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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: 16,996 (73% Liked) Likes: 33,647

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  • Aug 19

    Twice i made promises that gave comfort to dying non religious patients.

    One I didn't know well. He said, "If i die tonight tell my wife i love her."
    He seemed to relax when i promised to do so.
    He repeated the request just before going into V tach. Was aDNR.
    I was the one who called the wife at the primary physicians request. She came in and i told her again.
    It was the only time in my decades of nursing that a patients dying words had so much meaning.

    A diffrent patient I cared for three nights in a row on CRRT, IABP, and drips told me his life story. He had been an ordinary worker and lousy husband. He raised a son by himself. He dedicated his life to his boy.
    After a couple days off I learned he had died. I sent his son a card telling him what his Dad had told me, how proud he was, how much he loved him, and what a joy his son was to him.

    The son sent me a card at the hospital thanking me and praising all the nurses.

  • Aug 18

    Quote from karrikon
    Yes, the question was for you. I heard a lo of wisdom and experience in your suggestions. I figured you must have had a lot of well-rounded career experience. Thank you for sharing!
    I forgot my favorite that worked for me. But then I had rational nurse managers.
    When asked to stay over after a 12 hour night shift I would say, "I would if I could, but I can't because to do so could harm my patients. I am too fatigued to assume that responsibility any longer."

    The one time I was told I had no choice I wrote two papers with what I had said, the name of the person ordering me to assume responsibility for a patient assignment, the date, time, and unit. I included that I would care for the assigned patients the best I could under the circumstance of fatigue and sleepiness. I signed one, asked him to sign, and kept one for myself and one for him.
    He returned after a phone call and told me to give report to him.
    When I returned to work that night I found that a cancelled nurse from another unit had been called and volunteered to come in.

    I learned those magic words in a CE class. "I would if I could, but I can't because..."

  • Aug 18

    Part of how the law was passed in California.

    Florida nurses working for violence prevention

  • Aug 18

    I clearly remember a 1978 newspaper article. A nurse at a nearby hospital sued a surgeon.
    She and other staff testified that they had been reporting via incident report and to the medical director that he was frighteningly verbally insulting and threatening to staff. He had once thrown a scalpel which lodged in a wall.

    The suit was regarding a time he opened a sterile tray that was what he had asked for, but not what he wanted.
    She told him, "Oh. That is what you asked for."
    He cursed and threw the plastic tray at her. It hit the bridge of her nose causing a small cut with a few drops of blood.
    She hired an attorney and sued him for $1.25 in civil court. She said that she needed to use a couple bandage strips and suffered moderate pain for four days. She wanted 25 cents a day for her pain and suffering.
    The judge ordered that he pay her the $1.25 plus ten thousand dollars punitive damages.

  • Aug 18

    Quote from maporcrn1
    Nurses need to feel safe in the work environment. Deescalating training and Security support is essential, especially in the Emergency Departments. Defense training may not be a bad idea as well.
    Our ER and mental health nurses routinely learn and practice restraining an unarmed person. It mandatory for them and available for all staff. Many of us on nights in critical care took it. More than once five of us small to average size women were able to restrain a patient safely until sedated.
    Training and practice plus luck were needed as neither staff nor patient were injured at those times. Not even the young football player on PCP who was trying to leave.

  • Aug 18

    I was told this story be several nurses I met in a CE class. I'll attack links to newspaper stories. The papers didn't tell the whole story.
    Ventura County, CA ER nurses were attending meetings with their management regarding violence in the ER. Attempted or actual assault by visitors or patients happened an average of twice day. Police were called to the ER more than twice a week. The last straw was when police responding to a call regarding a patient who was threatening staff with scissors drew their firearms in the nurses station.
    The patient had come to the nurse's station bleeding.
    Although the officer didn't shoot nurses knew they had to do more than meet with management. One RN led the campaign for ER safety. No more keeping such incidents secret.

