MunoRN 49,359 Views
Joined Nov 18, '10 - from '.'.
MunoRN is a Critical Care.
She has '10' year(s) of experience.
Posts: 8,385 (70% Liked)
The anti-vaxxers get upset because there is a question of whether or not we ought to force them to comply. Forcing people to do things they don't want to do, especially with regards to what goes in their bodies absolutely sucks for us morally and we should avoid it whenever we can.
Force takes many forms. Threatening to cut off a person's employment or income counts as force. As does prohibiting school.
Using force is justified only when you are very certain that it will benefit the community and also very certain that it will not cause harm to the individual. Then you have moral grounds with which to use force.
My problem with using force on the flu shot is that we don't know what getting it 80 times over the course of a lifetime will do to people and we do know that flu doesn't usually kill healthy people. It does kill sick people, so maybe it is justifiable to use force for healthcare workers-- as in take your shot or don't come to work, don't get paid.
But for folks not working in healthcare I don't think force is justified with regards to the flu shot. It's a vaccine people are expected to get every year. We don't know what effect, if any that has over a lifetime yet.
In 100 years when we have evidence that giving flu shots to a person every year from ages 3 to 100 did not cause undue harm to that person, then we will have moral grounds to use force.
I think gardasil is also one where using force is not justified for similar reasons. It hasn't been around long enough. Gardasil is a weaker case against force then the flu shot, because we aren't expected to get it every year.
With proven, older vaccines that prevent devastating illness like polio, I think we are justified in straight up forcing people to comply. Not like, hold a person down and put a needle in him, but definitely keeping kids out of school, and maybe even cutting off income.
And I say that as a quasi-anarchist who vaccinates her children and gets her required annual flu shot. And also as a psych nurse, who sometimes really does have to hold people down and give them a needle. It breaks my heart every time and I don't do it unless it is really, really necessary.
As of 2009, just over half of ADN students were second career students, often with previous degrees, this comes from research put together for a 2009 committee on making BSN the entry to practice, it says I'm not supposed to "re-publish" any of it, I'll see if that is still the case.
I agree that the research has shown different levels of education in programs a couple of decades ago resulted in differing outcomes. There was no delineation of what exactly these outcomes resulted from, but the best guess seems to be that it was the differing content and curriculum, it could be due to other factors are less obvious but seem unlikely, for instance it could be because BSN students are more likely to live in a dorm, I tend to doubt that having ASN students live in a dorm for a year would necessarily improve the outcomes of their patients down the road.
Well, it was a bit tongue in cheek. The statement I was challenging was "Minimum wage increase benefits everyone." I think that is naive, and is probably not shared by all those actually paying minimum wage.
Hypothetical ice cream shop that pays minimum wage to high school students. They have no particularly unique or difficult skills. The owner works his tail off and is not wealthy. The kids who work there don't need a living wage, they need some pocket money. Any more that he pays them is money out of his pocket that won't be helping his kids pay for college.
I don't think he benefits from minimum wage increases. If he did, he would simply raise wages. I am quite sure that there will be some businesses right on the edge of survival that will fold if minimum wage goes up.
That being said, I agree that minimum wage should be raised. Effectively, minimum wage has gone down hugely.
It's just that I accept the fact that economic decisions are complex, and very few benefit everybody. They need to be seen in balance.
This is very much on my mind as a new tax code is being developed. There are people who have made it their life mission to make rich people richer. They are telling me that that with certain changes, everyone, including me, will benefit. While I think it is awesome that they have taken a sudden interest in my well being, I am a bit skeptical.
I Googled it, I guess subcutaneous infusion make sense?
I am sure some nurses would make a big fuss over this.
So the patient was previously transferred from another facility. I think the facility who transferred the patient should have clarified with the doctor if he/she wanted the subcutaneous infusion discontinued at the time of discharge.
The patient came to your facility with the subcutaneous infusion running and it was not caught that there was no order (by the same doctor? or a different doctor?) to continue it. No one realized it hadn't been reordered.
What was it infusing? Pain medication? Insulin? Chemotherapy agents? Heparin? Nitroglycerin? Normal Saline? Dopamine? Anyway personally I wouldn't make a big deal out of it. Unless it was some potent powerful drug. Simply call the admitting doctor, ask if he/she wanted the subcutaneous infusion stopped or continued.
My imagination was going a little overboard. Can you imagine dopamine subcutaneous....YIKES.
Does that seem like a weird category title to anyone else? Isn't it kind of like opposite meanings? Is it like 'Miscellaneous"? Or am I misreading it?
It's not important, really, but I'm just curious.
Try working in EMS for 15 years and nursing for 7; you'll get it then....
I think it's funny. But I'm actually a nurse, and you're.... not?
