Content That NRSKarenRN Likes

Content That NRSKarenRN Likes

NRSKarenRN, BSN, RN Moderator 108,010 Views

Joined Oct 10, '00 - from 'RN Spirit from Philly Burb'. NRSKarenRN is a PI Compliance Specialist, prior Central Intake Mgr Home Care Agency. She has '35+' year(s) of experience and specializes in 'Home Care, VentsTelemetry, Home infusion'. Posts: 27,252 (22% Liked) Likes: 13,256

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  • Aug 8

    I get on AN via my laptop in the morning with my coffee and check up on my Bookmarks and the Good Morning thread. I check it again around lunch time from work on my desk top computer. When I get home, I get online while having my glass of wine after work and before I start dinner. I never have any problems with my laptop or desk top computer.

  • Aug 8

    I never use anything but my trusty MacBook Pro laptop to access AN.

    I dislike using a smartphone for anything except phone calls and texting . . . even though I hate texting.

    You'll hear no complaints from me - although I'm sure I'm in the minority.

    I just don't understand not using a laptop.

    Your friendly neighborhood dinosaur.

  • Aug 8

    The mobile app is no longer supported. We recommend that you UNINSTALL the app from your devices.

    We fully disabled the app due to low usage and more specifically the app company changed its Privacy policies / Term of Use over the past years.

    We are sorry for the inconvenience this may cause some of you.

    Moving forward, we are focusing on introducing new and exciting content to help you move forward. We are focusing on mobile apps for nurses and students. We are focusing on improving page loading time. We are focusing on improving every corner of

    At this time there is no ETA of when we will offer another mobile app.

    Thank you for understanding.

  • Aug 7

    Quote from jk2185
    This is my least favorite "go-to" that I hear all to often. Why even have monitoring in the first place? I trust the monitors more than my own ability to intuitively know a patient's condition based on my limited assessment skills; and just to ward off evil comments spawning from this notion I want to remind everyone that we all have limited assessment skills, our senses can only do so much. And of course, if your monitor screams asystole or vfib and your patient is smiling at you politely asking for more apple juice, I do hope that we all know to check lead placement or something.

    We didn't have numbers 100 years ago and look what kind of healthcare we had...not the greatest.

    I just wish we could flush this saying out or maybe change it.
    Numbers have been around far longer than a century. Just saying.

    I'm sorry you dislike the expression. Does "look at the patient, not the monitor" appeal to you instead?

    Years ago -- decades ago, actually -- I worked in an old, decrepit hospital. A brand new hospital was built, and many new nurses were hired to staff the additional beds the new hospital afforded. Moving day came, and we moved into the MICU with it's bright, shiny new, state-of-the-art monitors. The first patient was moved in and hooked up to the monitor with a lot of fumbling because the monitors were new and unfamiliar. The second patient was moved in and also hooked up to the monitor . . . And so forth. Not long afterward, the nurses were gathered around the nurse's station when the monitor alarm went off. Patient 1 was in ventricular tachycardia. Everyone went rushing into his room with the code cart and code drugs, following accepted ACLS protocol. The rhythm deteriorated from ventricular tachycardia to ventricular fibrillation to asystole, despite the interventions. Then a wondrous thing happened . . . The patient began to strenuously object to defibrillation and chest compressions despite the asystole on the monitor.

    During the construction process, somehow the monitoring wires in the two adjoining rooms was crossed. Patient 1 wasn't in asystole; Patient 2 was. And because all those brand new nurses and former medical students (did I mention this was July?) were treating the monitor instead of the patient, a patient died. And the patient they were treating had some pretty bad burns and broken ribs.

    Use your judgement. Sometimes, the monitor can alert you to the beginnings of badness before anything else will alert you. Other times, the monitor's malfunction will send you careening down the wrong path. According to Samuel Shem in "House of God," the first pulse to check in a code is your own. Maybe you like that expression better.

