Kareylea 1,228 Views
Joined Dec 15, '10.
Posts: 14 (43% Liked)
to clarify concerning my reference to Hurricane Sandy.
My understanding is that the hurricane had a profound affect on thousands in the area? People without power, transportation impaired, schools out, etc and the area remains not completely recovered? So I was thinking the stress of this event, plus the turmoil it caused could possibly have made people more susceptible to commutative illnesses? It was just a thought. It was something different that happened this year and the % of influenza cases are much higher this year.
Thank you OP for breaking this down and for providing the culture reports.
This is one thing I was afraid of. First of all I am so sorry so many people are sick with this stuff. God speed.
Second--when you hear of influenza/flu prevention-- what do you hear---yep thats right--GET THE FLU SHOT! Well, thats just wrong.
Different strands are causing a lot of this outbreak it seems and one cannot constantly outguess mother nature--even for the limited protect this years influenza vaccination is suppose to provide. I know there are more reasons than just the flu shot but my reasoning is this.
What I wish I would hear on TV , radio, internet etc etc is how to best protect yourself from getting Influenza. Yes, the influenza vaccination can be a small portion of protecting yourself, but there is much more to it--as we all know. Those parts--we hear little about and to me they are more important. I have actually had people tell me they can't get the flu because they have had the influenza vaccination.
And dont get me started on Tamiflu.lol
On second thought I do wonder if the aftermath of Hurricaine Sandy is somewhat to blame?
I had a patient that broke her arm and was in a sling. She needed to see PT so I asked the doctor to put an activity order in, I figured I would get the normal: NWB RUE. Nope, "No handstands."
"Sooo, flu vaccination of caregivers reduces health care costs by reducing complications in vulnerable patients?
[FONT=verdana, arial, helvetica, sans-serif]If so then it does seem like a reasonable expectation to have nurses take the flu vaccine."
[FONT=verdana, arial, helvetica, sans-serif]The trouble with this is that the influenza vaccination effectiveness is questionable. By all information that I can gather it is at BEST only 60% effective overall. Also remember that it is only designed to protect agaisnt 3 viruses that the CDC guess will be the ones that are prevalent this season. There are over 200 different viruses that can cause influenza. Its a gamble.
I have no problem with the influenza vaccination per se-- i do have a problem with business's and government when they start mandating yearly ineffective vaccinations. A thought...if it was effective then they would not have to mandate it would they?
Visitor control and proper infection disease precautions will go further to reduce "possible" nosocomical infections than staff vaccinations in an acute care facility. But--those types of things are not popular with hospital administrations. Visitor control ( both is visiting and visitors being made to do proper infection control) and staff infection control cost the hospital bad public relations and money. How does it cost the hospital money--because proper isolation/infection control measures and lower patient to nurse ratios cost more.
That type of approach would also reduce the amount of MRSA, HIV, pneumococcal[FONT=verdana, arial, helvetica, sans-serif] pneumonia ( and THAT may be coming as the next mandatory vaccination!) and various other infections we are so familiar with.
I've never gotten the flu and I've refused it every year, which is going to change next year when it becomes mandatory. It drives crazy that I am so contagious, yet no one cares about the 40 aunts, uncles, grandmothers, grandfathers, neighbors, friends, co-workers, cousins, and kids who cough, sneeze, touch, and wipe all over the patient. Same people who refuse to wear gown, gloves, and mask, who never wash their hands, or sometimes actually wear PPEs, but walk outside the room, use their cellphone, and remove their gloves when no one is looking. If hospitals really wanted to reduce to transmission rate of the flu, limit all hospital visitors to those who have been vaccinated. I bet the rate would be close to zero, but that is a crazy standard and we can't deny people the right to see their loved ones. I wash my hands all day, use hand sanitizer, usually always wear gloves, and obviously never cough on people....I know that doesn't guarantee anything but compared to the visitors that have snot everywhere, I doubt something is coming from me. I had a patient last week that had visitors every 10 minutes, 3 at a time, never the same people for 12 hrs straight. On top of every person asking "how they doing, how they doing, they doing," I couldn't get people to wash their hands, cover their mouth, or stop people from lifting their kids for hugs and kisses in enough time. I often wonder in a non-realistic scenario, how dirty hospitals would be with flu and mrsa if it was limited to just patients, hospital workers, and immediate family only....if each visitor was screened for flu-like symptoms, cough, or open wounds...if the hospital was treated like the OR with limited visiting areas and masks. I think the nurses that are arguing against flu shots see other major factors. Plus, if nurses actually have the flu, they are restricted from work. I have seen quite a few people who got vaccinated, but still got a different strain of the flu. On the other hand, the nurses that are arguing for getting vaccines, we are being exposed to those visitors which can then be transmitted to the patient, so there are both sides to argue. Personally, I think vaccination is being implemented because of all the visitors that are bringing it in. So, the only thing left to do is cut out our part of the link. Mandatory vaccination will never go away because the flu is coming in via a whole other route and that route is never going to be limited or restricted. How dare I tell the guy that is a distant cousin, who doesn't even know the pt's last name, to not come in because he has a cough...who never washes his hands, who constantly wipes his nose, touches his face, and wipes the snot off his kid nose, and then insists I give him a wet hand towel so he can wipe all over the pt's face with his own wet hands. Pts who are immunocompromised have strict limitation, such as limited visitors, so why can't that be the same for all pts? Don't they deserve that? In the end, I will get vaccinated. I don't have a choice. But, I love my job, I like what I do, and I don't want to put patient's lives at risk, so I will do it. But I don't think it does anything toward the problem and I'd rather not put something in my body that might not even work, but it's not about me. I'd rather work in a hospital and get vaccinated verses sitting at a desk with shirt and tie, crunching numbers 5 days a week for the next 40 years. It would be nice if visitors would at least wash their hands or god forbid, stop coughing and touching the pts face every 5 minutes.
