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gonzo1 18,206 Views

Joined Jun 8, '05. Posts: 1,710 (45% Liked) Likes: 2,437

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  • Jan 16

    Quote from Emergent
    And what is ADN, ASN, CNA, LPN, RN, EMT-B, EMT-I, can you answer me that?
    It's making little checkmarks in certain little boxes.

    credentials-png

  • Jan 16

    I hate "99% of people will scroll past this post. If you love God, country, our soldiers and Jesus, like and share!"

    Those purveyors of guilt risk banishment from my news feed.

  • Jan 16

    I've had to unfollow a lot of people who mainly post about how much they hate Hillary or Donald. I get sick of that tiring subject.

    I generally find Facebook posts of people's meals ridiculously boring. I prefer pet videos, family photos, and interesting discussions. (Sadly, the latter is rare on Facebook).

  • Jan 16
  • Jan 8

    Yep. All we do is chart and give meds.

    Dude, for real, this is so dependent upon the area you're in. Come watch me run an ECMO pump on an 1800 gram baby and then talk about just giving meds and charting. You know the thing about the duck, that the duck looks calm on the surface of the water but underneath you can't see that the little feet are paddling away? That's nursing.

  • Dec 28 '16

    As far as I can tell, ninety percent of people don't look at badges closely enough to have any idea what's on them at all, so I could put "RN, BSN, High Queen of Narnia" on there and patients would still be confusing me with the dietary aide they reported their pain to ten minutes ago.

  • Dec 28 '16

    Don't ever let anyone make you feel ashamed or embarrassed to have an education and especially the BSN. The "have nots" who are making the snide remarks are the ones with the problem. Don't let their insecurities make you feel less proud of your accomplishment.

    Around my city not having BSN on your badge would be very unusual. Snobs? No. Just professionals accepting the changing times and not holding onto the 1970s.

  • Dec 5 '16

    The medical record is a permanent collection of legal documents that should supply an all-encompassing, accurate report concerning a patient's health condition. Physicians, nurses, social workers, dieticians, mid-level providers and other members of the interdisciplinary team contribute to each patient's medical record to paint a comprehensive picture of the patient's status along with any care that has been rendered. The patient's chart needs to contain enough pertinent data to enable each member of the healthcare team to render care in an integrated manner.

    Most nurses have probably heard the old adage, "If it was not charted, it was not done!" However, some types of documentation should not be entered onto the patient's medical record for various reasons. Since the chart is a permanent record that is subject to entrance in court-ordered legal actions, nurses and other healthcare professionals must exercise extreme caution when documenting. The following is a very general list of the notations that nurses should not document in the chart.

    Never document nursing care before it is provided.

    Nursing staff should never chart assessments, medication administration or treatments prior to actually completing the tasks because this may contribute to an inaccurate record filled with incorrect data. If the medical record contains nursing care that was never performed, this is fraudulent in some cases. Always remember that other clinicians may depend on correct documentation to assist in formulating decisions regarding patient care.

    Do not routinely document care rendered by others.

    It is allowable in several instances to document care, tasks or procedures performed by another individual. However, the documentation in the medical record must clearly indicate the individual who actually rendered the care. If the house nursing supervisor applied the four point restraints, be sure to identify him/her as the person who carried out the task. But do not regularly chart actions that have been performed by other people. If a coworker or super-ordinate does something incorrectly that results in patient injury or death, you do not want culpability.

    Never leave blank spaces between entries.

    In this day and age of prevalent electronic medical records, some facilities and healthcare settings still utilize paper charting. Nurses who still use paper and pen to chart must never leave blank spaces between entries. These unused spaces might be used by others to add questionable notations, so always be sure to draw a line across blank areas.

    Do not chart that a patient is in pain unless you have intervened.

    No prudent nurse would even think of documenting "Patient complains of radiating chest pain," without subsequently documenting what was done about the issue. Thoroughly chart all notifications, interventions and actions taken to avoid liability.

    Do not record another patient's name in the medical record.

    Let's assume that Mr. Wright gets into a physical altercation with his roommate, Mr. Robinson. The nurse is violating Mr. Robinson's confidentiality if she documents his name anywhere in Mr. Wright's medical record, and vise versa. To get around this issue, employ a vague description such as 'the roommate' or the 'patient in bed A.'

    Whenever possible, do not document subjective descriptions.

    Attempt to refrain from charting subjective descriptions such as "Patient's blood pressure is really high." Obtain accurate vital sign checks, intakes and outputs, and other objectively measurable data and record this information in a timely manner.


    Do not openly criticize the care that was rendered by a coworker.

    The medical record is a group of documents that should provide a comprehensive view of the patient's condition. Conversely, the medical record is not appropriate for criticizing care performed by other members of the healthcare team. Berating a fellow nurse, nursing assistant or technician in the nurses notes will accomplish nothing other than perhaps fuel the fire of state surveyors, malpractice attorneys and anyone who happens to read the chart at a later date.

    Do not mention short-staffing in the medical record.

    Documenting the existence of staffing issues in the medical record rarely, if ever, helps to increase the number of staff members. On the other hand, medical malpractice lawyers love reading nurses' notes that provide details about a facility's lack of staff.

