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JollyBug92 BSN, RN

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  1. JollyBug92

    Obsessive resident/Please help.

    First, you need to tell the resident that her behavior is inappropriate. If she is making inappropriate comments or saying things that make you uncomfortable, tell her to stop as soon as she does it. Tell her it's inappropriate and that it is making you uncomfortable. Whether she is cognitively intact or not, you need to say this and then redirect her. Don't say you're too busy, she'll make a reason for you to see her. The next time she makes up an illness, express concern for her need to pretend to be sick, and say that if it happens again, you will have no choice but to notify the doctor and have her assessed. Also do a little detective work: is it only you that she has these behaviors with, or has this been increasing with all staff? Second, document the behaviors, your actions, and her response. She may seek you out because you make her feel safe, or you remind her of someone. The illnesses she's making up may have to do with her feeling like something is wrong, but she's not sure what. She may need some reassurance frequently, so try saying, "You're fine. I have to check on a few other people but I'll be back once I'm finished, ok?" Her behavior may be repetitive, but try redirecting her and reassuring her. You need to document her behaviors so that other nurses and staff are aware. This will also help you see what works to mitigate her behavior. Her care plan may need an update to deal with conditions, such as loneliness or boredom, that may be influencing her behavior. Third, get your director and other nurses on board and make a plan that will be implemented to handle this resident's behavior. You may need a physician, geriatric psych, or behavior support to come in an assess her. Be professional, but firm. When in doubt, look to your director of nursing or director of care for guidance. At the very least, make your supervisor aware of the issue you have.
  2. JollyBug92

    How NOT to write an incident report

    Ah yes, I think someone has to talk with her and remind her that one should never use sex positions when filling out incident reports! Otherwise, reading her incident reports might become a bit like reading the Kamasutra!
  3. JollyBug92

    Things Patients Have Taught Me NOT To Do.

    1. Don't remove your 24f foley (with a 50cc balloon still inflated....YIKES!) yourself. It will hurt. There will be blood, and painful surgery to repair your shredded urethra. 2. Don't chew up pills and inject them into your sore arm. It does not "get the medicine working faster". 3. Your nitroglycerin rectal cream for your anal fissure and sublingual nitro spray are not interchangeable. Similarly, your nitroglycerin ointment goes on your skin, not under your tongue "like your spray". 4. Don't try and pop that that "weird giant cyst" on your belly button yourself because it's not a cyst. That stuff coming out wasn't "infection", that was poop. You lanced your umbilical hernia. Congrats. And my personal favourite, as told by a colleague of mine. 5. Putting insulin into juice doesn't "dissolve the sugar". I get that you don't like needles, but you can't just empty your Lantus pen into a Coke and call it "diet Coke". That's not how it works. Back to Diabetes Education Classes you go!
  4. JollyBug92

    Trigger Warning!

    Really? What is the world coming to that we have to give trigger warnings before we say something that might hurt someone's feelings? I think it's great that we are being sensitive to others, but having to say "Trigger warning" is taking it too far. I find people are so easily offended these days that you can't say anything. If people are so easily "triggered" that they can't function without trigger warnings, maybe they need professional counselling so they can learn to cope with, address, and manage the feelings that come with triggers. Or, maybe I am in the wrong and have completely misread and misunderstood trigger warnings.
  5. JollyBug92

    Scope Of Practice Question

    It was my understanding that regardless of the role you are in, if you are an RN, you are held accountable as an RN. I would raise concerns with management over this "policy". Your nursing standards should at some point state something like "RNs practicing as RPNs or unregulated health care providers are held accountable as RNs. RPNs practicing as unregulated health care providers are held accountable as RPNs". This is one of the nursing standards regarding "other work" where I'm from, so I suggest you look at your nursing standards and bring this to managements attention STAT. Basically, don't turn a blind eye or deaf ear. Document as an RN, know that you will be held accountable as an RN, and talk to management about this unsafe policy. Protect yourself and protect your patients. Best of luck to you!
  6. JollyBug92

    HIPAA and "Hallway Patients"

