Content That malamud69 Likes

Content That malamud69 Likes

malamud69 6,358 Views

Joined May 10, '12. Posts: 449 (59% Liked) Likes: 866

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  • Jun 25

    Best way to improve medical outcomes and patient satisfaction? Hire more nurses. Period.

    A Health Affairs study comparing patient-satisfaction scores with HCAHPS surveys of almost 100,000 nurses showed that a better nurse work environment was associated with higher scores on every patient-satisfaction survey question. And University of Pennsylvania professor Linda Aiken found that higher staffing of registered nurses has been linked to fewer patient deaths and improved quality of health. Failure-to-rescue rates drop. Patients are less likely to die or to get readmitted to the hospital. Their hospital stay is shorter and their likelihood of being the victim of a fatigue-related error is lower. When hospitals improve nurse working conditions, rather than tricking patients into believing they’re getting better care, the quality of care really does get better.

    Excerpted from: The Problem With Satisfied Patients

  • Jun 25

    Thank God that wasn't my hospital because I'd be on the news for decking an administration member. Seriously, why is everything the nurse's fault? Bad HCAPS - blame the nurses. Doctors don't communicate with the patients - blame the nurses. Long ER wait times - blame the nurses. So sick of it.

  • Jun 25

    This is disgusting and makes me see red! Ya know, it MUST be nursing's fault and never that there isn't enough staff and resources (sarcasm font needed)

    I hate this mentality that it's everyone's fault except administrators who don't want to pay for adequate staffing.

  • Jun 24

    Quote from julie03209
    I will be the first to say that the LBGT community's practice is an abomination to Gods will. But I would NEVER refuse as a Nurse or Christian to provide medical care.
    Well, that is really BIG of you..being willing to take care of "abominations" because you're such a great nurse and "Christian."

    Wow, amazing that you felt the need to come to a thread about the MURDER of people simply because they are gay and make sure they know they are "abominations" at the same time you toot your horn for being so tolerant as to actually DO YOUR JOB in spite of the fact that you judge them so harshly.


  • Jun 24

    What a hate site. It is comforting to know that LGBT, Jews, Muslims, Blacks and Hispanics are equally hated in this country and nurses are not immune.

  • Jun 24

    How convenient and simplistic. Us vs. them. There were a hundred shootings in the US this year. Most perps used assault rifles. How would you classify them, because almost 99% were Caucasian males of a certain denomination above reproach.
    His boyfriend came out on Hispanic TV to say it was a revenge attack. He was a regular at that nightclub. He was settling scores.
    There seems to be a parallel system of justice in this country. All lives don't matter. This thinking will fracture this country irreconcilably.

  • Jun 23

    I work in a Psych ER and the one thing that you need is patience. That is what I struggle with sometimes. Because you can see the same patients over and over again like a revolving door and it wears you down emotionally and physically.

  • Jun 23

    Assume the thousand yard stare. And start mumbling incomprehensible things pertinent to the Mylai massacre.

  • Jun 19

    You'll be in your 50s when. You start working as a nurse. How old will you be in 2-4 years if you don't go to school?

    Try to pay as you go, though, rather than taking on a mountain of debt that will be difficult to pay off and may delay retirement.

    Nursing is a good job with good benefits, a decent salary and lots to learn from now until you're 100! Go for it if that's what you want.

  • Jun 19

    I would ask you to reconsider the LPN part. If your goal is to be an RN, just go straight to school for that. That would likely entail few debt $$.

  • Jun 19

    Yup. When you commit to one specialty for a few years you lose skills that you don't use in that specialty. The good news is that they come back relatively quickly if you move to a specialty where they're needed.

    I'm not sure what District Nursing is -- home care? Some sort of public health policy making position? Either way, it would bore ME to tears. Fortunately, there are people who enjoy that sort of job, so I wouldn't have to do it. The hustle and bustle of the ICU is overwhelming to some folks, and the cardiac unit that fascinates me might be a big bore to someone who is more interested in Neuro or Labor and Delivery.

