MunoRN (22,482 Views)
Joined Nov 18, '10.
Posts: 7,023 (67% Liked)
Opiates can cause itching relieved by antihistamine . Any opiate--oxycodone, morphine, hydromorphone, codeine, hydrocodone can cause itching it's a common side effect. Many providers standing order Benadryl or Allegra for itching as long as no signs of anaphylaxis.
I'm not sure what you mean by "perceived problem". Is there any other way to define misery other than how it's perceived?
Are you kidding me? Where do you work....Stepford General? Why is it any of your business if a nurse chooses to have a buzz cut? I've been in nursing a long time and I've never see a slovenly nurse. As long as dress policy is adhered to...not a problem. Not everyone is the same or has the same fashion ideals as you. I guess everyone is far too busy working to worry about what they look like. I'd absolutely hate to be at work and know you were looking me up and down with a sneer on your face. Wow.
There's a variety of evidence to choose from as to why communication is the hot topic these days when it comes to patient safety, take your pick from IHI, AHRQ, or other industries. "Why hospitals should fly" by John Nance is worthwhile read.
I can tell you first hand why interactive communication is important. I worked at a facility where we trialed a faxed report. A patient came into the ED with CP, was on revatio for PH so was not given nitro in the ED. Of course there was no checkbox on the form for "didn't give nitro because patient was on revatio." The fact that the patient was on revatio was available to the receiving nurse in the EMR, although she was unfamiliar with the med and didn't make the connection to nitro. The patient coded after the nitro and couldn't be revived. When the nurse who had the patient in the ED, who was unaware at the time that the patient had died, was asked what they remembered of the patient the nurses first description of the patient was "the one who had CP but couldn't have nitro because they were on revatio". While this could have been avoided if the nurse had written this somewhere on the form, that's not the only way this information gets passed on, it often gets passed on because the receiving nurse is able to ask "why didn't they get nitro?"
It means the check cleared. Nothing more, nothing less.
Pausing tube feedings is one of the stupidest things that nurses do religiously... nothing like saving a patient from potentially aspirating on 4.8cc's of additional TF.
In Texas if you buy at gun show from private seller you just exchange cash for gun.
Last two used handguns I purchased one was from a garage sale (great deal) and one from a individual (good deal) selling on a forum, Just negotiate best price and take possession.
Just my number, but surely, how much do you think it'll cost? It can't just be a few percentage points... if a lot of people are paying hundreds of dollars a month, upto a thousand a month for family insurance under obamacare, and if you figure they make $4-5k a month, then bam 20-25% of their income to pay for it.
Also, look at Europe... they pay through the nose....
Most hospitals have a policy against smoking 100% legal substances like cigarettes or using chewing tobacco. They drug test us in the beginning and reserve the right to drug test us. They add the nicotine drug test on too (it looks like a pregnancy test).
Drinking and working isn't allowed at any hospital I know of either.
I'm sure a lawyer will be happy to take your money to essentially double your monetary obligation in the contract. I can guarantee "doesn't like job" is not covered can as a bona fide reason to legally dissolve the contract.
It's going to cost a lot of money in penalties and fees.
Few positions are immediately available. Reference checks, drug screens, employee health clearances, etc. can take 2 weeks or longer to complete.
As a hiring manager, if you told me that you would quit your current employer without notice and start my job immediately, I would not make an offer. I don't want to be on the other end of a "quick exit" when your next best job comes along.
Here is the Libertarian Party on healthcare.
This guy sums up how I feel. There's some rather spicy language so if you're easily offended you might want to skip it.
Making sure that core measures are completed is not outside the scope of practice for a nurse. Writing the order yourself for VTE prophylaxis or the ACE-I for a CHF patient is another story, but I doubt you are being "coerced" into doing that. Core measures are evidence-based best practices for patient care. Yes, most of them require a physician's order. However, I have seen plenty of situations where core measures were missed, and it was the fault of the nurse. (M.D. orders SCDs, but the nurse never documents that they were applied or refused. There is an order to remove a foley on POD #2, but it isn't done. Discharge instructions are not complete or documented properly. Things like that..)
It is probably a huge hassle for some quality nurse or your nurse manager to be crawling up and down your back to make sure that things get done. I promise that there is some hospital finance person or CEO who is crawling all over them about it too, because of the impact that it has on facility reimbursement from Medicare. Most non-profit hospitals run on extremely tight margins, and they rely on getting every single penny of reimbursement that they can in order to survive. With value based purchasing, there is a financial incentive for the hospitals to make sure that their core measure scores are high. Unfortunately, historically there has not been any sort of similar financial incentive that impacts the doctors, but that is changing.
So... Take a deep breath, and ask the dang doctor for the order or the needed documentation. Even tho it doesn't feel like it sometimes, the measures really are important, and they are EVERYONE's responsibility.
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