    Do not make insulting references to patients while charting.

    Try to avoid referring to patients as 'drug seekers,' 'rude,' 'vulgar,' 'profane,' or 'crazy' when documenting. Utilize objective phrases and direct quotes whenever possible such as 'Patient states to this writer, "You are a ___ (B-Word) and I will kill you!"'

    Do not ever document the existence of incident reports.

    Never document the preparation of an incident report in the nurses notes. The incident report is an internal document meant to facilitate improvement of systems and processes within the healthcare facility. If a nurse charts a note describing that an incident report was completed, this internal form now becomes subject to discovery by external medical malpractice lawyers if legal action were to arise at a future time.

  • Nov 25 '16

    You probably need to take legal action.

    For what it's worth, I had to evict a tenant who was a hoarder. She refused me entrance to inspect the property. I gave her due notice by voicemail, attempting a phone call once a day, 3 days in a row. She wouldn't respond. So, I sent her a certified letter giving her notice.

    She sent me a threatening letter, accusing me of harassment and threatening my nursing license, saying "You will never work as a nurse again!”

    I hired a lawyer, and the letter was exhibit A. It was a sad situation, she was emotionally troubled. Fortunately, a nice Christian lady helped her move. It was 20 trips to the dump to clean up the place, a firsthand look at a certifiable hoarder.

    You need to contact the police, dear. This man is threatening you. Keep the texts, they are evidence. Ask the police for advice. I doubt if he knows anyone on the board of nursing, that is utter horse manure.

  • Nov 19 '16

    Quote from caliotter3
    One of my employers said that their company buys the list of nurses from the Boards after I asked how they knew to send me one of their solicitations. I found out that the information is given to the public when I inquired regarding another situation. I was told that an individual nurse could make her information non-public by going through a request process when she is a victim of stalking, domestic violence, etc. I looked at the process and thought one would probably be dead before they could get any benefit from that policy.
    I had the same issue. I wanted it removed so my crazy ex couldn't find me. It would have taken an act of God. I did mess with the person I talked to. I asked for her full name and address (if she has mine I should be able to have hers) and told her that I was keeping a record of it so if my ex hurt or killed me my family knew who to name in a lawsuit. I know, it was mean but I just don't agree that the public has the right to my personal information like my address.

  • Nov 17 '16

    I would love to hear what everyone is serving for their Thanksgiving meal, or making, or if you are going out to a restaurant instead (we have done this three times and it is awesome).

    I am hosting just my sister this year, so there will be me, my husband, my sister and my two kids (9 and 11):

    Turkey
    Stuffing
    Gravy
    Mashed potatoes
    Cranberry Sauce
    Sweet potatoes/marshmallows (sister bringing)
    Roasted brussles spprouts with shallots and bacon
    Corn souffle
    Crescent rolls
    Peacn pie (sister bringing)
    Chocolate silk pie

    We always do bagels and lox for breakfast Thanksgiving morning. In our town, the HS football team plays the town next door at 10am. We always go to that game, then come home and eat around 1 or 2 PM. No appetizers or anything b/c we do it as a lunch. Then of course Turkey gobbler sandwiches for dinner that night

    What do you do?

  • Nov 14 '16

    Quote from TheCommuter
    Although I am a self-described centrist, I just wanted to elucidate that the majority of food stamp recipients are employed.

    The "too lazy to work" stereotype is not totally accurate. Even many enlisted military men and women qualify for food stamps due to their incomes and family sizes.
    I have a dear friend back in TN who was diagnosed with HIV/AIDS some 17 years ago. He now lives without any real restrictions and has been on SSI/Medicare/Medicaid for years. I asked him years back why does he just not return to work, because he appears so healthy. He explained that he would lose his prescription coverage and just one months of meds was well over $1k. He was stuck riding the system or basically die. It is sad that healthcare is just so out of reach for so many. If my friend could return to work and afford his meds then it would save the system money in the long haul.

    I was able to perform clinicals in a remote clinic for a semester and it amazed me how many patients just did not have health insurance and could not afford treatments they needed all because of money. I do not know the answers, but I know we are failing as a people when we make healthcare out of reach for so many.

  • Nov 8 '16

    Quote from Been there,done that
    The patient is not a "drug addict", the patient has a history of drug abuse. Medicating the patient for an acute condition is the same as medicating any other patient.
    GET THEIR PAIN UNDER CONTROL. Give any ordered pain rx, if it is not effective get another order. The nurse that gave Tylenol needs to be educated and written up.
    You're right. +1 this.

    And just to be clear - even if the patient were a current drug addict, that is no justification for denying them pain medication in a situation where you would expect them to have significant pain (e.g. post-operatively). We don't torture patients in this country, drug addict or not. In fact, in such a situation, a patient with a history of opioid abuse will typically need a higher dose of pain medication than most patients to achieve the same degree of pain control due to their higher tolerance.

  • Nov 8 '16

    Excited to have a chance to join such important research! Just finished my first survey.

  • Nov 8 '16

    I, too, have been a participant in the Nurses Health Study 2 for decades now, and strongly encourage younger nurses to join the new cohort.


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