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NRSKarenRN, BSN, RN Moderator 150,343 Views

Joined: Oct 10, '00; Posts: 27,409 (22% Liked) ; Likes: 13,622
PI Compliance Specialist, prior Central Intake Mgr Home Care Agency; from PA , US
Specialty: 35+ year(s) of experience in Home Care, VentsTelemetry, Home infusion

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  • Mar 19

    Is it me or have you noticed that too many nurses are just downright nasty to their colleagues? Not just the Charge RN, but, virtually any other nurse. Let me give you some examples.

    -The Charge nurse is talked down to & yelled at, because a nurse "feel(s) that this always happens to me." Or, when giving report, the reporting nurse is short, rude, and impatient.

    -Two staff nurses just don't get along, for only heaven knows why, but, there is always some bickering during the shift.

    -A nurse can't get the tech to do what needs to be done, while the tech is constantly belittling the nurse to other employees. The tech is loud and curses at the nurse.

    -Some nurses seem to always have to write-up another nurse, instead of professionally communicating to the other nurse what the problem may be.

    There are many more stories, but, the bottomline is this: I don't see this happening in other disciplines. I'm not saying it doesn't happen, but, I just don't see it happening.

    I have long believed that there are too many females in nursing, and with our distinct differences from males, female nurses tend to resolved conflict by not resolving conflict, or by having nasty, unproductive attitudes that block any kind of resolution.

    And, female nurses seem much quicker to write-up another female nurse, when what's needed is a time of teaching, helping, or just supporting the other nurse, asking her, "How can I help you?"

    Professional communication is not only useful for communicating between and among the different disciplines, but, it's necessary for how we speak to our colleagues. Conflicts WILL happen, and we all need to be proactive in finding solutions.

    Conflict resolution also involves a lot of listening, understanding, and empathy. Every nurse has had one of those days, and as humans, we can get so wrapped up in what's happening only to ourselves that we forget we have a whole unit of other nurses that are being impacted.

    Nursing is stressful. So why not apply some of the same mindfulness techniques to ourselves that we implement for our patients. Techniques such as deep breathing, listening to music, or even going outside for fresh air during our shift.

    Our profession has been seen as the most trusted & compassionate profession for quite some time. Sadly, we seem to have lost these qualities when it comes to our colleagues.

    When I look at the physicians, residents, & even the dietary employees, I see them working together, gladly helping each other & training each other. I don't see or hear them almost incessantly talking about writing up another employee.

    The last thing I want to mention is that many nurses are under stress from all the requirements that we have and many more that are always coming. Nurses need to step back and realize the systemic-organizational level culture that drives the policies and that ultimately adds to the high stress-high fear culture on the work floor. Many nurses believe that they can never make a mistake, as such, many nurses are working in fear.

    In order for nursing to continue being seen in a positive light and in order to continue the advancement of our profession, we need to turn that penlight right on ourselves, and begin to make the appropriate changes.

    Nursing and nurses will be better for having the courage to self-reflect and self-assess. For the good of our patients, our employers, and our working relationships with our collegues.The time is long overdue and there are many benefits for doing so, whether personal or professional. The time has come, the time is now!

  • Mar 18

    Your comments are thought-provoking. I remember the first time I learned, "What?! you can turn away a cancer patient? Did you see Patch Adams? I admire his healthcare model.

    My husband and I visited with folks from England and Canada who have socialized medicine. They empathize with our mess. I've read about England adopting a nationalized health service after WWII to care for veterans. I dream of a nationalized system for us.

    I once argued with someone who said Americans worship the almighty dollar. I'm not arguing anymore. The lust for power and wealth are intoxicating. And we call ourselves a Christian nation.

    I need to read about Margaret Sanger. I've never heard of her.

  • Mar 18

    I have an advance directive that states I do not want to be tube fed, have dialysis should I ever go into chronic kidney failure, nor live on a ventilator should I have a fatal disease. If I'm still well enough, I want to live out the short rest of my life enjoying it by doing the things I love best instead.

