Content That gonzo1 Likes

Content That gonzo1 Likes

gonzo1 16,618 Views

Joined Jun 8, '05. Posts: 1,702 (45% Liked) Likes: 2,411

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  • 9:19 am

    Feel free to job hop and demand compensation. Let us know how that worked for you.
    "I was a float nurse at 60. I saw the younger staff nurses coming in early to research. The old fogie thought they were crazy to work for free.

    In general, generalizations are useless."

    Quoting myself! Feeling left out of the discussion Generalist.. no response?

    I was a traveler float at the Mayo Clinic.. the Mayo does not play. The regular staff came in early to peruse a RIDICULOUS computer print out of old and new orders and diagnoses. The esteemed MAYO did not care about HIPAA or labor laws.
    Those nurses came in early to CY their A.

    If ANY nurse feels they need additional time to prepare.. that is a personal decision.

    Corporate health care is forcing us to work around their profit driven demands. In the meantime.. we do what we need to do, to get through the day , and keep our patients safe.

    What are YOU doing to assure safe nurse-patient ratios?

  • Aug 12

    Quote from NOADLS
    You are a new grad. What you are currently experiencing is expected. Pass the test of time and work for your respect.
    Hell has frozen over. I liked a NOADLS post

  • Aug 8

    The allnurses.com mobile app is no longer supported. We recommend that you UNINSTALL the allnurses.com 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.

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    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 allnurses.com.

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

    Thank you for understanding.

  • Aug 8

    I've obtained three mortgages during my lifetime and was never specifically asked whether my current employment was full-time, part-time, or PRN/casual/per diem.

    The loan officers only cared that my previous two to three years of income could be verified through W2 forms. They focused on my annual income and credit rating, not the status of my employment at the job I happened to hold at that time.

  • Aug 1

    There really is never anything "right" to say when someone's loved dies. What helps is simply what actions you take, sometimes it is to say something comforting, other times it is to simply slip away and let them grieve, other times it's say nothing and hug them. I see death more than I care to, some days it is beautiful, a person slips away surrounded by people who love them peacefully. Other times it is gut wrenchingly tragic a life cut short a family in shock.
    The one time instance that stands out in my mind is a family that got the horrific call their son was in an accident and had to hear that his injuries were fatal. They stopped all lifesaving measures and stood watching him slip away. His motorcycle helmet was the one thing they wanted to take with them and their nurse was busy so an aide and I quietly slipped away found it and cleaned it up so there was no evidence of the traumatic events and gave it to his mom. I said nothing just offered it to her and she grabbed me in the biggest hug I have ever had. I have never felt such gratitude in a hug in my life, I just held her back and let her cry on my shoulder for a moment. I had no words for her, nothing comforting to say. How do you find words that encompass the loss this family had experienced?
    When they left later that night she found me, she grabbed me in another huge hug and just whispered to me "Thank you". I squeezed her with everything I had, I couldn't talk but I think it was what she needed because she left cradling the helmet and gave me a small sweet smile before she left.

  • Aug 1

    we get $2/hour. I like it. I just started recently. It really isn't that much extra work. I had a GREAT preceptor and I like to pay it forward

  • Aug 1

    I thin our facility offers an extra $1.50 to precept. I feel like precepting helps keep my knowledge current and I enjoy it mostly. It is more work a lot of the time and can be exhausting but I love helping the new nurses develop their skills.

  • Aug 1

    How about the internal incentive (or human decency) that acknowledges that you were a new RN at one time and needed preceptors?

    I once had a coworker (20+ year RN) who really needed a day off (some family event) and wanted to switch with me. I said, "Sure, but I am precepting that day you want to trade so if you could work with my student it's fine with me."

    She said, "Oh, I DON'T precept!"

    She would rather miss her function than precept for a single shift. What a horrible person.

  • Jul 31

    I'm putting my money on a tick being in there. Bug extraction should happen easily with a flush, except an attached tick. Damn, that sucks.


    Sent from my TARDIS using Tapatalk

  • Jul 31

    Your article started with the Johns Hopkins study on medical mistakes and then wandered to the area of the intentional. Mistakes are mistakes; if it's intentional, it isn't a mistake. Two different subjects.

    Not all mistakes are process errors, but then, I think, you wander toward the intentional. I've seen some horrific medical mistakes in my time, most of them fortunately not fatal and most of them not even skirting the area of intentional. But there are a few that are so incomprehensible they border on intentional . . . The person who overrides the Pyxis, for example, to take out ten vials of medication. We all know to question the order if we need more than two vials, don't we? I know the nurse in question didn't mean to kill her patient, but what was she thinking?

    The intentional "mistake" seems rare, though. Focusing on process mistakes is more likely to yield process changes that can help prevent them.

    Understaffing is one very real problem that negatively impacts patient outcomes. Of far more interest to the suits in the boardroom, however, is the fact that it negatively impacts those cherished Press-Gainey scores. It seems to me that patient satisfaction is a ridiculous measure of quality of health care and an even more ridiculous marker for reimbursement -- another process error that needs to be repaired. But be that as it may, requiring healthcare workers to take time from their very busy days to "satisfy customers" at the expense of actual patient care is bound to result in legitimate mistakes.

    The nurse whose med pass is constantly interrupted for more blankets, "more ice, but the last ice was too cold so get me some warmer ice" or soft drinks for all eighteen of the patient's visitors is likely to make mistakes. If she doesn't she's a heroine in my opinion. Much of the risk for mistakes with med passes could be eliminated just by hiring more staff. It doesn't even have to be more expensive nurses (you know, the experienced type who don't hesitate to quell such nonsense with a look and can recognize the patient about to go down the tubes from 20 paces), it can be CNAs or even "Customer Service Representatives." CSRs are basically secretaries who can fetch ice, blankets and soft drinks.

