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klone, MSN, RN 87,385 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: 11,741 (56% Liked) Likes: 29,113

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  • Oct 22

    Here is the question no one has ever been able to explain to me, if you don't believe in science then why are you a Nurse/healthcare professional? I realize scientific opinion can change, but vaccinations aren't one them. The flu vaccine alone has been used widespread for over 80 years. The smallpox vaccine has history back to 1000AD and over 200 years in western cultures. How can you legitimately practice effectively if you don't believe in science when it doesn't correlate with your predetermined opinions?. I guess this why we have to have so many policies and regulatory agencies to keep people in check that won't believe in science even it is to the detriment of their patients, family and public at large.

  • Oct 22

    1. Do the 2 year program.
    2. Stop being the unofficial class president and focus on your studies.
    3. During your year off, work as a CNA.
    4. Figure out why you failed and work to change so it doesn't happen again.

    Not necessarily in that order.

  • Oct 21

    It's very sad to hear people say a BSN is useless - you are missing the point of the higher education. While it may not actually do anything towards your day to day work it will help you to think more broadly about various issues. The BSN will train to do research and to draw conclusions; to make improvements in patient care (I focus only one one example). If you are completely satisfied with your limited nursing education, then do nothing. So many other disciplines are advancing their education why not nursing?

  • Oct 20

    Quote from wondern
    I called the nurses station and asked for more pain medicine. I could see the physician at the desk from our room with a look on his face like, Really? He hasn't got his pain med yet? which I understood more clearly shortly thereafter.
    Yeah, I've seen that look before. Right when the doc realizes he forgot to actually order the pain medicine and he's trying to cover it up by throwing the nurse under the bus.

    Not saying that's what happened in your case but I've seen it on more than one occasion in my three decades of nursing.

  • Oct 20

    Sometimes it takes a few min for the Med to get ordered in the computer system. Sounds like you heard the verbal order before the doc sat down to actually put in the computer order? Iv, labs, then sent to radiology? If that’s the case, I can see where she would go eat while he went to have a scan rather than waiting for him to get back from the radiology if the order had not shown up prior to him leaving for the scan. I don’t know the whole story, so I’m unable to say what I’d do in this specific case. I will say I’d give the pain med as soon as I could, but I would not delay a ct scan. I wouldn’t have said the part about taking a lunch or not getting one at all. 30 min doesn’t sound too unreasonable, especially if during this time he got an iv and had a ct scan.

  • Oct 20

    Wow, they got a lot done in 30 minutes.

    I hope your DH has healed and recovered.

    Here's what I do. When CT is ready for the patient super fast (like it sounds was the case), I ask my patient if they would like to take a quick trip to CT first, or if the pain is such that they'd rather get it under better control before going to CT. Sometimes it's very obvious which thing needs to happen first. Whenever possible I let the patient help decide. If your husband was uncomfortable and wanted pain meds for CT, I would've done it myself or asked whether a co-worker had a moment to help (though they're not just standing around, either).

    Here are a couple of matters that you may have misjudged:

    - The physician looked indignant and shocked because he has no clue that the orders that took him only 20 seconds to enter, represent about 20-30 minutes of nursing tasks. They can waltz back out to the desk and with a couple of "clicks" order an entire care set of multiple orders. Then they look shocked that it takes more than a few seconds/minutes to get it all done. So the physician's incredulity here is irrelevant.

    - The nurse flushed the new saline lock with saline, as is done with all saline lock insertions. Otherwise it would've clotted off. I'm pretty sure there was no intent to deceive.

    - Here's a scenario that may be very likely (well, it would be very likely if I was looking at your DH, a patient on blood thinners with an abdominal trauma and now swollen abdomen): I would know that a CT itself is quick, but CT results take time. I would be concerned about what could be a critical or surgical situation, and I would want those results as fast as possible. I would love it if the patient could tolerate the quick trip to CT and back, and then I could work hard on comfort and getting settled in when pt returns from CT. I wouldn't be one bit surprised if that was the goal. Then he realized he might actually be able to grab a bite to eat while your DH was out of the department.

    - Unless I'm misunderstanding, within 30+/- minutes, your DH was triaged, was evaluated by a physician, got a saline lock inserted and labs drawn and sent to lab, and he went to CT and came back, with results already pending. In almost any ED I've ever heard about in this country, that means the care of this abdominal pain case is moving right along at a faster than usual pace. Just the facts. Sounds like they decided to get to the bottom of this right quick.

    I would request that you extend grace. People are trying, they really are, I promise you. I don't know what to say except that we can't be everything to everyone all the time. It saddens me to think that no matter what choices we make, there's no guarantee that someone won't come along to say it was the wrong choice. Pain control is crucial and I would never pretend it isn't. Just the same, not everything can be done "at once."

  • Oct 19

    Quote from Wuzzie
    Nurses, teachers and school administrators are obligated reporters. With children and vulnerable adults we are required to notify the authorities of suspected abuse. It's a little stickier with adults that don't fall into the "vulnerable" category. If we suspect abuse we are required to assess the situation if possible and provide resources.
    I am well aware of the mandated reporting of suspected abuse of vulnerable populations as I am a school nurse and used to be an ER nurse. I've made "the call" many times. I don't remember reporting on adult, mentally/physically competent victims of abuse that came into the ER. Like you said, our protocol was to provide support and resources to those patients.

    So does a manager LEGALLY have to report if he/she suspects an employee is a victim of abuse or not? Or is the manager's role to provide resources and support?

