Nurses allowed to close units of hospital - page 2
Twin Cities nurses using ward-closing power Maura Lerner Star Tribune Published May 27, 2002 From the moment Joan Johnson arrived for her 7 a.m. nursing shift, she knew it was crunch time at... Read More
May 29, '02Joined: May '02; Posts: 1,022; Likes: 64Mattsmom, that is why I still have a job. They knew they would be lambasted publicly if they canned me. They knew my first stop out the door would be to the area newspaper who has a reporter who is actively seeking healthcare horror stories. -jt, I agree. I must have misunderstood the article in this post. I didn't realize the suits only "agreed" after a strike. Our strike was settled after the State threatened to take away the various specialties that make money for the hospital.
The VP where I work is, in my opinion, delusional! He is convinced that he and his supervisors are doing a wonderful job. Never, ever gives a straight answer and addresses turnover in a specific unit by saying he encourages people to braoden their horizons and try new things. I do to if that is why they are really leaving. This VP also has no problem floating people to areas where they are not competent. This puts a strain on the person floated and the rest of the staff who are trying to keep their own heads above water. While I truly believe there are no easy answers to the problem of lack of nurses and surplus of patients, I think the suits need to put their money where their mouths are. Let's face it, they are heavily compensated and look where all those high salaries have gotten us! One of the worst staffing situations in history!!!
May 29, '02Occupation: RN Joined: Apr '02; Posts: 2,065; Likes: 48Nancy, you are right......again......the squads bring the anyway. Honestly, It makes no difference where the patient is if they are not getting safe care due to low staffing, ER, MEDSURG, or ICU........Seems in the ER, you end up holding critical patients, whil more critical patients keep on arriving who aren't even stableized yet........MOST dangerous. Our facility has just hired a new DON who replaced the wone who retired. Rumor has it things are abput to change regarding these policies on holding in the ER...I'll keep you posted...LR
May 29, '02Joined: Sep '01; Posts: 16,606; Likes: 680When I worked at Ohio State University Medical Center as a traveling nurse years ago, the nurses were on strike (in shifts so no patient care was compromised)...anyway, the nursing admin told the docs they were closing a ward and moving their patients due to shortage of staffing, and the docs didn't believe them. At exactly the time and date the nursing admin told the docs they were taking action, they did. Beds and patients were moved, a ward was closed, doctor's scattered about from ward to ward to see their patients who had been moved BY NURSING ADMIN and nursing staff, and by the next working day all was well with the world again. Sometimes, serious situations calls for serious measures, and nurses need to start taking these measures everywhere. STOP compromising patient care at unsafe levels, STOP risking our nursing licenses, STOP taking the bull-crappy from the ones who have stopped caring about why they became doctors and nurses in the first place. Sometimes they need to be reminded of this! es rule!!!
May 29, '02Occupation: RN.... Joined: Apr '02; Posts: 255; Likes: 6Yes, many ER patients could go to a clinic in the day time, and about 50% of our patient are actually referred from the local free clinic. The only positive thing about these patients is that they do go home. Yes, they clog up the system, and it isn't good, but they don't usually need admission....I think about this problem alot, but I don't really see any easy solution....
May 29, '02Joined: Jan '02; Posts: 5,673; Likes: 159What I can't understand is when I'm being pushed to accept 12 ICU patients when I only have staff to safely care for 8....
WHY is their solution to push and push the nurses way past safe limits RATHER than call agency?? You see, they could if they wanted to....the supes tell me 'The CFO will have my head if I call agency.' That's when I REALLY dig in my heels.
And hey, ER can stabilize and transfer...but of course the ER medical director will lose some of his bonus bucks...can't have that.
Poor planning on the hospital's part does not constitute an emergency on my part.
May 29, '02Joined: Jan '02; Posts: 1,614; Likes: 2I hate it. My unit has been closed since the census is low :-( I am a CNA, so I can float/drift all over. I'm cardiac/telemetry/overflow, usually.
Today i thought about this allnurses.com and the thread on C-Diff when I brought it up in front of 2 actual nurses today. I am sitting for a guy in burn unit getting over pnemonia, So I figured, incorrectly, that he was on the anti-biolotics for that, producing the toxic smells. He farted, loudly, and it smelt bad :-)
The two nurses neither reacted, so I pushed it and asked for them to explain it, and one talked about not knowing the name at all.