    Health care is a team event; more team members means less work for each team member and more time for those ridiculous "customer service" requests. A nurse who is interrupted during wound care to "find me a TV set with more channels" or "move the blankets off my brother's toe" is a nurse who may be seething at the ridiculousness of the interruptions and demands while she's trying to maintain sterility or dress a complicated wound. Yet not only is she expected to manage the wound (and document that she did so in at least three places in a computer that, in all likelihood, a visiting resident from the renal service is hogging), she's expected to produce a TV set with more channels AND move the blanket off the patient's toe -- a task which the interrupting visitor could easily have done. Is it at all understandable that she could forget to mark in one of the three places that she changed the dressing? And is it or is it not a "medical mistake" that she failed to note the increase in wound drainage that might have heralded the beginnings of a problem?

    If hospital administrators really wish to improve patient outcomes -- something that I truly question -- it seems that staffing appropriately to the workload would go a long way to accomplish that. It seems, however, that patient outcomes take second place to the bottom line. Since reimbursement is tied to patient satisfaction, it seems that hospital administrators are more interested in those Press Gainey scores than in outcome statistics. Make no mistake, there are plenty of problems in health care today. But the understaffing resulting from Administration's focus on the bottom line and the "customer service" model of healthcare are two big places to start if we actually want to fix it. I'm just not sure anyone with the power to change things cares enough to try. Unless of course, like Dr. Peter Pronovost, YOUR father died from a medical mistake.

  • Jul 30

    So, I reluctantly took my CCRN exam yesterday thinking it was going to be a monstrous headache. I only have 1 year ICU experience and 3 years med/surg. To my surprise, however, I passed with 90.4% correct! I want to write a quick review of what I thought and give some pointers for those that may be taking it.

    To start if you have taken different practice exams you will find that the ACTUAL exam is EASIER. Yes that's right. Easier. However, I am only speaking from practice with Barron's CCRN (the best!) and Pass CCRN questions (not so great). Now I'll give my 2 cents worth on prepping/taking exam.

    1. Best advice I can give is use Barron's CCRN prep book Barron's CCRN Exam: 97814384587: Medicine & Health Science Books @ Amazon.com
    A little over 20$--making it one of the cheapest books out there for prep--and you will have the full outline of what you'll need to know, and it's a small volume book without all the "extra" information like the infamous Pass CCRN book. I read through it twice and passed with flying colors.

    2. Some people panic about the cardiac drugs. Just know, based on hemodynamic numbers (yes you need to memorize those), if you need to fix preload, afterload, or contractility. That's it, just those three things. If you know the class of drug, you can determine what you need just fine.

    3. For our audio/visual learners out there. Laura Gisparis videos are great but they will cost a pretty penny. The Barron's book covers exactly what the videos cover (in a no-frills, to-the-point manner). But they're not as entertaining as good ol' Laura

    So that's what I discovered to help me excel at this exam. I used Pass CCRN online quiz bank the day before my test but I found the questions don't reflect what the test is like. So from my personal experience I did not find that source helpful.

    Good luck to those venturing in the CCRN realm!

  • Jul 30

    Quote from CourtJester
    Quick question.

    This is my first nursing job and have recently oriented to charge nurse on a critical care floor. I have been charge only one time but I have heard from other nurses that nurses will request to have a new group for a number of reasons. I have personally never done this outside of having a shingles patient (per company policy as I was pregnant). I understand wanting to change assignments due to being burned out by a heavy patient. However some nurses change assignments because they want to be next to a certain nurse or not next to a certain nurse. Sometimes they don't want to get report from a certain person. My first day of charge I had a nurse tell me to not assign them to a patient the next shift before I even had a chance to clock in! Is this normal in other units? Is this okay behavior? Wasn't sure if maybe this is normal and I'll just roll my eyes at it and keep moving like I have been doing.

    Asking for an assignment change for any reason other than the most dire ("the patient is my cousin and I can't be objective about his care" or "the patient is a former POW and because I'm Asian, he keeps having flashbacks to the Vietnam war and his imprisonment") is something that didn't used to happen. It seems to be becoming more and more prevalent. I personally would refuse to change assignments for "social reasons" such as wanting (or not wanting) to work next to someone, get report from them or give report to them. UNLESS the concern was placing an inexperienced nurse next to a mentor.

    To answer the question, this does happen in other units, and it is not OK behavior. Just roll your eyes and keep moving.

  • Jul 30

    I have never heard a nurse say they want to change their assignment because they do or do not want to work next to a colleague, if I did, I would respond with, no I'm not changing the assignment, I do not enable divisiveness, we all work together as a team.

  • Jul 26

    What nursing or medical pet peeves drive you bonkers in movies or on TV?
    I find myself yelling at the tv and huffing about how wrong they got everything.
    For example, when people rip out their IV's but don't bleed. Or ETT that are not taped down. AT ALL. Or when they shock a flatline. Or when nurses and doctors run for even the most minor things. Code patients who wake up looking refreshed and alert/oriented. Oh! And when doctors do things like start IVs or clean up vomit (yeah, right).

    What about you?
    TV/movie pet peeves?
    Best/worst medical shows?

  • Jul 25

    If you can't handle codes, don't do it. Codes don't bother me but the pts that are rotting from inside out, or outside in. Laying in the bed crying, on the vent, pressure to soft to medicate are the problem. Families that want everything done while mom sits in the ICU alone with the most horrific skin, wounds etc. That's the part about ICU that can get to you. One thing I have learned in the years of being a ICU nurse is... There are worse things then death!!


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