ixchel, BSN, RN 46,997 Views
Joined Jun 3, '11.
Posts: 5,158 (75% Liked)
Jan, your post was beautiful and thorough, and I very much appreciate it! Sloughing of bowel was actually one thing that happened with my now deceased loved one. It was hard to understand just how much she had deteriorated in only a few days. I was thankful the nurse was candid with me, though. Any site I have read so far with the position that Jahi is not dead has cherry picked comments left and right. You can tell because the people who are crying out for prayers and miracles are slinging profanity at comments that no longer exist. I'm blown away that in one sentence they ask for and offer unconditional support, but they immediately follow it up with a bunch of eff yous and insults.
So, physiologically..... What is going on inside her right now? She's had no nutrition, and meds are keeping her going, right? But what's happening in her body? A dear family member passed on in November after a pulmonary embolism in a pulmonary vein, which stopped her heart and she never did wake up. She was sedated (only because she'd seize when they tried waking her up), had vasopressors, and was on a vent. Now, she was facing cardiac death, not brain, but ultimately, her organs started failing. Her kidneys stopped, her intestines stopped, they stopped feedings because her residuals indicated nothing was moving beyond her stomach. She was mush, pretty much. Jahi has extremely different circumstances, of course, but 3 weeks with nothing going in but meds, and no basic brain function .... Wouldn't she essentially be mush as well?
But, in this specific scenario, it really wasn't feasible to obtain an order for PICC draws right at that moment, in time for that blood draw that needed to be drawn at that time.
I think adressing it in the morning, to be taken care of that day, is fine and being an advocate and a prudent nurse and all that.
If this had been passed on from shift to shift with no one owning it, and the patient getting poked over and over, that'd be another story.
"Not sure why" doesn't cut it. Your patient is lying helpless in an ICU bed, repeatedly being stuck with needles. You need to speak with the doc (that does not give a rat's pattooty that their patient is receiving multiple invasive and painful procedures) and get their rationale as to how this benefits the patient. Unless the PICC is used for TPN, there is NO reason it cannot be used for blood draws.
PLEASE advocate for your patient.
Because the doctor said so.... is never a reason to carry out any order.
Does this happen at your hospital?
Radiology tech: "this patient has q0600 portable chest X-rays part of his old ICU order set. They normally DC these but they didn't DC his. Do I really need to do this?"
Me, to a different radiology tech: "we just discovered he might have foot fractures and I'm putting in orders right this exact second. Do you mind grabbing images of his feet while you're here?"
Rad tech: "the order wasn't already in so your, have to get that later."
Me: "the order is in right now."
Rad tech: "no."
Two seconds later, does the images anyway, because she realized it meant she'd have to come all the way upstairs again.
Respiratory: "Earlier MD asked for a different patient to have ABGs done at 0800" (after RT's shift would be over) "so we can just do this patient's in a few hours, too, right?"
Lab, after walking the whole unit to find me: "that patient has a PICC, why can't you draw her?"
Me: "I don't have orders saying I can."
Lab: "I saw her get drawn off that line last week, you need to draw her."
Me: "her line isn't being used for labs. I don't have an order saying it can be. I CAN'T use it. You need to draw her."
If it weren't the same people trying to get out of their orders every time, I'd figure they were just confirming things, but I am absolutely convinced they're trying to get out of doing their job, and they're trying to get the RN's "okay" so they can pass the buck to us, I am so done with this! If they want to questions orders, they should call the people writing them. :\
I have spondylolisthesis, which was discovered in 2012 after a fall. I fought muscle spasms for nearly a year before turning to acupuncture. I believe that should be long enough to discount placebo effect. I had noticeable improvement after my first treatment, incredible improvement in quality of life after the second, and have had my pain under control 90% of the time since my third or fourth.
I initially turned to acupuncture, though, after trying IVF and having an unsuccessful embryo transfer. The second transfer, I started acupuncture at the same time as starting meds. On the exact same medication protocol, and changing absolutely nothing else in my life, I had a 25% thicker endometrial lining than at the first transfer. Perhaps it was a coincidence, but I only tried it at the suggestion of my midwife, who handed me a newspaper clipping saying that studies were showing acupuncture to be effective at boosting IVF success rates. My first treatment ever, I was laying on the table thinking, "okay, really.....? There is no way this actually does something...." It did, though. (As evidenced by two little monkeys )
Had a young guy ambulate to the hallway to let us know he needed help ambulating to his bathroom (which was closer to his bed than the hallway).
Oh, my deers............?!
Sunshine,. lollipops and rainbow aside.
How can anyone with a disability, perform nursing care for the disabled?
1) Diaper (not sugarcoating the product being used is in fact a diaper)
2) Bodybag (shroud)
3) Paperwork (Candycrush)
4) Paperwork (extended break)
5) On the phone with the hospital (extended break)
I have been a nurse over 20 years. My mother did the same thing to me. Don't do it, nursing will crush your soul. I am pretty much dead inside, have tons of health problems and hate my life.
I am a full time nurse 3p-11p. Our 11-7 nurse is out on DBL. The charge nurse told me she will file Abandonment charges against my license If I don't pick up some of those extra shifts.
Here is the thing...it isn't Abandonment because they knew of those absences in a reasonable time frame to find appropriate coverage. We even have contract nurses available.
What can I do about all of this?
And she didn't even ask me to pick up the shift. She threatened me with mandation, and when I informed her she could not legally mandate me she immediately told me she would file abandonment charges against my licence.
I'm in NY.
My views of male nurses consist of the top side, the bottom side, the left side, the right side, the front side, the back side, and the outside. I've never seen the inside of a male nurse.
Had a lady call me asking if we do fresenius dialysis, when I told her we are not afiliated with fresenius she asked, "well, what kind of dialysis do you do there?" I guess I could've explained that fresenius is a company and the different modalities of dialysis, but I didn't...I refered her to an outpatient clinic (not fresenius either). I guess I'm bad.
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