MunoRN 40,686 Views
Joined Nov 18, '10 - from '.'.
MunoRN is a Critical Care.
She has '10' year(s) of experience.
Posts: 7,925 (70% Liked)
It's typically a two year program. I believe you can become credentialed as an RCIS using only an RN degree combined with a year of cath lab experience and a minimum number of cases, but my understanding is that most places only hire those with "RCIS4" which means they graduated from an accredited two year cardiology tech program and passed the test.
I was an ACT nurse very recently in my career. I, too, had a patient who clearly needed to be medicated due to psychotic symptoms but was with capacity in terms of decision-making. What we did was slightly different. She had been bugging her case manager to take her shopping for sneakers (the patient had the money but we were her payee and needed to approve any special request checks out of her account) so her case manager said, "well, I'll take you into the office, the nurse will give you your shot, then we'll go get your sneakers." It was the only way she would accept the shot. We were bribing? Yes, but it was with her own money.
In your case, I would tell the resident that he or she had to finish what was started, and that you are not on board with this at all. If the injection begins to work after a few doses, the patient may very well come around and realize the improvement in quality of life.
ACT is not for those who can't think outside of the box.
I've never seen a facility policy that specifies what particular size syringes can be attached to a phlebotomy needle and don't see why such a thing should exist, there are too many particulars to be taken into account that a policy cannot capture.
There have been multiple posts putting down the nurse and blaming the nurse. Those are obviously the asinine comments I was referring too.
Replace religion and have the same OP vent and say the ratios are unsafe and all that because a nurse went on maternity leave for 3 months. No one would be putting down the nurse that had the baby. I am pretty sure also the OP said the nurse did offer to work more Sundays and the management told her she didn't need to. (I could be mixing up threads on this one but I recall seeing that said somewhere and I think it was here)
But unless they were deleted their were numerous threads bashing the nurse and placing blame on the nurse and so on.
What unethical means did the employee use? Were you there? The OP was very unfair to bring this woman's religion into this forum, as it could have been any reason given to her employer. It not anyone's business why someone is having days off.
Also, "helping someone" on Sabbath is different to working at your career job on Sabbath. You're not volunteering and it is not a once in a while emergency. The problem lies squarely with the employer to staff the unit appropriately.
Nurse managers are typically salaried, and as a result it's not unusual for them to have to work well over 40 hours a week. Ours work about 65 hours a week, they split weekend coverage but that still means they usually work 6 days per week. On an hourly basis they get paid less than many of the floor nurses they oversee.
Schools most follow the policies of the clinical sites they partner with, and it's not unheard of for hospitals to prohibit any medications that carries a warning related to impairment, typically the "do not drive or use heavy machinery" warning. Whether or not the student or their doctor feels it actually is impairing doesn't really matter.
To have more access, if you have that many meds going through. You should only run three meds at once through one PIV, and you can connect those by the hubs. If you have over three meds, you should get more access.
The only time I have ever seen those connectors used is on a PICC or subclavian. They get very confusing and I find to be dangerous if you are not meticulous on checking everything. I always figure out how to get rid of them. I personally hate them.
If that lone IV blows...so could the rest of your shift
I'm assuming the pt is in active childbirth right OP?
I've seen a similar situation where a manager got all bent out of shape because everyone was charting their medications as given in the EMR before the pyxis said the meds had been removed, I asked her to come look at what time the pyxis thought it was right now, which turned out to be 3 hours off.
It depends on the area, in my area the ADN programs require a previous bachelor's degree and a 3.7 or greater in the core pre-requisites, the BSN program is generally easier to get in to, but far more expensive.
It should be spelled out in your contract or job description, if it doesn't say that you get the premium for Mondays as well then you've really got no argument to make. No facility I've worked at has paid weekend premium pay for weekday work, and I'm not sure why they would since Monday is not part of the weekend.
Can you explain " daisy chained". Sounds perfect.
If the child has medical issues that may occur in the classroom then the teacher and other staff working with the child need to be aware of what to watch for, sharing that with them is not a HIPAA violation.
From the description, it sounds as though the LPN went into the classroom to take the child's BP, which is inappropriate unless it's a clear emergency.
These extensions are sometimes "daisy chained" together to provide the number of ports needed, open hearts typically come back with 5 or 6 triple spliters daisy chained together.
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