Double-Helix, BSN 25,704 Views
Joined Apr 5, '11 - from 'New Jersey'.
Double-Helix is a Nurse, Children's Hospital.
Posts: 2,695 (50% Liked)
First things first, HIPAA covers protected health information. This is personal, identifying information released without consent. Gestational age, or a statement of "we just admitted 34 week twins" in no way contains personally identifiable health information. So no, it is not a HIPAA violation.
Though we tend to use the term HIPAA to be synonymous with "patient privacy", the two are very different. Hospitals usually have policies regarding respecting patient privacy that go above and beyond the scope of HIPAA. So while your comment about "going to admit 34 week twins" was not a HIPAA violation, it doesn't mean you might not face reprimand or disciplinary action from the hospital for violating patient privacy. However, given that your unit publicly posts signage identifying which rooms contain twins, I doubt simply informing another patient about the arrival of another set of twins would be considered that serious.
You might find the Holistic Nursing forum here helpful. It's under the Specialties tab in the yellow bar at the top of the screen. Here's the link for you. Holistic Nursing
You're right that there aren't really any nursing programs out there that only teach holistic nursing. That's because nursing school has to prepare you to pass the NCLEX and practice safely in any nursing setting. A huge part of nursing settings involve giving medications and working in an acute care setting. You have to learn that in school in order to be a safe and competent nurse.
There are nursing avenues that would suit what you want to do, but you will still have to learn the Western medicine techniques and possibly even spend a few years in a more traditional nursing role in order to gain the experience necessary to move into one of those avenues. The real question is whether you would be able to tolerate the lecture and clinical work required for nursing school, when you seem so starkly opposed to those beliefs. Just like you can't enter nursing school and say, "I only want to work with children and don't want to learn how to care for adults," you also cannot say, "I only want to learn holistic nursing therapies and not learn how to give medications."
If you don't think you'll be able to get through nursing school, then another career path will better suit you.
I understand your points about Western medicine. I do believe that alternative therapies and good nutrition can be very helpful in the prevention of certain diseases and can be effective when used in conjunction with more traditional therapies. However, there is a point- such as when the patient already has diabetes, heart disease, or an infection- when medications are a necessary part of the patient's recover.
I'll also suggest that you may want to alter your vocabulary when you speak to other nurses about these issues. While this might not be your intent, your post comes across as quite condescending toward nurses- as though all we do is push pills and could care less about other aspects of health and wellness. Nothing could be further from the truth. Any nurse will tell you that we do encourage proper diet and exercise habits as much as possible. However, one of our biggest obstacles is convincing the patient to make the needed lifestyle changes. That's an obstacle that you will face no matter which career you choose to pursue. You can be adamant about proper nutrition all you want and preach proper diet, exercise, and homeopathic remedies until you're blue in the face. But unless your patients agree to stop eating McDonald's cheese burgers, drinking soda, and watching TV for 10 hours per day, it's not going to make any difference.
The point is that it's not just about what I believe good health is. My job is to help the patient recover from their disease. Do I believe that many of my patients would be healthier and recover more quickly if they exercised more and ate a proper diet? Absolutely. But if my patients refuse to change their lifestyle, it is not ethical for me to toss them out into the street until they decide to come around to my way of thinking. Instead, my job is to help them recover using therapies that they will be compliant with. For many patients, this means giving them medications.
Take no offense, please, but you are young and your views of healthcare are idealistic. While they many make sense in theory, they often don't work out as you want them to in the real world. Please try to avoid offending others who work in healthcare and don't exactly agree with your views. Instead, collaborate, discuss, contemplate, and we can all learn from each other.
Let's think for a minute about what HIPAA is. Health Information Portability and Accountability Act. While what it actually is, and who and what it covers is a very detailed topic, the short version is that a HIPAA violation involves releasing or sharing protected health information without the consent of the involved party.
So now you can answer your own question. If the parent was not a patient of this provider, nor a patient at the hospital, they are not protected by HIPAA. Arrests/criminal actions are a matter of public record and not at all related to HIPAA. Inquiring about one's neighbor who was arrested, regardless of where they were arrested, is in no way related to HIPAA.
This story sounds like the "Lemonjello and Orangello" twins. Everyone says they have heard of patients by those names, yet no one can provide proof that they exist.