They were probably already declared dead. Brain death and cardiac death are two different things. If the organ team was involved, that child was probably declared dead a long time before extubation. The child was being kept alive while the organ procurement team was getting all their ducks in a row, which can take days. But in those instances, death is declared after a brain flow study has shown no activity. With an anoxic injury, that often happens.
That's why I'm saying there is more to this and the coroner screwed up by not understanding the process. We all need to not place judgement unless we were there and know the details of the case.
Physicians at UCLA's pediatric intensive care unit told Cole's family that the child was not brain-dead but "would never recover normal neuro function and ... could never awaken," according to an entry in his medical chart.
Hi, im a nursing student so forgive me if this question is a bit elementry.
If a patient has 2 separate orders for Norco that read:
Norco 5/325 1 tab PO Q4hr PRN Pain (4-6)
Norco 10/325 1 tab PO Q4hr PRN Pain (7-10)
Is it ok to give a patient a 5/325 2 hours after giving them Norco 10/325 if the patients pain is still in the (4-6) range. Do the orders stand alone or not?
No, you aren't a moron. The morons don't ask.
Welcome to AN!
Why are travelers not an option? The difficulty with your suggestions is, it's really not the staff's job to cover the floor by picking up extra hours. Working their agreed upon FTE is.
Call-in/pickup bonuses could help, since it would then benefit the employee to work extra.
The Health profession and nursing training program is much more than providing loans for nurses. In fact only a small portion money is allocated as loans for nurses, and those loans require a 2 year service in critical shortage areas. This program is designed to help resolve health care disparities and ensure a future supply of healthcare workers. https://www.aamc.org/download/428928...stestimony.pdf
Many national and state hospital associations have model guides or policies on this issue. For example, here is Washington's: http://www.wsha.org/wp-content/uploa...Acceptions.pdf and here are the guidelines from the AHA: http://www.aha.org/content/00-10/gui...easinginfo.pdf
Most of these guidelines follow the HIPAA requirements, which are protective of PHI. Generally speaking, I would only allow nursing staff to notify law enforcement of a fugitive if the nurse has a reasonable belief that doing so will prevent or minimize an imminent danger to the patient or any other individual. I would want to see that reasonable belief articulated in the chart and to have the nurse check with me, Compliance, Privacy or nursing leadership first.
As for the OP, most hospitals do already have a policy on this: it is typically written and administered by Medical Records, Compliance, Privacy or Risk.
This has been done in LTC facilities all over the country. Many states have alarm elimination initiatives for LTC.
The evidence shows that falls did not increase when facilities eliminated alarms. In fact many facilities reported that falls decreased when they eliminated position-change alarms. (The evidence on whether it decreases falls is weak. The evidence that falls do not increase is strong.)
To quote one study "We took a tiered approach to removing positio-change alarms from our facility, monitoring the fall incidence rate for a period before, during, and after the elimination of these alarms. After discontinuing their use, we found a decrease in the rate of falls, and a decrease in the percentage of our residents who fell. Staff has easily adapted and reports a calmer, more pleasant environment."
Another study says "Using real-time information provided by falls incident reports the ADON tracked and trended data on a monthly, quarterly, and annual basis. During the final quarter of 2005, that encompassed the months of alarm reduction and increased resident monitoring on the target unit, there was a 32% reduction in the quarterly average of falls for this unit, when compared to the average number of falls for the first three quarters of 2005.
Incidentally, this unit also experienced a reduction in the number of pressure ulcers identified for the final quarter 2005, as compared with the first three quarters of 2005. This could be the result of residents' toileting in advance of need, and more frequent ambulation and positioning, which were a part of the residents's individualized fall prevention plans.
In addition, there was a 21% decrease in the CMS 'Prevalence of Falls' quality measure when comparing July 2005-December 2005 to October 2005 through March 2006. Both six-month periods shared the two-month intervention interval and subsequent evaluation. Additionally, the Director of Nursing has reported that the increase in activities on the unit has had an impact on the 'depression quality measure.'"
From MASSPRO a Massachusetts Quality Improvement Organization, "The noise produced by alarms agitated residents so much that residents fitted with alarms did not move at all to avoid activating the alarm. This put them at greater risk for decline. Residents with dementia experienced an increase in agitation when fitted with alarms."
Quality improvement in nursing homes: testing of an alarm elimination program. - PubMed - NCBI
Elimination of position-change alarms in an Alzheimer's and dementia long-term care facility. - PubMed - NCBI
Interventions designed to prevent healthcare bed-related injuries in patients. - PubMed - NCBI
Nursing homes find bed, chair alarms do more harm than good - The Boston Globe
The problem isn't that the facility is eliminating alarms. It is that they did not take a planned, systematic approach.
Advertise With Us