Content That Chaya Likes

Content That Chaya Likes

Chaya 6,488 Views

Joined Mar 5, '03 - from 'Bosstown metro area'. He has '15' year(s) of experience and specializes in 'Rehab, Med Surg, Home Care'. Posts: 1,116 (19% Liked) Likes: 474

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  • Jun 27

    Quote from NurseGirl525
    But why call CPS? What did the mother do wrong? She didn't have anyone to take her kids and was obviously seriously ill. If she had to be on fall and seizure precautions was it better to send her out in a car? If you are thinking legality issues, that's honestly a big time legality issue. Can you see my point?
    CPS isn't just for neglect. It's an emergent social worker that has greater resources than a hospital worker to locate kin and can assist in getting family to the child or child to family and secure temporary guardianship for non-immediate family until the parent recovers. It's not to file a complaint against the ill parent. It's to secure emergent social work services and safe placement.

  • Jun 26

    Quote from pugmom79
    Thank you. That's where I work. It helps to know that the ED community has been supporting us.
    My heart hurts for my colleagues.
    As an ally my heart hurts for the victims and families and friends
    As an American, my heart hurts for all of us.

  • Jun 25

    Hahah. I give my husband one of 2 things depending on my mood - a smartass answer or I start a super technical science answer and he gives up. [emoji23]

  • Jun 19

    When I was a young graduate, I remember I had a pediatric patient and his mom was deaf. She was trying to tell me that something was happening in the room of her son, but I was very frustrated because I was not able to understand her hand movements. I thought she was upset or angry with me. I went to the room and the IV pump alarm was flashing (the line has air). That was an awkward moment for me because I did not know how to understand deaf people. And that broke my heart.

    I've been a Registered Nurse for about 14 years. I have cared for many patients. Maybe I have forgotten some of them, others are still in my heart as they were the first time I met them.

    I remember this little baby. She weighed 5 pounds 7 ounces and was very tiny. She had Thrombocytopenia and received Garamycin for awhile in NICU. When she was 3 months, her mother was in shock when the audiologist told to her that her daughter was deaf. OMG! Nobody in the family was deaf so they were all scared about all the typical questions about her health and future.

    In that moment, I confirmed what I always had in my mind! I have to learn American Sign Language (ASL). What will happen if I have another deaf patient again? ASL it’s so important for the Health Professionals. So I decided to enroll in ASL course. I learned at a very fast pace how to sign my name, and the basic words I need to communicate. I am still practicing and learning, but I know more signs that I knew before.

    The mother of the little girl looked all over Puerto Rico to see what she could do to help her daughter. Not only pray for a miracle at nights, she looked for a specialist in Puerto Rico that might help her girl. Finally, she found an ENT who accepted her in order to perform the surgery for cochlear implant (a new procedure in the Island). She was one and a half years old... When I recently saw the pictures of that moment, two tears came from my eyes! The surgery took about three hours. Her mom was very anxious and worried. But the girl was so strong, stronger than the family. She was discharged from the hospital the next day and had her processor a few months later. The first time she could hear, she just cried. Her mom cried too!

    Since that time, I encouraged the nurses and other health professionals how important it is to know at least the basics of ASL. Being deaf in a speaking society is like being in another country where the people cannot understand you and speak another language. Even worse, because being deaf is a limitation that is not easily recognized until you speak to the person and the person does not answer you.

    Unfortunately more than 38,225,590 have hearing problems in United States. (1)
    And the question we have to ask as a nurse is…Do I know ASL?

    Once I took the ASL course, I learned another way of speech, another way to love, and another way to communication.

    • I not only can sign (I AM YOUR NURSE) I also can sign I LOVE YOU and (CAN I HELP YOU?)
    • I not only understand (THIS HURTS!) And (I HAVE HEADACHE!)
    • I also understand (MOM, I LOVE YOU) when my daughter was signing back to me.

    That little princess is my baby and now I know ASL because of her.

    Ten years later she speaks and hears almost perfect. She is an honor student, she speaks and also knows ASL. I am still learning that you do not have to wait until a family member has a situation to do something for others. Do it now!

  • Jun 19

    Quote from Mrs.in2015
    Of course I have replayed the situation over and over and each time I have a clever response that puts him in his place without getting me fired. But what would you have said/ done? He then questioned my credentials each time I reentered the room which is just down right disrespectful. Any advice for next time? (Other than get the dang iv on the first sticky lol)
    If he made the one remark, I would figure that a certain percentage of people are going to say things like that. Sometimes their outburst is about frustration with the hospital scene in it's entirety, and we're usually on the front lines when it boils over.

    Since he escalated in the form of questioning your credentials every time you walked in the room it would be time to have a neutral party come and talk to him.

  • Jun 19

    Scrubs n Sirens: "Break out the serious nurse voice!" Yes! I love that. It's a real thing. And when used with compassion, is very effective!!!