"The general bacterial load associated with living life as a human being is not the huge threat the advertisers of "sanitizing wipes" tell you. A good immune system doesn't happen by accident. Evidence-based practice ROCKS!"
You said a mouthful. An active immune system is a happy immune system. Sure, infection control measures have their place, but not for the healthy average individual walking around. Heck, my kids ate all kinds of nasty stuff (when I wasn't looking) and no ill effects.
I get sick very seldom. I just figure that no self respecting germ would live in my body.
I have not changed my habits at all. I was never germ-phobic. In Trauma, I see far more damage done to human bodies through poor choices than lack of sanitation.
People tend to have more dread over things that seem out of their control(germs,planes, terrorists) while drinking too much, eating poorly, smoking and ignoring signs of bigger health problems.
We are only human.
She knew what she wanted.
She'd watched her husband of 52 years die on a vent, and followed his wishes to remain a full code. But she knew that was not what she wanted for herself.
So, she wrote a Living Will, had it notarized, gave it to her personal physician, told all her friends and family what she did not want. She wasn't eligible for a DNR, as she was a healthy 89-year-old, but she knew what she wanted.
"I do not wish my heart to be restarted through usage of any chemical, mechanical or physical intervention..."
Of her 6 children, one fought against her mother's decision, and it was this child, this one desenting voice, who found her mother collapsed on the kitchen floor.
"I do not want any external device to be used to maintain my respiration if my body is incapable of sustaining it on its own."
The daughter told EMS her mother was a full code, and they intubated her on the floor of her kitchen. Once at the ER, her heart stopped, CPR was performed, and her heart was shocked back into a beat. Under the hands of those trying to follow the daughter's wishes, the woman's ribs cracked and broke.
"I wish to die a peaceful, natural death."
She was then sent to ICU, where her heart tried to stop 3 more times. Each time, the broken ribs jabbed and ripped into the fragile muscle and skin as CPR was performed. Electricity coursed across her body and her frail heart was restarted a 4th time. By this time, the other children were there, but the act had been done, over and over. No DNR was written, and the Living Will fluttered impotently at the front of the chart.
"I do not wish artificial means of nutrition to be used, such as nasogastric tubes or a PEG tube."
Her swallowing ability was lost in the storm in her brain that had left her with no voice, no sight, no movement. A scan showed she still had brain activity; she was aware of what was being done to her. Including the PEG tube sank down into her stomach, and the trach in her throat.
"I wish nature to take its course, with only medication to prevent pain and suffering."
The daughter who wanted the mother to remain a full code also refused to allow narcotics to be given, stating she did not want her mother sedated, since she would "wake up" when the correct medical procedures were performed. Her nurses begged the doctor to write a DNR, and he said, "the family can't get it together, and I'm not getting into the middle of it."
"Allow me the dignity we give to beloved pets. Let me die in peace."
I met her one Tuesday night, and spent that night pouring Jevity into her tube, only to suction it back out. Her legs were cool and mottled, her bowel sounds were non-existant, and her blue eyes stared blindly at a ceiling she could no longer see. The MD refused to terminate feedings, but I held them since there was no digestion taking place. The woman was turned and repositioned every 2 hours, and each time, she moaned and gurgled as her lungs slowly filled with fluid. I whispered my apologies as I did the very things to her she tried so hard to prevent.
