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BabyLady 11,510 Views

Joined Dec 17, '08. Posts: 2,406 (41% Liked) Likes: 2,549

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  • Jan 21

    Quote from CRNA1982
    Really? With all due respect, I find it hard to believe that a transport team RN can tube a patient more proficiently than a CRNA/MDA. Intubating is a skill, just like starting an IV. The more you do, the better you become at it. If you are not intubating multiple people on a daily basis (And I find it really hard to believe that transport RN's are) then you simply cannot be as proficient as an anesthesia provider at managing an airway. This includes tubing newborns emergently as well as 430 pound pts. presenting for laparoscopic gastric sleeves; all of which are not uncommon during an average day for an anesthetist.
    At our facility, RN's are never checked off for intubations...ever.

    The only ones that are, work on transport teams and even then, you are with an RT, who will do it first.

    Now, in that rare circumstance that there is a bona fide emergency, an NNP or MD is not available (b/c the one assigned may be on a delivery as well) and let's say that the RT that is assigned to your unit is also on a delivery, and a nurse from the transport team is not staffing that day, the most SENIOR nurse that is present attempts the intubation.

    Now, you will NEVER find a nurse on our unit that will call a CRNA to intubate an infant..ever.

    We intubate all of our kiddos prior to sending them to surgery...CRNA never does it.

    The reason: CRNAs, for the most part (not all), do not seem to have a true appreciation for this particular patient population and will attempt multiple intubations if they fail (rather than allowing someone else to try) with the "I am a CRNA, and I can get this myself" mentality.

    The reason for the decision, at least at our that this has happened more than once and with more than one CRNA...intubations with 14, 15 attempts..with the RN begging the CRNA to call someone else...and he/she refusing....permanently damaged vocal cords, horrific gashes to the interiors of the mouth, huge slices to the gums or deep depressions.

    You see that a few times and don't call the CRNA anymore.

  • Sep 18 '16

    I had this happen one time at a physician's office about 6 months ago where I was greeted by a medical assistant...I assumed that she was a nurse, because the secretary called her one and she answered the phone in my presence earlier and told the patient she was Dr. So and So's nurse.

    To make conversation, I started chit-chatting about some of my labs and realized that she seemed unusually I asked her if she was an RN or an LPN, and she said that she "didn't HAVE TO go to school because Dr. So and So trained her."

    So, as she was taking my vitals, I said calmly, "you know, you should really be careful about telling someone you are a nurse if you are could get into a lot of legal trouble because it is a protected title."

    She laughed and said, "Well, gosh, who is going to care enough to do that?"

    Without missing a beat, I said, "Someone like me...who is."

    I told the doctor when I saw him.

    The next time I went to the office, they were making a really BIG DEAL out of calling her a medical assistant.

  • Aug 21 '16

    I have a close friend who is an FNP.

    She got her BSN, passed the NCLEX, went straight for her FNP and now works in a physician's office/General Practice.

    She has never worked as a staff nurse.

    She is an EXCELLENT FNP....she really cares about her patients and constantly works to keep up her skills. She has been practicing about 5 years now and has a very devoted list of patients.

  • Aug 15 '16

    Quote from kendel
    its possible it was switched but i dont know i remember there was no name on the bottle i i had to put it down a shoot that she retrieved
    Anytime I have taken a drug test, the urine/blood has been labeled in front of me...I even sign the label so that it never leaves me sight when it is labeled.

  • Aug 15 '16

    Quote from GM2RN
    Good Morning Everyone

    I work in the ED for a hospital in Michigan, and like many other hospitals these days, mine has been forcing nurses to work under-staffed for quite some time. Not every day, but often enough that I'm sick of letting it continue and I'm trying to figure out how to effectively protest while doing what I can to protect my license and my job.

    I've been trying to get information about my rights to refuse an unsafe patient assignment, and what constitutes patient abandonment. If I worked on the floor I wouldn't have a problem, but working in the ED makes me less certain of how these two issues work.

