Content That kablammo Likes

Content That kablammo Likes

kablammo 1,599 Views

Joined May 14, '12. Posts: 3 (33% Liked) Likes: 2

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  • Jul 30

    Quote from Pangea Reunited
    "Patient attempted to strike nurse when informed unit pantry was out of chocolate pudding."
    Patient is a violent POS who should probably be in prison (and probably has been). Add him to the "do not admit" list in a hurry.
    That's so cool!!!! You have a "do not admit" list??? I want one!!!!

  • Jul 5

    Quote from Wake88
    Agreed. I get sick of this condescending attitude which typically comes from a superiority complex.

    I'm not lying when I say I've seen this again and again on this site from certain people.

    This is a good website. This condescension towards other people sucks, though. I haven't encountered it on other sites as much as here. It sucks when people talk down to you, whether it's nurse to nurse, or nurse to nurse aide. It gets annoying because it's childish, and people should know better.
    I agree and now Been There, Done That is stalking my previous posts to this website and making snide comments. That is a high degree of emotional intelligence right there! Says a lot when a nurse of 33 years uses a forum like this as a catharsis to take out their issues on other nurses.

    http://allnurses.com/general-nursing...ml#post9109019

  • Jul 5

    Quote from Been there,done that
    I realize it is difficult for a nurse with 5 years of experience to comprehend the knowledge base and depth of experience a nurse gains over 34 years. In my 20 years of charge nurse duties, on the front lines... I never made a wrong call. I knew when any staff nurse was in trouble, before s/he realized it. I knew the situation on all 30 patients on the unit.. watched them and the staff like a hawk.
    If a nurse said to me "I'm so busy".. I would know what s/he was busy with... with or without "inquisitive" questions. I knew what was going on,and supported each and every one when they truly needed leadership.
    I find it hilarious that you support your impressions with footnotes... from some article written by someone that has never schlepped the halls of a chaotic step-down unit. I am not old.. but I am wise.

    Can we get back to the OP's issue now?
    Several points to make based on your reply.

    1) This "footnote" is actually from a scholarly reference and is a piece of a concept analysis on "Wisdom" in nursing.

    Toward an Understanding of Wisdom in Nursing.


    Authors:
    Matney, Susan A.; Avant, Kay; Staggers, Nancy


    Affiliation:
    University of Utah College Of Nursing, Salt Lake City, UT
    Roger L. and Laura D. Zeller Distinguished Professor of Nursing, University of Texas Health Science Center, San Antonio, Texas


    Source:
    Online Journal of Issues in Nursing (ONLINE J ISSUES NURS), Jan2016; 21(1): 7-7. (1p)


    Publication Type:
    Article


    Language:
    English


    Major Subjects:
    Nursing Knowledge
    Models, Theoretical
    Nursing Theory


    Minor Subjects:
    Literature; Concept Analysis; Paradigms; Psychology; Conceptual Framework; Work Experiences; Life Experiences


    Journal Subset:
    Core Nursing; Double Blind Peer Reviewed; Editorial Board Reviewed; Expert Peer Reviewed; Nursing; Peer Reviewed; USA


    ISSN:
    1091-3734


    MEDLINE Info:
    NLM UID: 9806525


    Entry Date:
    20160120


    Revision Date:
    20160127


    DOI:
    Error: DOI Not Found

    Accession Number:
    112345105


    Database:
    CINAHL Plus with Full Text

    2) As someone with an undergraduate degree in management, 5 years of military service, 8 years in business, management, HRM, and project management, and 5 years of nursing I feel I am pretty well qualified to discuss management roles and leadership qualities. My graduate education has also helped me to view the wider scope of nursing practice and my background has helped me to develop ideas, thoughts, and views on the profession.

    I do realize that for a person with 34 years of experience in anything, it might be hard to comprehend newer philosophies and theories in organization, management, and leadership with solid research backing up such principles. I also realize it could be difficult to have enough emotional intelligence to not be prideful or boastful of oneself and to state in a public forum that one has never made a wrong call. I also realize that it might be difficult for someone to recognize "footnotes" from peer reviewed articles might have some validity and could contribute to the direction and the evolution of the profession of nursing. I totally get it.

    3) I also totally understand that you would think your ranking of 33 years of nursing practice might allow you to come on this public forum and talk down to or berate nurses with less experience in nursing, even when some of those nurses are proven professionals in other fields. It is ok, I get it. I don't take it personally. But one thing you should recognize, aside from your superiority complex as both an experienced nurse and someone who has never made a wrong call, is that it is ok for other professionals to have differing opinions and different thought processes. It is ok for people to come into this profession with different backgrounds and challenge the status quo. Change is a good thing. Nursing in it's current state is unsustainable and in need of drastic change, the ways of the past will not work for the future.

