Latest Comments by ixchel

Latest Comments by ixchel

ixchel, BSN, RN (30,477 Views)

Joined Jun 3, '11. Posts: 4,602 (74% Liked) Likes: 17,410

Sorted By Last Comment (Past 5 Years)
  • 8

    Ugh I STILL haven't caught up on this thread! I'm sorry, guys! I just wanted to say really quickly...

    Looks like a lot of life has happened in the last week or two. I'm so sorry for the losses, and I celebrate the gains! Hugs to all of you!

  • 0

    Maher, welcome to AllNurses!

    This website is a great place for connecting with colleagues worldwide. I see you are looking for work in Sweden. I recommend using a search engine and looking to see if they have any good job search websites with jobs local to where you are moving.

    The AllNurses forums unfortunately won't point you directly to a job. You may find that there are individual members, however, who might be more familiar with Sweden who can help you out.

    Good luck to you, Maher! And, again, welcome!

  • 5

    Quote from Tweety
    If you're asking have I personally addressed the elephant by making demands, refusing assignments and organizing staff protest, no I haven't.
    Quote from Tweety
    Will I organize a protest, refuse assignments, quit for a better job, contact labor unions, march to the capital. No.
    If you attempted protest in this way, you would be labeled a troublemaker and escorted out the first chance they got something to pin on you.

    Planting the seeds of change don't require waging war. Look at trends recently. How are satisfaction scores? CAUTIs? CLABSIs? Falls? Readmissions? These things COST money for the hospital. (Satisfaction scores because they decrease Medicare reimbursement.)

    Some people protest by simply quitting to go somewhere that seems better. Others find enough love where they are to make things better. If you are the latter, just talk. Talk to your unit manager. Talk to your hospital's quality department. Simply have conversations. If you feel voicing opinions isn't enough, bring numbers to them - numbers that illustrate how staffing is hurting their bottom line. It should be easy to find fall and infection numbers, in addition to satisfaction scores.

    Quote from Mavrick
    More Masters prepared minions without a clue to the nursing leadership rescue!
    Thank you, sir! May I have another?!

    Quote from NursesRmofun
    I just did some rudimentary math and came up with a figure of approx. $300,000 (plus or minus a bit) that a facility/hospital may save per year by not adding one staff to any given unit per shift. Say it's a fairly small hospital and they are saving that per unit for a few units.....that adds up.
    Quote from chare
    How exactly did you come up with this amount?
    If the RNs make $30/hr, that's $360/shift. 14 shifts/week for one more RN per shift, 52 weeks/year, $262k/year. HOWEVER, when you consider decreased adverse outcomes and better patient satisfaction scores, hospitals should find themselves more profitable from this investment.

    Quote from [emoji768
    Nurse;8896422]I’m glad to see that you’ve had that culture at some point in time in your hospital, because there may very well be a lingering framework for Quality Improvement.

    Hear me out: Nothing, ( and I know you will agree with me ) nothing speaks louder than Numbers to the bean counters that ration nursing FTE’s per bed units.

    The best way to go forward is to show the C suite suits how much money they can save by equating number of nursing FTE’s to (Insert the biggest cost savings issue that your unit has at this moment). What keeps you up at night regarding your unit r/t staffing issues? (for example)

    Narrow it down to one problem that can be focused on.

    Do your research on that issue, get about 5 to 7 critically appraised peer-reviewed, higher level research articles about your issue together.

    Perhaps you would like to get a journal club together and get whoever else on the unit together to brainstorm with you. Keep it to a handful of people to make it workable.

    Figure out how the best way to run the project (for example- - - say you want to tie nursing FTE’s to decreased incidences of UTI’s). How many UTI’s have you had in the last quarter of 2015. Each UTI costs the unit X amount of money per incidence. Find out how much that is (Talk to Performance Improvement, or Quality Assurance, Or Quality Improvement, or whatever the data people are called in your facility). They’ll be able to tell you, because THEY KNOW.

    Look at the staffing patterns in your unit. See if there is any way you can correlate staffing patterns to UTI’s. (This is very, very simplified, but I’m using it for the sake of simplicity in the general picture).

    I realize that correlation does not always mean causation, but if you can show a strong p value to support your numbers, you’ve got a running start.

    I’d love to hear how things go. I hope that what I’ve shared makes a difference. That’s all we really want in the end: to make a difference.

    Take care
    This is beautifully well thought out!

