JKL33 5,719 Views
Joined Oct 2, '08.
Posts: 852 (81% Liked)
Say she removes the jewelry and then tells everyone she swallowed it and that she is having sharp lower chest or epigastric pains. Doesn't matter if it's "likely" to cause any harm or not at that point - we're now off track and won't be able to get a psych bed for this patient anywhere that isn't med-psych - which in plenty of areas simply means you won't be getting a bed. These, and more, are the kind of things that happen. There are actually reasons for the SOP.
And like canoehead said, once the dog is there, what can you do?
What harm have you seen swallowed nipple or navel rings cause? I'm trying to understand this, because it's not a button battery or a magnet. It's a small foreign body that will most likely pass with no adverse sequelae. Am I missing something? I'm really more curious than anything...
The smaller ER across town does not do any of that.
This woman had piercings, nipple and belly button and she was told to remove them. I am not sure who made that demand, but when she refused, a security guard forcibly removed them lacerating both areas. Apparently a nurse was in the room. This exacerbated the woman's anxiety and she fought back...escalating the situation and she ended up netted and medicated.
As a retired RN who worked many years in an ER, I found this appalling. If a patient refused anything I would have brought that to the attending ER doc and gone from there. NEVER would I have allowed unprofessional, untrained, brutes to forcibly remove sensitive piercings like that.
I was also told that patients in mental crisis are stripped and searched at that hospital where I use to work. Is that routine?
What about calliing in professional mental health crisis workers?
This woman had not been declared incompetent, or a danger, so it seemed like they went way overboard.
She said when she had discussed her questions about it with their pediatrician, she simply said, "Don't you wear your seatbelt??? It's the same thing."
Let this be a lesson to all. If your gut instinct tells you something is wrong, escalate. However busy you may be, errors in delivering proper care will only make your day busier. Also, make sure to confirm the dosage in mg or mcg rather than mL. I shudder to think of what would have happened if I had given the full mL of medication.
I think good information is available to lay persons now, and I'm not sure it was always the case or that it was presented in a way that seemed as compelling as the information presented by the anti-vaccine side.
Example: Parents often ask why the vaccines must be given on this particular schedule - and believed that this would overwhelm the baby's immune system. It was pretty common to hear a response like, "Your baby is exposed to multiple germs every day - hundreds or thousands! Even eating food introduces germs!"
That's fine and good (and true), but it's not going to make sense to the parent because the parent isn't dealing with a feverish, fussy and/or "lethargic" baby every time the baby "eats food." It makes perfect sense to them that the immune system could be overwhelmed because clearly something is different; the child is acting a little different.
[By the way, this same rhetoric is still available though reputable online sources; I know it's factual, but I call it rhetoric because it isn't answering the underlying unspoken question, which is, "why does my baby act so punky after getting immunizations, and is that okay?"]
I was once told at my doctor's office that vaccines don't cause fever. I had inquired whether it would be okay to give a dose of acetaminophen prior to the visit - and was told it was unnecessary because if my baby had a fever after the previous set of vaccines, it must've been a coincidence.
Misinformation and information delivered in a paternalistic manner breeds mistrust in people who simply feel very responsible for taking care of a tiny baby.
I really wonder if more respectful, forthright discussions could have helped, especially before wide use of "Dr. Google." Back then, if you happened to come across Dr. Sears' book - you just might end up giving it all a lot of thought.
No need to be a conspiracy theorist at all.
BTW, everyone I am responsible for is FULLY vaccinated, on time.
I sense you are a "nice" Person, who does her job and doesn't like to make waves.
Rules for this situation:
1. Stay calm
2. Stay calm
3. Show no particular emotion.
4. Rather than "deer in headlights," practice a "look of interest" +/- slowly nodding 'yes', as if to say, "Aha." or "Oh. I see."
5. After the patient is gone, "explain" to coworker: "I am learning and I am trying. I appreciate the information you shared, but you need to do it respectfully. Please don't speak to me like that again."
6-9. Stay calm.
10. Learn what you should from the situation and let the rest go.
Refuse to be emotionally troubled by individuals like this. It's one thing to be straight-forward. It's another thing to attempt to elevate oneself by humiliating someone else. This gal is in the latter category and her secret feelings of inadequacy are not your problem.
Best wishes ~
Low-level ESIs already could be redirected to alternative services (urgent care/walk-in, primary care)...
I'll just say what I think I would do: The Question is already in everyone's minds. Therefore, I think I would go back to my manager and say something like, "I wanted to come back and thank you for caring; for your inquiry about my black eye. When you asked about it, I had forgotten about it and was kind of caught off guard. [Blah, Blah]...I'm glad to know that if any of us here ever have a problem, help is available."
Add brief deails of incident if appropriate to share and if the truth itself doesn't sound cliche (reasons of clumsiness, etc.) If it was something specific and innocent like my child carelessly swinging something that hit me in the face, for instance, I would just let her know.
I looked up my state's reporter law. As is too often the case, there is some room for question. In some places it says "adult" and defines that as anyone over age 18, and in other places it specifies "vulnerable adult" and uses that phrase independently (i.e. as a substitution for "adult"). Suffice it to say your manager may feel obligated to report this, but nothing AT ALL is going to come of it if 1) you are not vulnerable 2) you don't need/want help.
I would be remiss to not agree with/reiterate the other responders urging you to seek help if you are in a harmful situaton.
I'm not sure how her statements amount to an accurate portrayal of EMTALA. As it stands right now, patients must receive an MSE (medical screening exam) and emergency conditions must be treated/stabilized or transferred appropriately, active labor must be completed/delivered. Low-level ESIs already could be redirected to alternative services (urgent care/walk-in, primary care) but no one does it for various legit reasons.
You signed. You pay. You're probably going to find a much worse job at which you will have to work many hours of OT in order to pay back the contract.
You signed a contract. Your patient ratios were actually not that bad for a med-surg unit. It is a tough job with a steep learning curve. I am sorry you didn't stick it out. Your contract is likely binding. I would call them and see what you can do to work with them. If you left in good standing you may even be able to get your job back. It is not just "bad" employers doing these contracts. Nearly every hospital in my local area has them now due to providing new grad training only to have the new grads jump ship within a very short time period. It is very expensive to train a new graduate nurse. This helps them get at least a modest return on investment.
I wish you the best of luck. If you can afford a lawyer you can afford to honor this commitment.
Doesn't really matter how common this is as far as right vs. wrong is concerned. I think it's despicable; the bald-faced lying as an inducement to consider/sign the contract. Of course none of that is in writing.
Unlikely the lawyer will have any good news, but might as well hear what s/he has to say.
Steer clear of these pathetic loser places and their contracts. If the conditions were as good as they pretend, the contracts would be unnecessary.
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