  • Mar 18

    What do you think of this?

    "Urgent action must be taken to address the dramatic rise of cancer drug prices and to better align prices with value, according to a report released today by the President's Cancer Panel. The Panel's report, Promoting Value, Affordability, and Innovation in Cancer Drug Treatment, finds that while some cancer drugs have indeed been transformative, and may warrant prices that reflect their value, many new drugs do not provide benefits commensurate with their prices. The Panel concludes that stakeholders across the cancer enterprise-including drug developers and manufacturers, policy makers, government and private payers, healthcare institutions and systems, providers, and patients themselves-must work together to maximize the value and affordability of cancer drug treatment and to support investments in science and research that drive future innovations."

    So...how do we do we make cancer medications more affordable?

    The American Cancer Society states; "Cancer is one of the leading causes of death and disease in the U.S. The American Cancer Society (ACS) estimates that roughly 1.7 million new cases of cancer will be diagnosed in the U.S. in 20171 and more than 15 million Americans living today have a cancer history."

    Almost all of us know of someone that has had or does have cancer. Many forms of cancer that were incurable now show long survival rates. However, what if you or a loved one is diagnosed with a cancer that is treatable but only by a very costly means? What do you do? Why are these meds so expensive?

    An article from the Journal of Oncology Practice details the reasons for the high cost of cancer medications:

    "First, pharmaceutical companies use a variety of strategies to delay or discourage competition by generic companies, for example "pay-for-delay" and "approved generics.

    Second, as part of the Medicare Reform Act of 2003, and influenced by the pharmaceutical lobby, legislation forbade Medicare to negotiate drug prices. This, together with the Medicare expansion in 2006 to include prescription drug benefits, resulted in a financial bonanza to companies, clearly charted by the skyrocketing profits since 2006.

    Third, the Patient-Centered Outcomes Research Institute (PCORI), which evaluates treatments for coverage by federal programs, is prevented from considering cost comparisons and cost effectiveness in its recommendations. Such mechanisms, which emphasize value and price, rebalance the legitimacy of the purchaser and patient perspectives by diminishing their position as passive price takers.

    Fourth, US laws forbid the importation of prescription medicines from abroad, even for personal purchases. The purported reason (supported by the pharmaceutical lobby) is patient safety.18 However, in the latest estimates of the Canadian government's Patented Medicine Prices Review Board, as of 2011, US consumers pay 100% more for patented drugs than elsewhere."

    The President's Cancer Panel concludes; "that when it comes to defining the value of cancer drugs, patients' benefit must be the central focus. When patients' finances are strained, they are less likely to follow treatment regimens, potentially worsening health outcomes the drugs are intended to improve. The term "financial toxicity" describes the negative impact of cancer care costs on patients' well-being. Like medical toxicities caused by cancer treatment, financial toxicity can impose a significant burden on cancer patients. Rapidly rising spending on cancer drugs is unprecedented and cannot be ignored, and that public-private collaboration is critical to ensure that patients receive high-quality cancer treatment and experience the best possible health outcomes without financial toxicity."

    Some of the suggestions from the Panel include:

    • Enable communication about cancer treatment options and include information about cost
    • Stimulate generic and biosimilar competition
    • Ensure adequate resources for the FDA
    • Invest in biomedical research

    So, where do our patients stand? Its seemingly up to us, as nurses to provide some of this education. Its not enough that providers and physicians prescribe, but we must all be mindful of the cost.

  • Mar 18

    Quote from Wuzzie
    OP are you referring to the current shortage of certain IV fluids?
    0.45% NaCl = equal parts sterile water and 0.9% NaCl. It's referred to as 'half normal' because it is half the concentration of 'normal' saline.

    Now that I think about it, "Half Normal" would be a good name for a band.

  • Mar 18

    Quote from Anon101
    This basically results in 2 mL of feed being left in the extension tubing after the feed, which is discarded. Is this to be expected? Is the additional 2 mL that is added to the feed essentially to prevent air from going into the patient? I am just wondering, because if the extension tubing is primed (2 mL), why not just program the pump for 18 mL to prevent wasting of the feed? I feel like I'm missing something.
    You will have 2 mL in the tubing when the feed is done.

