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klone, MSN, RN 71,966 Views

Joined Apr 2, '03 - from 'Oregon'. klone is a L&D. She has '10+' year(s) of experience and specializes in 'Women's Health/OB Leadership'. Posts: 11,248 (55% Liked) Likes: 27,214

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  • Mar 27

    Well, now she might (know the real Paco USA was standing right behind her)

  • Mar 24

    Nursing informatics and missing education programs are becoming more common as well.

  • Mar 22

    "There was one incident where I forgot to chart a narcotic. "

    In some facilities, not charting narcotic administration will get you walked out the door. You cannot blame the system that "where it's easy to pull a narcotic on the wrong patient and administer it to a different patient. " We are professionals that work with the system we have.
    It was not a weird meeting, you are now on administration's radar for narcotic errors.
    Find out what you need to do to work with the system, and prevent another narc error.

    One more could cause you a lot of grief.

  • Mar 15

    This is Master's level work?

  • Mar 14

    An ER nurse has a rough day at work. When she gets home she vents on Facebook about her exhausting shift, about the drug addict that staggered in, about the drunk that urinated on himself in the waiting area, and how irritable each of her patients were that day.

    Harmless, right? She didn’t mention any names. Didn’t post any pictures. And yet, a ‘friend’ of the nurse who was angry at her, decided to file a complaint with her state board of nursing alleging “unprofessional conduct.”

    Though this is a hypothetical situation, the end result is fairly common. If the nurse does not have her own professional liability insurance, she may not be able to afford a lawyer. And though she probably does not feel she did anything wrong, she could end up plea bargaining with the board and taking a year of probation. Probation appears on your record and can have adverse effects when you apply for a job.

    What to Avoid When Posting
    Many of us use social media daily to share our lives with friends, colleagues and family. Unfortunately, there are associated risks, particularly for nurses, who are held to a high standard by their state boards. Two areas of risk include:

    • Unprofessional behavior. Examples include posting photos or comments about alcohol or drug use; profane, sexually explicit, or racially derogatory comments; negative comments about co-workers, and employers; or threatening or harassing comments.
    • Patient privacy and/or confidentiality. Breaches of patient privacy/confidentially can be intentional or inadvertent, with inappropriate postings including patient photos, negative comments about patients, or details that might identify patients.


    A Simple Tweet or Text can Result in a Licensing Complaint
    Violations of the above risks can result in a complaint being filed against your license with your state board of nursing. Complaints can be filed by virtually anyone, including friends, family, patients, patients’ family members, your employer, even your own spouse.

    Licensing complaints are more common than you think. There are almost 30 times more licensing complaints filed against nurses than malpractice lawsuits. Between 2010 and 2014, there were 3,357 malpractice suits filed against nurses and 96,659 licensing complaints.*

    Disciplinary actions by your state board can involve; no action, a simple reprimand, fine, continuing education, probation, suspension or permanent loss of licensure.

    10 Simple Do’s and Don’ts When Posting, Tweeting, Texting or Blogging
    By using caution, nurses can enjoy the benefits of social media without risking the loss of their license and their livelihood. The following tips can help keep your social media content in the clear:

    • Always maintain patient privacy and confidentiality.
    • Do not post patient photos or videos of patients or identify patients by name.
    • Do not refer to patients in a disparaging manner, even if patients are not identified.
    • Use caution when connecting with patients or former patients via social media.
    • Do not post inappropriate photos, negative comments about colleagues or employers.
    • Never discuss drug and alcohol use.
    • Use social media to post positive comments about your workplace and its staff.
    • Share educational information that may benefit others, such as safety notices and medical news.
    • It is permissible to refer doctors, specialists and healthcare practices.
    • Use social media to enhance the role of nursing in the community, among friends and the public.
    • Remember posting, tweeting, texting and blogging are not private communications and can be used against you in an investigation by your Board of Nursing


    Protect Yourself
    Social media is great way to connect with family and friends, but you need to be cautious. If a complaint is filed against your license for whatever reason, your state board of nursing will conduct its own investigation. That could include looking to see if you have a presence on social media. You might be investigated for one reason, and have your situation made worse by comments you made on Facebook, Twitter or in text message.

    Nursing professionals need to be aware that online postings are permanent and can negatively affect their license and ability to practice. Think twice before you post content that could be judged as “unprofessional.”

    About the Author
    Melanie Balestra, NP, Esq., owns her own law practice, the Law Offices of Melanie L. Balestra in Irvine, Calif. She also works as a pediatric nurse practitioner at the Laguna Beach Community Clinic in Laguna Beach, Calif. She can be reached at balestralaw@cox.net.​

    *National Practitioner Data Bank, Department of Health & Human Services, www.npdb.hrsa.gov, October 2016.

  • Mar 14

    The oddest such case I ever had to look into was a young woman who had her boyfriend taking close-up pictures with his cellphone, in a semi-private room, prior to surgery, of her clitoral hood piercing. The piercing had a diamond in it, and the patient was concerned someone in the hospital would steal it while she was in surgery or recovery, and wanted to document that it was there prior to surgery. One of the pictures allegedly included the front page of the local newspaper so as to document the date the photo was taken. The most valuable thing I took away from this incident was that if you Google 'clitoral hood piercing' to learn something about the subject, what is subsequently seen cannot be unseen.

  • Mar 13

    Quote from offlabel
    Can we just stop with the "birth rape" thing? It's a visceral, emotional hook phrase that isn't meant to improve care of women in labor at all. And it is so completely dismissive and invalidating of victims of actual sexual assault. It demeans women. Quit it.

