Content That getoverit Likes

Content That getoverit Likes

getoverit 4,404 Views

Joined Dec 30, '07. Posts: 435 (51% Liked) Likes: 768

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  • Dec 6 '11

    This is how I check for carotid pulses.

  • Nov 30 '11

    Quote from getoverit
    and flyingscot, I've also coded someone and ran into them a few days later in the grocery store holding a case of budweiser and carton of marlboros. nothing like getting a new lease on life!!
    The weird thing is we not only coded him but pronounced him after being assessed by multiple skilled medical practitioners and an US confirmation of no cardiac movement and we had stopped all care for a prolonged period of time. I was in and out of the room afterward cleaning up and whatnot and he was still dead. It wasn't until about 30 minutes later when I went in and noticed subtle changes like the tips of his ears were pink that I realized something had happened. I threw open the curtain and yelled out "Dr. N he's aliiiiiiiiiiiiiiiive!"

  • Nov 29 '11

    So many people get confused on ths one, I did before I started school. There is a major difference between ventilation and respiration. Respiration is the act of oxygen and carbon dioxide exchange. This is a physiological process that cannot be replicated by a ventilator. It is a physiological process that can't be replicated by a ventilator. So not matter how you look at it, it is NOT called a respirator. It has and will always be called a Ventilator. Sincerely, Your Respiratory Therapist. ;-)

  • Oct 4 '11

    "It's a little cumbesome" ? With all your alpha-bets you find it too cumbersome? Gale Darn! I have not been on here in awhile but things have not changed much... so let me spoon feed you the info and enable your slothful behavior. Try the largest air medical provider in the world and also try the organization that represents the profession. Or just search the threads here at allnurses.com, because this has been answered numerous times already.
    May we pack you a lunch? For crying out loud you should be looking for a pilot job with all this hand holding....

  • Jul 11 '11

    Quote from NSGstudent12
    I'm not a nurse yet but my biggest fear would be for someone to die bc of something i did or didn't do.
    I think that is every nurse's biggest fear. If it isn't, they are not in the right profession.

  • Jun 23 '11

    getoverit,

    It was not my intention in any way to find fault with you, your situation, or your opinion. I sincerely apologize for any ill will my post may have created. It seems that the written word somewhat failed me.

    Part of the point I was trying to make is that an economy that is circling the bowl and high unemployment rates CAN influence people's decision making. It's not just the nurses working in the trenches. Corporate interests see the harsh economy as an opportunity to make cuts to insure and possibly increase profits. The rah rah rah of shared sacrifice and doing more with less can certainly bring out the best in people. It is noble and springs forth from the heart of a caregiver. But, when to taken to extremes, it can be used to intentionally cultivate a culture of profit- driven hit and miss substandard care.

    There are many signs and symptoms that can indicate this sort of thing. Chronic short staffing, staffing without regard to acuity, and the cultivation of values shifting such as instructing staff to falsify records can be among those signs and symptoms. There's often a big picture that when pieced together and considered with current trends is not reassuring.

    The bottom line is that each person must decide for himself or herself what's right and what's wrong. Each person must decide what he or she can abide and what he or she is willing to live with.

    Those who would continue in nursing would be wise to take out a copy of their state's nurse practice act and review it--especially if they often find themselves in a chaotic work environment. A nurse can't work as a nurse without a license.

    Please consider your statement about how you'd be failing your family if you were fired for refusing an unsafe assignment. Fair enough. Suppose a nurse accepts the unsafe assignment and despite the nurse's best efforts, there is a breach in the standard of care and a patient is harmed. The nurse has failed the patient. The nurse could very likely lose her license. The nurse without a license can not work and can not support her family and meet other responsibilities. If the environment is one of chronic short staffing, then it's quite possible it's just a matter of whether the nurse loses the current job NOW, or if the nurse eventually loses his/her license later and has NO prospects of getting a nursing job anywhere.

  • Jun 23 '11

    Quote from getoverit
    Essentially the same scenario happened in our ICU tonight, obviously not resolved yet.
    The above poster mentioned that nurses must refuse to accept unsafe assignments. Our chief pulmonologist made the exact same suggestion. It sounds good in theory, but what about when nursing managment makes it clear they will fire you if you ever refuse to accept any assignment, regardless of the circumstances? that's the way it is here, and I don't work in a draconian system or anything like that...but I do see where nursing administration talks about patient safety and supporting nurses but in practice they do very little besides making posterboards.

    It is said that people demonstrate the ethics and moral values they think they can afford. This results in situational ethics. By situational ethics, I refer to a person participating in something they know to be wrong or unacceptable in one case where they would not participate in the same wrong or unacceptable thing in another case. For example, a nurse believes the patient to staff ratio is unsafe, but accepts the unsafe assignment because of fear of firing.

    There's enough that can go wrong without the consequences of situational ethics coming into play. Those who practice these situational ethics will find themselves stuck holding the bag when being so short staffed contributes to a horrible outcome. I have seen this time and time again. Before becoming a nurse, I worked as a medical malpractice investigator (defense work) for the state of Louisiana. I have seen nurses in deposition and in court confronted with the state nurse practice act that holds them responsible for accepting or refusing unsafe assignments. Those nurses certainly wish they had refused the unsafe assignment.

