firstyearstudent 4,070 Views
Joined Nov 4, '05.
Posts: 890 (13% Liked)
in their rush to defend themselves, the business casual folks do send the message that they believe bedside nurses are a bunch of ignorant children to be treated like such.
i find it telling that everybody that has jumped on me about my satire automatically assumes i'm only talking about nurses or the nursing heirarchy.
why does the hospital support an army of billing people, dutifully filling out forms, locked in mortal combat with another army of clerks at the insurance companies, dutifully denying claims or procrastinating on payment, negotiating reimbursement rates, preapprovals and god knows what else, until 270 days after the service is rendered, the provider (maybe) gets a check for 30% what was billed?
how does all this busy work contribute anything to the end product?
why, in the digital age, is it getting more complicated rather than less to get paid?
how many assistant nurse managers does the manager of a unit need? if all 3 are on duty, is it unreasonable to ask for relief for a real lunch when short staffed?
does an education department that simply leaves a video tape at the desk with a sign off sheet need 6 full time staffers? (how about one of them come take over so i can go put on my "business casual" clothes to sit in the conference room to watch a 45 minute manufacturer's video on how to prime an iv pump?)
if the nurse manager has a fruit bowl, jelly beans and a coffee maker in her office, why is it such a big deal if i have a (covered) drink tucked out of sight at the nurse's desk? (especially when i frequently miss meal breaks due to short staffing?)
if my nurse manager has so much empathy for me, why can't she look the other way and ignore the drink and save the intimidation game for something that means something?
why do i have to carry a voip phone with me every minute of my shift? can i pee in peace rather than be told "room 6 wants a warm blanket" at that private moment?
you folks that "did what you do for 20 years", did it 20 years ago. come out here now and be flogged for 12 hours and see how dark your "education-phobic, nitwit" mood becomes.
then you'll have some "street cred" with the unwashed masses and every right to tell us "whiners" to suck it up.
chances are, you'll see just how petty silliness impacts my ability to render safe, efficient care. oh, and maybe enjoy my job (like 15 years ago) rather than cringe everytime i see yet another memo posted telling me i'm not working hard enough.
prove me wrong and we can transform the nursing part of healthcare together. continue in the status quo and watch the attrition rates continue to surge.
If, in your "healthcare job" you never touch anything but paper, or smell anything but coffee, YOU ARE PART OF THE PROBLEM WITH HEALTHCARE TODAY!
If your job description DOESN'T have an annual requirement to be on your knees, geting freaky with Resusci« Annie, YOU ARE PART OF THE PROBLEM WITH HEALTHCARE TODAY!
If your hospital department is closed on Christmas Day, YOU ARE PART OF THE PROBLEM WITH HEALTHCARE TODAY!
If the "alphabet soup" after your name on your employee badge is LONGER than your actual name, YOU ARE PART OF THE PROBLEM WITH HEALTHCARE TODAY!
If you have an assigned parking spot for your 9-5 job, while the 24/7 clinical staff walks from their assigned parking 1/2 mile away, YOU ARE PART OF THE PROBLEM WITH HEALTHCARE TODAY!
If, from your primary work area, you couldn't see an actual patient with binoculars, but earn twice as much as those who do, YOU ARE PART OF THE PROBLEM WITH HEALTHCARE TODAY!
If there is an "RN" after your name, and you NEVER, EVER wear anything but business clothes to work, YOU ARE PART OF THE PROBLEM WITH HEALTHCARE TODAY!
If "every other weekend" is NOT in your job description, YOU ARE PART OF THE PROBLEM WITH HEALTHCARE TODAY!
If you've ever written a memo that had the words "mandatory in-service", "self-education module" and "during employee's spare time" and distributed it via company-wide email, YOU ARE PART OF THE PROBLEM WITH HEALTHCARE TODAY!
