OCNRN63, RN Pro 35,080 Views
Joined Aug 27, '10.
Posts: 7,133 (75% Liked)
LOL...the "Thread Necromancer" strikes again!
When Big Pharma and For Profit hospitals charge $47 for 50mg of Benadryl
for inpatients, and inpatients don't even have a say in the matter because nobody KNOWS the price until they ask for and itemized bill...or outpatients cannot make informed choices because you cannot ' shop around ' for the best price, or even a fair price for an MRI because nobody at the front desk even knows the flat rate for imaging - or the flat rate is price gouging so that between the insurance companies and the deductible patients are faced with a coercive monopoly...THAT kind of profiteering is well beyond a $3500 bill. I'm not talking about small business....for that, I certainly agree. I am talking about big healthcare, the kind that woos doctors and nurses with gifts and gadgets to pedal their drugs to patients. Those are billion dollar companies whose CEOs are running off with the steak and leaving the bone and gristle for the rest of us. As patient advocates, we should all be angry.
Small businesses, as you said, often struggle, and no, not everyone should get a free pass.
It depends on whether you are taking the introductory chemo/bio which gives you chemo cert (9 CEUs), or if you are taking the second one which gives you chemo cert with additional certification (15 CEUs). The second one is complex. There are more than 10 modules to read with multiple subsections, as well as 4 interactive posts you have to make within the modules. There is a 50 question test at the end. Honestly, the one that gives you like 15 CEUs took me about 30 hours all together to complete.
I realize that. But there was also this: "Oh load." What is that?
I just assumed a poor communication style. I mean, who calls $6,000 "60 grand"?!
Not trying to argue, I just think OP needs to clarify.
Honestly, I think you need a better hobby. Truth will out.
You could always try having just one highlight of light blue/pink/purple, rather than coloring your hair 100%. Subtle, but just enough to let you feel like you're different.
I'm really not one for crazy hair colors, and personally, I side with your supervisor, but I wouldn't get bent out of shape over one highlight.
Agreed - we have to call Donor Network regardless of Advanced Directives or a will or any statement the patient does not want to donate.
Who cares about someone's feelings when LIVES are on the line? The pursuit of organ donation should be aggressive and persistent. We owe that much to those who are dying and to the families to know what their feelings may cost.
Organ donation is serious and should be treated as such, their tears will dry but dead is forever. Maybe their loved one's death will mean that others may live.
Feelings v. Life
I picked up compartment syndrome on a peds. patient. The boy had pain that was off the charts; nothing relieved it. He also had sluggish cap return. There was just something about him that said "compartment syndrome." I called his surgeon, who had a terrible reputation for how he treated nurses. I expected to get eaten alive because I was calling at 0300, but tough rocks...the patient came first. He did bark at me at first, till I told him I thought his pt. had compartment syndrome and gave him my assessment. He asked me to check one other thing with the pt. Ten minutes later he was on the unit, and within twenty minutes we were rolling the kid off to the OR.
I don't see anything you did that was wrong. Your case was nebulous, at best.
Don't beat yourself up for not being a mind reader.
Is it not possible to grieve after a donation has been completed? I don't understand this "it's predatory to talk to people when they are grieving" argument. You can grieve your loved one at any time. Donating organs doesn't change that process.
We have a hopsice IDT today and are going to discuss this. The rep from the donor network told me that IF I had advanced directives with the box checked AGAINST being an organ donor, then all would be well. But the advanced directives did not have that box checked so they were going to call the legal rep of family even though the family said no. I think we'd like to start addressing this fairly soon after admit to hospice with our patients and family members. So we have a firm yes or no decided way ahead of time.
It was explained to me by the donor network rep I was talking to at 0145 a.m. a few nights ago that they started training people specifically to deal with families of dying or dead patients regarding encouraging donation. And that I was not supposed to tell the family that there would be someone calling in an hour. And I was not supposed to talk about donation to the family because I didn't have that "special" training. Sounded like subterfuge to me.
Wow, the timing of this thread is shocking!
I'm in California as well and I work hospice. For our hospice patients in SNF, when they die, we have to call that 1-800 number. I've been doing it for years but recently it has gotten more difficult to deal with them. Even if you say the family has said no, they continue to ask you questions that take about 20 minutes to ascertain if the patient would be a candidate.
I had a patient die a couple of days ago. Uterine cancer with mets everywhere. She had a large open necrotic coccyx wound. When she died, I called her family and then started the paperwork as I called the Donor Network. I told the rep the family said no and again, had to answer all the questions. Very detailed, H&P, labs, X-rays, MRI, CT scans, etc.
The rep said the patient qualified for skin donation. I told her the family had already said no to donation - the legal rep of the family. I was told that another specially trained person would be calling back in an hour to talk with the family about donation and I should not talk to the family about the upcoming phone call or anything about donation.
I was appalled. So, OP . . . I totally get your point.
And I am in favor of donation.
But this new way to change people's minds reminds me of Mortuaries and how they prey on the grieving families in order to get them to purchase more expensive caskets.
"Predatory" and "unethical" indeed.
I'm still fuming about it . . .
OP: It is not sustainable for you to work so many hours and then spend your time off work obsessing about your patients. A lot of warning bells are going off in my head as I read your post. Your body is going to crash and burn. For the sake of your physical and mental health, make an appointment to see your family doctor and talk to him/her about your work hours and spending time off ruminating about patients and what you could have done better.
You're setting yourself up for failure, because you will never be able to give your patients "perfect" care. Never.
Get better friends.
What are these lengthy, multiple request situations you're describing? I have never seen the organ donation representative approach a family a second time after a refusal- in fact in our training on donation protocol they emphasize that part of the reason only they are to speak to the family, aside from decoupling the treatment team from the donation process and protect us, is that they have to strike the delicate balance between attempting to maximize donations (and save lives) while minimizing any potential harm to the family- both for their own sake, and to protect the reputation of organ donation as a process. The slight possibility of changing a single grieving family's rejection to a yes is not worth the risk to the organization or to the entire field of organ donation if an angry family were to take up a crusade against them after a negative experience, and they are acutely aware of that.
In all the training and real-life experience I've had with this, they've stuck firmly to this principle. I've never seen them badger a family who gave them a no, and really- how many times *could* they "meet" in the limited window for discussion?
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