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Joined Mar 14, '04 - from 'California, USA'. herring_RN is a retired registered nurse. She has '>40 years' year(s) of experience and specializes in 'Critical care, tele, Medical-Surgical'. Posts: 16,676 (72% Liked) Likes: 32,449

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  • Mar 21

    IIf I were being disciplines I would request representation by the union. You don't have to be a member. If all the staff nurses are represented and you didn't join they trill must provide you representation.
    Even for a verbal warning a nurse should be represented.

    If they are determined to terminate you the union representative can often help you fight for another chance ot negotiate voluntary resignation.
    Often when the errors are minor or exaggerated the nurse still doesn't want to stay. Being able to avoid a termination a the record can be the best outcome.

  • Mar 20

    IIf I were being disciplines I would request representation by the union. You don't have to be a member. If all the staff nurses are represented and you didn't join they trill must provide you representation.
    Even for a verbal warning a nurse should be represented.

    If they are determined to terminate you the union representative can often help you fight for another chance ot negotiate voluntary resignation.
    Often when the errors are minor or exaggerated the nurse still doesn't want to stay. Being able to avoid a termination a the record can be the best outcome.

  • Mar 19

    I have volunteered. It was very rewarding. In one day I saw more people with toothaches than in my entire previous life.
    The patients were so grateful.
    They have their own was of doing things as they have done in the years before so many antibiotic resistant infections.

    For your peace of mind bring what you want to clean your sphygmomanometer between patients. Most likely you will be doing basic screening, which they call triage, to determine whether a person is well enough to have dental work done.
    We found people with very high BP. They have their own standard procedure for that. The person is given a banana or other fruit and a bottle of water. Most had been up all night waiting, often in pain. Sometimes sitting and having a snack brings the BP down. If not the person will see a physician or NP for BP treatment. .

    Diabetes, cancer, and hypertension were diagnosed at the three I've worked.
    Commonly people with health insurance, including Medicare came to see a dentist because they had no dental insurance and no money to pay.
    Many had full time jobs, big families, and painful teeth.
    My son's mother-in law, a dental hygienist came with me the first time. The second two she came on a weekend with the dentist she works for. They are both proud of being able to help so many thankful people.

    Truly, if your patients don't appreciate you the RAM patients almost surely will.
    Volunteer - Remote Area Medical

  • Mar 19

    I have volunteered. It was very rewarding. In one day I saw more people with toothaches than in my entire previous life.
    The patients were so grateful.
    They have their own was of doing things as they have done in the years before so many antibiotic resistant infections.

    For your peace of mind bring what you want to clean your sphygmomanometer between patients. Most likely you will be doing basic screening, which they call triage, to determine whether a person is well enough to have dental work done.
    We found people with very high BP. They have their own standard procedure for that. The person is given a banana or other fruit and a bottle of water. Most had been up all night waiting, often in pain. Sometimes sitting and having a snack brings the BP down. If not the person will see a physician or NP for BP treatment. .

    Diabetes, cancer, and hypertension were diagnosed at the three I've worked.
    Commonly people with health insurance, including Medicare came to see a dentist because they had no dental insurance and no money to pay.
    Many had full time jobs, big families, and painful teeth.
    My son's mother-in law, a dental hygienist came with me the first time. The second two she came on a weekend with the dentist she works for. They are both proud of being able to help so many thankful people.

    Truly, if your patients don't appreciate you the RAM patients almost surely will.
    Volunteer - Remote Area Medical

  • Mar 19

    Quote from Desiree1816
    Hello fellow nurses I am in send I need to pick something to write about in regards to disparities in Healthcare.. I need to have some evidence in the paper but I need some help with a topic ?? I am very lost as to what to write about
    Try a search engine:
    disparities in healthcare articles - Google Scholar