If the trunk of your car is full of pens, post-it pads, pen holders (and other trinkets with a brand name drug on them) that you hand out by the thousands so you can bribe your way into spending 5 minutes shmoozing a physician, YOU ARE PART OF THE PROBLEM WITH HEALTHCARE TODAY!
If you have NO IDEA why the blue thermometer tastes better than the red one, YOU ARE PART OF THE PROBLEM WITH HEALTHCARE TODAY!
(with kudos to Jeff Foxworthy)
The main thing I'm learning in nursing school is that while some of the alternative medicine has been proven helpful for some, very few approaches have held up in clinical trials.
I think there are a number of reasons that people tend to hate on Western medicine.
1. It's the status quo. Some people gain a sense of superiority by being non-conformist, and have this attitude of "enlightenment", thinking they know more than the thousands of qualified pharmacists, physicians and scientists who've run legitimate critical trials on these drugs and treatments. Some people have a real conspiracy theorist mentality and think they know more than the people who have dedicated years and years to studying and research.
2. The controversial "business" aspect to the pharmaceutical industry. Some folks think if something makes money, it's inherently evil (i.e. socialists). They fail to realize that if a business is unprofitable, it will cease to exist. Naturally greed needs to be curbed, but money has to be made to fund R & D.
3. The earthy / vegetarian / green / holistic approach is appealing to some.
There are a million reasons to like Western medicine. For one, we have a longer life span thanks to Western medicine. So do all the non-Westerners that come here when they need it. People are coming here to get the care that their countries fail to deliver. Does that say anything at all? As usual, we Americans don't understand how good we have it. We're spoiled, plain and simple. We breed this culture of "Armchair Authorities".
I'm not necessarily bagging on alternative medicine, just from what I've read in class, it's effectiveness is not always validated by evidence. Western medicine, while not always yielding the optimal results for every case, has evidence behind it.
I think my true problem was not so much the restraints itself (although it was extremely emotional to see it), but rather the lady being called, by multiple staff, a crazy old lady. She used to be someone's mother, sister, daughter, etc. I guess I just think it wouldn't be too stressful or take too much time out of the day to refer to someone as an actual human being.
I definitely understand this now better today than I did yesterday. Thank you everyone for explaining this. I looked up some more information and i'm a little surprised we weren't taught that in school. We were pretty much only told that there were 'physical restraints, and then chemical restraints'.
I know what you mean. I guess I've just seen some nurses attempt it more than others, and that's the type of nurse I would like to be, at least to try for. Even just this semester alone I've gotten some good perspective on why things are the way they are.
I hope to continue learning like this (if maybe a little less emotionally ), and despite how terrible I felt yesterday, I think it was a good experience, because I definitely learned a lot about restraints and why they are used, and how people react to them. Thank you everyone for your help and encouragement.
Well, even though it is frustrating to us, we have to keep in mind... being in the hospital is a HUGE inconvenience to a patient. I mean, yes, it's an inconvenience when we have to "tip-toe" around the phone cord to get vitals, admin meds, etc... but it would suck even more if someone had to wake us up every 4 hours, constantly come in our room and disrupt us, give us no privacy and on top of all of that... being sick at the same time. We are nurses and nurses are "persons educated and trained to care for the sick". Part of our care is respecting patients and their privacy. When I find it difficult to deal with "rude" patients I try to look at it from the other side. What if it were my mom in the hospital (who is 6 hours away) and I didn't have any time off that would allow me to go see her... wouldn't I want her to be able to talk to me whenever I had the chance to talk to her? Would I really want her to be lonely and laying in a hospital bed with nurses who were frustrated at her because someone called to check on her? I would hope that whoever had the privilege of taking care of her would "respectfully" ask my mom to get off of the phone nicely if the procedure absolutely called for it. Otherwise, I'd want them to be happy that she had someone who cared about her enough to be on the phone with her for so long.
I don't know... just my own thoughts.
