Latest Comments by Double-Helix

Latest Comments by Double-Helix

Double-Helix, BSN 22,633 Views

Joined Apr 5, '11 - from 'New Jersey'. Double-Helix is a Nurse, Children's Hospital. Posts: 2,680 (50% Liked) Likes: 4,632

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  • 0

    In order to generate business, you'll need to be a certified instructor in BLS, ACLS, and PALS through the American Heart Association. TNCC and ENPC are through the ENA, so I'm not sure how you go about becoming certified to teach those courses.

    Then, if you want to offer classes independently, you'll likely need to get approval from the AHA. You'll need advertising, a facility where you can teach, materials such as CPR mannequins or simulation dummies, instruction booklets, monitors capable of displaying various rhythms, intubation equipment, etc. It will be a huge financial undertaking, so you'll need to be prepared for that.

    I'd start by speaking to other AHA instructors in your area. See how they do it. Do they rent facilities and equipment? Are they employed by a training center or a hospital? If they are independent, do they operate financially through an LLC? And certainly, speak to a professional in the business/legal industry.

  • 0

    On top of the reasons stated above, when a patient is receiving care at a facility, it's necessary for the facility to have a record of that visit and medical information (allergies, emergency contacts, etc.) in case that patient experiences any medical emergencies while in the facility.

  • 0

    This is a big undertaking. Kudos for being ambitious. I do want to let you know that changing policy and developing any kind of tool for widespread use is a task that will require more than just a nursing student. Tools like this have to be proven to be valid and consistently applied. You'll want to get some of the staff from the hospital on board if you really want to take this beyond a theoretical project.

    Some points about PICC line indications:
    - It's not the number of antibiotics that require a PICC line, but the frequency and duration. Also of consideration is the kind of antibiotic. Some, like vancomycin, are more damaging to veins, and in a patient with poor peripheral veins may blow through so many standard peripheral IVs that a PICC is a better option.

    -Patients may be discharged home with PICC lines for long term antibiotics or other medical therapy. Clearance for discharge is sometimes, but not always an indication for removal of access. My other concern is that, sometimes, the patient may not be discharge ready for one reason or another, but no longer needs a PICC line. Making "clearance for discharge" a necessary criteria may miss those patient's who still require admission but no longer need central access.

    -A patient with poor peripheral access (think veins damaged by chemotherapy, or vasculitis, etc.) may be candidates for PICC lines for that reason alone.

    - Blood transfusions, administration of concentrated electrolytes, and need for frequent blood draws are also indications for a PICC line that aren't addressed in your tool. Here's a quick list of PICC line indications- Why Choose a PICC

    I think you've got a good start, but your tool requires some tweaking. How are rounds conducted in this hospital? Does the nurse participate in bedside rounds with the physician? I wonder if a more attainable goal might be to get the staff nurses to encourage a daily discussion with the physician during rounds to assess the continued need for central access. The tool you develop can be used by the nurses to facilitate the discussion.

  • 0

    Without experience, the jobs you'll find in the medical field will be things like unit clerk, secretary, PCT, patient observation (1:1 aide, patient watch), and patient transport. You can also look into your state laws and see if you're eligible to get your Nursing Assistant certificate after a certain number of clinical hours. All of those jobs may give you the chance to get your feet in the door and network.

    However, if what you're really looking for is income to pay for school, your best bet is to get a job that allows you to make the most money in the least amount of time. That may not be in healthcare at all. Restaurant service, working weekends and Friday nights, might be the most profitable.

  • 0

    What sort of help are you looking for? It sounds like you've done all that you can do in terms of studying and trying to be successful. Are you trying to get advice on how to deal with this instructor? Well, if you need something from her in terms of help in the class, then you'll have to address her and the attitude you think she has toward the students. If you don't need anything from her, then just keep your head down and keep doing working hard. Perhaps you can form a study group among the students to support each other and help each other learn. If you're trying to speak to her directly and meeting resistance/disinterest/disrespect than I suggest bringing your concerns to your faculty advisor or the program director.

  • 5

    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.

  • 1
    Kitiger likes this.

    In addition, you can also call your facility's Compliance Department (some places have a hotline). You should be able to do this anonymously.

  • 5

    The fact is it doesn't matter if you believe the patient. It doesn't even matter if the patient was telling the truth. The patient has a right to be reasonably accommodated in their healthcare decisions, provided it doesn't jeopardize safety. If the patient wants to be assigned female staff, whether its because of a h/o abuse, cultural reasons, undisclosed personal reasons, or simply because he doesn't feel comfortable with another male seeing him naked, that should be accommodated, provided there are ample female staff available.

  • 1
    sarc likes this.

    How about:

    Does administration of oxygen affect respiratory drive in patients with COPD?

    Or

    Does management of Type I diabetes using an insulin pump provide better glycemic control than a subcutaneous insulin regimen?

  • 0

    You really need to ask your school. None of us can tell you what classes will or will not be considered equivalent. The admissions department is a good place to start.

  • 2
    Kitiger and Maevish like this.

    Tell your instructor about the conversation and your concerns. If the instructors feel this behavior could affect her clinical performance, they will investigate further. If you feel led, privately, express to this classmate that her statements earlier were concerning to you, and remind her that the school has mental health resources available to her if she feels she needs them.

    Short of that, she is an adult, and you can't force someone to seek medical attention unless they appear to be a danger to themselves or others.

  • 0

    You say this is your third semester. How did the first two go? Did you perform well on tests? Was there something different about your study habits or techniques?

    Without more information, I'm guessing that these are your first nursing tests that have NCLEX-style questions. That is, questions that ask you to read a scenario, apply your knowledge, and choose the best response. These types of questions- "thinking like a nurse" are difficult for a lot of students to adjust to because it's no longer all about memorizing facts and spitting them back out. There isn't one correct and three incorrect answers on these tests. It's about assessing (reading the questions), diagnosing (deciding what the question is asking), and making the best choice from the options given. You may have a question with several "right" answers, but only one is the "best", most appropriate choice for the situation you are given.

    Your first step should be to sit down with your nursing instructor and go over your test. Identify areas where you are struggling and see if you can come up with a plan to either study or take the test more effectively. Maybe it's a matter of studying the wrong content. Maybe you're having trouble applying the pathophysiology to the nursing process. Your instructor has definitely seen these problems before and is best suited to advise you on how to be successful in his/her class.

  • 0

    Which goals did you choose? Perhaps you could make your presentations a comparison of current practice versus the Joint Commission's goals so that your classmates can see how their practice may be impacted.

  • 2
    xoemmylouox and WinterLilac like this.

    Who accused you/reported that you fell asleep? When I worked in home care, falling asleep would have been grounds for termination. We weren't even allowed to give "the appearance of sleep" (such as head bowed in prayer for more than a brief period) because it could be construed by the client as sleeping. It's a serious accusation and clearly is affecting your ability to work. If it's truly an unfounded accusation, I would insist on meeting with your supervisor and her manager to learn who accused you, and when, and make clear you refute the allegation.

  • 0

    Without supporting research, the only potential problems I could think of are if the antibiotics are either particularly vaso-irritant or nephrotoxic. Back to back vaso-irritants may increase the risk of IV complications from phlebitis, infiltration, etc. Nephrotoxic medications administered without breaks may increase stress on the kidneys.


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