Suctioning improved her lung function, but would make her body tremble. Over the next 2 nights, she slowly died, all while the daughter demanded more interventions, and maintained that her mother wanted to be a full code. We had read the Living Will. We knew better.
"Thank you in advance for helping me in the last moments of my life to have a gentle, peaceful passing."
She had another stroke, and went back to the ICU, where she was coded until there was not enough surviving heart tissue to maintain a beat. Finally her heart was broken.
And so was mine.
* I wish you wouldn't complain loudly about how much you hate being here -- not only in the halls, but in patients' rooms. It puts me and the patients in a bad mood and it's getting to the point that I hate being at work when you're there
* Thanks for your bright smiles and generous help. You made a horrible shift that much better.
* Thanks for sharing your abundant knowledge; I learn so much from you
* PLEASE don't grill me about the smallest details in report if you're going to look it up yourself anyway. I believe in being detailed, but it's 8am already and I'm exhausted. You can easily look up labs from days ago on your own time without me sitting there watching you in frustration because I still have one more patient to give you. Please do me that small favor since I already helped you send off a pt to a test who wasn't even mine. And PLEASE stop running away in the middle of report for small things. They can be taken care of when we're done. I know you're trying to be thorough, but you are usually the first to want to get out early at the end of your shift because you want to spend time with your kids. I don't have kids, but I do have an urgent date with my pillow. So could we get this done with?
* Please don't leave your phone and pager on your computer and walk away from it. If someone needs you, they won't be able to reach you and someone may get hurt. Don't be offended if I hunt you down and hand them back to you. It's unsafe.
* Please don't riddle your every day conversation with strong language. I don't swear and don't appreciate it. I understand the need to vent and will let it go, but it does bother me. Thanks to those of you kind enough to apologize even though I don't say anything and am not meaning to give you dirty look (and I sincerely hope I'm not). I really do appreciate it. That kind of sensitivity is rare.
* You are an AWESOME charge nurse. It's a joy to work with you. Thanks for being so supportive and amazing. You're my hero and I want to be you, minus the whole charge nurse thing.
*Thanks to those nurses who received report from me on Thursday morning. I had a truly awful shift and gave the worst report of my life. Thanks for putting up with it and be so nice about it. It means a lot.
* Thanks to my aides. You guys bend over backwards for me and I really appreciate it.
* Please don't say horrible things about other nurses/aides/whoever when I'm around. I don't want to know. I'll figure it out for myself and I'd really rather not have a bad attitude toward them because of something you said. I have to work with them too and would prefer to have a good working relationship if it is at all possible. On the other hand, please don't be offended if I walk away when you start gossiping. I don't think I'm better than you. I'm uncomfortable and don't really want to know what you're saying.
* Please don't one-up me with horrible shift stories. I just finished having an awful shift, you reamed me over something that was passed on to me wrong, and I want to cry. I'm trying to vent and feel a little better for missing that one small thing and all you can do is mention how much more horrible YOUR last shift is. I'm sure it was awful and I'm sorry. Could you just listen to me for a second, though? I'll listen to you later. Really. I just need to feel better and you're not helping.
Each time you are rude to me while I am passing report after a hectic shift I WILL remember next time when you happen to report off to me like a chicken with your head cut off.. and please do not think it won't happen. It IS the way of the world. You put off an err like you are going to write me up for something stupid? You bet your butt if you do the next time you give me report that is something that won't be forgotten!
Remember when receiving report it is never fair to judge the off going nurse, because you never know what happened through the last 12 hours while you were resting your pretty little head on your pillow. Ok, roll your eyes again... so mature.
And to those who graciously take my report when I've had a horrible day, thank you. Your respect will be returned and remembered.
Please dont call me on my day off, especially when I have picked up at least 1 shift every week for the past 2 months.
I'm sorry, how is this thread considered mean or nasty when the thread about things you would love to say to patients is massive?
When you spend 8 to 12 hours with a group of people on a regular basis, you start to pick up on certain things. Its a lot more healthy to vent on a safe site where we support each other and can relate than to verbally accost someone at work when you finally can't take it anymore and snap out.
what i wish i could say would get me banned from allnurses
Living in the Midwest, the weatherman isn't always right, no matter how late you stay up watching for any changes. Surprises happen and I wish we could all drive 4 wheel drive trucks and have family rush over to take care of our little children. Or have family in the same state for that matter. We are all trying to make an honest living in a stressfull career. Let's not get to the "if I can do it and you can't, then you are inferior" . I am all for a hospital winter weather emergency budget to get nurses where they need to be. Nurses feel guilty enough when they truly can't get to work. God Bless
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