    disparities in healthcare at DuckDuckGo

    disparities in health care - Yahoo Search Results

  • Mar 17

    Originally Posted by Tankweti

    To Futterwacken: I thought that was an excellent comment you made about facilities not being interested in new grads but being interested in overloading the nurses they have to unsafe levels. You have really hit the ball out of the park with that one. It is as if they are ignoring the ramifications of what they are doing in terms of safe staffing. And they are. All CEO's in health care are rolling the dice now, overloading nurses with very ill patients, and hoping that nothing bad happens, i.e. that no patient dies or that they get sued. Of course, if they do get sued, the overloaded nurse will bear the brunt of it.
    Quote from 8mpg
    or a brand new untrained nurse can be more detrimental than overloaded experienced one....
    New grads need adequate orientation with a preceptor and not assigned total responsibility for patients until his or her competency has been validated.
    The new grad is not "untrained". The new grad is an advanced beginner. (Benner)

  • Mar 6

    I wish the ANA had included a goal of advocating for mandatory nurse-to-patient ratios for hospital and long term care (SNF) settings.
    this is from the ANA, but not included in the Strategic Plan:

    State staffing laws tend to fall into one of three general approaches:

    • The first is to require hospitals to have a nurse driven staffing committee which create staffing plans that reflect the needs of the patient population and match the skills and experience of the staff.
    • The second approach is for legislators to mandate specific nurse to patient ratios in legislation or regulation.
    • A third approach is requiring facilities to disclose staffing levels to the public and /or a regulatory body.

    The American Nurses Association (ANA) supports a legislative model in which nurses are empowered to create staffing plans specific to each unit. This approach aides in establishing staffing levels that are flexible and account for changes; including intensity of patient's needs, the number of admissions, discharges and transfers during a shift, level of experience of nursing staff, layout of the unit, and availability of resources (ancillary staff, technology etc.). Establishing minimum upwardly adjustable staffing levels is statute may also aide the committee in achieving safe and appropriate staffing plans.
    Nurse Staffing
    The ANA risks losing members because they are not focusing in safe staffing, which saves lives and prevents nurse burnout:
    New York, NY — October 26, 2012 — Nurses have voted by 91% to move forward and disaffiliate from the American Nurses Association.
    The nurses, members of the New York State Nurses Association, say they will focus on fighting for working nurses and their patients.
    Their number one focus is passing a New York law that would mandate safe nurse-to-patient ratios in hospitals.
    New York nurses vote 91% to move forward and leave the American Nurses Association - News & Events - Massachusetts Nurses Association

  • Feb 24

    The Only Way to Fulfill the President's Pledge of More Coverage, Better Benefits, and Lower Costs
    The economic case for single-payer reform is compelling. Private insurers' overhead currently averages 12.4% versus 2.2% in traditional Medicare (2).
    Reducing overhead to Medicare's level would save approximately $220 billion this year (Table) (3).
    Single-payer reform could also sharply reduce billing and paperwork costs for physicians, hospitals, and other providers...
    Single-Payer Reform | Annals of Internal Medicine | American College of Physicians

  • Feb 14

    Quote from OrganizedChaos
    I just can't imagine a place where women can't have access to the healthcare they need. Having affordable healthcare access to things like birth control can prevent so many unintended pregnancies & help women with certain medical disorders.

    I am not fond of abortions but sometimes it is a better decision than women having children & those children being put in foster care or having to live in horrendous conditions. Would you really want the system clogged up with kids who weren't wanted? That costs so much more than an abortion. What about all the children that are born into abuse & the many that are killed? No child deserves that.
    I am pro-life yet some of my tax money pays for the death penalty.

  • Feb 14

    Quote from pmabraham
    Because being in a union offers ZERO guarantees of anything being better. So you have less in your paycheck to support those who may not be doing a single thing to make things better. And if they help bad employees stay employed, then they take a part of your pay to make life worse.
    If "bad" employees are kept it is due to incompetent management.
    A union contract generally requires that discipline, including termination, be for "Just Cause".