    Fear of firing should NOT figure into a person's decision making process. If that's the case then practicing situational ethics will result in all sorts of bad nursing care. If employers don't want to provide adequate materials or supplies or want nurses to cut corners, the nurse who fears being fired will do it. That nurse is trying to keep a job--NOT keeping the patient's safety and well-being a priority.

    When nurses or other employees allows themselves to be manipulated to do one small wrong thing, they make it harder on themselves to refuse to do bigger wrong things. Wrong things add up to catastrophes for patients. A nurse's fear of losing a job can cost patients their lives, limbs, livelihoods, or quality of life.

    At my first nursing job, I kept a copy of the state nurse practice act in my clipboard. The charge nurse was flabbergasted when I pulled out the nurse practice act and presented it to her when I refused an unsafe assignment. The other nurses were stunned to the point that they didn't speak up and volunteer to take on an unsafe assignment. All the nurses behaved as if they had never heard of the state law. The charge nurse called the nurse manager and they got busy and found staff to come help. I don't know if the nurses were called in or if they floated from another unit. That did not matter to me. My patients were safely provided care.

    An employer can fire an employee at any time over anything. For those with strong beliefs about what's right and what's wrong, it's better to be fired and unemployed and able to sleep at night knowing you did the right thing. I know it for a fact. I am living it. I was instructed by my employer to falsify a medical record, and I refused. I was fired. That was five months ago and I'm still unemployed because the economy is circling the bowl. Lest anyone think I'm living "high on the hog" on unemployment, I'm certainly not. I was denied the $247 per week unemployment benefits and I am appealing it.

    I have bills and responsibilities just like everyone else. I do not regret refusing to falsify records and I will not regret it. That wasn't my first rodeo. Long before I became a nurse, I worked in other fields. In those situations I faced the fall out and the consequences for doing the right thing. I paid the cost both financially and professionally, and it was worth it to me. Eventually my efforts resulted in changes that were a great benefit to many people. I have always slept well.

    I don't believe you can go wrong when you try to do the right thing and keep patient safety and well-being your priority. It may make you unpopular and it may cost you your job, but losing a job is not the end of the world. Losing a patient because you compromised care because of fear of losing a job could certainly result in the loss of your license and the end of your practice in the nursing world. Who wants to contend with that sort of regret?

  • Jun 22 '11

    Quote from getoverit
    Essentially the same scenario happened in our ICU tonight, obviously not resolved yet.

    It was interesting to read the different viewpoints of responsibility. What I see most often is the nursing administration gets involved and operates under the premise that "whoever is yelling loudest must be right". We think it's wise to learn as much as you can about the details involving a situation before you start hitting your knee with a hammer.

    The above poster mentioned that nurses must refuse to accept unsafe assignments. Our chief pulmonologist made the exact same suggestion. It sounds good in theory, but what about when nursing managment makes it clear they will fire you if you ever refuse to accept any assignment, regardless of the circumstances? that's the way it is here, and I don't work in a draconian system or anything like that...but I do see where nursing administration talks about patient safety and supporting nurses but in practice they do very little besides making posterboards.
    I've refused patient assignments before, when I was a travel nurse. Didn't get fired, even got renewed. That, of course, was long before the recession hit. Not so sure what would happen today.

    Fact is, our BON (w/e state you are in) can set w/e parameters it wants about when it's ok to refuse and when it is not, but its the business facilities who decide what the law is. If the institution wants to put its foot down, not much the BON can do about it, regardless of whether they agree or disagree with the institutions stance.

    Its one of those things, it'll keep happening (nurses getting fired for exercising their right to refuse) until some institution loses big in a lawsuit for it. Then, for awhile, they will be more mindful of it until the smoke has cleared, and they'll go back to their old ways then.

  • Jun 22 '11

    Quote from HannaJo
    My guess would be that it would be inaccurate due to the location the tip terminates but the Critcal Care MD said to use it anyway. Any feedback?

    Often times we will transduce whatever venous access they have even though it might not be a true CVP. We'll transduce to just look at the trend (not necessarily the number) to see if we are headed in the appropriate direction until we can get a definitive line placed.

  • Jun 13 '11

    do you believe reading, writing and math classes are a waste of time? just the tech stuff is good enough to make a well rounded professional? no need for understanding any of that research stuff which might provide for more implimentation of ebm instead of "the way we've always done it is good enough". no need to understand the health care system other than at a task level?

    *** um, you replied to my message and yet seem to have either not read it at all, or somehow leapt to a wildly inaccurate conclusion as to my views.

    yes even an intro the healthcare management can be very informative and you can then grumble about management and costs from a more informed perspective.

