mercurysmom, RN 7,777 Views
Joined: Jul 25, '11;
Posts: 165 (72% Liked)
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NIOSH is issuing new guidelines regarding handling a disposal of hazardous drugs, so lots of institutions are changing their policies. The gown sounds like overkill for non-hazardous drugs, but I've always gloved for all drugs and my hospital switched to nitrile gloves a year or two ago because they are chemo-safe (even though most floors don't even give chemo, the patient could then be transferred to any floor).
I couldn't even tell you how many pairs of gloves I go through in a shift. On the other hand, I don't particularly want any transdermal exposure or to give the patient a sticky pill if my hand is still a little damp.
What's their NCLEX pass rate?
We had a patient recently who stated he wanted no provider of any kind who was not white or did not speak English. I was quite pleased when management told me to ask him what hospital he wanted to be transferred to. I have no tolerance for anyone who acts like this patient did and was glad the powers that be had our backs. Patient quickly back paddled.
To be frank, I deal with patient's only for a short amount of time (ER nurse). If someone is verbally abusive/screaming/yelling/acting inappropriate we will place them in a room, on the monitor, and shut the door partially. We deliver care and follow through on the MD orders, but if the patient refuses then we stop and again shut the door partially and continue to monitor the patient. If they are unable to control their actions due to medical diagnosis we will medicate them with haldol, geodon, ativan, or benadryl. We will place spit masks on the patient's that are biting/spitting, place pt's in restraints if they are physically aggressive. During all of this we do not engage/speak/attempt to placate the patient if it only furthers the behavior.
If the patient is alert and oriented, I will tell them to stop. I do not make demands, I will simply say: "That is unacceptable, you need to stop. There are children/other patient's nearby who are sick and this is not fair to them." I will then deliver the ordered care without verbally engaging with the patient. If the patient continues to be verbally inappropriate, I have had the MDs discharge them from the ER and have security escort them out. Legally we have an obligation to ensure they aren't dying/treat obvious life and limb situations but we do not have to put up with harassment.
If the patient is sick enough that they need to stay, I will continue to provide care but will not go to the bedside unless security is present/at least one other nurse is present to protect myself from being both physically assaulted and/or to prevent the patient from saying I did something inappropriate/did not medicate at ordered/etc.
You should have never discussed your personal religious beliefs with a patient ...especially a crazy one. Now he knows exactly which buttons to push.
Go to your local community college and speak with an academic advisor. The community college can test you, find your weaknesses, and advise which classes to take to be able to pass TEAS.
If you're seeing math on the TEAS that you haven't seen before, it may be that you simply haven't been taught the basics. The community college can bring you up to speed.
Go for your dream!
At the end of the day it's a social contract. We get vaccinated to protect the people who can't. Herd immunity requires 93-95% of the population to be immunized or it stops working. It's not for you, it's for your patients. And they are the whole reason we are nurses. Immunizations are at the bottom of the list of occupational hazards that surround us at work. We handle chemo, biohazard waist, body fluids, plastics and off-gassing furniture carpet and paint are everywhere, everything is coated in cleaning products that contain carcinogens, UV lights are being used more because they are bacteriocidal, hell even the air we breath isn't always safe. Who here actually thinks they have a perfect seal every time they wear an N95? No one knows what a lifetime of exposure to that environment does to US. At least we know what immunization side effects are.
Any through and sound research on any given topic requires evaluating *both* sides of the issue and every topic has two differing sides. The point is not to only research the findings of those who agree with you, but to honestly and objectively explore, examine, and educate oneself on both viewpoints, so that an unbiased and unprejudiced conclusion can be found.
because the huge majority of the medical community has a decidedly strong stance on the issue, most, if not the entirety of "peer reviews" come from individuals who share the same belief regarding the issue. So just because something isn't "peer reviewed" by the medical leading majority, doesn't mean it is invalid. D
I've seen some scars and had a look on my face like "what the hell is wrong with you?"