  • Jun 19

    I tell my unruly patients from the get go-- I will fight for you, I will bend over backwards for you, I will do everything in my power to help you. What I expect is respect back when I give it to you. I don't want deference, that's not what this is about. Nursing is a partnership entered into by the nurse and patient.

    Respect needs to flow both ways. But when my patients mistreat me or other staff members, I remind them of this partnership. Often in the ED we get overdoses, drunks, psychs, or patients who are non compliant with treatments and get sicker as a result.

    I am nice as pie at work. I'm a multiple award winning nurse because of this. But I will not tolerate rudeness and disrespect to any team member trying to help.

    I will break out the serious nurse voice when the patient becomes agitated and belligerent and inform them I am there to help them. I am not there to hurt them. I am not there to cater to them. I am there to help them heal and recover.

    I don't know where this idea that it is ok to treat healthcare workers so badly comes from. But anymore I stopped tolerating it. I won't raise my voice or degrade a patient. But they will get the riot act read to them. "If you want my help, which you obviously do if you came in to the ED today, I strongly advise you reconsider your tone and choice of language with me. I will not tolerate being cursed at, threatened, or insulted. I will not hesitate to contact security. Now, if you want to stop this now, take a second to recollect yourself, I'd be very happy to move forward with caring for you"

    Do no harm, but take no sh**. Seriously.

  • Jun 19

    I think until you have been a patient (and I mean a patient)you don't really know just how scared and frustrated a patient can be. I was very sick for almost 2 years and ultimately had 18 inches of my l removed during the hospitalization for my surgery I had to have several IV starts and my veins all crapped out and for some unholy reason the doctor would not consider a PICC. I had multiple nurses from all over the hospital try. I managed to take it with a sense of humor though. I had husband bring a big box of Hershey bars and I let it be known that the nurse that got the stick would get a candy bar.

    After all the things I've been through I seriously try not to let people rent space in my head - I don't stew over stuff like this because it's just not important.

    Hppy

  • Jun 19

    I usually stick to "it is not okay to speak to me that way," end the conversation, and get my charge if they seem like they want to complain to somebody. Our charge RNs back us up, while carrying a bit more authority than the bedside nurse seems to. Once my charge told a patient that he would have the unit manager speak to them in the morning, when pt was still complaining to him (pt was mad that I wouldn't give her sister toiletries and a hospital gown to sleep in.)

    As for the IV access/stat meds issue, i'd call the MD and say "hey, pt only has one PIV and is refusing a 2nd stick. Do you have a preferred order of administration for these 8 stat meds, or do you want to discuss placing a 2/3 lumen PICC? Or do you have any other thoughts?" (I know that's not the advice you were asking for, but included it because I'm sure it will come up again, for you or someone else reading)

  • Jun 19

    I get flustered when patients speak to me that way and I often need to take a deep breath before I speak or continue. I used to get really upset and leave the room but after working in critical care/trauma my perspective on these things changed. I would have families literally screaming in my face for no real reason. I came to realize that people/patients are usually not angry about whatever it is that they are yelling about (like your need to poke him a 2nd time, which isn't a big deal and the patient usually doesn't care). They are scared about being sick/hurt/in pain, do not like feeling vulnerable, and are taking it out on you because... well... you're right there. After letting them get it out of their system I would take a breath, put my stuff aside and ask them what's going on. Nine times out of ten they will unload a boatload of anxiety on you, but then will relax and allow you to continue (and then you become their favourite nurse). I've even gotten apologies after the fact. It's all good, it's a scary situation for a lot of people -- regardless of why they are there.

    And good on you for having such amazing IV skills! Not everyone has the accuracy you do.

  • Jun 12

    a lot of talk about this problem going on here WHAT IS THE ANSWER How many people have died because of all this BS from administration
    *** How can Nurses as a group address this issue to someone who can solve it and make the money grubbers see lives are in danger does money really make administration blind I HAVE A SOLUTION require all administration to be an RN in order to work in administration
    also require administration (who would be required to be an RN ) to do bedside 8 hours a month

  • Jun 12

    Quote from Pangea Reunited
    In some cases, I've seen families take home an elderly relative for unselfish reasons. One man, in particular, was very active but unsteady, confused, and had an impaired swallow. The family could have opted to put him in a nursing home, physically or chemically restrain him, place a G-tube and deny him the PO food and water he asked for. Instead, they took him home to live out what was left of his natural life.
    It's the kind of ending I would want for myself ...not sure about your family and the ventilator, though.
    I selected nursing home placement for my mom back in October. Exactly 6 months and 27 days later, (1 year and 28 days into my oh-so-loved regulatory position), I'm on family medical leave with no money, no freedom, no prospects for another placement for mom, but a STRONG possibility that I'll have to resign my position. You guessed it....mom got kicked out of the nursing home, bags first!! She's sitting over on the loveseat as I type this, just as happy as a lark.