    The most extreme I read about in the paper was a hospital where employees were allowed to be late routinely because they traveled from another job. Also some took lunch breaks that took up almost half their shift:
    ... Some employees habitually fail to show up, logging weeks, even months, of unexcused absences each year. And those who do come to work often don't do their jobs, causing one consultant in 2002 to remark that they had "retired in place."
    Others are distracted or impaired. County Civil Service Commission filings tell of staff members grabbing and clawingeach other's necks; inspection reports tell of patients literally dying of neglect.
    Underfunding is a myth, but the squandering is real - LA Times
    The most extreme example I've been told about was a nurse who wanted to fight a termination after he was caught with narcotics in his socks. His fellow nurses were there when he refused to stay when the count came up short, ran, and was stopped by security.
    Because the union had to provide representation a rep attended the meeting and took notes as one after another witness reported the same.
    The union refused to go to arbitration, he threatened to sue. He was given a list of attorneys because he was also reported to the board. He never sued.

    I remember once I was asked to attend an arbitration at another facility. An RN had been terminated for rudeness.
    The manager had written her up once before for refusing to care for a patient in ICU and and four others on her telemetry unit. She had fought that because she was not competent to work in ICY and because it was physically in another nearby unit.
    Even though that nurse had prevailed the manager felt there had been progressive discipline.

    The "rudeness" consisted of an accusation that she had been rude to a patient. The assignment sheet did not include that patient.
    In report she was told the patient was discharged and just waiting for a ride. She was getting an admit from ER into that bed.

    About 7:20 pm she saw the patient in a wheelchair in the hallway. The secretary said no one had been able to contact his family to take him home. The nurse called both phone numbers and left a message. She bought him dinner from the cafeteria because he was no longer in the computer. She helped him to the bathroom.
    he then told the charge nurse who called the supervisor. She put her concern that her assignment was unsafe because her patient had no room and with him to care for she was assigned more patients than allowed by the ratio regulations. The supervisor said, "Do the best you can."

    About 10:30 pm she noticed the patient was gone. The secretary told her, "The daughter came and got him."

    She testified at the arbitration that she had told her manager that she had neither discharges the patient nor took him down to the car, but her manager accused her of lying.
    Plus he was no her patient because he had already been discharged.

    The daughter testified that the doctor had told her at 3:00 pm her father would stay another night. She went shopping. She didn't have a cell phone with her. When she got home she was surprised and angry with the message. She came to get her father and a nurse seemed to be in a hurry. She pushed him out to the car. That nurse was so rude she wouldn't answer any questions. After her father was in the car she asked, "Why is my father going home? The doctor told me tomorrow."
    She said, "That rude nurse just kept saying, "OK, Bye."

    When the union representative's turn came to question the daughter he said, "Do you know the name of the nurse?
    daughter, "Yes it is *****." (the name of the terminated nurse)
    Union rep, "Did you read her name tag?"
    Daughter, "No ***** told me her name." (gave name of terminated nurae)
    Union rep, "Would you recognize her if you see her?"
    Daughter, "Yes I would. I looked at her face and asked her questions and she just said, "OK. Bye"
    Union rep, "Is she here in this room?"
    The daughter looked at all us women. She made eye contact with me and the six other women at the table and against the wall. Then she said, "No. She is not here."

    The terminated RN began to cry. The arbitrator said, "I will reverse the termination. You will receive my written judgment in three days."

    The RN was crying. She asked her manager, "Why do you hate me?"

    The manager yelled, "Because you look like the woman my husband left me for."

    That was the most exciting arbitration.
    But although most are tedious and boring they are important sometimes when a nurse is terminated and there was no just cause.

  • Feb 14

    Quote from nrsadvocate
    I believe the most important issue that unions resolve is nurse-patient ratios. That's why unions are able to organize and get voted in by nurses. It's all about patient safety. I would like to hear from the nurses who are never short staffed and feel that their patients and nursing licenses are never in jeopardy because of short staffing. Do these hospitals exist??? Unions have nurse committees for the purpose of bargaining and negotiating, so that their members voices and needs are at the forefront. If union dues are the issue, just think about the cost of one mistake...it could cost your license and your career So where are the hospitals that staff their floors appropriately on a regular basis because I would like to apply for a job at these hospitals. Let's get real, hospitals are not going to provide safe staffing unless forced to do so.
    While nothing is perfect it is SO MUCH BETTER since our ratios went into effect January 1, 2004!