  • Jul 5

    Quote from Been there,done that
    I was a charge nurse for 20 years and received a leadership award from a huge health system.
    Just a side note.. when the charge nurse is "busy doing discharge paperwork and watching telemetry and answering the phone ".. what exactly.. could snowflake expect mother charge nurse to do?
    OP acknowledged snowflake's statement, informed her she would direct help from the returning crew. Snowflake did not say she was drowning... she said she was busy. Aren't we all? Any time I was assigned to monitor telemetry.. I could NOT leave the monitors.

    OP is not guilty of "unacceptable practice and deplorable leadership". OP was dealing.
    I disagree and think that there is a lot more to the situation than what is being described for the situation to result in termination. I also think that your reference of "snowflake" for the nurse who was asking for help is a reflection of the consistent issues plaguing professional practice.

    Anyone can win an award and time in service in any one job does not necessarily make you a subject matter expert. There is quit a bit of litigation against nurses who had a wealth of experience but made poor decisions. So while I respect any nurse achieving a high status, getting a higher level degree, or receiving awards, I don't see the merit in mentioning that in this discussion.

    A foundation of leadership is communication style, even when under pressure. When I served in the military during OIF I can recall a time when a JDAM fell off of one of our jets, this is live ordinance, and landed on the hand of one of the guys in my command. This became a live ordinance issue on-board a flight deck that could have killed 5,000 of us on the ship and there was someone with their hand stuck under it. The Chief who was up there was trying to coordinate getting the hand of his man out from under a bomb, a possibly deadly situation for everyone standing there. One of the new guys in the command came up to him during this event and asked a totally erroneous question about a jet on the other side of the flight deck and that Chief answered him and gave him guidance, then got back to the situation at hand (No pun intended). The new E2 mentioned this when we did a safety stand down and talked about the fact that the Chief who was dealing with such a dangerous situation was able to give him direction and not bite his head off for not realizing the severity of what he was dealing with. This was part of what earned that Chief a NAM which is a level of recognition in the Navy and Marine Corps.

    The reason I bring up that story is because I think that more transformational leadership is needed in nursing. I think that how leaders communicate to their people, how they read their people, and how they help their people is a reflection of their leadership abilities. I think that as the leader, the charge nurse is responsible for asking inquisitive questions like, "Are you ok?", "Do you need help?", etc. I think that if this charge had asked those questions and noted what was most likely a look of depravity on the nurse, rather than just writing her off the situation might have gone differently. Isn't that what we do a nurses all day? We walk into a room, we see a patient and can tell something isn't right, we ask questions, we take note of subjective findings, then we take action. I find it incredibly hard to believe that a nurse would be fired for simply the situation as is described.

    "Wisdom is assumed to be intrinsically associated with age and experience [but] age is not necessarily a factor in being a wise nurse. Wisdom is assumed to be intrinsically associated with age and experience. Although older people have more experiences, age is not the only characteristic associated with wisdom. Pasupathi (2001) has posited that those who are "open to new experiences, are creative, who think about the how and why of an event rather than simply whether it is good or bad, who demonstrate more social intelligence, or who are oriented towards personal growth display higher levels of wisdom-related knowledge and judgment" (p. 403). This is important for nursing because it means that age is not necessarily a factor in being a wise nurse."

  • May 22

    I've seen this happen a couple of times in 30-plus years as a psych nurse. I've found that the nurse usually has at least as much pathology as the ex-patient they're dating. And it's not always the patient that's the vulnerable one. Some of these guys are cons and know how to weave their way into some idiotic nurse's heart. Either way, this is definitely a bad situation and somebody needs to have a talk with Nurse Hot Pants.

  • May 20

    Quote from Irish_Mist
    Straight from the Department of Justice: "Sexual assault is any type of sexual contact or behavior that occurs without the explicit consent of the recipient. Falling under the definition of sexual assault are sexual activities as forced sexual intercourse, forcible sodomy, child molestation, incest, fondling, and attempted rape."

    There is no mention of shaving pubic hair without consent. You could argue that it is battery since this was done without her consent but the sexual assault argument does not hold weight at all.
    "The term "sexual fondling" means the touching of the private body parts of another person (including the genitalia, anus, groin, breast, inner thigh, or buttocks) for the purpose of sexual gratification."

    Since when is it ok to handle patients' genitals when it is not required for medical care?

    If that were me, I would feel utterly violated. I would raise heck. If that were my patient, I would raise heck. I would document and file an incident report and report to however many managers I needed for an intervention to take place. How do you define what is uncceptable to do to an unconscious patient outside medical necessity, if you think touching and shaving a vulva is ok?

    On the note of hair in general, 99% of the time it is NOT a hygiene issue. If it wraps around a Foley (which was recently discussed), get permission to trim it. If it's literally caking with feces, maybe get permission to trim it. As someone pointed out, shaving is likely to compromise skin integrity in an area that - esp with bowel incontinence - is saturated with unfriendly bacteria. In four years, I have never once had a patient that needed their pubic hair removed for the sake of hygiene.

