Latest Comments by scherzo

scherzo 745 Views

Joined Apr 21, '04. Posts: 7 (0% Liked)

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    All of you go back to school and get your masters in midwifery and start your own company...! Use the "unemployed" and "laid off" status to help you get financial aid in school! Link up with a sharp nurse with an MBA. Start your own birthing center! Contract an MD to cover you and build relationships with the local hospitals taking complicated OB pts....

    You're a nurse! You can do ANYTHING you set your mind to.

    Success is the BEST revenge.

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    I am a new part time professor and I will never consider full time employment as a tenure track professor at least until I am retirement age...and I have my kids through college.

    To work full time in teaching, I have to quit my clinical practice and work more than twice as hard and for about half of the money I make now. I will have to attend committee meetings, curriculum meetings, governance panels, write and give lectures, teach labs, and take two maximum capacity clinical groups through a hospital that struggles with keeping its census up.

    I can teach freelance on contract for corporations and have written many CE courses and certification prep courses. Today, I get to do what I love...teach and take patients....

    To become a full time professor, I would never have time to do anything except work in the school.

    This sort of problem is not unique to nursing. Many, many fields have professors that take lower pay than their students will be making after graduation. (ie: Engineering, mathematics, computer science, etc)

    The pay cut would be less painful for me if I could be able to continue the papers and the projects and the teaching methods I enjoy, but there will not be time.

    I am definately going to be a professor someday...but not for a long while. Unless some things change for the better.

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    You and your RN buddies need a good lawyer.

    Find an employment attorney that will take this case on contingency. Get with the others in your situation and explore your options together. Are you in a collective bargaining or union state?

    You might not get your jobs back, but you will see your "severance packages" improve greatly as they make some forced out-of-court agreements.

    Best, but not necessary: Find an RN attorney that can represent you!

    If s/he is not a nurse, go for the bull dog that wins. You'll scare the crap out of them. I can bet that the hospital you work in is a for-profit and that the executives got a nice raise....

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    Laura,
    Congratulations on your coming graduation!!!! I am so happy for you and happy that you are so thrilled to be a part of this wonderful profession!

    You state that you are finishing cardiovascular nursing. Did you like it?

    What are your career plans? What kind of nursing do you plan to practice?

    For the record, I go by Scherzo and I am an ICU nurse in a very large and busy metropolitan area. I teach BSN nursing clinicals, as well. I was going to start a doctoral program this fall, but opted for some time off, just as you did. I am planning to start that program in a year. I want to continue with teaching and speaking at conferences and workshops...and keep taking patients at the bedside! My students and colleagues say that they love that I do the advanced practice things AND I regularly take a patient load.

    My mother was an LVN...but she never got to see me as a nurse.

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    This post is over a year old...but I am a new member of this board...and upon reading the replies, I am not seeing the words "SAFE HARBOUR" anywhere.

    I have been an RN in a rural hospital. Yes, they can put you in some really compromising positions. Safe Harbour is a regulation that says, "this situation is unsafe and I am making you aware of this." You are making them formally aware of the problem when you fill out the paperwork and submit it. If anything happens, it protects you from liability. The DON and the supervisor and everyone have formally stated that they know that it is unsafe but they have no other options. Most hospitals will do whatever it takes to avoid safe harbour because it increases their liability.

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    I used to live in Europe many years ago and met plenty of adults that lived with their parents. Then (20 years ago), it was harder to live on your own as a young person. Jobs paid so little and the cost of living was outrageous. But, even with enough resources, most of the adults I knew had good relationships with their parents and adult-level boundaries.

    I do sympathize with the RN that has to care for a dependent personality. I find, though, in my own practice that setting limits early and consistently with all patients can avert many problems. It doesn't solve them all, but it helps avoid many of them.

    The fellow with the Foley catheter dilemma: As long as it was medically necessary to measure I/O...like it would be with someone with a facial fracture...you want to know immediately if he develops diabetes insipidus (DI)...I would place a condom catheter on him and measure it that way. The MDs do not want an invasive foley...for infection reasons...and you NEED to KNOW his urine output to give safe care. This man's problems are deep and will not go away by making him pee in a urinal. This is also the kind of patient that often sues over the smallest infraction...or his mother will. I would just get through my shift with as few problems as possible...and help the physicians get him safely out of the hospital...whatever it takes. I would ensure that he got a psych consult...and that this was documented. I would document ever single refusal for care...and write that the patient refuses to pee in a urinal (using quotes from him) and that a condom catheter had to be placed in order to assess for risk of developing DI. All language in the document needs to be descriptive and contain no judgements about the person. For example, "Patient urinated in his bed. Amount unknown. Entire bed was soaked. Due to risk for DI secondary to facial injuries and the patient stating "I don't want that urinal, I want a Foley," Drs. Smith and Jones were consulted. A condom catheter was placed and an emotional care consult was requested. Patient talking with his mother on the telephone. No observable distress."

    These patients can be like road rage participants. They can really make you mad...and engage you in their need for attention. I have learned that letting them have the road as much as safely possible will let me avoid a collision with them. This issue has been going on for this patient long before I got his assignment...and I will not be able to fix him. I do not have the training, for one thing.

    I had a patient once who was VERY difficult...a man in his 40's. He had a massive heart attack and was in heart failure and needed a ventricular assist device to keep him alive and possibly get him on the transplant list. The night nurses were fed up with him because he was refusing to speak. I read in his notes that he had survived a code which prompted an emergent VAD placement. I spoke to the attending MD right away and got a neuro consult as well as a psych consult. The man was angry enough to throw things across the room, so he would also need emotional care. The two MDs arrived together to assess him. It was discovered that this man had expressive aphasia from a small stroke...and he was a physics professor...someone used to talking eloquently to many people all the time. He was extemely frustrated that he could not communicate...thus the anger expressed by throwing things. For a week, he was getting lectures from his doctors and nurses about how his lack of cooperation was hurting him and that he needs to talk to us. The night nurses were laughing at his strange behavior...and afraid of his rage. Getting him a piece of paper...and eventually a lap top...and some antidepressant medications altered the course of his treatment for the better.



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