  • Aug 5

    I had a serious injury last year, with 8 severed nerves, 5 severed tendons, and a very, very painful recovery. I have lingering limitations and pain.

    Yes, I understand pain.

  • Aug 5

    Unsophisticated and low level of education? My god is this a generalization. Here is the thing, instead of passing judgment on these individuals, how about taking addiction courses to learn how to help these patients? Most of the time, a great deal of these individuals have no where else to go; especially in inner city hospitals. They are not seeking these meds due to being a junkie. Most of the time, they are in pain. They are masking other symptoms and are using as coping mechanisms. Yes they clog the ER, but they need help. Get some empathy and put yourself in their shoes. I used to be like you, until I had an injury and a chronic pain condition. It was hell, but I eventually pushed through it and am back to work. Am I a junkie if I go to the ER because I cannot manage my pain properly? I work in part of the ER, and I can tell you that our pain seekers are of all classes and education levels. There was no need to even mention that in the first place, and it comes off very ignorant. I am not sure if you intended this or not. Here is some advice from someone who has been in their shoes. Ask the pain level, look at their facial reactions and ask them to describe the pain. Most pain specialists go by the description of the pain, and not the number. I used to attend a pain clinic for years, and my experience has made me understand just how easy it is to get dependent on a drug and even when you do not intend to. I do highly suggest addiction courses online. McMaster University in Hamilton has an excellent program. I do think it will help in the ER, and then help stop patients from being transferred to Clinical Decision Units to investigate their pain.

  • Aug 5

    Quote from Emergent
    I went skiing with a nurse who told me she keeps left over Toradol to use if she needs it. I couldn't believe she was telling me this, she is my friend's friend. At my hospital we have to count it, probably because people with bad backs divert for their own use.

    As far as searching, that's pretty invasive. If you are a serious thief, you would hide it in your undies, unless they are going to pat you down or strip search you. I think a better plan would be surveillance cameras.
    Perhaps surveillance cameras would be a better policy for employers hoping to catch petty theft; but for me, as an employee, not so much. I'd rather be subject to a bag search as I leave than wonder about where the cameras are every time I need to step into the med room to adjust my bra or fish out a popcorn kernal that tumbled into my cleavage.

  • Aug 5

    Quote from AndyB
    What part of the Constitution says government HAS to provide medical care?
    I've never described the law, called EMTALA, as being part of the Constitution or that it's the government that is legally required to provide medical care. The vast majority of hospitals are CMS participating facilities, and are legally required to provide medical care to anyone in need of care that without it could result in harm or death to the person. This care makes up the majority of our healthcare costs. Really, the only medical care that isn't legally required aside from quality of life treatments (ie hip replacements) is the medical care that could reduce the cost of the medical care we guarantee.

    If someone has a heart attack, ends up in the ER and needs OHS, doesn't recover well and ends up in a SNF that's likely to be more than $1million worth of care, all required under EMTALA which only ends when the person is no longer requiring ongoing care, which may never happen. There's no reason why I should have to pay for that persons potential bills if they are just as capable as I am of buying insurance, that's essentially stealing from me and everyone else who's being responsible.

  • Aug 5

    Whatever anyone says, I'm voting for Hillary Clinton as she is the best of the two. That trump shouldn't take any leadership role at all. The man acts like he grew up in the street with no parents or guardian to teach him how to talk and the difference between right and wrong. Any time he opens his mouth, he talks trash. It would be a big shame to say he is the US president. Even his fellow republicans are leaving him to vote for Hillary. That should tell u something very important.