  • May 7

    I have a whole different take on this issue. This young man clearly has behavior/psych issues. Could be anything from borderline personality disorder to High Functioning Autism. The biggest key that there is a sensory issue is his refusal to make eye contact. so you telling him to stop what he is doing and make eye contact could be very threatening to him. I work in an acute psych environment and YOUR behavior could very likely end with your getting hurt. Every person who overdoses should be considered a suicide attempt until proven otherwise. Person's in the middle of a mental health crises can present as angry, rude, obscene, calm, happy, labile. As nurses we should not be passing judgement on these patients or their families who have likely been dealing with these maladaptive behaviors for years. Also where psych is concerned I have found that the mental health apple doesn't fall far from the tree.

    The fact that he started screaming and punching himself in the head could be clear signs of psychosis and not necessarily bad behavior.

    I honestly believe every nurse should work at least a year in a psych setting. These patients are not all locked away in psych wards anymore - they pop up on every unit.

    Hppy

  • Apr 27

    Quote from Ndy-RN
    Lorazepam (Advan) is an anti-anxiety medication and could also be used to treat seizures. Many people (mire than you know) do take that...in some cases including nurses. No one will penalize you for taking Lorazepam! It is not their business to go into your confidential medical history to see if you have a prescription or not. You are worried for nothing! Stay Calm and get ready to start tour BScN program. [emoji4]
    I'm baffled as to how you can claim to be a nurse yet get such egregiously false "advice"!

  • Apr 17

    Quote from RNINIA5
    "patient sitting in chair eating a piece of candy, does not like what is on TV and says the hospital food is gross ".
    Well, if the Patient is unable to transfer themself, is diabetic, has no TV in their room, and liked the Hospital food, I'd say you had a Psychosis NOS axis I, DM axis III, and the charting would be relevant.

    Otherwise, it's superfluous.

  • Apr 8

    Did you dominate the inserts, and were they adorable?

  • Apr 6

    Quote from Anna Flaxis
    A person who is determined to harm his or herself can change their plans according to the circumstances. Pills, weapons, or sharp objects can be hidden in clothing.

    The goal of the initial encounter in the ED is not to persuade the patient not to self-harm. It is to make the patient and the staff safe, and bring in a professional assessment to determine if the patient is safe to discharge or needs to be admitted to an inpatient setting for further treatment.

    Patient and staff safety is achieved by removing clothing and personal items that can be used for self harm or as weapons, placing the patient in a room with no cords, tubes, heavy objects, or other items that can be used for self harm or as weapons, and frequent observation at regular intervals.

    Active suicidal ideation is a medical emergency. Just as we undress the victim of a car crash, for example, who is at risk for death or disability and must be rapidly and thoroughly assessed for injury, the suicidal patient is also at risk, and we are obligated to take steps to ensure the person's safety.

    It has nothing to do with power, control, dominance, humiliation, or any of the, quite frankly, disturbing attributes with which the OP is painting her experience. I'm really kind of speechless, actually. It has everything to do with keeping the patient and the staff safe, and nothing more.
    Not all suicidal persons have the same level of risk to self harm. Unless the person is in severe psychosis, there is always ambivalence at play. Especially with someone who recognize their own feelings, determine that they need help and set about to seek that help. And that assessment ( of the risks to self harm) is done by simply talking with the person.

    This cookie cutter approach used here implies that every person who thinks about suicide is a time-ticking bomb waiting to explode. Not so. A majority of depressed people are in fact non violent.

    To insist on striping someone of his or her dignity, under the guise of safety, might precipitate a peaceful situation into possible violent acts. All this when said person only wanted to explore their own feelings with a professional therapist.

    I will say it again, safety is not the end all be all. Comon sense must be applied.

    Dany

  • Apr 6

    Quote from OCNRN63
    And buy enough for all three shifts. This is a side comment. It used to bug me to no end when a family would bring a treat in "for everyone" and there would be nothing left for 3-11/11-7. I had someone tell me that day's deserved to eat more because they did most of the work.

    This has been a public service announcement. We now return you to you scheduled program.
    I'm not sure what you are complaining about. I mean, I bet you got to clean up the mess when you got to work, and the smell of pizza lingered even though only a couple half masticated crusts remained.

    Oh, and of course all our patients slept all night - we (night shift) had it SO easy. *gag*

  • Apr 6

    Quote from Farawyn
    Nope, not allowed.
    Why doesn't Dad write a great letter about the workers to the DON (or whomever) and buy the floor some pizza?
    And buy enough for all three shifts. This is a side comment. It used to bug me to no end when a family would bring a treat in "for everyone" and there would be nothing left for 3-11/11-7. I had someone tell me that day's deserved to eat more because they did most of the work.

    This has been a public service announcement. We now return you to you scheduled program.

  • Apr 4

    Nonesense and outdated - making nursing diagnoses!

  • Mar 6

    we're worried about scents when we have pts who can literally stink up a whole floor( to where other pts are gagging) ?

    Also, we have to wipe everything down with bleach and whatever that dispatch stuff is. And housekeeping has added vinegar ( which helps) to their cleaning materials

    So if the place doesnt smell like poop, it smells like a pool, or a salad.

    I dont think anyone notices my deoderant.


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