Because when someone asks a question they get told to search because their question has been asked before!
How are so many old threads being dragged up lately? This thread is from 2007 and last reply was 2008. All the posters have graduated nursing school by now.
My first question is- what text book is your INSTRUCTOR teaching from? That's the book that you should be using to study for the exam, as that's where the information will be based. The Saunders book may be good for NCLEX prep, but I doubt it is covering the exact same material in your syllabus.
Second, as your instructor if you can sit down with your exam and go over the questions that you got right and wrong. Evaluate what kinds of questions you're getting wrong and see if you can identify why. Did you not understand the content? Did you fail to prioritize correctly? Do you understand the concepts but fell down on applying the information in critical thinking situations? This might help you see where you should focus and adjust your study techniques.
I think this is the point. Smokers tend to less healthier then those who are non-smokers. Therefore, they take more sick days, and the group insurance rates go up.
I also think that fat people are just as at risk, but I'm thinking that so far, they cannot "discriminate" against obesity. At least not overtly.
As nurses, it’s our job to make patients better, to improve their lives in some way. For acute care nurses, the goal is to help patients recover from an illness, surgery, or accident. Rehab nurses help patients reach their highest level of functioning. Community health nurses promote wellness and primary prevention. Hospice nurses help a patient die with the most comfort and dignity possible.
As PICU nurses, our job is to fix children. Pediatrics is arguably the most diverse field of nursing, and we see a huge variety or illnesses, injuries and ailments. I’m very pleased to say that the great majority of children go home well. Kids are extremely resilient. A two year old who aspirated his scrambled eggs can be on ECMO one day and smiling and playing only three days later. I’ve seen kids overcome insurmountable odds on the road to recovery. I’ve seen the smiles from ecstatic parents, felt their grateful hugs, read their heartfelt thank-you notes. These memories make it especially hard when there is a child so sick we know they won’t be going home.
It doesn’t help that our unit has recently had several children with chronic conditions and hopeless prognoses: A few progressive genetic disorders, a fatal surgical complication, a routine procedure that ended in brain death. As PICU nurses, these are our least favorite patients. The ones that we cannot fix. The ones we cannot send home better, or cannot send home at all. These cases are hopeless from the beginning, but we run tests and do research and try new treatments until the question of their care changes from ‘What can we do?’ to ‘What should we do?’
Such is the case with the child who weighs heavily on my mind. A little boy just over a year old, the victim of a serious genetic defect who has already outlived his prognosis by several months. He is cherished by his parents. Though his face and body are severely malformed, his mother looks at him like there has never been a more perfect child. She wants desperately to keep her son with her, but he is nearing the end. A string of recent hospitalizations have left his body exhausted and unable to recover from this most recent respiratory infection. He won’t leave the hospital. It takes nearly a week and several family meetings to convince the parents it’s time to let him go. In that time, the child has nearly died more than once. A ‘Full Code’ order required that we compress, push medications, even insert an IO, and left the nurses frustrated and questioning the ethics of our work. It's heart-wrenching for us to process. This child has spent months with us over the past year and we have grown to love him. While we hate to let him go, we hate the thought of hurting him even more. We have reached the ‘Can’ versus ‘Should’ moment.
After several family meetings, a DNR is signed. The child is placed in the mother’s arms. Family is called in to say goodbye. This time, when the child’s heart rate and saturations begins to drop, the scene is different. The nurse doesn’t press the code button and sound the alarm. She doesn’t place the child on a back board, initiate compressions, push epinephrine or begin bagging. Instead, she holds the hand of the crying mother, she silences the alarms, disconnects the child from the monitor and steps out of the room to give the family privacy. In the eyes of an ICU nurse, she is does nothing.
It’s the hardest nothing she will ever do.
The parent’s see the difference now. Instead of facing their child’s death with fear and anxiety, they sense the peace in his body. He is exactly where he should be- being cuddled by his mother and kissed by his father. His last moments are free from pain and full of security and love.
The family spends as much time as they want holding the child, saying goodbye. When they are ready, the nurse places the child in the crib, removes his lines and tubes, washes his tiny body, makes handprints and footprints in ink and cuts a lock of hair as a keepsake. One by one, the family files out of the room. The mother is the last to leave. She turns back for one last look at her son before waddling out the door. She waddles because this mom is also 36 weeks pregnant.