Dude, let me tell you -- you are ONE cranky old man. Yes, we "forgot" your breakfast, and for that, I apologized up and down and sideways, even ran to the basement to personally see to it you got a lunch tray. And how did you reward me? You lit into me about every single injustice done to you at this hospital, including, :HORRORS: having to be "last in line" in the x-ray line because YOU had a sepsis infection.
I mean -- dude, you are getting out alive. Yes, little things were missed. There was probably a team of 100 or more taking care of you these last 3 weeks. Do you ever wonder that perhaps just everyday human error in a large organization COULD result in a few glitches in your care? Are YOU fricking perfect? You certainly expect everyone else to be.
The truth is -- you were well taken care of in this hospital. People waited on you at your beck and call, every GD 15 minutes. You have been nothing but nasty to everyone, and now you take the LAST day out on me.
Well, I hope people like you get what you deserve - whatever that may be. You are nasty and rotten to the core. You see people in service to you and you simply choose to demean them. I hope whereever you're going, that it's not someplace good. You are evil to the core. You live in the greatest country in the world, get what is STILL the greatest healthcare in the world, yet you continue to complain. Ugh. You make me SICK. Your last gripe was having to "wait" 2 additional hours for your private ambulance ride to the rehab place because you choose to be a louse over your bum knee. Seems to me you've got one good leg, so why dont' you use it? You've got enough dilaudid in you to kill a horse, yet you can't even seem to get up to sit on a commode!!
Goodbye. Good riddance!!!!
we often see threads with the title "fired for no reason," or "new grad harassed and fired" or something to that effect. and i always feel at least a little sympathy for the individual involved, if only because i can clearly see by reading between the lines of their self-justifying post that there was a reason for their termination, even if they just don't get it. (there are always a few posts every year from a new grad who is convinced that the reason she's not getting along with her co-workers is that she's just so beautiful they're all jealous, that crowds of mean people are following her around, that she's so wonderful she's going to rock the er or icu or nicu or or and no one sees her wonderfulness clearly, or that some mean, tired, old nurse who ought to retire and get out of the way is targeting her for no good reason.)
i worked with a new grad who was recently terminated for, as she puts it, totally bogus reasons. evidently seeing mine as a sympathetic ear, she went on and on and on about how unfair it was that management expected her to get her act together and actually understand what was going on with her patients. "i've got the time management thing down pat," she said. "i don't know what else they want. they're just picking on me for no good reason." i liked sal, i really did. she was interesting and entertaining and really, really nice. she was also smart, hard-working (when she was at work) and well-educated. but she didn't study outside of work, and really didn't understand what was going on with her patients. i participated in several meetings with her in which it was pointed out that it's not enough to do the tasks, you have to understand why you're doing them. it's not enough to draw the labs. you have to understand what the results mean and then address them. for instance, if the inr is 9, it might explain the nosebleed, the cherry red urine and the fact that the hemoglobin is now 6. giving the coumadin at 6pm as scheduled is not a good thing, even if you gave it right on time and were able to explain to the patient that "it's a blood thinner." i could go on and on.
i got a call from sal today, complaining that she knows she's blackballed for no good reason because she just can't get another job. she wanted me to give her a reference. did she just not get it?
all you new grads out there who are convinced that you're being picked on for no reason, that your more experienced colleagues are just out to get you, and that you're being unfairly targeting, harassed, or picked on, hear this: it may be something you're doing (or not doing) and all those "mean people" are trying to explain it to you so you catch on, learn your job and succeed. we all tried over and over with sal, and she still doesn't get it. are you guilty of the same thing? if your preceptor says you lack critical thinking skills, do you take it to heart, think about it and learn from it? or are you convinced that the entire issue is that she's jealous of your extreme good looks? if your charge nurse charges you with a deficit in your time management skills do you spend time figuring out where you could speed things up a bit? or do you dismiss her as a tired old dog who can't learn a new trick and ought to retire anyway? are you taking to heart and benefitting from any negative feedback you're getting, however poorly given it is? or are you obsessing about how "mean" that nurse was to you and totally overlooking the message?
i wish sal would have "gotten it." she would have been delightful to work with if she had. but right now she's focused on badmouthing her preceptors and the charge nurse, and she still doesn't understand what she did wrong. don't make the same mistakes.
