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Kooky Korky 17,460 Views

Joined Feb 12, '10. Posts: 2,900 (52% Liked) Likes: 3,880

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  • 2:38 am

    If you don't want to answer their questions, just say, nicely, that you are reluctant to share your personal information in general. Say that you've learned that it is best not to talk too much about it and be apologetic and assure the questioner that it is not personal against them.

    Or make up some untruthful answers. Just be sure you can remember them and use them consistently.

    And if you don't want to talk with your coworkers, eat someplace alone. Otherwise, you will be deemed rude and unfriendly.

    Good luck.

  • Feb 23

    You have no idea if it's true or not. The person who told you could just be repeating gossip or surmising and assuming things.

    It does not directly involve the patient.

    You are not even on the case any more or in the employ of the firm any more, right?

    Hard call.

    I don't know what the legal requirement is.

    Nurse Beth, can you help us figure out the moral duty/ethics?

  • Feb 22

    Quote from Jmmfan1
    So I am not a nurse but wanted to share this with all of you still. I see how hard the nurses and CNA's work. I am a patient and this is my fourth facility. My second facility I was in I had a nurse come in at 2:30 in the morning, flipped on the lights and said I am here to give you your shot! I said Shot? What kind of shot? He then told me it was my Insulin shot. I said Insulin? I am not Diabetic! He said oh you are not? I said no I am not. He then said I must have the wrong room. I was glad I caught it the first night and the second and third night. After the third night I told the DON (I reminded the nurse the other two times.) I also told the DON I did not get my meds the night before. She talked to him because he came and tried to convince me he had given me my meds. My meds had been counted to which he replied well I know I gave her some meds!! At that point he was put on suspension, the DON was fired and he came back within a day. The Center Director told me I made accusations against his staff. A month later or so he passed away of a overdose. I am not putting blame on him persay how ever there was evidence he was rushing through his med pass. My concern was the possible of insulin shots when I am not diabetic. I had seen this in another facility I was at. When I did HR and Payroll I made sure I had checkpoints in place to ensure my work was correct. Is there anyway of adding checkpoints to med passes as well? And the doctor that barked orders, did you repeat back what he told you? Thank you to all of you for what you do.
    This is pretty terrifying. Maybe a report to the accrediting bodies is in order.

  • Feb 22

    Quote from prmenrs
    Any error (esp. a med error) should always be viewed as an 'organization' error. Analysis of the error should focus on where, in the process of administering the medication, the error could have been interrupted. It should never be "whose fault is this", but how could the process be altered so that it doesn't happen again. No one should be singled out. Sure, the nurse who made the mistake will know, and feel guilty, but she should made to be part of the problem solving. "How can we, as an institution, make it more difficult for an error like this one to occur?"

    Sometimes, as the group analyzing to error works together, it will turn out that, by changing something simple, the nurse would've paused and caught the error before it happened.

    A few years ago, a colleague was about to flush an IV w/heparin (as we did back then). She selected Heparin 1000U from the PYXIS, which dispensed it. It came in a little vial w/a blue stripe on the label. She drew the med up in a syringe, disinfected the port, and looked again @ the vial. Turns out, the vial contained 10,000 units of heparin, not 1000u!!! Our unit didn't even use that strength Heparin! She called pharmacy. Pharmacy tech that filled the machine thought s/he had put in the 1000 unit vials. Both vials were the same size, and both had a blue stripe, but a different shade of blue. Pharmacy got in touch w/the FDA. Ours was not the only place where this error had happened, or, in our case was a 'near miss'. Eventually, the manufacturer was compelled to change the packaging to make it harder to confuse.

    My point is that patient care delivery has many components, and many, many ways to mess up. We need to resist the urge to point a finger @ an individual, acknowledge that there are lots of ways to make a mistake, and it behooves the institution to analyze errors, and find ways to help NOT make an error.
    One of the best ways to avoid errors is to get doctors to stop yelling and for nurses to accept verbal and phone orders only in an emergency.

    These should be issues that Management should address.

  • Feb 22

    Actually I am not undecided. I think some nurses have good management skills and some don't.

    And some nurses have some good management skills but fall short in another aspect of management.

    Good article.

  • Feb 21

    Quote from brownbook
    I am more unsettled that a nurse who is working in Psych and is afraid the patients are somehow a danger to her!

    Patients with serious psychiatric illness are not a danger to the public, including any care givers they come into contact with during their hopspitlization.
    I beg to differ. I've seen and heard of numerous staff seriously injured by Psych patients. What makes you think Psych is not dangerous?

    And since Psych patients are not always cared for on a Psych floor, they can be dangerous wherever they are - the ER, ICU, clinics, etc.

    Also, patients on locked Psych wards are often still a threat to themselves or others. And there is often insufficient staff for personnel on those wards to feel truly safe.

