Latest Likes For Double-Helix

Latest Likes For Double-Helix

Double-Helix, BSN 23,133 Views

Joined Apr 5, '11 - from 'New Jersey'. Double-Helix is a Nurse, Children's Hospital. Posts: 2,689 (50% Liked) Likes: 4,662

Sorted By Last Like Received (Max 500)
  • May 23

    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.

  • May 22

    I'm a peds nurse as well, although I do see my fair share of teenagers and occasionally adults. The IV's we place are primarily for short term use- sedation/anesthesia, radiologic contrast, blood draws. The only time we need 20g or larger are for certain radiology exams- usually CT angiograms.
    Here's a few things I know:
    1. 20g's are more difficult to thread than 22's or smaller. Because the bevel is larger, you need to advance the needle a bit more after you get a flashback in order to make sure your catheter is fully within the vein before attempting to thread. Otherwise it will blow.
    2. Adult veins tend to roll more than peds veins. They have less supporting subcutaneous fat (this is especially true to hand veins) and it's not uncommon for you to stick a good looking vein and after you stick, the vein just isn't there anymore. You can help this by using your non-dominant hand to tack down the vein above where you're going to stick. You can grab another person to help with this until you're comfortable.
    3. Unless it's a very sick patient, and you anticipate giving a lot of fluid/blood, a 22g will work just fine. If you're starting the IV, any size will allow you to draw blood. We draw labs with 24g IV starts all the time. A well-maintained 22g works just fine for repeated blood draws as well. And there is a lower risk of phlebitis from a large catheter in a a vein. So, especially if you're not comfortable with the gauge, there's little benefit of a 20g over a 22g.
    4. Adult veins tend to have more rigid valves. When you're looking at a vein, look for areas that appear more rounded, almost like bumps along the vein. That's where you're likely to find a valve, and have a harder time threading the catheter. If you see a valve, go above or a good bit below that spot.
    5. My favorite veins for adults are the cephalic vein- from the forearm up to the anticubital space- and the medial ante brachial in the forearm. Hand veins can work as well, just watch out for valves and make sure they are stabilized when you stick.

  • May 21

    I'd say something like, "I'm going to assume you're an educated professional until proven otherwise. I would appreciate the same courtesy."

  • May 21

    I'd say something like, "I'm going to assume you're an educated professional until proven otherwise. I would appreciate the same courtesy."

  • May 20

    I'd say something like, "I'm going to assume you're an educated professional until proven otherwise. I would appreciate the same courtesy."

  • May 20

    I'd say something like, "I'm going to assume you're an educated professional until proven otherwise. I would appreciate the same courtesy."

  • May 20

    I'd say something like, "I'm going to assume you're an educated professional until proven otherwise. I would appreciate the same courtesy."

  • May 20

    I'd say something like, "I'm going to assume you're an educated professional until proven otherwise. I would appreciate the same courtesy."

  • May 20

    I'd say something like, "I'm going to assume you're an educated professional until proven otherwise. I would appreciate the same courtesy."

  • May 20

    I'd say something like, "I'm going to assume you're an educated professional until proven otherwise. I would appreciate the same courtesy."

  • May 20

    I'd say something like, "I'm going to assume you're an educated professional until proven otherwise. I would appreciate the same courtesy."

  • May 20

    I'd say something like, "I'm going to assume you're an educated professional until proven otherwise. I would appreciate the same courtesy."

  • May 19

    I'd say something like, "I'm going to assume you're an educated professional until proven otherwise. I would appreciate the same courtesy."

  • May 16

    Diverting is not the same as using. Someone could be stealing medication to sell, to give to a friend or family member, etc. A negative drug screen doesn't prove innocence from diversion.

    OP, it seems you have a history of poor relationships with prior employers, and this isn't the first time that you've been accused of unprofessional/illegal behavior by an employer, including patients who are willing to corroborate those accusation. So you should know that the time to contact a lawyer is BEFORE anything is reported to the BON, not after. Ask for accusations or complaints in writing, and don't take any more of their calls.

    What are your facility's policies regarding controlled substances? You said there is no policy against picking them up from the pharmacy. What pharmacy allows any nurse to pick up controlled substances for patients? Do sign for them? What's the chain of possession for those medications after the fact? What happens once the medications get to the patient's home? Is there a log where medications are counted and signed out? If you truly are innocent, documentation should support you.

  • May 15

    Diverting is not the same as using. Someone could be stealing medication to sell, to give to a friend or family member, etc. A negative drug screen doesn't prove innocence from diversion.

    OP, it seems you have a history of poor relationships with prior employers, and this isn't the first time that you've been accused of unprofessional/illegal behavior by an employer, including patients who are willing to corroborate those accusation. So you should know that the time to contact a lawyer is BEFORE anything is reported to the BON, not after. Ask for accusations or complaints in writing, and don't take any more of their calls.

    What are your facility's policies regarding controlled substances? You said there is no policy against picking them up from the pharmacy. What pharmacy allows any nurse to pick up controlled substances for patients? Do sign for them? What's the chain of possession for those medications after the fact? What happens once the medications get to the patient's home? Is there a log where medications are counted and signed out? If you truly are innocent, documentation should support you.


close
close