    Until we elect new members of congress I think ratios will have to be done state-by- state or in union contracts.

    National Campaign for Safe RN-to-Patient Staffing Ratios:
    National Campaign for Safe RN-to-Patient Staffing Ratios | National Nurses United

  • Feb 14

    On line I found this bargaining update for St. Mary's hospital RNs in Reno. It is dated September 2013.
    http://www.nationalnursesunited.org/...ain-090613.pdf

    In October they settled a contract. They seemed to get a better deal with health insurance. They were unable to improve the previous contractual ratios of 1: 6 in med/surg and 1:5 in telemetry. The nurses wanted to improves these. They were already OK with their critical care ratio of 1:2 or fewer patients per RN.
    St. Mary’s Regional Medical Center RNs Ratify | National Nurses United

    Las Vegas St. Rose Dominican Dignity Health RNs and California dignity RNs have the same contract. Nurses I know who work at Dignity hospitals are pleased with their contract:
    New Four-Year Pact for 12,000 California and Nevada Dignity RNs | National Nurses United

  • Feb 8

    Quote from Joeyzoom208
    Hi all!! 4 year veteran LVN in SoCal here. I'm looking to finally get my RN and am looking into the 30 unit option here in L.A. Now, I already know that I can not take this outside California unless I get an actual degreed RN .. but what about getting an RN job here
    IN Cali ?? Anyone go through this program ? Anyone KNOW anything about job prospects ?

    I am a very independent learner, so I'm not worried there at all -- I just want to complete an RN as soon as possible. I have an email into the Director of Nursing at UCLA, as many of their postings DO NOT state "must be graduate of accredited RN school", but many do.

    ANY insight here would be appreciated. My other options are of course the LVN to ADN, or LVN to BSN .. but with my work schedule that may never be possible (or at a snail's pace!). I'm 34, and really wanted to have my RN 4 years ago! C'est la vie! ;-)

    Thank you all in advance for deeper insight into this option here in California !
    I was doing the "Snail's Pace Option" taking one prerequisite a semester while working nights as an LVN. When it became clear that hospitals were phasing out LVNs I went full time, took a test to skip the first year of the associates program, and then applied to the RN program at my local community college.

    When I started the program I went to eight 12 hour nights in a two week pay period. The RN program was easier than LVN school had been because of my experience. I was so tired that I easily slept in my car during a two hour break between classes. But I graduated and passed NCLEX.
    Years later I did an RN to BSN program.

    Look for a school with Accelerated Fast Track (AFT) program that admits LVNs only. The education is set up to only teach what was not learned in the LVN program. Regardless of the program you will need the required supervised clinical experience. Some are quite time consuming compared to regular college classes. (For example my two unit maternal/child class required two clinical days, six hours of which was at the bedside and 1 1/2 hour for pre and post conference. then we had to do care plans and tuen them in on the 1 1/2 hour classroom day. We also had to read the chapters and pass the written tests. 17 1/2 hours a week, not counting study time, for 2 units.

    Here are the accredited programs:
    Board of Registered Nursing - RN Programs

  • Feb 1

    Nurses worldwide have a proud history of political activism in advocating for our patients, public health, and the welfare of all people.

    In the United States the ANA has accomplished a lot:
    http://www.nursingworld.org/Function...icalReview.pdf

    Nurses achieved state registration and licensing to protect people from uneducated and untrained people holding themselves out a nurses. Only those with an RN, LPN/LVN are nurses under the law.
    Nurses were instrumental leaders in women getting the vote, stopping child labor, and public health.
    I am certain nurses will continue to work for the health of us all.

    Some may be interested in an event happening in D.C. this coming Thursday:
    First Broad Post-Election Rally – Thursday, DC Sen. Bernie Sanders to Join Day of Action | Common Dreams | Breaking News & Views for the Progressive Community

  • Jan 28

    I don't think management is represented by the union.
    Many managers appreciate having rules written in the union contract. It makes it easier regarding pay, schedules, vacation and other time off, and such.
    Disciplinary rules are written too.
    My nurse manager liked working where we had a contract.


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