  • Oct 19

    Quote from Been there,done that
    It was unprofessional of your manager to mention it. You are all grown up, your black eye is your business.

    Honestly, I don't understand your comment. While victims of abuse aren't the only people who attempt to hide their bruises, it is common behavior in abuse victims and an indication that might be what's going on. If you do encounter this, I think reaching out to that person is the decent thing to do, whether you happen to be in a managerial position or not. It's just something I would do from one human being to another. Do you think the manager and other coworkers should just keep on ignoring it, even if their colleague keeps showing up with new bruises and perhaps worse injuries? Domestic violence is a killer. I think we owe it to each other to try to help a fellow human being who might be living under threat.

    From some of the sports I practice, my forearms and shins are often black and blue. While people at work can't see my legs, my arms are quite visible. When I was new at work, many of my coworkers would ask me why I was bruised. I appreciated their concern and by now they know it's from sports and I don't get much comments. The occasional patient does however ask me about it.

    OP, I don't know how you got your bruise but I will echo the advice offered by previous posters. If you are in a abusive relationship/unsafe situation, please do seek help.

  • Oct 19

    I wonder if your supervisor was concerned that you are in a domestic violence situation. That might be why she offered EAP. That would be my first concern if I had an employee with bruising they attempted to cover up with no explanation for what happened.

    If you are comfortable telling your supervisor the truth how you got the bruise, I would do that. I'm sure she was just wanting to make sure you are safe, and to offer some assistance if you aren't safe.

  • Oct 19

    No, we are not "OB/GYNs without the doctor's title." Doctors generally subscribe to the medical model of care for pregnancy and childbirth, whereas midwives subscribe to the midwifery model of care:

    What is a Midwife? – Our Moment of Truth
    Philosophy of Care

    In a nutshell, you could say midwives are trained to view pregnancy and childbirth as essentially normal, but are also trained to pick up on and either treat or refer abnormal situations, and doctors are trained to view it as a pathological state that requires a lot of medical intervention. This is painting the issue with a broad brush, but that's the nuts and bolts. Some midwives are extremely medically-oriented and interventive, and some doctors are extremely progressive and practice more like the midwifery model of care, but those are the general differences between the two philosophies.

    Doctors are surgeons. They can perform cesarean sections, as well as all kinds of GYN surgeries. Midwives are not surgeons, although they may get additional training to be able to be the first assistant during cesarean sections.

    Doctors go through four years of med school, then four years of OB residency. Midwives have a bachelor's degree in either nursing or something else, and a master's degree in midwifery.

    Midwives also care for women throughout the lifespan, providing well-woman GYN care, contraceptive counseling, menopause management, and may have extra training to do things like colposcopy or prescribe medical abortions.

    Midwives work in private practices, solo practice, directly for hospitals, and in various types of clinics. 95% of midwives who do deliveries do so in hospitals, the other 5% work either in freestanding birth centers or doing home births.

    Note: all of the above refers to licensed certified nurse-midwives or certified midwives, NOT certified professional midwives, who are very different. The top link I listed describes the differences among midwives.

    Does that help?

  • Oct 18

    Contracts have to have consideration "something of value" from BOTH sides. What did they promise you, and did they live by it? Simply giving you a job usually doesn't qualify. And, an employer is required to make sure you are able to do your job. So, giving you the same orientation and training they give everyone, including those who don't sign contracts, usually wouldn't qualify either.

    Who signed the contract on the employers side? Was it a local recruiter? If so, it's likely the recruiter isn't someone who is authorized to sign into legal agreements on the behalf of HCA.

    In my opinion, many of these new grad contracts are designed to scare you into staying, and aren't binding.

  • Oct 18

    Quote from cleback
    I know. And yes. "Oh for heaven's sake!"--discourteous and unnecessary.
    Well at least I didn't tell the OP she didn't "know what she was talking about".

  • Oct 17

    Quote from DaveICURN
    Would it be wrong of me as a health care provider to encourage a Pt who may be experiencing Gender Dysphoria to speak with a counciler before serious life decision? At what point am I no longer allowed to express my logical reason for fear of hurting feelings?
    The law in question affects residents in SNF/LTC facilities who are mostly senior citizens. I would think that anyone aged 65 or older has made their "serious life decisions" long before coming to LTC

  • Oct 17

    Quote from missmollie
    I've had a similar issue, and you find that you respect the wishes of the family. I took the family into a conference room to discuss why they didn't want to tell her, how they were going to handle it when they did tell her, and if they need someone else to speak to concerning the decision. I coordinated time for the family to speak with a resident and had a chaplain available when they felt she was ready. I emphasized the need for that grieving process to begin, but ultimately it was their decision. I do my best and I don't lose sleep over patients, families, or their issues.
    It's not "ultimately their decision", your responsibility is to your patient and to abiding by basic ethical principles regarding advocating for your patient and their rights, not appease their family's request to intentionally deceive a patient about the fate of their spouse.

  • Oct 16

    Quote from Remimaco
    But unless you go to a large teaching hospital in a less conservative area, the chances of being a male nurse hired onto OB are slimmer.
    I also disagree. I'll say from my experience that the teaching hospitals ignored me and the community facilities jumped on me when I wanted to switch. I also had a director at the flagship teaching hospital in a major metro tell me they wouldn't hire guys because the physicians wouldn't like it. Had a nice meeting with their CNO, CEO, and VP of HR after that one. Mileage will always vary, but you are correct that if he has a thumbs up from a hiring
    Manager he should get the experience. Once you have that it's much harder to get weeded out during hiring because good, experienced L&D nurses are worth their weight in gold in some cities.