KTakami25

Do you know of any nurse who had their employer sponsor an EB3 visa so that the nurse could get permanent legal status in the US? If so, what was the process like? A bit of context: My nurse coworker friend is a DACA recipient. He worked many extra shifts to help our COVID unit during the heavy December/January COVID surge and is an excellent nurse. There is NO pathway for citizenship for him (though there's another DACA bill on its way to Senate that is not likely to pass) and I think that's messed up, especially because he was there on the COVID frontline helping care of our COVID patients, helped us with many extra shifts. And so, that's why I'm thinking instead of waiting for DACA to miraculously provide an upgrade/pathway to citizenship, we probably should look into asking our employer if they could sponsor him an EB3 visa as described here https://www.uscis.gov/sites/default/files/document/guides/E2en.pdf As an immigrant myself (lucky for me I had a green card and now am a US citizen) and as his friend, I feel inclined to help. He's not one to complain so I asked our HR department on his behalf for input/help (with his permission). While I wait for HR's input, I want to hear from you guys if you have any experience in the matter. Thank you in advance.

Husband and I are considering moving to Oregon in order to buy a house (in the next year or so) without the California price premium. My career conflict lies with the fact that I have been a bedside nurse at my local hospital for 8 years (since I was new grad nurse) and have come to love the supportive culture within the organization. Also because it's a Magnet hospital, bedside nurses have access to numerous opportunities towards professional development and advancement through the clinical ladder. If we move to Oregon, I will likely want to stay full-time at the bedside because of the 3 shifts/week, 12 hours/shift schedule. Do you have any tips/FYIs for someone in my situation? For those who have moved to OR from CA, any good-reputation hospitals/healthcare systems you'd recommend I look into? Also, how are staffing ratios in Oregon? Have you seen them enforced (non COVID vs COVID times)? Thanks in advance:)

I just posted similar questions just a moment ago, too (from CA to OR). I'm curious to see other nurses' responses to our questions:)

Thanks for your details response, areason4stars!:)

Hi Cat365, I agree with you that individual barcodes would be a great safety feature. Thank you so much for your input!

Hi Here.I.Stand, BSN, RN, Thank you for your input! :)

Thank you for your input! :)

Hi Jessy_RN, Thank you so much for your insight! That's great to hear that there is a hospital somewhere that does have patient-specific barcodes on single-use insulin pens! That is so interesting to hear that they are also locked in the pt's room instead of in a med room. Because I am thinking of eventually proposing a workflow like this at my hospital (we are currently busy with transitioning to a different EHR), would you mind telling me what organization/hospital you work at? If this is too personal, would you mind telling me what state you are from? This info will help me in substantiating my proposal and possibly allow me to find out from your organization about the workflow. If not, that is ok, too. You letting me know this workflow exists is very helpful already! Thank you so much!

Hi marienm, RN! Thank you so much for replying with very helpful specific details! My hospital is transitioning over to EPIC next year from Allscripts SCM and I am wondering if we would have patient-specific pharmacy prints for our insulin pens, too, by then (but we currently stock ours in Pyxis). Also, thank you for describing to me your hospital's Pyxis system setup and RN double-check process that goes with it. I appreciate your insight! Sincerely, KTakami25

I think EllaBella1 has a great point. I think more experienced nurses in my hospital and older doctors still say "Hep lock the patient's IV"--even for your basic peripheral IVs. In fact the other day, a surgeon entered nursing instructions" "HLIV," and verbally told me to hep lock her IV. At my Southern Californian Magnet hospital, we saline lock the basic (short) peripheral IVs but hep lock long midline peripheral IVs and central lines as long as there's no HITT suspected. What I am curious about the scenario you mentioned is how an IV cath was used in the pt's abdominal fat tissue so that morphine can be given subQ. I wonder why is an IV cath in the pt's abdomen for subQ med administration? At my hospital, we use subQ needles that we stick in the patient's abdomen and stay there for some days for comfort care/end of life care med admin. I have to say I have not seen a situation like yours--maybe because I have only been a nurse for 5 years.

Hello fellow nurses! I am in the process of reviewing literature on whether double-checking vs. single-checking subQ insulin is improving patient outcomes. If you are a nurse who administers subQ insulin via patient-specific insulin pens, could you share on what safety checks/processes are REQUIRED at your facility to make sure that you are using the right insulin pen on the right patient? For example, at my facility here in Southern California, barcode scanning does not ensure that the pen is for the right patient--only the required double-checking process (with another nurse) does. Thank you so much for sharing! Your input will help me think of ways to ensure patient safety when using insulin pens at our hospital. KT

Hi kalycat, Thank you so much for the details in your input! :)

Hi Glycerine82, Thank you for your help! It definitely sounds like a busy floor you're at that there wouldn't be time to flag down another nurse.Thanks!

Thank you for your helpful input, kataraang! :)