BEWARE of frauds...

Lololololoollkkgddfuih · Feb 6, 2019

Is it possible that she was just well.. maybe kinda dumb? CPR is pretty simplistic there are videos of dogs trying to do it on youtube. Also it’s possible she could just be drunk or abusing narcotics. You never know, but I’ve learned if some people really don’t know what the hell they are doing sometimes you seriously have to tell them what they are doing wrong.

Divine-LPN,BSN · Feb 6, 2019

Thank you for that reply Mr. Wallace. I was so disturbed and typing so fast that I typed the apparatus wrong for the tracheostomy. My supervisor said that if the **Tubing*** was too small then it is still okay to use on the patient.

Long Term Care Columnist / Guide · Feb 8, 2019

On ‎2‎/‎6‎/‎2019 at 10:11 AM, Lololololoollkkgddfuih said:
Is it possible that she was just well.. maybe kinda dumb? CPR is pretty simplistic there are videos of dogs trying to do it on youtube. Also it’s possible she could just be drunk or abusing narcotics. You never know, but I’ve learned if some people really don’t know what the hell they are doing sometimes you seriously have to tell them what they are doing wrong.

I had to give you a Like for this video. ?

BrisketRN, BSN, RN · Feb 8, 2019

I'm a bit confused about the trach part. When I worked in private duty all of our trached patients always had an "emergency" trach either a size or half size (depending on type of trach) in the case that their regular trach came out and we were unable to insert the regular sized one. Even in that case the policy was to insert the smaller trach and call the doctor/911. Maybe they meant something similar?

BrisketRN, BSN, RN · Feb 15, 2019

Addendum to my above comment: should read "either a size or half size smaller"

Alex Egan, LPN, EMT-B · Feb 15, 2019

I have some issues and questions here.

Are you saying that the agency you were at was operating without a current license? That seems to be what you are implying. Was the agency in its application period? often agencies and branches that are in the process of application for Medicaid will need to take a few cases prior to the inspection. This is a requirement from the state. (in PA)

An emergency downsize trach tube is absolutely appropriate if the ordered size will not pass.

How exactly were the numbers for CPR "way off"?

I look forward to your reply.

Divine-LPN,BSN · Feb 15, 2019

Good day Alex and BiscuitRN. In order to protect myself and to avoid potential issues of libel, I will not go in to anymore details. The scenarios that I mentioned are truthful and the point that I am trying to emphasize is that we - Nurses- should be careful. We need to make sure that the company(s) is legit, reputable and that the organization has the best practices/up-to-date protocols to care for clients. Nurses can face legal trouble if they work for an agency that is not licensed, if they perform nursing care on a client that is incorrect- even if the doctor prescribed the medication/treatment- or if they follow a plan-of-care that is outdated. This expectation applies to LPN’s as well. We are expected to be competent enough recognize these types of safety issues. In my case, seeing that the agency was issuing flashcards for CPR and other emergency procedures with numbers that did not coincide with the American Heart Association's guidelines, was a red flag. I value my license and I would never want to work for a company that is unorganized and careless since this can be harmful to patients.

BrisketRN, BSN, RN · Feb 15, 2019

35 minutes ago, Divine-LPN,BSN said:
Good day Alex and BiscuitRN. In order to protect myself and to avoid potential issues of libel, I will not go in to anymore details. The scenarios that I mentioned are truthful and the point that I am trying to emphasize is that we - Nurses- should be careful. We need to make sure that the company(s) is legit, reputable and that the organization has the best practices/up-to-date protocols to care for clients. Nurses can face legal trouble if they work for an agency that is not licensed, if they perform nursing care on a client that is incorrect- even if the doctor prescribed the medication/treatment- or if they follow a plan-of-care that is outdated. This expectation applies to LPN’s as well. We are expected to be competent enough recognize these types of safety issues. In my case, seeing that the agency was issuing flashcards for CPR and other emergency procedures with numbers that did not coincide with the American Heart Association's guidelines, was a red flag. I value my license and I would never want to work for a company that is unorganized and careless since this can be harmful to patients.

Fair enough. I'd also never go without Liability Insurance especially when working outside of a hospital setting. The $100 I spend on it annually is well worth the protection.

RNNPICU, BSN, RN · Feb 15, 2019

Regarding the tracheostomy, using the smaller size trach if the same size is absolutely correct and can save the patients life.

I know that in the community, for a non-CPR certified person, many times they will teach 30 compressions and 2 breaths. There is no need to go into 1 man/2man or try anything confusing. The idea would be to get the heart started. Whether you are doing 15 and 2 or 30 and 2 in a community setting outsiode of a hospital and have no other help is irrelevant at that point and more important to try an attempt at resuscitating. There is even hands-only CPR which is just compressions only, no breaths

LovingLife123 · Feb 15, 2019

Umm, you can use a smaller size trach. You are incorrect about that.

Golden_RN, MSN · Feb 19, 2019

If you think that your employer should update their procedures, why don't you speak to your supervisor about it? The BON does not oversee healthcare organizations or review their P & P, so you may be barking up the wrong tree there.

And in an emergency situation or when changing the trach, it is totally ok to insert a smaller trach if the size ordered by the MD is met with resistance.