I don't know, but I am completely sick of hearing about patient satisfaction and having management lay it on MY shoulders. If management was truly concerned about patient satisfaction, they'd have a lower ration than 1 nurse to nine patients. They just want to work me like a mule and ALSO lay all the blame on my shoulders, when they put me in a situation that I will never succeed at. It's a bunch of crap.
Well, I am in trouble. I whipped off my nasty email and my manager has called me in for a "chat" on Monday at 2 pm. I know that I should not have been so nasty in my email and I wish I had talked to some of you before I sent it. You guys gave me some great ideas regarding the supervisors motives and how to respond to her, but I was angry and instead of sitting on my anger for 24 hour before taking any action, I let my anger overtake my logic. And you know, it always sounds worse when you send it in email instead of saying it in person. I don't think I am going to get fired, but I won't be surprised if I get suspended (this has never happened to me before). But I guess I deserve it. I shot my mouth off and I have to accept the consequences of my actions. I will send you guys an update. But I still don't like her and I don't want to work with her. And I WON'T be offering her an apology.
you pay 400,000 for only 1 bathroom and 1 1/2 bedrooms. the cost of living is horrrrible. im so sorry that you have to do that, but im sure you're making it just fine. i know where i live dallas, texas a 400,000 house could get you at least 3000 square feet 4-5 bedrooms. i hate how the cost of living is different all over. wouldnt it be great if it was unified all over?
I didn't necessarily want to drag up this whole thread but I wanted to add some thoughts to this discussion and comment broadly on some points posters brought up in the last spat of posts.
1. Anesthesia and pain control. I agree with posters saying that this is the least of the concerns. Whether or not a procedure is painful doesn't factor into whether or not it is ethical to perform that procedure. The ethical practice of medicine generally says that doctors and nurses only perform medically therapeutic procedures this is waived a bit in many cases such as plastic surgeries but when done only for the sake of vanity they are generally done only on adults, so far as I am aware. In a proxy consent situation it is particularly important to only provide medically therapeutic interventions which either correct a current problem, fix a deformity, or sometimes provide a benefit that is necessary to the well being of the child (or other patient) but can't be achieved in any other, less invasive, reasonable way. Circumcision doesn't fit that category in any way and there is no objective reason to perform it.
Whether we call it mutilation or not (I do) circumcision most definitely causes damage in every case. There is cutting, there is bleeding, there is a wound that must heal, scar tissue forms. Scar tissue is by definition damage. It's only a question of how much damage and how many get more damage than expected. I've known several people who had severe complications that are bad, noticeable, but they can 'live with it'. That isn't right, there was no objective reason they had to go through that or live with it. I'd venture to say there are probably more complications then we are aware of if only because when someone 'grows up' with a problem they may not notice that it is a problem. They may think that the skin on their penis is supposed to be so tight that it causes a bent erection for example or that the significant scar tissue is normal, they may not even know it's a scar.
But as most of you are aware, most medical procedures do cause damage and wounding but those woundings are justified by the therapeutic aim of the procedure. This therapeutic aim is an essential justification under conditions of proxy consent, consent for those unable to consent to the wounding for themselves. The burden of proof of justification is on the person who causes (or wishes to cause) the wounding. Consequently, a physician (or parent) would need to show that infant male circumcision was medically necessary before it would be justified. If there is equal doubt as to whether or not it is medically necessary (which is by far the most favorable position that, at present, could be taken in favor of infant male circumcision), then the procedure must not be carried out. In other words, in situations of equal doubt, the person with the burden of proof (the physician or the parent) cannot proceed.