    I called the Bureau of Health Professions this morning, and the short version of my story is that since Michigan has no NPA, they couldn't help me. The person that I spoke with referred me to an individual that licenses hospitals, thinking that he could give me some answers, but I had to leave a VM for that person and haven't heard back from him yet.

    Do any of you know the answers to my questions or where I can get this information?

    Every state is different.

    In my state, you are not legally responsible for a patient until you receive report or if it is a new patient, perform the triage for admission.

    Until one or the other happens, if you refuse to take a patient, it is not abandonment.

    Just TELLING you a patient is yours, should not constitute "accepting" of the patient.

  • Jun 26 '16

    Quote from Malenurses
    If lawyers show their name for advertisement (to promote their business), I'm sure there are plenty of times they use only their first name to protect their self or their families....but again, the use their name to promote their paycheck. Same with real estate agents or insurance agents, they use their name to increase their paycheck.

    Police officers and judges often take extra security to hide their identity (gates at homes, face masks, etc.) I wonder why? Ever hear of judges being shot in their home? I have. I've never heard of a nurse being shot in their home for being a nurse, maybe there is a reason.

    I been involved with the child welfare system, often times the last name is not used. Yes, they generally have to have a name tag or id card of some kind, but they too take extra precautions to protect them self and their families, because people do get upset when kids are taken out of their home. They also work hand in hand with police and the legal system so they have a bit more protection close at hand.

    Ever hear of a teacher or college professor getting shot or attacked for being a teacher or college professor? I have.

    Yes, patients certainly have rights. I respect those rights and enjoy providing those rights to my patients. I have rights as a member of this country and above all my kids have rights. I'm a male nurse so I stick out, I'm 6'9", so I stick out, I'm 300 lbs., so I stick out, I run 1/2 marathons and jog all over town, so I stick out. My wife and I have a full size van to haul our large family (we don't fit in a mini-van) so we stick out. We live in a small town, so yes, we stick out. People know us, I know I'm listed on the state's professional license site, but if I'm treating a psych patient or intoxicated person or some other crazy situation and I don't want to share my last name...well, that is why at my facility first names work. If there is a complaint or concern by patients, well that is why there is administration.
    Then you are a perfect example of why the profession of nursing is not more elevated than what it is.

    We cannot claim to be professionals and then HIDE from the public when they have EVERY LEGAL RIGHT to know WHO is treating them and they shouldn't have to go through additional channels to find that information out.

    Your paycheck example doesn't hold is a matter of transparency to the general public.

    So what if you get a psych patient or a drunk to take care of...ALL JOBS HAVE THEIR OWN RISKS!!!!...find another one if you are that paranoid about it.

    I for one, am a true professional, wear my name badge proudly and would actively support any law supporting the first and last name being 100% available to the public and would actively oppose any law to the contrary.

  • Jun 4 '16

    Here is my experience when I went to do drug testing with my hospital, as just after hiring, I underwent a medical procedure where opiates were prescribed, so I was pretty sure I would "fail" the drug test.

    I went to the hospital records (you don't need a physician's need proof of a valid isn't anyone's business what it's prescribed for) and got a copy of my MAR and brought it with me.

    My hospital used an outside lab for drug testing...this is for integrity purposes.

    When I went to my drug testing, I told the attendant that I had a MAR with me for a recent medical procedure and she looked at me and said, "Stop! Don't tell me anymore...that is for your privacy....IF we find medication that we are testing for in your system, THEN we will require proof of valid administration, otherwise, keep your records...we don't need them."

    They never called me...much to my surprise.

    Also, understand that they are testing for drugs that tend to be abused and illegal substances, they don't test for every drug under the sun.

    NEVER, EVER disclose any medical condition or medication to ANY employer unless you are SPECIFICALLY told you are required to do so.

    You have the right to privacy, just like any other patient.

