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Sharon's Latest Activity

  1. Sharon

    Help in Bangladesh

    If a water point is a water fountain I agree with the previous poster that there is no risk. But if a water point is communal bucket of water like it is in some communities. He will need to use his own glass and there should be a serving ladle that no one drinks from. Please clarify what do you mean by a water point.
  2. Sharon

    Liability laws for DON's

    Liability law is comprised of common law, state and federal regulations, and state and federal case law. Regardless of the subtype, for instance DON, liability law is not located in one area. You would have to research the specific issue and sub-issue to speculate on how it would impact you as a DON in the type of facility as well as the location, Florida. The legal doctrine you should research is Respondeat superior. A legal rule that the principal or employer is liable for harms done by agents or employees while acting within the scope of their agency or employment. You can start with Findlaw at http://www.findlaw.com
  3. Sharon

    Volunteer Nurses Needed for Hurricane Emergency!

    LA Nursing Board is coordinating with the other state boards for volunteers. You are to contact your local Board of Nursing who will verify your license/certification status per the National Disaster plan and forward a list of Volunteers to LA Board of Nursing. Please do not overwhelm LA Board of Nursing with individual calls of offers to volunteer. The LA Board of Nursing does not have the time to do license checks on nurses who call them from out of state.
  4. Sharon

    OHN from Brazil

    Katia, Don't worry about your grammar. Your skills are much better than mine would be in any second language I would attempt. My background has been the occupational/environmental health of rescuers, safety, relief, law enforcement personnel and children during all phases of disasters. I have also had experience in radioactive events and emergencies. Some of the industries I have worked in include food manufacturing and retail, transportation, government and non-profits. I have recently started some educational programs to get more experience with how the laws and courts work. Classes actually start fulltime tomorrow night. Good luck with your classes. Sharon
  5. Sharon

    OHN from Brazil

    Katia, Welcome to the board. It is great to have a nurse from Brazil participating. I have interacted with Occupational and Environmental Health Physicians from Brazil in the past. Are you working in a specific field or industry or cover a variety? Sharon
  6. Sharon

    Regarding Hep.B Infection.

    Youknowwho Yes you can have antibodies already but if you don't you will have to pay for it again. Since we know second vaccine titers don't last very long, none of the schools where I have taught Nursing would accept a second vaccine titer level. Check with your school before going to the expense. You usually need pot prove the entire series and titer to start clinical.
  7. Sharon

    COHN Certification

    The test is based on the highest basic nursing program you completed. To take the COHN-S you must have completed at least a Bachelor's Degree. It does not reflect your actual duties. The portion most often failed by all candidates is the direct care questions.
  8. Sharon

    Staph Aureus question

    I see people all the time who continue to work through the pain, ADLs including sports. Decreased ROM is one possible sign of a fracture. Even when I did disaster rescue decreased ROM was rarely a sign of severe fractures even in the field. Step classes are notorious for fractures check with sports medicine. Regardless you do not have confirmation of either illness. I think it was reasonable to be treated for the most likely conditions, an infection and a fracture. BTW I have never seen symptoms such as yours caused by Staph not grow Staph on culture. But then the physicians I have worked with would have cultured your arm either by swab, punch biopsy or some other form of biopsy. Just out of curiosity - Is MRSA so rampant on your unit/facility that the ED physician automatically assumed you have it? If he was concerned that it was MRSA why did he not get an ID consult in the ED? If you are going to be concerned about how your case was handled I would be more concerned about how the initial assessment of what infection was going on and what drugs you where treated with. I have recently seen virus joint and soft tissue infections that sound just like what you have. Guess what? You haven't been covered for that. BTW you are in the right gender and since the two labs you mention are dead on for an acute flare of collagen vascular disease, do you have any other risk factors?
  9. Sharon

    national medical reserve corps

    The medical reserve corp. has been around for generations under various names. I had a great aunt who received her LPN as a member back in 1901. Many of these volunteer opportunities have always existed there has just been a lack of interest by health care professionals to participate.
  10. Sharon

    Staph Aureus question

    I did have a case like this and it did prove to be only a fracture. The scans supported this. There was no acute or six month uptake to support a systemic infection of any type. We where concerned about an infection seating at the stress fracture site because of the high risk position he was in. The individual was a post transplant recipient who was an industrial hygienist who had multiple sewage exposures. I can't remember why but there was another non-infectious cause found for the elevated WBC and shift. BTW don't forget any swelling ("only swollen") is considered a deformity. It is not uncommon for minor fractures, i.e. stress, not to swell for days, weeks or months; sometimes not until further damage occurs like from immobility. Rarely do stress fractures show up on flat X-rays during the first six months. Actually today I just saw a facial one show up via the third CT scan that we have been looking for for 24 months. We strongly suspected it was there based on deformity (swelling) on the opposite side of the face, discomfort, warmth, temperature, and elevated WBC's. At one point a severe sinus infection occurred and was aggressively treated to prevented osteomylitis at the fracture site. I am glad my patient did not file a complaint between onset of care and the past 24 months!
  11. Sharon