    *** "management" classes taught in bsn programs are a joke and a perfect example of the need to strengthen the bsn curriculum. i judge them to be a joke based on my experience taking them and comparing them to the management classes offered from the same university but in a different field. another indication that they are entirely inadequate is the very, very low level of professionalism among bsn prepared nurse manager i have experienced in the 16 or so years i have been a nurse, as compared to the level of professionalism i experienced from bachelor's degree educated management in my previous field.

    no room for growth except for a few more tech skills? checking off the tasks will suffice? if you go before any legislative body to petition for increased benefits, are you just going to carry a folder of ceus from one day courses given out for just being there to show how educated you are? don't let your attitude against education or the advancement of nursing as a profession

    *** again you have either failed to read my message at all, or chose to reach a wildly inaccurate conclusion completely unsupported by my statements. i wonder did you education include a reading comprehension course?

    prevent you from seeing any benefit from your college education.

    *** like a great many adn rns i already had a college education before i became an rn. being so educated allowed me to compare the rigor of my previous bs to that of the bsn. both were taken at the same university (university of wisconsin madison). the bsn is indeed full of fluff and lacking rigor.

  • Jun 13 '11

    Quote from getoverit
    Nice response. You've outdone yourself in proving your point.

    I don't know why you think I've insisted on you or anyone else taking note of my credentials. Really, why? I've never mentioned any certifications other than RN and CCEMT-P. and I've never suggested that anyone look at my profile. You have said that I don't know what I'm talking about, that sharing my personal experiences in trying to help the OP or anyone else who may read this thread is somehow wrong or for ulterior motives and that I may have been making things up about myself. Why would I care if anyone knows my certs? I sign my name, RN. that's it. Thanks for providing further evidence that you really don't understand what I'm writing.

    If you won't:
    "engage in a discussion that I am clearly not familiar with"
    then what have you been doing here?

    Why would I not be able to:
    "stand it when someone posts something and then uses a link to illustrate their source. You want people to believe only you and not the credible organizations or study sources?"
    I click on some links, even a few of yours. What has possibly been communicated here that would lead you to believe that I discredited any organizations/studies or ever insinuated that I was the only person who had a valid point?!? On the contrary, you've discredited numerous organizations, people, schools and studies in many threads...in fact, I would say in almost all of them. I've given you credit when it was due and acknowledged things I agreed with you about. You couldn't find one person who knows me that would agree with your statement above. Not one, either here or anywhere else.

    "If you are as important as you have stated, just post who you are and be done with it. "

    It's amazing that you, of all people, would write this. A perfect example of how you contradict yourself. It ranks high among the few things I appreciate about you. Sadly....you're not one of a kind. Since you admitted that you:
    "don't believe half the stuff posted here if there is not a credible link or source for their information provided..."
    then I'm sure you wouldn't believe my name without being a birther about it.

    One of the many things you've shown about yourself is that you need to get the last word, so have at it buddy. But if you want to continue this
    (psst...this is where you need to pay attention)....with me
    , then it'll have to be on my message board. I've asked you to contact me that way several times before and you have yet to take me up on it.
    you win.

  • Jun 13 '11

    Quote from getoverit
    Posted by trauma surfer:

    "It (sic) you have good information with links to the sources to post which will be of use, there is no need to put up a bunch of alphabet soup or brag about personal tales on an anonymous forum."

    Nobody has put up the alphabet soup or bragged about any personal tales on this thread.
    Are you able to answer my question?


    pretty funny to read the posts between you two.

  • Jun 1 '11

    Budget cuts that mean they had no training or gear(as stated in the article) for a rescue that was in a bay that is known for cold temps and swift currents. Rescuing a man that is comitting suicide is not the same as a rescue of a normal drowing victim.
    1.Without any gear, that is going to be difficult considering the body of water temps and currents. No floatation device and no rope to tie off is a very foolish thing to attempt.
    2.A man committing suicide is likely to want to take you down with him or fight you, more than an already difficult drowning type rescue. He is trying to die!
    3.The bystanders also saw a real the danger in this. It appears to be much more than wading out and retrieving him.
    4.I am (along with my Fire Dept engine co. of course) the boat crew for my city for the Mississippi area we cover. No gear, cold swift water, and a suicidal victim equals a likely tragedy for all involved.
    5.My experience from news articles\TV reporters that cover incidents I have been involved in, has been that they are very inacurate and tend to leave out important details that make for more drama. Thats as nice as I can put this. We are likely not hearing anything near the full story here.

  • Jun 1 '11

    As sad as the situation is, I can't blame the fire and police crews. The wader wanted to die, but the people on the shore did not. And if they didn't have the ability to safely rescue the wading man, then they did the right thing by staying where they were at. There would have been no sense in everyone jumping in and drowning with him.

  • May 31 '11

    What happens a LOT where I work is a pt comes in A&O and wishes to be a Do Not Intubate..but then their condition deteriorates and the family with the Doctors consent changes the patient to be a full code. Just recently this happened where I work, pt was Do Not Intubate but crashed one night and the Dr talked the family into intubating her, which only prolonged her life by 36hrs..pt was 89 yrs old.
    Another pt came in with a living will which stated she did not want intubated, tube feedings, blood or antibiotics. She ended up with the last 3.

    Why even HAVE a living will if family or Dr's can override them?? IMHO it ought to be a criminal offense.


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