    I agonized over placing her there, but when I arrived at acceptance, she gets tossed out because she won't stop fighting! A couple of years ago, I created a thread here called "When Do I Get To Cry". Well, the universe's answer to me was, "you don't". So, I'm trying to make the most out of an unavoidable situation. I was shocked that even memory care units would not take her, neither would behavioral health facilities. I can't even take her to area day programs while I work because of incontinence issues. After seeking facilities out-of-state near other family members (thinking she'd behave herself if they visited frequently), even those facilities said no.

    So, here I am. With only one day of freedom away from her in which I go to work a single 12-hour night shift in an effort to make ends meet.

    God has a way of working things out, though. My practically non-existent income while caring for my mother has made me exempt from repaying my student loans that came due 2 years ago. I'm very grateful for that, however, there is no price tag large enough to place on my personal freedom, forfeiture of retirement, health insurance, vacations, etc.

    But, every night that I tuck her in, (she has the best nurse in the world, ya know), I thank God that she had at least one child that could take care of her at home to avoid situations like the OP described; and that I'm sitting here watching her watch Matlock instead of humping up and down those halls, trying to be in 6 places at once. We're ok and I love her, the pit bull that she is.

  • Jun 12

    Quote from amoLucia
    jade - you said it all!!!! Like you, whenever I've seen the discharge/placement issue, usually, money is at the root.

    Families are reluctant to reveal any details about the pt's financials. A liquidation of assets and/or 'spend-down' will deplete any potential inheritance that families expect. And families have no real idea of the difficulties that they will face in trying to provide adequate care for their relative, or they just don't care. All they see is the MONEY slipping away.

    OP's family might have been experiencing denial or ignorance re discharge care options. Or they were trying to 'protect' the assets.

    I really think there may have been more to OP's post that was unknown re the pt's disch. Sad for the pt.
    Unless you are privy to the details of a patient/family's financial situation that likely only the person who does their taxes is, you are making a lot of assumptions. Trying to conserve financial assets is the action of a fiscally prudent, sensible person: I am sure you try to conserve your family's financial assets. Would you volunteer: "Here is a statement of all my family's assets; I am willing to liquidate the large assets because you have recommended nursing home placement and I will not even consider either alternative financial arrangements or the option of looking after my family member at home even if that would be in their best interest and/or is their preference because you are the expert and I should defer to your recommendation?" I'm sure you would want to reflect on the whole situation and determine how best to take care of your family member and their finances. In addition, if you are ever in the position of having the power of attorney for someone's finances, you will understand that managing a person's finances responsibly and prudently is an actual legal duty.

  • Jun 12

    Quote from amoLucia
    jade - you said it all!!!! Like you, whenever I've seen the discharge/placement issue, usually, money is at the root.

    Families are reluctant to reveal any details about the pt's financials. A liquidation of assets and/or 'spend-down' will deplete any potential inheritance that families expect. And families have no real idea of the difficulties that they will face in trying to provide adequate care for their relative, or they just don't care. All they see is the MONEY slipping away.

    OP's family might have been experiencing denial or ignorance re discharge care options. Or they were trying to 'protect' the assets.

    I wish there were a MANDATORY course in all nsg schools (right before graduation time) that would start to explain the "Intricacies of Financing Healthcare for Pts 101". Something that would only begin to start to explain application, eligibility & services, etc for the layman consumer. I believe it would open a lot of eyes and generate a better sense of fiscal responsibility for all.

    I really think there may have been more to OP's post that was unknown re the pt's disch. Sad for the pt.
    Or there may have been nothing sinister going on at all. Why are you so sure a nursing home would have been the best option for the patient? You almost sound as though you have a vested interest. Decent people do exist who actually want to take care of their family member/s in their own homes, especially when they know that their family member would want to remain in their own home. Health care professionals frequently let their prejudices blind them to the patient's family member/s often genuinely caring motivations, and this is very harmful for the patient/family. Of course nursing home fees have to be grappled with, unless one is wealthy. How would you like to be perceived as being abusive to a relative by someone who knows nothing about you or your family? Not everyone is trying to take advantage of their family member. The OP didn't provide enough information for us to determine that there is any kind of patient abuse happening; however you are very quick to assume the worst. I wish there was a mandatory course in nursing school 101 Dealing With Family Members: "Keep An Open Mind About Family Members Motivations Unless You Have Substantial Reasons To Believe They Are Acting Contrary To A Patient's Best Interest."

  • Jun 12

    I think you may be making some false assumptions about what would have been more beneficial for the patient. By far the best treatment for hospital acquired delirium to get the patient out of the hospital, preferably to a familiar environment such as home. When an 88 year old just keeps getting more confused and delirious with every additional day in the hospital, the worst thing you can do is keep them in the hospital because of the delirium. And while that's nice of you to offer the family to send them to a nursing home, I sort of doubt you were also offering to pay the $250 per day that would cost, and yet for all that money it wouldn't have reduced the patient's fall risk over being at home with family support, and certainly wouldn't have helped their delirium to resolve.

    I get the frustration in seeing bad things coming and then knowing those bad things actually happened, but sometimes all of the options carry a lot of risk.


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