  • Aug 5

    me too I read the entire speech given in 93 and it sounds like a week thought out approach.....I have been in health care since 1984...I do not remember hearing this

  • Aug 5

    Quote from PinayUSA
    I don't look at facts and data, I live in the real world. I am very aware of ISIS and Al Queada and Abu Sayaff and other faction muslims that have only one goal, that is to either kidnap me for ransom or try to kill me. I spend about 3 months per year in PHilippines, mainly in Mindanao section. As and tall, white long nose American Citizen there are many parts that would be almost certain death for any American from the Muslim community. Take a trip to Jolo Sulu region in PHilppines in the Autonomous Region in Muslim Mindanao (ARMM) and will give you a few hours before you are either kidnapped or killed.
    It's facts and data that define the real world, your version which you admit isn't real should probably be clarified in quotes; the "real world".

    Obama has led a multinational military offensive against ISIL since mid 2014, yet in your "real world" he is a "Muslim who would never attack his own". He's done this without the support of the Republican led congress who's opposed the military campaign against ISIL. So in your "real world" the candidate who's promised cuts to the military, representing a party that has opposed a military offensive against ISIL is the better choice to defeat ISIL?

  • Aug 5

    Quote from AndyB
    Anyone who thinks that email can be hacked when it is erased or hacked when the server does not exist has serious critical thinking issues. I'm guessing you have retired a long time ago.
    Erased data on a server is never actually erased until it is overwritten by new data, so yes "erased" emails can be recovered and also hacked.

  • Aug 5

    I'm sorry, but I have been a nurse since long before the public ever heard of Hillary Clinton, and I don't remember her ever saying any such thing. Whether or not you like her, she has decades of experience in politics, and it makes no sense whatsoever that a consummate politician would belittle such a large voter bloc in that way.

    It does make sense, though, that the political opposition would try to demonize her by putting rumors out there that she's insensitive and unkind to working women.

    I'm amazed that professional nurses would buy into such a rumor, much less repeat it, without being able to substantiate it other than by "I've heard----" "Somebody at work told me---" "It's common knowledge, even though I don't know where it came from---" When we hear an unpleasant rumor about a politician, it seems to me that the first thing we ought to do is ask ourselves, "Does it make sense, politically, that this person would have made such a remark?" The second question should be, "Is it documented verbatim and in context (no paraphrasings or partial sentences)by a credible source?"

    Unless someone can produce that documentation, in my opinion, this one doesn't pass the smell test.

  • Aug 5

    I was not a nurse at the time Mrs. Clinton made this statement, but, I am a politician by hobby-I love to discuss politics. This posting is so timely because as an ANA member, I am starting to think about how my money is being used-to support candidates, parties, and positions, that I would NEVER or have long ago ceased to support. It's self-vote defeating for me to pay membership dues to an organization that would vote and support candidates in opposition of my personal vote.

    I believe and know you're right-the money is an important, if not the most important, factor in supporting a candidate, regardless of the membership base who pay dues regularly. The money is important, even if it's not in exact dollars, because, as we all know, money is not just about the dollars, money is a broader concept that includes networking, accessing, power, position, promises, opportunities, etc.

    As a member of ANA, I have been thinking of writing/asking for more clarity on the politics of the matter, so to speak. I don't think many members of most organizations realize or understand how their dues may or may not be supporting their own choices of political candidates and issues. I would urge members/nurses to be informed, ask questions, expect pushback or formulaic responses, and then, make decisions not only about your dues/membership, but, about the sanctity of your vote.

  • Aug 5

    It's incredibly common to misremember things that happened 23 years ago. I certainly mean no disrespect to anyone who is simply stating that they remember it. My guess is that they remember people talking about it. I've read all these memories closely and they don't seem to match up with each other. I maintain that if this many people were in an uproar about it, it would have been mentioned in print media. As I've said, the entire archive of the New York Times is online and searchable, as well as some other major newspapers (and minor ones--I found a reference to Hillary's speech--to hostile doctors, apparently--at the Atlanta hospital in a Rome, Georgia newspaper) and newsmagazines.