    When the DON attended a county board of supervisors meeting to present a routine report that RN leader had requested to be on the agenda. Most off duty ER nurses and RNs from other departments attended too.
    After the DON barely mentions that a problem was being worked on the RN leader gave her presentation.
    She had a print out of each date and time police were called to the ER. She presented a petition signed by all ER RNs, ER physicians, most other ER staff, and hundreds of nurses from other units demanding a police officer be present in the ER.
    For the first few months it was part time, but nurses made it clear that an officer was needed 24/7.

    More than a year later I heard from those nurses again. They said they worked with officers who came and stood by when called by a nurse.
    When a visitor or patient threatened violence, or even loudly expressed anger, the officer would ask for ID. If the person had any outstanding warrants he or she would be arrested and taken in by another officer the ER officer called in.
    The probation or parole officer was called if that person was under that supervision.
    A public health nurse said, "The word on the street is that you have to behave in the ER or go to jail."
    Patients and staff continue to be safer with an officer on duty.

    Ventura County Medical Center will pay for police officer in emergency room
    Ventura County Medical Center will pay for police officer in emergency room

  • Aug 18

    I clearly remember a 1978 newspaper article. A nurse at a nearby hospital sued a surgeon.
    She and other staff testified that they had been reporting via incident report and to the medical director that he was frighteningly verbally insulting and threatening to staff. He had once thrown a scalpel which lodged in a wall.

    The suit was regarding a time he opened a sterile tray that was what he had asked for, but not what he wanted.
    She told him, "Oh. That is what you asked for."
    He cursed and threw the plastic tray at her. It hit the bridge of her nose causing a small cut with a few drops of blood.
    She hired an attorney and sued him for $1.25 in civil court. She said that she needed to use a couple bandage strips and suffered moderate pain for four days. She wanted 25 cents a day for her pain and suffering.
    The judge ordered that he pay her the $1.25 plus ten thousand dollars punitive damages.

  • Aug 18

    I was told this story be several nurses I met in a CE class. I'll attack links to newspaper stories. The papers didn't tell the whole story.
    Ventura County, CA ER nurses were attending meetings with their management regarding violence in the ER. Attempted or actual assault by visitors or patients happened an average of twice day. Police were called to the ER more than twice a week. The last straw was when police responding to a call regarding a patient who was threatening staff with scissors drew their firearms in the nurses station.
    The patient had come to the nurse's station bleeding.
    Although the officer didn't shoot nurses knew they had to do more than meet with management. One RN led the campaign for ER safety. No more keeping such incidents secret.

    When the DON attended a county board of supervisors meeting to present a routine report that RN leader had requested to be on the agenda. Most off duty ER nurses and RNs from other departments attended too.
    After the DON barely mentions that a problem was being worked on the RN leader gave her presentation.
    She had a print out of each date and time police were called to the ER. She presented a petition signed by all ER RNs, ER physicians, most other ER staff, and hundreds of nurses from other units demanding a police officer be present in the ER.
    For the first few months it was part time, but nurses made it clear that an officer was needed 24/7.

    More than a year later I heard from those nurses again. They said they worked with officers who came and stood by when called by a nurse.
    When a visitor or patient threatened violence, or even loudly expressed anger, the officer would ask for ID. If the person had any outstanding warrants he or she would be arrested and taken in by another officer the ER officer called in.
    The probation or parole officer was called if that person was under that supervision.
    A public health nurse said, "The word on the street is that you have to behave in the ER or go to jail."
    Patients and staff continue to be safer with an officer on duty.

    Ventura County Medical Center will pay for police officer in emergency room
    Ventura County Medical Center will pay for police officer in emergency room

  • Aug 17

    Sometimes a patient cannot be blamed for his or her actions.
    I've only been injured by a patient once. It was about 2:00 am when I heard my colleague call, "I can use some help in here."
    His patient was in flash pulmonary edema with 02 sat dropping. We knew his agitation and confusion were cause by hypoxia. I paged the resident on call. He said to put on )2 by non-rebreather.
    My colleague was applied wrist restraints. As I held the 02 mask on his face the patient kicked my cheek. I saw stars and was dizzy.

