nellwolfe 792 Views
Joined: Dec 13, '05;
Posts: 7 (0% Liked)
I am writing a paper on NPs and why they are cost effective alternative to MDs and how they treat the family. My problem is: I can't find a definition for "Family". Can anyone point me in the right direction? Thank you.
Many schools for the MSN/NP only require the MAT (Miller Analogies Test) which is very easy. You might want to look at some of these schools.
In my insitution Risk Management has repeatedly stated that staff are encouraged to report errors so that the error can be reviewed as a "systems issue" and appropriate interventions to prevent a repeat can be implemented. A few months ago 2 long-experienced nurses made a terrible mistake with fatal consequences to the patient. Since that time, nearly every situation, even those which nursing staff and nursing management do not deem as errors, are being reviewed by VPs with little to no recent bedside Nursing experience. Nearly every review has resulted in institution of the progressive disciplinary process. This even when nursing unit management has stated that the nurse did nothing wrong. With the grapevine being intact, such VP decisions are communicated throughout the institution with the result being that virtually NO "close calls", "marginal outcomes", or "near misses" are being voluntarily reported. Nurses have become silent and self-protectve because they perceive their hospital administration as looking for a "blame target". Such VP reactivity has set staff trust and reporting back 15 years. And the worst part is that the VPs don't even know it is happening!
Well, let me see if I can add fuel to the fire.
In this same large midwestern hospital, part of a chain with the same name, I observed a doctor walk around the PACU checking the names on each patient's chart. When he recognized a name that was familiar, he logged into the confidential computer medical file data base to learn more about the patient's current reason for being in PACU. He then came over and spoke to her about why she should have sought his surgical services instead of the doctor who was treating her. Finally, he reached for her chart (it was my patient) to review it further. I took the chart away and told him that HIPPA requires "need to know" access. He told me he could do anything he wanted because he was a doctor. All of this happened directly in front of the Nurse Manager. She did not report him.
I also routinely found "wrong surgery" evidence. Allow me to explain. The patient received surgery on the extremity that needed repair but the consent was for the other appendage. This constitutes "wrong surgery" and is considered a sentinel event reportable to the feds. Every time I would point out the mismatch between the surgery (evidenced in the OR report) and the consent, Risk Management would tear out the consent form and shred it in front of me with the remark, "the consent must have gotten lost".
I would find that the operative report would list a D&C or hysterectomy for a male. When the CRNA assigned to the case and who was responsible for the final OR printout was asked to edit the op report, she would tell me she was too busy.
Specific ASA numbers are assigned to the risk level of each case. ASA 1 are for healthy people, ASA 2 are for folks with a condition such as asthma, diabetes, etc. ASA 5 is for organ donor - dead when we are finished harvesting your organs. I found several cases where a healthy young person had been assigned ASA 5, obviously a mistake beacuse ASA 5 do not come to PACU to be awakened. When I pointed out the error to my Nurse Manager, the CRNA, and Risk Management, I was told to "get a life" a stop nit picking on the little details. I was even referred to Employee Assistance for my "obvious emotional problems".
Yes, there IS more to the story. This nurse was forced out of ICU because of her poor interpersonal skills. Our PACU was required to take her because of hospital policy stated that if we had an opening and she applied, we had to accept her. She would start Nitroglycerin drips on patient without consulting the anesthesiologist. She told a Black anesthesiologist to "kiss my lily white ass" in front of a room full of nurses, doctors, patients, and management; she told a patient to behave because "you won't like what I can do to you if you make me mad" loud enough for family members visiting at nearby bedsides to report it to the hospital administration yet she is still there. I resigned, the anesthesiologist refuses to talk to her, my team leader with 35 years experience retired early because she was sick of the out of control atmosphere of the PACU. Is that enough of the story?
Where is the Nurse Practice Act? It states that if a licensed nurse has knowledge of an activity which harms a patient and that nurse does not take steps to advocate for the patient, the nurse is considered to be as guilty of patient abuse as the perpetrator. Looks good on paper but empty words in reality.
I have worked in a large hospital where one of my coworkers NEVER washed her hands or used gloves. She was repeatedly observed catheterizing a patient bare-handed after emptying another patient's suction canister. When this was reported to management and observed by them, nothing was done. I was counseled for poor peer interaction. I then contacted the state health department which inspected and cited the hospital. The nurse's behavior continues to this day. I became the object of the hospital's effort to terminate me by repeatedly finding any opportunity to counsel me, They even went so far as to accuse me of hacking into a computer (to which I had no access nor knowledge of its existence) to retrieve patient information. I resigned and moved away. Has any other nurse experienced similar problems?
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