Anna Flaxis, ASN 24,850 Views
Joined Oct 15, '10.
Posts: 2,863 (67% Liked)
Wow , what a Jerk, Jerk Off, and yes PA are not MD ...you should call him by his first Name.
I see people complaining about the amount of NPs being created, however it is good that nursing is addressing the problem of healthcare provider shortage. .
Family doctors are more critically needed than ever. NPs are not the equivalent to an MD no matter how much some think they may be.
Wow. There are more people applying than residnecy spots? How is that possible..... we have a physician shortage so why do they keep it so low on purpose tou have toask.
Assuming this is not a rhetorical question, to put it simply, the smaller the sample size, the less precise the information is.
How about we talk to our patients instead of each other, ask them about where they live, what they do, who's waiting for them? do they have kids?
So still an easy and relaxed conversation and they are not just listening in, but participating.
I agree with previous posters that discussing the outcome of the election in front of patients was inappropriate. There are some potentially divisive topics like for example politics and religion that are best avoided altogether in the workplace, especially so in front of patients.
Not to defend the staff who discussed the election, but I do wonder if the fact that the campaign had been so vicious and the voters so polarized might have contributed to the inappropriate conduct. Less than 24 hours after the result was in, I assume many people were still reeling from shock of the election outcome. It might have made people who wouldn't normally talk about things like politics in front of patients become more "loose-lipped" as they were processing the result of the election.
As I've already mentioned, I don't think that politics and religion are ever suitable topics for staff to discuss amongst themselves in front of the patient. But I do think that there are times when staff discussing less incendiary topics in front of patients can actually be beneficial. Of course it depends on the patient, we all have different preferences but as a nurse anesthetist I find that patients often find it calming when the medical team around them are relaxed enough to discuss their dinner plans or child's birthday party or whatever. I've had many regional anesthesia, minimal or moderate sedation, surgical patients express that they get scared when the team is all quiet and focused on the job. Even though I'm talking with my patient, the silence from the rest of the team, makes the patient fear that something's not going well since the team is concentrating so hard instead of talking and sounding like they're having a routine day at work. Some patients certainly prefer this quiet focused on the "task at hand" approach, but some definitely don't.
Something I have learned from my experience in the diagnostic role: you miss some. You do your best but some will still surprise you.
Per NIH "no compelling evidence for routine cultures or empiric treatment with antibiotics. Further research is required." This is my kid we are talking about. Use sterile procedure, culture that green and yellow stuff, determine if and what antibiotics are necessary. I would expect the same for my patients.
I do I&D's as a clean procedure. I do not culture or script abx unless there is a complication.
It is a clean procedure where I work. Instruments are sterile but sterile gloves are not used. I don't routinely culture unless the patient has recurrent abscesses. Antibiotics are not necessary unless this is a recurrent problem or the patient has systemic symptoms. This is per our health system's protocol.
I use a disposable scalpel, which is sterile. I only touch the handle and never touch the site after it's cleaned. The sterile blade is the only thing that touches the abscess.
I certainly hope not.
What about experience; how many veteran nurses and new grads are there?
Great thread with lots of thoughtful responses.
A couple of thoughts for OP
Its unwise to "jump to solutions" until you actually know what the problem is. In my consulting years, a lot of work involved reversing the superficial "improvements" that were implemented to solve problems - AKA, it seemed like a good idea at the time. My mantra became "Today's problems were yesterday's solutions". Don't fall into that trap.
Look at the research being done on "missed nursing care", "failure to rescue" and "nursing surveillance".... there's a ton of evidence out there to inform your decisions. Better yet, start analyzing those near misses or nursing failures using a system like HFACS or a rigorous root cause analysis process to determine the systemic problems that may actually be the causative factors.
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