    After the patient was treated with IV Lasix, IV drips, had a pulmonary artery catheter inserted, and all the usual treatment he was againg alert.
    He sort of remembered kicking me saying, "I thought you had broken into my house and were tying me up."

    In my 18 years working nights in CCU I observed many patients become disoriented and combative when hypoxic.
    That is but one condition in which I cannot blame the patient.

    We must have a plan protect ourselves. We must not generalize. In my opinion.

  • Aug 17

    Quote from karrikon
    Damn, you're good! Are you in management? You could be a counselor!
    If this question is for me the answer os no. I turned down management jobs.
    I'm a retired staff nurse after working 45 years as a nurse.
    I was a night shift leader when we joined the CNA. Then headed up the Professional Practice committee at my hospital working on patient care issues.
    Thousands of us worked to get the safe staffing ratio law passed and implemented.
    That law continues to save lies in our hospitals.

    For passing the New Regulations to Prevent Workplace Violence in Healthcare Settings I was a follower, just writing politicians and signing petitions.

    If not for me, sorry for answering.

  • Aug 17

    From our State Board of Registered Nursing:

    Workplace Violence Prevention Plans-- Hospitals
    http://www.rn.ca.gov/pdfs/regulations/npr-b-84.pdf

  • Aug 13

    Quote from karrikon
    Yes, the question was for you. I heard a lo of wisdom and experience in your suggestions. I figured you must have had a lot of well-rounded career experience. Thank you for sharing!
    I forgot my favorite that worked for me. But then I had rational nurse managers.
    When asked to stay over after a 12 hour night shift I would say, "I would if I could, but I can't because to do so could harm my patients. I am too fatigued to assume that responsibility any longer."

    The one time I was told I had no choice I wrote two papers with what I had said, the name of the person ordering me to assume responsibility for a patient assignment, the date, time, and unit. I included that I would care for the assigned patients the best I could under the circumstance of fatigue and sleepiness. I signed one, asked him to sign, and kept one for myself and one for him.
    He returned after a phone call and told me to give report to him.
    When I returned to work that night I found that a cancelled nurse from another unit had been called and volunteered to come in.

    I learned those magic words in a CE class. "I would if I could, but I can't because..."

  • Aug 11

    Quote from karrikon
    Yes, the question was for you. I heard a lo of wisdom and experience in your suggestions. I figured you must have had a lot of well-rounded career experience. Thank you for sharing!
    I forgot my favorite that worked for me. But then I had rational nurse managers.
    When asked to stay over after a 12 hour night shift I would say, "I would if I could, but I can't because to do so could harm my patients. I am too fatigued to assume that responsibility any longer."

    The one time I was told I had no choice I wrote two papers with what I had said, the name of the person ordering me to assume responsibility for a patient assignment, the date, time, and unit. I included that I would care for the assigned patients the best I could under the circumstance of fatigue and sleepiness. I signed one, asked him to sign, and kept one for myself and one for him.
    He returned after a phone call and told me to give report to him.
    When I returned to work that night I found that a cancelled nurse from another unit had been called and volunteered to come in.

    I learned those magic words in a CE class. "I would if I could, but I can't because..."

  • Aug 11

    Quote from karrikon
    Damn, you're good! Are you in management? You could be a counselor!
    If this question is for me the answer os no. I turned down management jobs.
    I'm a retired staff nurse after working 45 years as a nurse.
    I was a night shift leader when we joined the CNA. Then headed up the Professional Practice committee at my hospital working on patient care issues.
    Thousands of us worked to get the safe staffing ratio law passed and implemented.
    That law continues to save lies in our hospitals.

    For passing the New Regulations to Prevent Workplace Violence in Healthcare Settings I was a follower, just writing politicians and signing petitions.

    If not for me, sorry for answering.

  • Aug 11

    From our State Board of Registered Nursing:

    Workplace Violence Prevention Plans-- Hospitals
    http://www.rn.ca.gov/pdfs/regulations/npr-b-84.pdf


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