  • Feb 21
  • Feb 20

    Quote from CapeCodMermaid
    I gave a month's notice. They're bringing the new DNS in on Monday... ***... Can you spell disrespect?
    So are you supposed to orient her? You don't say how long ago you gave notice, only that you gave a month.

    I think this wall is a hoax. It is a terrible liability for a facility to have such a thing in sight of family members.

  • Feb 19
  • Feb 19

    Quote from oceanblue52
    Honestly, if you are not supplied with any 2 inch needles, I wouldn't worry about it, you do the best you can with what you have. If he is having EPS and hallucinations it sounds like he needs a different medication, or at least a tweaking of his other meds to better control the EPS. Have you relayed your concerns with the provider? Providers often only assess every few months and might warrant an earlier appointment.

    More seasoned nurses can probably offer you better feedback, but my understanding is that you never split a dose into 2 separate muscles on a LAI, because it messes up the absorption rate. Not to mention that you would have to place a second clean needle on a dirty syringe...which strikes me as a major infectious disease prevention no-no.
    Not saying she should split the LA med into 2 sites.

    If there were going to be 2 shots for 1 patient, why not divide the medication into 2 syringes before injecting the first site? Then there's no issue at all re: infection.

  • Feb 19

    Quote from sallyrnrrt
    You did alright.... I use 2 inch needles a lot, on appropriate patient population, trust my in excess of four decades experience..... With a two inch needle, you did not give a sub que, injection..

    It will get better
    She didn't use a 2 inch needle. She said her facility doesn't carry them.

  • Feb 18

    Quote from brownbook
    I am more unsettled that a nurse who is working in Psych and is afraid the patients are somehow a danger to her!

    Patients with serious psychiatric illness are not a danger to the public, including any care givers they come into contact with during their hopspitlization.
    I beg to differ. I've seen and heard of numerous staff seriously injured by Psych patients. What makes you think Psych is not dangerous?

    And since Psych patients are not always cared for on a Psych floor, they can be dangerous wherever they are - the ER, ICU, clinics, etc.

    Also, patients on locked Psych wards are often still a threat to themselves or others. And there is often insufficient staff for personnel on those wards to feel truly safe.

  • Feb 18

    Quote from oceanblue52
    Honestly, if you are not supplied with any 2 inch needles, I wouldn't worry about it, you do the best you can with what you have. If he is having EPS and hallucinations it sounds like he needs a different medication, or at least a tweaking of his other meds to better control the EPS. Have you relayed your concerns with the provider? Providers often only assess every few months and might warrant an earlier appointment.

    More seasoned nurses can probably offer you better feedback, but my understanding is that you never split a dose into 2 separate muscles on a LAI, because it messes up the absorption rate. Not to mention that you would have to place a second clean needle on a dirty syringe...which strikes me as a major infectious disease prevention no-no.
    Not saying she should split the LA med into 2 sites.

    If there were going to be 2 shots for 1 patient, why not divide the medication into 2 syringes before injecting the first site? Then there's no issue at all re: infection.

  • Feb 17

    Quote from brownbook
    I am more unsettled that a nurse who is working in Psych and is afraid the patients are somehow a danger to her!

    Patients with serious psychiatric illness are not a danger to the public, including any care givers they come into contact with during their hopspitlization.
    I beg to differ. I've seen and heard of numerous staff seriously injured by Psych patients. What makes you think Psych is not dangerous?

    And since Psych patients are not always cared for on a Psych floor, they can be dangerous wherever they are - the ER, ICU, clinics, etc.

    Also, patients on locked Psych wards are often still a threat to themselves or others. And there is often insufficient staff for personnel on those wards to feel truly safe.

  • Feb 17

    Quote from Here.I.Stand
    Well unless they're breaking out the fava beans and Chianti.... I'm not seeing evidence of cannibalism.

    Stealing is wrong, but not limited to CNAs. Laziness/poor work ethic is wrong too, but again not limited to CNAs.

    You can't make the blanket statement that nobody has anyone's back in nursing. Come work with me for 5 minutes -- my team and I survive on each other's backs.

    Now I see some stuff in this post we need to talk about. You felt the need to bring age into it...was this *experienced* nurse seeing evidence of pain or air hunger in the bradypneic hospice pt? Does she know that holding the MSO4 will result in uncontrollable pain by the time the next dose is due?

    You express surprise that your colleagues are licensed nurses, or even high school grads. Not nice.

    What really stood out to me however, is the way you phonetically quote the CNAs' speech/grammar patterns. Not nice. At all.

    There are clearly some issues with the workplace culture. I have very little tolerance for subpar elder care. The CNAs should try their best, regardless of what they're being paid -- they knew their wage before accepting their jobs, and it's not the residents' fault CNAs are paid so low. Theft should not be tolerated.

    But really? If we're talking NETY, honestly I see a lot of room for you to improve here.
    Quoting speech and grammar, spelling errors - it's reality. He's just telling it like it is. I also marvel
    at some of the spelling I encounter. It really grates on me. Pet peeves and all that.


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