    Unlike a gravity feed, the formula in the tubing remains in the tubing instead of emptying into the baby. If you program the pump for 18 mL, the baby is only getting 18 mL. If you didn't prime the syringe, the baby would get 2 mL of air and 18 mL of formula. By priming the tubing, the baby gets the whole 20 mL of formula. I am not sure why you are concerned with wasting 2mL of feed in the tubing.

  • Mar 18

    All Nurses have dealt with strong and/or offensive odors at some point in their careers. There are many things you can do to help prepare yourself in this situation. Here are just a few:

    #1 Mask odors by placing a little menthol-containing products (like Vicks) on the upper lip; use scented lip products with peppermint, lavender, etc.

    #2 Try breathing through the mouth (although, if you have a strong gag-reflex, this might not be such a good idea).

    #3 Identify certain illnesses that have characteristic odors ahead of time and get yourself mentally prepared.

    #4 Some Nurses have even tried hypnotic therapy.

    What has worked for you??


    Thank you NurseCard for the winning caption. You won $100!

  • Mar 14

    Quote from Neats
    I do not think you really did anything wrong you should however called the family to let them know. Some family would rush right over to the hospital and your late calling kept a family form being there for their loved one. When people say they are going to sue let them as long as you have done everything you could you should be fine. Even calling 3 hours later. The person was notified. You might catch heck form the stew as most states require "timely notification" . I would not fret over this too much.
    There's an important clarification there, the family can only be notified at the direction of the patient or with consent from the patient. As a nurse who works in an ER, the understanding family seems to get from nursing homes regarding this is a bit of a pet peeve. Family are often under the impression that if they ask to be notified, then they have to be notified, when really it's completely up to the patient, for us to notify someone that a competent patient has been admitted to the hospital without their consent is a HIPAA violation. And often after meeting these family members it becomes clear why the patient didn't ask that they be notified.

  • Mar 14

    In my experience, they all lean left. Some farther left than others, but all lean left.

  • Mar 14

    Quote from OldDude
    So...what do you do from now to then?????
    You participate in peaceful protests like this to let politicians know that they have a tidal wave of anger coming for them at the voting booth. And that it's easy to see which politicians are choosing the blood money of the NRA over children's lives and it's not acceptable. There IS power in numbers, in organizing, in civil disobedience. Will things change tomorrow? No. But these kids are making it clear they do have a voice and I think it's a powerful message.

  • Mar 12

    In my experience, nurse coaching and legal nurse consultant 'certifications' are a money maker for the certification body only.

  • Mar 12

    I think one thing to also consider is the number of women who use assisted reproductive technology. It seems to me (completely only my opinion) that if one cannot conceive naturally due to anything other than physically blocked tubes, that perhaps that could be a possible confounder. In other words, just because you can doesn't mean you should. What if we compared apples to apples- I wonder what the numbers would then say?

    Just a thought- and not a very deep one. It's something I think should be at least part of this discussion.

    In my early days as a n RN in the NICU (40 years ago) one of my patient's mother died a week post-partum. She was 19 and had horrific HTN/ eclamptic seizures. She never saw her child. It broke my heart.

  • Mar 9

    Huh. Then why is it blank near impossible to get a nursing job in my area? We can't all go to BF Egypt for work and life you know.

  • Mar 9

    Ross is out of touch with reality. The only shortage is of experienced nurses willing to work for low pay and crappy working conditions and constantly increasing demands from upper management. Why would any nurse stick around to put up with that. Now you have your answer to why there's a "shortage".

    P.S. this should be moved to general nursing where it will get more views.

  • Mar 9

    "America is undergoing a massive nursing shortage. Not only are experienced nurses retiring at a rapid clip, but there aren't enough new nursing graduates to replenish the workforce, said Ross. "

    All those nursing schools aren't churning out enough to replenish the workforce?


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