Latest Comments by MunoRN

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) Likes: 19,874

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  • 0

    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.

  • 1
    elkpark likes this.

    Quote from Penelope_Pitstop
    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 would actually think it makes it far worse, not better, that it's her own money.

    The basic premise of offering someone some sort of benefit, monetary or otherwise, for complying with a course of treatment is that otherwise they might cost the system a lot of money, so if they can reduce those costs to the system through compliance then they've earned a portion of the money that is saved.

    Withholding someone's own money from them (money that is already there's) unless they are compliant would seem to be pretty straightforward financial abuse.

  • 3

    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.

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    Quote from ~Mi Vida Loca~RN
    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.
    Maternity (FMLA) leave is a legitimate and legally protected time off, that's much different than taking advantage of the fact that administrators won't typically want to the hassle of denying a bogus religious exception claim.

  • 0

    Quote from Stepney
    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.
    Per the OP, it was their coworker that stated they had to have Saturdays off for religious reasons, this wasn't just assumed to be the reason.

    Quote from Stepney
    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.
    Whether or not caring for patients is in keeping with the Sabbath is not dependent on whether you are getting paid in any religious doctrine. It's what you are doing, not whether or not you are getting paid.

    Weekend staffing is done by weekday staffing sharing the weekend coverage responsibilities, when a particular weekday staff isn't sharing that load it gets put onto other staff, which certainly makes it their business.

  • 2
    dishes and PrincessAlexis like this.

    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.

  • 0

    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.

  • 1
    Noctor_Durse likes this.

    Quote from LovingLife123
    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.
    I'm curious what your rationale is for your "3 med" rule. There are many factors that determine what can go through a single lumen, but simply the number of components is not one of them.

    The type of IV and placement determines what combined rate can be safely and effectively infused, they must be compatible, and the flow characteristics must also be considered, for instance if you have an insulin infusion plugged into a port on an intermittent infusion, then when the intermittent infusion is stopped the entire line below the insulin connection will contain insulin, which means when the intermittent infusion is started up again it will push potentially an hour or more of insulin ahead of it.

    As long as the resulting combined rate is appropriate for the catheter and the medication can be safely combined there is no reason why more than three different components can't be combined.

    It's important to remember that additional IV access carries risks with it, so there needs to be a legitimate reason to additional IVs.

  • 0

    Quote from AJJKRN
    If that lone IV could the rest of your shift

    I'm assuming the pt is in active childbirth right OP?
    If there's indication for a spare IV then that's already in place, adding a new line for meds would be the third line.

  • 2
    Savvy20RN and TriciaJ like this.

    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.

  • 0

    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.

  • 1
    Sour Lemon likes this.

    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.

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    Quote from Dubs3035
    Can you explain " daisy chained". Sounds perfect.
    You attach a splitter to one of the ports of another splitter, then attach another splitter to one of the ports of the splitter you attached to the first one, and on and on.

  • 2
    NutmeggeRN and sirI like this.

    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.

  • 1
    renardeau likes this.

    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.