Out of all fowl smells, how many can be truely C_diff? 25%? I don't know. After I brought that up, both nurses cold shouldered me all day, hard. Now I am crying to myself? I'm sorry :-(
May 30, '02Occupation: RN.... Joined: Apr '02; Posts: 255; Likes: 6Whenever we have tried to stabilize and transfer- we are refused as there are not enough availabel RN's at the other facility, so we holding them, not stabilizing and transfers. Our ED docs don't get bonus checks-I know because I'm dating one of them.
May 30, '02Occupation: RN Joined: Oct '00; Posts: 2,662; Likes: 46aside to Mario......
so now you know who not to go to for help, right? dont let the cold shoulder of those people get to you. just take it from where it comes.... maybe they have miserable lives - nothing you can do about that. capisce?
Clostridium Difficiles Toxins (C-diff)
Methycillin Resitant Staph Aureus (MRSA)
All have very distinctive odors along with other signs. If its C-diff, there would be a high number of liquid BMs (like almost constantly) along with mucous & possibly blood streaks - and that distinctive odor. C-diff is manifested by the diarrhea - the odor is in that.
And isnt this just such a wonderful topic to discuss before Ive had my morning tea & bagel. ciao ; )
May 30, '02Occupation: a just a nurse contemplating the nature of my career..... Joined: Oct '01; Posts: 2,344; Likes: 21-jt...
boy, howdy.....did i get reaquainted about the "c-dif" stool last night.....
it also stains the skin.....
along with the odor....
at least we can treat it.....
okay....gotta go get my morning coffee
May 30, '02Joined: Jan '02; Posts: 1,614; Likes: 2(still floating)
Thanks JT, andnow i can narrow my understanding, and realize, the smell comes from the bacteria in the diarrhea itself, right? This clostridium difficiles resides in the descending colon (?). Why don't the antibiotics make the smell go away? Thank you for the help.
Everyone who floats, I send my regards and to tell you I float too. Just keep your morale up and enjoy the "unit shift" Sometimes its hard to keep your balance when you float, and gravity changes can add to your stabilization techniques
May 31, '02Occupation: RN Joined: Oct '00; Posts: 2,662; Likes: 46<Why don't the antibiotics make the smell go away? >
The antibiotics are the cause of it.
Things like clindamycin kill off not only bacteria of the infection they are treating someplace else in the body, but also good bacteria in the GI tract - normal flora - that keeps other bad bacteria in check. When you throw in antibiotics for something else, the balance in the GI tract is disturbed & without normal flora to keep the other bacterias in balanced levels, the bad ones can proliferate & take over. So you end up with things like C-diff diarrhea. Then you add 14 days of flagyl to the med regimen & get the c-diff bacteria back under control.
Dont feel funny about asking questions. The day you stop asking questions is the day you stop thinking.
Jun 3, '04Occupation: Registered Nurse:Theatre Specialty: 11 year(s) of experience in Operating room Scrubbing, Anesthetics, ; From: SA ; Joined: May '04; Posts: 26; Likes: 10I work in relatively small state hospital in south africa. Our wards are very diverse. Female and male mixed, with about 6 surgical departments laying claim to the 32beds in each unit. This can sometimes lead to loads of confusion in the urology clinic claims that they simply must admit this patient, even though their quota of beds have been filled, and the gynae doctors refuse to have some of his quota beds used, and will sometimes admit patients who could have been cared for as day patients, but they want them under observation. In the medical ward it tends to lead towards cahos on more than one occasion. We have a very high incidence of TB and other imuno-suppressed related diseases where we need to have one patient in a 2 bed room, or a patient that is dying and we need to give them privacy. Unfortunatly we have some young doctors who will admit a patient because they question their own diagnosis and want the consultant to see the patient and evaluate him. Fortunatly as we are such a small hospital, the relationship between doctor and nurse is such, that they do listen to reason and will make an effort to rather send patients on their way than admit them, if you as charge sister go to them and explain situation. I am very lucky not to have beurocracy breathing down my neck(well, not much) as we are a state run hospital
Jun 3, '04Occupation: Registered Nurse Joined: Jun '04; Posts: 5Quote from l.raeI work at a Level 2 trauma center and when our floors are 80% full we go on diversion. Walk-ins are informed of extremely long waits and ambulance traffic is diverted to nearby hospitals. The only pt's we take are major trauma. I can't even imagine what would happen if we couldn't divert. Our hospital goes on diversion a few times a week!!How about it????? Are your ER's allowed to close as easily as the floors?? Our's sure isn't......LR