    Quote from Farawyn
    What shortcuts? Auto BP? Or "psychic" BP?
    Eeeeeeeeeeee!!!!!!!! MAGICAL VITALS!!!!!!!!!

  • 6
    LadyFree28, BostonFNP, Farawyn, and 3 others like this.

    Quote from BostonFNP
    Annoy the "provider".

    Wait a second...
    Definitely meant "Doctor". Our NPs are amazing and usually notice the same things we do before pestering them would ever start to cross our minds. I love them. [emoji5]️

  • 2
    kalycat and Wrench Party like this.

    Quote from Wrench Party
    1) I HATE being right. I had to enact our infection control policy on a patient because I saw ONE bedbug creeping across her pillow. The lab confirmed it. What IS it with me and my patients with parasites lately? (I don't work in the ED)

    2) I absolutely do not care if I have to walk into a group of providers and ask who has my patient and clarify/get orders, because our computer system went down. I really, really don't care if this annoys them or my charge nurse. Providers interrupt my work all the time with orders/calls/questions.

    3) Patients can be totally asymptomatic with A fib into the 200s after walking. A lot of our post-op patients pop into this rhythm after surgery and this was my first time really handling it till he converted back to sinus.

    4) Night shift, how I've missed you!! My favorite people were on my first night back and I was so happy!
    Let's be friends. Best friends.

  • 1
    MelpyRN2B likes this.

    Quote from Beffers81
    I learned that I'm scared ****less of my first day on the floor (which is tomorrow) even though I'll be with a preceptor
    I hope you have an awesome day! Be cordial, ask questions. No one expects you to know anything!

    Good luck and share an update tonight!

  • 2
    CBlover and ICUman like this.

    Quote from ICUman
    I learned that I got my dream job in ICU as a new grad. Happy.
    I am so, so excited for you!!! Congratulations!!!

  • 0

    Quote from TheCommuter
    This is similar to a post I recently made.....

    I learned (many moons ago) that some individuals seek out the 'yes'-people, nodders, PollyAnna personalities, cheerleaders, and head-bobbers to tell them exactly what they want to hear.

    This situation can be difficult to initially pinpoint because many people act as if they're seeking advice when, in reality, all they wanted was someone to validate a potentially crappy decision they've already made.

    I've also learned that I'll never quite understand human nature...
    This sounds like half the stuff ever written I the Internet. :\ Do the people you're stuck with get huffy and nasty when they don't get validated?

  • 25
    MelpyRN2B, redmielita, riblets63, and 22 others like this.

    Quote from aeris99
    How to rig a litter for transport.....
    This is how a litter is rigged for transport. [emoji5]️


  • 3

    Quote from Farawyn
    Yea, I'm not clicking that link, Wife.

    I've learned, over the last 6 months, when ixchel sticks a link in my face I click it at my own risk.
    Sometimes it's a beautiful reward, sometimes it's a serious horror show. (Esther)

    ETA: I've learned that my "friends" love shoving clowns where I can see them. Jensmom, Davey and now ixchel. *Tch.*
    You live for this shizz and you know it!

    Esther needs to be reprised for anyone who doesn't know who she is:

    Esther - YouTube

  • 2
    OrganizedChaos and WKShadowRN like this.

    Forgive me for being a crappy OP! I haven't been on here much at all this past week. Grrrr

    New thread is up:

  • 19

    Alright, friends. I'm keeping this one short and sweet because my brain is sore and my dog is annoying.

    This week, I have learned....

    1. There should be a time limit hospitals should have to fix a problem. If things aren't better after, say, 15 days, let someone else try.

    2. I'm in the mid Atlantic of the US with spring travel plans to Florida, and I'm actually feeling nervous about Zika. I had a guillian barre syndrome patient in nursing school. On his way driving home from work, his chest felt off, so he course corrected to the ED. When he pulled up and walked to the doors, he struggled with leg weakness. After he was done in triage, he couldn't stand. He was intubated, and completely paralyzed, before he left the ED for ICU.

    3. A patient on neuroleptics will still have detectable epileptiform patterns on an EEG.

    4. A good neurologist knows no matter how crazy the patient sounds describing symptoms, what they say is legit and will stay the course for diagnosis.

    5. My favorite doctors to work with are the ones who will sit and talk patho with a nurse and enjoy that the nurse legitimately loves to learn.