  • May 19 '16

    Quote from Padelcar
    Greeting everyone,

    Hopefully, I may get a job offer this coming week, but it doesnt start until the end of july. I was thinking that if they offer, to take it, and then keep looking to see if anything comes up before that.
    Yes, I consider that SMART negotiating.

    Hospitals are doing hiring at different times this year; some are even waiting until after graduation due to the economy so they don't commit to new grads that they can't follow through with.

    So, I see nothing wrong with, if something comes up that's better, calling to decline the job offer, however, never, ever tell them that is why you are turning it down. Just say, "I'm afraid I will have to decline the offer at this time, but I may apply again in the future, I was very impressed by your facility, yadda, yadda."

    If they press for exactly why, just say, "If I took the job I would owe you to focus on it fully and make it my number one priority, right now, circumstances will not allow for that."

    That should shut them up.

  • May 12 '16

    Quote from ToxicShock
    Now that this woman doesn't have an IUD anymore, what if she has sex, gets pregnant, and then decides to have an abortion? A lot of good removing the IUD did to prevent abortion!

    At the end of the article, it says that the NP refused to insert a new one. Can health care professionals refuse to do something if it against their personal beliefs? Couldn't the NP have the GYN or another NP insert the IUD for the patient?

    Yes they can. However, I also don't think they should charge them for the visit if that is the purpose of the visit...reception does ask these questions when you book the appointment and reception should have knowledge of which HCP's have an issue with IUD's for this reason.

    The morning-after pill or the RU486, falls along the same guidelines.

    Once conception takes place...any steps to stop that process, is technically a termination of a pregnancy.

    I'm speaking strictly from a medical standpoint.

  • Apr 22 '16

    Look at how little nurses get paid compared to a CRNA. Nurses have a ton of responsibility because some nurses kill people every day.

    CRNA's know the pay before they take the job. If they want the "big bucks" there is nothing stopping them from medical school.

    I fully support MD's making more money...b/c if they are going to invest a huge portion of their life in school, then they should be compensated for it.

  • Mar 8 '16

    Quote from Zookeeper3
    I have been through a DEPOSITION, aside from TESTIFYING it is the worst experience of your career. After you state your demographics and position, the FIRST question asked was... "do I have any personal notes at home or copies of the chart regarding this case"...
    ...which again, is why you would never tell anyone that you kept one to start with.

    Yup...I am 100% advocating lying to a court you know why?

    1. No way can they prove otherwise...if you told no one and I mean no one.

    2. Which means they cannot subpoena, what there is no proven existance of.

    3. Nobody is going to need to protect your nursing license more than you...and no attorney is going to care as much as you how hard to worked for it.

    People need to get off the conspiracy is simple: If you keep a journal, keep it 100% private and only for your personal reference. Nobody is going to go through your house, go through your drawers, find the journal and turn it over to your employer...seriously folks, I would love to find ONE published case where this has actually happened purely by random....the chances would have to be astronomical.

    In this day and age of a society where someone will sue at the drop of a hat and most nurses foolishly carry no malpractice insurance under some delusional myth that it makes them more likely to get sued, if you don't take every step to protect yourself...NO ONE ELSE WILL!!!!!!!!!!!!!!!!!!!

  • Mar 8 '16

    Quote from RadBSN
    Funny thing about thieves, they go through drawers, closets, cabinets, freezers and look for things in the places you might have hidden them. We were just broken into and they took the most random stuff. They didn't know what we had they just busted the door down and went through everything to find out. Again, by putting patients' PHI with identifying details in an unsecured location you are putting their info at risk.
    I seriously doubt if someone who robbed your house will go through a journal and say, "Oh my God, this person violated HIPAA!!! We need to report them immediately to the how do we explain how we got hold of this since we just broke into her house."

    Seriously...think about that.