    Assisted living and LTC nurses seem to feel that they get very little respect in the US, and that just floors me. I am in awe of the patience and kindness they show the often confused (or crazy) patients in their care. I know I couldn't do that job, and the idea that I might ever be asked to terrifies me. Those nurses have time management skills, therapeutic communication skills and assessment skills that I couldn't hope to attain. They can't teach the intern how to float a swan or insert a balloon pump the way that I can, but they can do so many other things, things that are arguably more important than the ICU nursing skills I've acquired during my years.

    My point, however slowly I'm coming to it, is that all nurses in all specialties have skills and knowledge that others lack, and should all be respected for what they bring. Anyone who says differently is wrong -- and you can tell them I said so.

  • Jun 14

    Rather than feeling a pulse you could always listen for an apical HR. Sometimes more reliable than a pulse.

  • Jun 13

    My personal opinion is that it is unethical to leave someone on prolonged mechanical ventilation and tube feeds, and withdrawing life support is the ONLY ethical choice.

    Let's say they are awake and alert underneath that appearance of a coma. They are being stuck every day for ABGs. They are suffering through uncomfortable tubes in their throats and noses that they can't cough back up, and then without their permission we cut a hole in their throats and their abdomens to make new ways for them to breathe and eat. They get stiff from lack of activity and they lose their abilities to move.

    We pull on them every few hours - creating sore spots, possibly dislocating their shoulders and hips when we do so especially if they are very obese. I have had obese patients we have extubated wake up and complain about extreme pain in their joints, and I can tell them exactly why they hurt - we have to be able to roll them over somehow. If they are so wide we can't reach across them to grab behind their shoulders/hips, we just have to pull on their arms and legs. If they are on tube feeds and having constant diarrhea, it only gets worse because we have to pull on them more often. Not to mention their butts are breaking down and they are developing huge sores that will take them months if not years to heal.

    Even q2h turns are not enough to prevent breakdown in the totally immobile ICU population, especially when they start getting so fluid overloaded their skin is stretched to the breaking point, and it isn't being perfused anyway because of vasopressor use routing blood flow to the important stuff. Their skin starts to break open everywhere, and the skin at their periphery starts to die. Add diarrhea on top of that to their sacrum and it doesn't stand a chance.

    Once their skin starts dying, we start rubbing nitro paste on their hands and feet to try and dilate the veins and the arteries in those areas so maybe they can make it out of ICU without getting their hands and feet amputated. I'm sure they probably have massive headaches from that if they are able to feel, but what would you pick - a massive headache 24/7 or the loss of both hands and feet? Odds are those half-dead extremities probably have massive nerve damage and hurt anyway, but I've never had someone wake up from being that sick and have enough brain function left that they could tell me if their hands/feet hurt or not, so I don't know for sure.

    If the diarrhea gets watery enough, then we can stick a rectal tube in them, too. I've had patients that after a couple weeks of the rectal tube being inserted, the tube eroded through the lining of the veins in the rectal cavity and the person had to go to endoscopy to get their brand new rectal bleed clipped. Then, they just have to go back to their butt being eroded from tube feed diarrhea because a lower GI bleed is a contraindication for a rectal tube.

    OP - do you personally want to live like that? What would it be like to be screaming in your head, "Please stop hurting me!" but no one can hear you? I would personally rather be in solitary confinement in prison for the rest of my life. At least nobody is cutting holes in me and dislocating my joints without my consent in solitary confinement.

  • Jun 13

    As a critical care nurse for enough years, and other specialties before that, it most certainly is ethical (refer to nonmaleficence). The process of succumbing to a critical illness or injury is not painless and to make one hundred million people linger because of the one that "woke up" is terrible logic. Yes, we need to 'check off lots of boxes' before switching to comfort measures, but to not acknowledge the limits of science is bad medicine. The suffering that my colleagues and I have witnessed...yeesh.

  • Jun 9

    Quote from TheCommuter
    I purposely avoid advising strangers in stores or on the street about health-related issues. I personally would have not made suggestions to the elderly woman about treating her cut, and I definitely refrain from revealing that I am a nurse unless someone specifically asks. It results in less aggravation for me.

    Good luck to you. I would let this situation go. The pharmacist was wrong for being so rude and haughty about his credentials, but you gave medical advice while not at work. The pharmacist did it on the company's time. That's the defining difference.
    ^^ This.