In a couple of weeks she will return to this hospital, to the Labor and Delivery unit, and she will deliver another baby boy. The nurses in the newborn nursery will assess her new son and deliver the news that the baby is perfectly healthy. There will be no five month stay in the NICU. No barrage of tests and procedures. No hopeless prognosis. This baby will not come home with a trach and a shunt and a feeding tube. His mother and father will take him home after two days and he will thrive. A perfectly healthy baby boy who, by the grace of God, his parents will never have to bury.
Staff line up at the door to see the family out. There are tears in the eyes of the family, the nurses, even our attending physician. We offer condolences and encouragement: “Take care of yourself.” “Get some rest.” One nurse hugs the mother and softly whispers, “You did the right thing” and the hug gets a little tighter.
The mother saves her final hug for her son’s nurse. “Thank you,” she says, “for everything.”
But we know what she really means is, thank you for nothing.
I've only been a PICU nurse for three months, but I have gained a huge perspective in that time! Being a PICU nurse is exciting, heart-breaking, frustrating, scary, and wonderful all at the same time.
Imagine taking care of a child on ten seperate medication drips who is on a ventilator, has three central lines, arterial line, a CVP and a foley. You're drawing hourly blood gases and blood glucose levels, counting all of your I&O's hourly, monitoring the ventilator settings, constantly alert for any changes in vital signs, making sure your syringes of pressors don't run out, hanging so many medications that you are running out of lines to use. You're giving updates to the docs and making adjustments to your drip rates based on their orders. You need to turn your patient every two hours, which requires two other nurses to help move the patient and keep the breathing tube in place. To top it all off, you have angry family members scrutinizing everything you do and demanding that certain non-essential things be done immediately.
Being a PICU nurse is never boring. There is always something new, something that needs to be done. I've taken care of kids with so many different diagnoses that I couldn't possibly list them all. Our unit is a 19 bed PICU that takes all different kinds of kids. Our hospital has a pediatric cardiac surgery program, so we always have at least a few cardiac patients with various congenital cardiac defects. Depending on the season, we usually have a couple kids with viral illnesses, particularly RSV in the winter months, one or two babies on observation for apnea, asthma exacerbations, ex-preemies with chronic medical issues and heme-onc patient. Most of the pediatric surgical cases bypass the PACU and we receive them directly from the OR. So we get tonsillectomies, thoracotomies, traumas, amputations, appys, cardiac cath's, neuro surgeries, etc, etc. Our general peds floor does not have monitoring systems, so any patient that requires continous monitoring of any kind (HR, rhythm, O2 sats, respiratory) comes to PICU.
Solid assessment skills are crucial. Kids can't tell you when something is wrong. You have to know what's normal and what isn't and be alert for any changes that might indicate the child is deteriorating.
Critical thinking: why is this patient presenting like this and what does it mean? What am I going to do if this kid goes south? What do I need to have on hand in the room in case of an emergency?
Prioritization and time management: You've got a lot to do. You need vital signs on all your kids at noon time and you also have three IV meds to hang, several po/GT meds, one kid needs an enteral feed and the other needs labs drawn and another has an infiltrated IV. What's most important? What can you get done early?
Communication: With docs, with parents, with the kids. Parents of sick kids are nervous wrecks. They have a lot of questions. You need to be able to explain what is happening in terms that they can understand. You need to explain things to the child. You need to convince a sick and scared child to swollow their medications. You need to explain to the doctor why you think one of your kids needs a different type of treatment. A big part of your job is communicating. And don't forget giving and receiving report.
My day begins at 6:45am and on a good day I leave at 8pm. Most days I eat lunch at the nurses station in five minutes so I am never far away from my patients. If I use the bathroom once I am lucky. But these are "my" kids, as I refer to them. They are my responsibility and whether I've taken care of them for an hour or three shifts, I love them. There is no other specialty like PICU, and there is no other place I would rather be working.
If you don't have the forms from the inservices, see if you can get a signed letter from the people who ran the inservices that states you attended and for how many hours.
As far as the bioterrorism one, try to get it as soon as humanly possible.
Oh, and please, keep all your tax documents. You never know when you might be selected for random audit by the IRS.
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