    6. Sliding scale coverage alone for inpatient management is not currently supported by research.

    7. If working day shift doesn't eventually make me check into a psych ward, nothing will.

    8. The GI doc who left me scrambling to save a guy's life (what felt like) single-handedly by doing no intervention before he got dumped on us (actively bleeding out 2 points of hemoglobin over 8 hours and maintaining a BP that won't leave 70s-80s) has suddenly become cautious enough to send a perfectly stable (hemodynamically, symptomatically, and on CBC) rectal bleed to ICU before meeting or scoping her after I've literally done all the work needed on her for the shift. And of course, I was rewarded with an end of the shift admission.

    9. The Florida Man Collective has evolved to include its latest - Wrinkles the Clown. He is a scary-looking clown who is for hire to scare anyone you want, for any reason.

    10. The more you annoy the doctor about the same thing, over and over and over, the more likely it is they will listen and maybe put in an order.

    I have nothing else right now. My broken brain is feeble!

    More effed up clowns:
    5 Real Clown Horror Stories - YouTube

  • 3
    poppycat, LadyFree28, and CBlover like this.

    Quote from nursehaley91
    I witnessed elder abuse first hand where a so called "professional" (leaving out details due to the high possibility of being realized in my general area) smack the ever living crap out of one of my patients right in front of me and act like it was perfectly acceptable. I intervened, reported, followed all proper channels but I'm currently suspended pending investigation in case My best just wasn't good enough at preventing further injury. So add that to the list- I learned this week why people are so afraid to report elder abuse out of fear of retaliation or being in trouble themselves.

    And thank you so much
    Oh my god!!!! How does your employer not recognize the absolutely devastating consequences to this action?! GET OUT! NOW!

  • 0
  • 18

    From loony tunes, to total inadequacies, this week was ... unusual. Certainly plenty to learn. I actually had a much bigger list and realized I was a bit *too* specific with some details. Don't want to anger the HIPAA gods!

    That aside, I got my fair share of unstable people and psych consult-worthy (and maybe law enforcement worthy) people. Good times....

    Flipping back to days this coming week, and only this week. I hate days. Expect Grumpy ixchel for the next several days. You've been warned! [emoji5]️

    This past week, I have learned:

    Biopsy was negative! And I'm surprised, because two different providers told me to expect something abnormal. Trust me - it's a happy surprise!

    Esme is back!

    Being on dayshift this week makes me want to cry. Also, there is no night shift jetlag/hangover when you stay up all night every night. Apparently I do better without all the sunshine.

    Using a little creativity to bring a patient a small bit of joy after a week in the hospital from sepsis can really fill the heart. All it took was brewing some fresh iced tea.

    "Roadkill", in rural poor slang, means cigarettes in public ashtrays that have enough left you can pull them out and finish smoking the rest.

    I have met the creepiest man on the planet. I swear to God he killed his mom the night before he was admitted, and I'm pretty sure every single morning he dosed himself with different meds to have different legit symptoms to keep him in the hospital. By the way, being hospitalized is probably a great alibi.

    There is a certain look that a terminally ill total dependent care patient gets on their face when you can tell they're only full code because their family insists. I wish I never noticed that exists. When you get them care that clearly makes them uncomfortable they get that look and all I want to do is apologize and promise I'll never cause them pain or discomfort again.

    Expecting short term rehab because your driveway is snowed in is totes legit, yo.

    If you are wondering why a medication that you get has increased in price, perhaps it's because their promotional brochure has started to include videos that can be played in English and in Spanish and is in full-color stuck in the middle of an actual pamphlet. God bless the pharmaceutical industry. (As much as I hate to link Vanity Fair, some of this is alarming. Deadly Medicine | Vanity Fair)

    Lantus still smells as bad as it did the last time I broke a bottle of it.

    If you feel your heart heavy after a shift because a patient situation was handled so horribly wrong, your hospital's patient advocate will enjoy hearing from you. You will also be able to go home and sleep knowing its in the hands of the person who is paid to solely make things better for the patient. If, as an RN, I opt for a 9-5, that's a job I could absolutely love.

    I have once again witnessed how hard a body will fight to live. I'm sad for the circumstances with everything that went wrong, but honestly remain enamored by how impressive bodies really are. Newbies, remember this - the body wants to live. Let that truth steady your hand.

    I actually found myself incredibly angry at EMTALA. It had good intentions, but now it can justify the non-emergent people pulling vitally needed staff away from the critically ill, leading to malpractice and negligence from severe lack of resources to handle the sudden influx of overflow.

    So, what have you learned?

    Duran Duran - Hungry Like The Wolf - YouTube
    (But those lips, though. [emoji15])