    Gossip and rumor are insidious things. And in the early 90s, we had fewer ways of factchecking. If someone told us that a politician said something, generally speaking, we were more likely to believe it. People who started using the internet in its earlier days no doubt remember how rampant the rumor-spreading was, how long it took before the average person stopped thinking email forwards were real, how it took a while for people to get into the habit of checking something like Snopes before passing it along. Speaking of snopes, perusing it (the actual site, not the forums), it gives so many examples of things that the majority of people were/are convinced of that did not happen. "Lies My Teacher Told Me," a book that recounts what amount to urban legends in our school history textbooks, is another example.

    I have, myself, experienced cognitive dissonance when something I'm sure I remember, or have always believed, is proven wrong. Actually, this happens all the time in nursing; I regard it as a nursing skill to be able to abandon old beliefs/practices and adopt new ones. We were all taught--those of us who have been practicing for a minute, anyway--that foleys were safer than intermittent straight caths in preventing infection. It turned out the opposite is true, and it can still be a struggle getting people to believe it. When my belief about anything turns out to be incorrect, I go through a process where at first I don't want to believe it, second I'm resentful, third I feel guilty about any damage I might have caused inadvertently, and finally, I'm grateful that I've been corrected. I don't want to have beliefs or memories that are incorrect. That's why when someone tells me something that is contrary to what I think or that is different from what I remember, I try to examine what they say closely rather than dismiss it out of hand.

    That's why I went looking for evidence that Hillary might have said this or something similar about nurses. My first thought was "Is that true?" and I went looking myself. I knew I didn't remember it myself. It would have been said when I was at the age where I was just beginning to pay a lot of attention to politics.

    That's also why I went back and carefully read information about the jury decision in the Michael Brown case and analysis of the evidence (which showed that Brown was plausibly reaching for the gun, enough that the officer was justified in believing he was, which I maintain is entirely different from saying Brown was "trying to kill" the officer, and again note that the police department does not claim he was trying to kill the officer--rather that the officer was in fear for his life). That situation was not what many, including myself, believed it was at first.

    Like a few other posters, I struggled with Hillary Clinton as a candidate. I didn't vote for her in 2008. Her positions on homosexuality back in the day (which are well-documented, even though in the early 90s gay people were not a respected group, unlike nurses) still burned me. That was a holdup in my full support of President Obama as a candidate, too, but he wasn't quite as vociferous (it was a different time, the tide was about to turn). I do think Hillary has experienced both political and personal evolution in her attitude toward gay people; almost everyone has. The change we have seen in that arena over a just a couple of decades is astonishing; my high school teachers felt free to say that gay people were sick and wrong in class, while across the country (not everywhere, still) now gay teens are comfortably out and some kind of make me wince when they seem to wonder what all the fuss was about. Eventually I decided I was simply holding a grudge for what someone said decades ago ad that that was not reasonable.

    So while I maintain that common sense should tell us the incident about Hillary publicly denigrating nurses didn't happen (both because there is no record of it and because the accounts of various people do not match; some of them verge on sounding like conspiracy theories), I agree with others that it shouldn't really matter very much compared to what any candidate's words and actions are saying today.

    So perhaps I should also stop giving Donald Trump the benefit of the doubt because he used to espouse various liberal principles, such as being pro-choice, and just listen to what he is saying today.

    There are legitimate reasons not to support Hillary Clinton for president (though it seems most prominent Republicans have decided to set those aside in favor of more important issues); if you are anti-abortion, or a pacifist, she is not your candidate. If like me it makes you uncomfortable to have two families with so much influence over American politics, I can understand voting a different way even though I've made the opposite decision. But right-wing propaganda and old, discredited remarks shouldn't be among them.

    I haven't seen a lot of left-wing anti-Trump propaganda--he does most of that himself and it doesn't seem to bother him--but for the record, a couple of days ago I criticized an acquaintance sharply for posting something to facebook that I felt unfairly criticized Trump for getting a medical deferment from Vietnam. I dislike unfair propaganda, no matter who it's coming from. I've even found myself defending Sarah Palin.