direct violation of the law in order to keep non paying patients out of the ER. And all the hoops we had to jump through to meet some standard of care because we were told it resulted in better outcomes for the patient when in actuality that was not true. The fact was that if we met the standard, the CEO got a bonus. I almost EXPLODED when I was told this.

    I believe that for profit hospitals should be against the law. No one should be making a profit off the backs of sick people.

  • Feb 20 '10

    In my experience, HCA facilities as a general rule are poor places to work.

    I do not know about that facility personally, but do mind your Ps and Qs while workng HCA, especially in Texas. Otherwise they may black ball you in GroupOne.

  • Feb 20 '10

    Sounds like someone knows "tricks" to being successful as a professional. Be quiet for 3 months? Don't offer suggestions? Having a hard time understanding how this makes a facility "a awesome" place to work. A better idea is to find a place where your contributions are respected, wherever that might be. This post could be titled "Mind your P's and Q's."


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