    PTSD Tort Defense

    I just came from my Torts class. I am studying for my Paralegal Degree to be a Nurse Paralegal. I am looking for some references/citations to cases involving defendants who used PTSD as a defense and where still convicted. I am even more interested if the crime or tort occurred against a nurse in the workplace. A couple of classmates, who claim to be healthcare workers, have stated in class that no one with PTSD can be convicted of a tort or crime because: 1.all people with PTSD are incompetent and require hospitalization and, 2.only veterans can have PTSD. I don't need a discussion on these wrong statements I need specific case citations before 7 pm EST tomorrow. I do not have access to either Westlaw or Lexis before then. Thank you for limiting your responses to specific cases.
  12. Sharon

    syphilis question

    If the patient is having further deteriorating symptoms, which she must be having since it has resulted in her diagnosis, then she is definitely is still infectious in some form. She will need antibiotic treatment to prevent further deterioration of her condition. If one of the conditions she has developed is neuro syphilis, treatment will not reverse the permanent brain damage that has already occurred. There was a recent very good episode of House about a woman who contracted syphilis 30 years ago and her only presenting symptoms was a change in libido. I have had three large blood and spinal fluid exposures to patients with tertiary syphilis and it is considered very infectious. Syphilis is named the great mimic because it can be misdiagnosis as any disease. One movie I show my students is Mrs. Evers' Boys about the Tuskegee Experiment.
  13. Sharon

    MRSA please help

    Inform your chain of command that HIPPA does not apply to every health care information situation in the world. It specifically does not apply to the following: Work Place Exposures, Injuries, Hazardous Material Incidents regulated under the community right to know act (SARA, Title II), and those rights covered under the Federal Whistle Blower Rights Acts. I could list a whole page of what HIPPA does not cover and the liability the average nurse has for preventing care by wrongly using HIPPA. I did do a little research on the following statements: "90% of all nurses have colonized MRSA in their noses". "40 percent of the population are carriers of MRSA, no big deal" Because you specifically mentioned the Center's for Disease Control I went to their website and drilled own in their publications and discovered that what they define a community carrier as is: "Community acquisition was associated with recent hospitalization, previous antibiotic therapy, nursing home residence, and intravenous drug use." 1: Infect Control Hosp Epidemiol. 1995 Jan;16(1):12-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7897168&dopt=Abstract Please note this is a ten year old definition. I cannot find any prospective studies of healthy nurses or of general population of MRSA rates. So the first two statements are not supported at this time. So what would I do to cover myself professionally and medically? 1. Throw the HIPPA crap back in your manager's face in a professional manner. 2. Another mechanism to move around the HIPPA and notification issues is to give your employer a written release and instruct the employer to notify my co-workers that I have an infectious disease and I want my co-workers notified in order to seek preventive and/or treatment ASAP. I would ask your co-worker who is sick to do this. This will begin to get both of you off of the HIPPA block. Do not rely on your employer to send out the letters you may want to send your own out to your co-workers. 3. File worker's compensation due to exposure of an occupational infectious disease. The cost of the medical surveillance should be covered by your employer. Medical surveillance should have begun before your placement, during and after. I would be interested in hearing how your employer reacts when you point out this is outside of HIPPA.
  14. Sharon

    infant hiv?

    Since the original poster has not been on this bulletin board since a week after posting this message, which was 1/29/2004, I am closing the thread.
  15. Sharon

    List of Case Managers

    Actually if you are talking about injured Maryland workers, in the state of Maryland there are specialty license requirements and the CCM does not meet the laws. Additionally if the Nurse is working on a case that are heard before the commission they must also be registered with the commission. I am unaware of a look up by License category in Maryland. Maryland License lookup Maryland WCCM page http://www.mbon.org/main.php?v=norm&p=0&c=adv_prac/wccm_rn-fne.html#WCCM Workers Compensation Commission http://www.wcc.state.md.us/Navigation.html (go to VR Registration & Certification Information)
  16. -------------------------------------------------------------------------------- "DATE RECALL INITIATED: April 2, 2004 LOT NUMBER / EXPIRATION DATE : X0667-2 6/24/2006 X0667-3 6/24/2006 W1419-2 12/6/2005 W1419-3 12/6/2005 MANUFACTURER: Aventis Pasteur Swiftwater, PA REASON: Aventis Pasteur is recalling four lots of Imovax Rabies, Rabies Vaccine (Human Diploid Cell) that were distributed in the U.S. This is a precautionary measure stemming from the discovery through routine testing of a non-inactivated production strain of virus in a single product lot, which was not distributed. As a special safeguard, Aventis Pasteur initiated the voluntary recall in the U.S. and abroad of distributed rabies vaccine lots produced during the same time period. The lots being recalled passed all release tests, including testing to confirm the absence of live virus. The firm is requesting that the use of these lots be immediately discontinued and returned to the manufacturer. The information in this listing reflects CBER's best efforts to communicate information that has been reported to FDA. Its accuracy and comprehensiveness cannot be guaranteed. " http://www.fda.gov/cber/recalls/rabave040204.htm