That is not the world we currently live in though, unfortunately, though I think and hope we are moving in that direction. I think the problem is that male circumcision is given a cloak protecting it from ethical scrutiny because of its religious connections. I have little doubt it would be illegal to perform on minors today were it not tied to religion.
2. How do boys or men feel and what does that mean? I think that unless they really think about it most don't feel anything one way or the other because that is just the way things are, why dwell on something you can't change (for circumcised guys). And until recently most people (in the US) thought it was necessary which colored opinion anyway. But that doesn't make it right. Whatever you believe about circumcision one objective fact can't be denied, the only boy/man who has any say in the matter are the intact boys/men who get to make his own decision about his most personal possession. Consider that there are two groups of men, intact and circumcised.
Now of all the intact men, there will be some small group who are not happy with their state. It doesn't matter why they aren't that's just the way it is. And that is actually fine. They can get themselves circumcised. On the other side of the coin, there are going to be circumcised men who are not happy with their state. It makes no difference why they aren't happy, that's just the way it is. And that is also fine. The problem is there isn't anything they can practically do about it. So the point is leaving a boy intact puts him in the only group that always has an acceptable outcome.
Now to illustrate this point further, I'll share with you a small survey on a large teen forum. The poster who wrote message #110 explains it quite well:
"We've had poll after poll here on GovTeen. Regularly, at least 1/3 of cut guys would have preferred to have the choice. Sometimes, the number breaks 40% or approaches one-half. You can keep telling yourself that no one really minds -- but this is a personal choice that some people wish they had, for a logical reason. Why would you deny them that?"
"In cases of masturbation we must break the habit by inducing such a condition of the parts as will cause too much local suffering to allow the practice being continued.", On An Injurious Habit Occasionally Met with in Infancy and Early Childhood The Lancet 1860, Vol. 1, pp. 344-345
"I refer to masturbation as one of the effects of a long prepuce [foreskin]."
The Value of Circumcision as a Hygienic and Therapeutic Measure, New York Medical Journal 1871, Vol. 14, pp. 368-374.
"[Circumcision] should be performed without anesthetic, as the pain will have a salutary effect upon the mind, especially if it be connected with the idea of punishment." Treatment for self-abuse and its effects of 1888, Iowa, p. 295 By John Harvey Kellogg.
Researchers conducting a meta-analysis of studies of the risk of HIV transmission during heterosexual sex have found that, in high-income countries prior to the introduction of combination therapy, the risk per sexual act was 0.04% if the female partner was HIV-positive, and 0.08% when the male partner was HIV-positive. However these rates were considerably higher in lower-income countries, if the source partner was in either the very early or the late stage of HIV infection, or if one partner had genital ulcer disease, write the researchers in the February issue of The Lancet Infectious Diseases.
Pooling the data from studies in high-income countries, the researchers calculated that the risk of transmission from an HIV-positive man to his female partner was 0.08% per sexual act: in other words, it was likely to occur once every 1250 sexual acts. When it was the female partner who was HIV-positive, the male partner's risk of acquiring HIV was 0.04% per sexual act - in other words, once every 2500 sexual acts.
Frankly, it sounds like you are just hurt and humiliated, so want her fired. Unless she has a history of flying off the handle or is not doing a good job or is repeatedly hostile toward you, you should just put it down to having a bad day.
A $400,000 McMansion? Where did they live, Idaho? I live in L.A. and our hovel, well over $400,000 is less than 1,000 square feet, has one and half bedrooms, decrepit plumping and wiring dating from the '20s, one bathroom and a miniscule kitchen with no modern appliances. Plus it is in smack in the middle of gangland with schools so bad we have to drive your kids to a charter school in another school district! And plenty of folks who run in-home daycare around here make more than my salary and my husband's put together.
Hello SubPrime crisis...(I know that not everyone who is affected was irresponsible, but I'm sure that many were...)
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