I blame parents. Parents are who kids, from the chute on up to 18, spend the most time with. No other adult. What time they spend in classroom is nowhere near as long as how they spend it with their personal families at home. Teachers won't provide you with breakfast and a warm meal at night and a bed. The parents do. That means that the amount of time they grow and learn how to behave is dependent on how the parent behaves and acts. If the parent likes to be informal and not resourceful, the kid will probably have an expectation that their parent will take care of them until they grow up and can feel good about leaving the house without a worry in the world about how they'll pay their rent. This is not always true. Eventually, the parent will grow tired of the kid thinking that the kid has no direction, but because the parent lacks resourceful information that provides useful for the kid, the parent struggles. Parents who are informal/formal and resourceful will raise kids probably the most effective way to live.
I give ONE. I bought sugar free mint ones that the kids don't like as much and I figure, they're just nasty candy and when my supply is gone for the year...it's gone. I do point out to the non-coughers that they haven't coughed since entering my office. about 95 % of the time this will result in a fake, half-hearted attempt at a cough. This is purely for my own amusement as I'm going to hand over the cough drop anyway. Oh, and I never give one to the same kid two days in a row. I tell them they can bring their own and no one is frisking anyone in the halls for contraband cough drops.
I did have a kid today who came in for a cough drop, I gave it. He came back several hours later asking for another and I asked if it worked earlier. He said no, and I asked "why would I give you another when the first one didn't work?" He was stunned that I didn't just hand over the cough drop. But seriously, if something didn't work, do you try it again or move on to other intervention? Even a KN can figure that out.
So Hubby and I are [I]those parents [I] who worked with the school to keep his butt in his seat and cut down the social visits. :-D Meanies!!!
Here's my update: I did ask the health director for help and she said she would talk to Becky. Here's what we have: My health office will now be getting siderails for all of our beds in the health office! Really. The director insisted that there's nothing we can do, and we must accommodate her or she could "sue us."
When Becky feels like she's going to have a seizure I ask her to sit on the floor and I put pillows on the floor next to her so if she falls over, her head is protected. This has kept her safe during the seizures she's had in my office. Apparently she doesn't like that and took advantage of the talk time with the director to complain. I'm at a loss for words.
I'd say it's time to get the administration involved. It's becoming an issue in the classroom, safety wise and probably performance wise. That's above your pay grade.
I think it stems from this totally false idea we hold culturally, that if you do everything right as a parent, your kid will be perfect, or at least very well behaved. This causes parents to look for excuses instead of solutions.
Those of us that have more than 1 or 2 kids know that some kids are naturally obedient and some kids are born to be wild. What we need to look at, is our response to that. What response works in helping a child grow? The answer is not always clear. And what works for one kid won't necessarily work for another. Sometimes parents are mismatched in temperament or personality to their children, and those relationships will be strained.
It really does take a village. We need to let other people correct our children and hold them accountable. We need to trust each other on a basic level in order to do that. We need to not bash each other when things go wrong. It happens both ways. A kid acts up in school; the parents bash the faculty and the faculty bashes the parents. In any way we can, we need to aim for a spirit of working together for the child's well being.
And let's not be so quick to pathologise children's behavior. When I was a kid we sang this terrible version of "Deck the halls". It was rude and obnoxious and it went like this "Deck the halls with gasoline, falala-la-la, la-la, la-la. Light a match and don't be seen, falala, la-la, la-la, la-la. Watch the school burn into ashes, Falala, falala, lalala. Aren't you glad you play with matches..." People would roll their eyes or say "Stop that song." Now a kid would be sent to crisis for a psych eval and maybe charged with terroristic threats for this kind of thing. I work in child psych and I have seen this. When I was a kid, I remember making a hate list of people I wished were dead. These were kids who were mean to me and once in a while my sister or my mom would make the list for something that made me mad. No one ever saw it because I enjoyed privacy, but if they did, they would have just blown it off. I have had kids admitted to my unit for this very thing. Some of the frequent flyers are absolutely convinced that they are just messed up individuals because of this kind of overreaction. And it can be a kind of self fulfilling prophecy.
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