    What is described above is medical malpractice, not some contrived pretense of "rape". When words are stolen to meet some bizarre agenda, they begin to lose their meaning and potency, and victims are further victimized. The physician responsible won't have any action at all against him/her if the complaint is "birth rape". But the agenda pushers will have had their platform. This is an issue of quality of care, not forcible, intentional degradation of a woman.
    What makes you think it's not "forcible, intentional degradation"? Who sez "the issue" must be one or the other and both can't be valid at the same time?

  • Mar 13

    Quote from klone
    Oh, I have so many things to say about this!! Don't have a ton of time right now, but wanted to mention that one of the things that HUGELY drew me to the hospital where I work now is that they have a comprehensive case management program for pregnant/new moms, which includes postpartum home visits within a day or two after hospital discharge for all women in the program (which is 90+% of all the women who deliver). What I would love to see is a program like this for ALL hospitals, in all communities. I would also like to see the postpartum home visits expanded to include another visit at a week, and/or two weeks.

    One of the things the nurses do, standard, at these visits, is a bilirubin check. They've caught SO many in-crisis breastfeeding pairs through this program, intervened early to help get breastfeeding onto a better path, and yes, even readmitted babies who required phototherapy.

    Wish I could give this post more than one like. I think for as advanced as the U.S. is in medicine we are really dropping the ball when it comes to perinatal/postnatal care. The Europeans do it so much better.

  • Mar 13

    Also, the BFHI only goes as far as the hospital. All of those readmissions say to me that moms are completely without support when they get home, from pediatricians, family members, spouses, and community resources. That is a huge problem, and not the fault of the BFHI.

  • Mar 13

    The issue is not with the BFHI, though; the BFHI steps are not that earth-shattering. The problem is when managers or admins or someone with an agenda misinterprets. The bit about rooming in? It says "allow mothers and infants to remain together 24 hours a day." Allow is the operative word. It doesn't say force, and unfortunately it gets taken that way. Nurseries get taken away completely and sore, exhausted mothers who can barely see straight are up for 48-72 hours straight caring for their babies.

    The part about giving infants no other food/drink except mother's milk unless medically indicated? Well, that doesn't mean you can never give it. If the baby is hungry or jaundiced above light level or dehydrated or losing too much weight or is hypoglycemic, that is a medical indication to feed them something. All the best reference texts, even the ones LCs have to study to pass LC boards, will say that rule #1 is feed the baby. Unfortunately - again - that has gotten twisted to mean that formula = poison and has no place in the hospital. Admittedly, it is 3rd best on the WHO preference list for maternal milk substitutions, behind pasteurized donor milk and then unpasteurized donor milk. But it is still considered an acceptable substitute and it can save lives. If I've got a newborn with a sugar of 25 who's already breastfed, God knows I'm not going to wait around for the pasteurized donor milk to thaw out before I feed that kid. I'll pop a bottle of formula and get him on his way.

    The whole point of the BFHI is to help mothers who want to breastfeed without undermining their efforts. It just means that hospitals can't do what used to be standard, which was take all the babies to the nursery all night and feed them formula...which definitely works against what we've plainly seen here can be a tenuous relationship, esp at first. It makes me sad that people hear baby-friendly and roll their eyes, because it doesn't have to be that way, but poor implementation and bad examples have made it that way.

  • Mar 13

    Agreeing with MMJ. Your employee is spouting off sour grapes and I doubt any amount of your well-intentioned interventions will change her vinegar into good vino.

    I don't think she's a bully, I think she's a saboteur. You'll need to stop her early.

    Definitely time for that heart to heart per MMJ. Check out her past personnel history file - there might be more to her in it. And proceed from there.

    Good luck to you.

  • Mar 13

    If truly 'everyone is afraid of her' then I would say a heart-to-heart, transparent, come to Jesus meeting with her is in order.

    She is a toxic employee, and letting her know her behavior is unacceptable and WHAT THE CONSEQUENCES ARE is critical. Unless you are clear and consistent- you lose. And the department loses. And your other employees lose.

    Get on her good side? That just enables the behavior and endorses it.

    Remember, you get more of what you put up with.

  • Mar 11

    We have all worked for such managers in our careers, if we have been at this very long. Fortunately, the worst offender I worked for, was actually tossed out on her ear after the staff UNIFIED and stopped her madness and documented everything she did. Then, the most articulate and cool-headed experienced staff approached the CNO and Chief of Staff with their written complaints, calmly----- and displayed why this manager was dangerous for unit morale and safety. She was fired the next week.

    So, you see, sometimes if you can get good people to join together, and NOT give in to the temptation to play the game, the good guys can and do win.

    If not, and it continues, you are in a toxic environment and have to ask yourself if it's worth it to stay; is it really worth your sanity, your happiness, and even your health.

    If the answer is no, and it has been for me in the past, then you make a brave move and get out. It may mean less pay, or different hours or a new specialty. But you do it. And you are happier again.

    Good luck.

  • Mar 10

    Quote from offlabel
    Maybe, but pushing against one that is too closed can create one.
    People all over the globe give birth without a single finger ever going in their vagina. I'm all for safe birth, but we both know the majority of cervical checks aren't done to 'save' women from pushing against a closed cervix.

    If you suspect a problem, that's one thing. But routinely? We do way too many cervical checks, and we damn sure don't need to be doing them without people's permission.

  • Mar 10

    Quote from eatenbylocusts
    This is about immunity and a response to someone else's post. If I stated something untrue, please point it out. Please don't make assumptions and try to shut me down because you don't like something I've written. We are responsible for educating patients so absolute statements like the one I was responding to hits a nerve with me.
    First of all, you don't know what I like or don't like because I didn't address that. Vaccination arguments are off topic in a thread about the issue of breast feeding and free choice, which is against TOS. Vaccination comments more than almost any others will totally derail a thread, and that's not really fair to the OP. That other person's post was off topic as well, but I never post til I've read everything, and yours was the last one. You're free to start a thread about immunity.


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