    It is my understanding, and perhaps that understanding is wrong, that whenever possible, we are to give patients the most privacy we can under the circumstances. Unfortunately, that sometimes means the difference between preserving privacy and providing necessary care. I would love for my patients to all have private rooms, but the reality of hall patients is all too real. In those cases, you do the best you can. In my facility (extended care, private facility), when I have something to discuss privately with someone and they don't have a private room, I either empty the room so we have privacy, or I take advantage of procedure rooms or examination rooms when I can. Otherwise, I pull a curtain and make do with what I have. I try my hardest, but sometimes, the setting simply does not allow for complete privacy. I feel for my patients though. They deserve better than a curtain that doesn't muffle voices or mask smells. Obvious breach of privacy: During my clinical hospital rotation, I had two elderly male patients sharing a room. Mr. A was near blind and VERY hard of hearing but refused to wear hearing aids. Mr. B heard and saw perfectly fine. Normally, with hard of hearing patients we would write on a communication board to communicate clearly. Well, not for Mr. A who is nearly blind! The doctor had to explain to Mr. A that he needed a catheter because he had BPH and wasn't able to urinate. The exchange went something like this: Doctor: Mr. A, we need to put in a Foley catheter. Your prostate is large and that's why you're having trouble peeing. Mr. A (yelling): WHAT? Doctor (yelling): A CATHETER. IT'S A TUBE THAT GOES UP YOUR... Mr. A (yelling): A WHAT? WHAT DID YOU SAY? Mr. B (yelling from the next bed over): HE SAYS HE HAS TO PUT A HOSE UP YOUR D***!! Mr. A (yelling): A D*** HOSE? Doctor (yelling): YES MR. A! IT'S GOING TO EMPTY YOUR BLADDER! Mr. A (yelling): WHAT? Mr.B (yelling): IT'S GONNA HELP YA PEE! Guess which lucky nursing student learned how to catheterize a patient with BPH using a Coudé Foley that day? Me, JollyBug!
  7. JollyBug92

    New job as NA

    Yes! I'm a charge nurse, and I can't tell you the number of nursing students who come through our doors to work at nurses' aides, health care aides, personal support workers, etc. Most of them are great workers, but they always have "nurse brain" where they are concerned about far more than they need to be! I love them to pieces though. Ms. Lemon gives excellent advice here. It will be overwhelming at first because you haven't found your routine and everything is new. Once you learn to multitask and work efficiently, things do get easier. When you're new, you have to learn everyone's names, their routines, the facility, and the system they document on. It's overwhelming! The good news is, it won't always be this way. Congrats and happy working!
  8. JollyBug92

    February 2019 Caption Contest: Win $100!

    Forty years Nurse Moses wandered the unit in search of a room which was rumoured to flow with coffee and donuts. One the eve of his retirement, he finally glimpsed the Promised Land.
  9. JollyBug92

    Will I get in trouble?

    Yep. You can get in deep trouble for that. You violated HIPPA by accessing your friend's chart! Yes, you accessed yourself but it is your own record and as long as you didn't change anything on said record, you are not in violation. As for accessing information on your friend, that is a violation of HIPPA. Whether the friend had called in or not, the hospital does audits on patient charts all the time. Don't be surprised if you get called in! Her chart has likely been flagged for audit since she was not admitted to your facility, or likely anywhere else when you accessed the chart, and she had no reason to have her chart accessed. You may think that there is no way to prove whether or not the person called in, but please think again about that. Hospitals have records of their phone calls, and would be able to see if any incoming or outgoing phone calls were made to your extension at the time the chart was accessed. They investigate chart snooping all the time and have ways and means of finding out if you violated HIPPA by snooping. You accessed something private, but are worried only about the possibility of getting caught. What you did was wrong and shows poor judgement and ethics. How would you feel if a doctor or someone you work with accessed your patient record without your permission?
  10. We've all heard "DON'T SAY THE Q WORD!" lest ye be cursed with a shift full of mishaps. What's the funniest, strangest, or maybe most true nursing superstition you've ever heard? Here's mine: Open the window to let the spirits out! When one of our patients has just died (or is on the way out), we crack open the window in the room to let the spirit out.
  11. JollyBug92

    Don't Say The "Q" word!

    The two most important things nursing in an extended care facility has taught me: 1. Never say the Q word. Don't think the Q word. 2. If it's a full moon, be wary. Be prepared to find at least one patient covered head to toe in the brown stuff. It's not pudding or chocolate either. Case in point: I was leaving work tonight, the night before the full moon. One of the nurses goes, "It sure is quiet 'round here, JollyBug!" I didn't have a chance to respond because at that moment, one of the personal support workers peeks her head out of a room and whispers to me, "Send the nurse down. Mr. B is playing in his poop again and Mr. A in the bed beside him just urinated all over the floor." The nurse could have killed me when I said, "Don't ever say the Q word. This is what happens when you say the Q word."
  12. JollyBug92