  • Mar 2 '16

    Quote from asc5
    First of all I am not a troll. I am from a middle class family where my dad made too much money for me to be eligible for any financial assistance. I am one of four and there just was not enough money to go around. The only way I could go to school was through student loans (and my interest started compounding the day I took the loan out) and my summer job as a camp councelor. I was able to complete my four year degree at about a 18,000 loan to be repaid the month I graduated. Did it stress me out? YES! Did I pay every fricken penny back? YES! I was THANKFUL that I could go to school, work a part time job, and graduate with a BS. I PAID my student loan back in FULL with interest. So no I am not a troll, I am a real person who made my payments in full. I am a bit cautious of the free rides out there because I sure did not get one and I am a thankful for the education I got. I am blessed enough to go back to school now for my true passion and again I am THANKFUL. And I am having to pay in full with no discounts from our savings.
    See, this is what screams "troll alert".

    I have never seen a student loan that had to be paid back the month that you graduated, and virtually all gov't loans have the interest paid FOR YOU while you are in doesn't compound until after you graduate.

    Even private loans, the interest may compound from the beginning but they are generally not due the month you graduate.

    If you only took out $18K, virtually all of your loans should have been gov't.

    If you ever HAD taken out a student loan, you would know this.

  • Feb 25 '16

    I am posting this because it has become a weekly topic of discussion on the board. To me, so many people overthink this task and make it much more difficult than what it really is. I decided to post some tips that may help with the business of giving your old employer the boot.

    Here is some pre-resignation advice:

    1. Do not discuss leaving with anyone before you put in your notice. Trust no one. It makes for good gossip as to who is leaving next...I wouldn't trust my best friend at work with this information.

    2. Be careful if you are posting your resume on, etc. Yes, you can remove your name, but other things in your resume may give away your identity, such as the year you graduated on the list of schools. Be careful.

    3. Remain professional...just because you know you are leaving doesn't mean you can slack off matter how tempting. Leave a good impression, even if you never plan on returning. You never know when your old boss or old co-workers may turn up at your new me, I have seen this more times than I can count. to fire your boss:

    1. First, find out what is acceptable for a notice. Everyone says two-weeks, however, this is going to vary by facility. For example, I happen to work in a facility where for nursing staff, 6 weeks is the typical notice given and unless you are on very bad terms with your employer, you get to work out the 6 weeks. Give your notice in accordance of what is customary.

    2. Put it in writing...and keep it short and professional. For those that are stuck, I will suggest the following: "Dear Mr/Mrs. Boss: The career opportunity given to me as a Registered Nurse here at General Hospital has been an invaluable experience, but unfortunately, at this time, my career is taking me in another direction. I submit my resignation from my position as a Registered Nurse for my last day to be <insert date here>. I sincerely wish the management and staff at General Hospital continued success in this organization and I thank everyone here for giving me the opportunity to be a part of the healthcare team." Sincerely, Jane Doe, RN.

    Yup...that is ALL you need to write. They do not care about why you are leaving...resist the temptation to vent, give them a piece of your mind, tell them everything they are doing wrong, etc. Write it out this way even if you think they are all a bunch of loons and wouldn't go back if they doubled your salary...seriously, in the end, it doesn't matter.

    3. Submit your resignation to your direct supervisor or other manager, as dictated by your facility. Bring TWO COPIES with you and give her one...making sure she knows you made two. Listen to any final instructions...they may ask that you not tell anyone you are leaving, etc...LISTEN the warnings, if any.

    4. Do not gossip about you leaving to other co-workers after you submit your resignation. While it is acceptable to mention you are leaving, if they ask why, say you prefer not to discuss it.

    5. BE PREPARED that your boss may let you go the day you resign...this is legal in many places. It all depends on how upset they are at you leaving...just be prepared for it. Many times it is done for security purposes.

    6. Don't bash anyone in the exit are leaving, what do you care?

    Hope that helps anyone looking to quit anytime soon.

    Another piece of advice: never, ever quit a job unless you have another one. The economy is bad right now and even experience may not get you in the door.

    Good Luck!