    First job home health RN advice

    My friends who work home health always have predictably unpredictable schedules! They know that they will be working certain hours, then have the option to pick up more patients as needed. Like you said, there are cancellations and pick-ups. My friends very rarely work past their schedule for the day unless they chose to pick up a patient. They don't worry about saying no to pick-up, but they also do say yes to pick-ups when they can. One of my friends works 8-4 Monday-Friday, but she usually has at least one no-show every day. She takes this time to fit in another patient if she can. She gets her patient assignment confirmed the night before usually. While it is unpredictable, home care offers a lot of flexibility, and as far as my friends have told me, they are never forced to see a client or stay past their scheduled hours. The most frustrating thing for them is when they have a no-show and are stuck sitting in their car or popping back to HQ for a while because they can't fit in another patient in that time. Hope that helps!
  13. JollyBug92

    job forcing app on personal phone

    What an interesting question! First, check your company policy and your employment requirements regarding use of personal devices for company use. If you are required to download apps, supply and use your personal phone, and use technology as instructed, you're out of luck there. If it's in the requirements, you have agreed to meet those requirements by taking that job on. Now, you say you didn't sign anything in regards to policies. Double check your company policies to be 100% sure that there isn't some sneaky thing hiding somewhere! Some companies get around supplying employees with company devices by saying, "Employee is expected to use technology as required". It is a vague statement, but can arguably mean anything from the work photocopier to your own personal phone. As a rule though, if your company expects you to be downloading apps and using your personal phone for work, there would be a policy for it. Second, if no policies exist on using personal phones for work, then your company does not have a leg to stand on when it comes to telling you that you must download and use an app that takes up data on your personal phone. If there is no policy on this, ask management where it is in writing that you are expected to have clients call your personal cell phone and download and use an app using your personal data. If management cannot show you, then you have every right to refuse to download it because your personal phone is yours, and you should not have to buy into a data plan, and possibly a new device, for work when they have no policy or previous requirement to do so. It is your decision now. Do you upgrade your phone, bring sanitizer wipes to wipe it with, continue to have clients call you 24/7, and use a data plan all at your personal cost? Or, do you find a job doing something else? All that aside, I think using personal devices to store client information is a mistake. I think that client privacy and confidentiality is at risk by having the Crescendo Connect app on your personal phone. What happens to client information if your personal phone is lost, stolen, or hacked? While these issues still exist with a company device, company devices usually have systems and apps in place such as theft-prevention, firewalls to deter hackers (or something to that effect), and GPS tracking.
  14. JollyBug92

    Dismissal from Nursing program; options?

    Your eye-witnesses will be kept anonymous simply to protect them. It's just how things work. While you may suspect it's those three officers, anonymity keeps you and them safe. You're more likely to report things when you're kept anonymous, right? It also protects workers from potential harassment, bullying, and negative comments in the workplace. I would ask your dean to pursue this further. Demand to see the security footage, and get a copy of it. You do not want to suddenly hear a week or so from now that, "Oh, we don't have that footage anymore." Get a copy of everything written down so you are not in a situation of "he said, she said" either. You NEED to get written statements that this was alleged by "eye witnesses" only, and that there was no evidence on tape. I can't believe this is happening to you. If the person alleging that this happened knew the cost, maybe they would have thought twice.
  15. JollyBug92

    Dismissal from Nursing program; options?

    Wow. How unfortunate for you! 1. Could you appeal this and win? YES. You have three eye witnesses, but a camera shows you not vaping. I would be more inclined to trust camera footage of this as even eye-witness accounts are less than trustworthy. I've had "eye-witnesses" claim I did something I didn't and cameras saved my butt. "I thought I saw" and "I definitely saw" are two very different things. These three security guards asked, "Do you vape?" and you said no. Was there an odour in the hallway that lead the security guards to think you were vaping? If so, what was that odour? If the security guards were talking to each other, then it's likely they were facing each other and at least one had his back to you. How could he be an eye witness if his back was to you? I would begin picking apart each and every thing. Also, see if you can follow your trail from the cafeteria to the security guards. Watch hand placement: do you, at any time, pick up something and bring it to your mouth? I've had people ask "Is that a vape?" When really, it's a chunky pen or penlight in my pocket. Again, "I thought I saw" and "I definitely saw" are very different. If the cameras don't show it, it didn't happen. Stick to that. A false accusation, even with "eye witnesses" is a false accusation. Follow the appeal procedures. Be objective. Use the cameras to prove you weren't vaping. Also, use your past history in your favour: Why would you vape when you were told another incident would result in dismissal? Also, I would be asking the three eye-witnesses SEPARATELY if you were vaping tobacco or marijuana. It would be interesting to hear what their answers are before they have time to consult with each other. I honestly think you can win this. 2. It depends on the program, but investigations are part of the process. If you were dismissed, they need to investigate why you were dismissed (did you harm a patient, or was it something else?). Keep in mind that most programs also require you to complete your nursing program within a certain time frame. For me, I had to complete my nursing degree in 5 years. 3. It depends. If you win the appeal, this is not necessary. If you lose the appeal, it is up to you if you want to take it to court. Get a good lawyer, but keep in mind that you will have lots of fees to do this. Is it worth it? Can you possibly sue the security guards because of the inconvenience they caused you? Consult with a lawyer and get legal advice. Costly, yes, but you are so close to finishing your program!