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pseudonym87

pseudonym87

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  1. pseudonym87

    I'm So Over Nursing. I would rather work at Costco!!

    First, I want to address the fact that you’re making valid points regarding the mistreatment of nurses by management and physicians. I’ve experienced it and dealt with it and is one of the contributing factors as to why I left the bedside. The other, and major contributing factor, is the lack of minimum nurse patient ratios. Everyday I felt like there was a situation where if it were taken to court, either myself or one of my nursing colleagues could have been held responsible and usually it was associated with short staffing or unsafe ratios. I think it’s great that you love your patients and are willing to do what it takes to promote positive patient outcomes. Documentation, although not obviously critical to your day to day activities as it relates to the current admission, is extremely critical when another dose of medication is ordered or another practitioner needs to make a decision based on documentation. So although management stresses documentation because of the legal implications of not documenting accurately, it can in fact contribute to outcomes in a negative way. The most concerning statement, however, is your comment regarding potentially overdosing on your meds or someone else’s. I understand that you’re most likely making a joke, but in my opinion, in our line of work where we have open access to controlled substances, jokes like that are not professional. With that said, even if there is an ounce of truth in that statement, I would highly suggest that you reach out to your hospital’s Employee Assistance Program (EAP) or seek out help from a qualified mental health professional. Believe it or not, despite the challenges in nursing, about 50% of nurses never face the mental anguish that you are describing. Therefore, I think it’s essential for you to reach out for help. Feel free to private message me and I have no problem connecting you with the right resources. You seem like you’re experiencing the textbook definition of burn out. This is not your fault but is a symptom of moral distress. More medical errors are made when nurses are experiencing burn out. So my concerns are for you and your patients. Please seek the help that you need and reevaluate whether or not the bedside is the safest place for you right now. Maybe you just need a break, or a different hospital or specialty, but you definitely need to do something ASAP before you hurt yourself or your patients. Best of luck! (Btw, I meant it when I said you can private message me if you want.)
  2. pseudonym87

    Assessing the student on drugs

    I'm not a school nurse, but after reading the consistency among all of you in your responses, it makes me really glad to see you advocating for the students and not allowing your position to be used in unethical manners! You guys rock!
  3. pseudonym87

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    vec was removed from Pyxis at 1459, code was called at 1529. During this 30 minute period is when the vec was administered.
  4. pseudonym87

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    Beautiful said! @MunroRn
  5. pseudonym87

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    How does it not make sense? It's proven in the literature that organ with blame-culture yield to under reporting of incidents.
  6. pseudonym87

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    Susie I agree with you. I'm not concerned with the consequences of being fired on the individual nurse. Instead, I'm more concerned with other nurses being afraid to speak up or document incidents if they see punivitive solutions to medication errors. We should want to promote a just culture. That will prevent future deaths and will protect the right of every patient to remain free from harm while under our care. Oh and yes, while I do have an agenda it's not a personal one. I believe that we can be better a profession and that starts by accepting, to err is human. I understand that she ignored basic safety rights. She needs to be written up, suspended without pay, etc etc. Termination, however, will lead to a lot of messes being brushed under the rug.
  7. pseudonym87

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    Unfortunately, to err is human. That's a fact of life. We can either use this as a lesson to make sure this never happens again or we can be vultures and breed a culture that promotes keeping secrets instead of reporting yourself. If we want sentinel events like this to happen again, then remain punitive in how we handle medication errors.
  8. pseudonym87

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    I see the point you're making and I agree with you. When someone comes to work impaired or diverts drugs even once, this person's license is subject to revocation. Usually, however, the Board of Nursing allows second chances. You should read your boards quarterly report on disciplinary actions and the fact is most of the actions are consent orders, administrative fees, suspensions, remediation, and/or completion of a supervised program. The Board of Nursings take their job as protectors of the public seriously and they also don't take license revocation lightly (and neither should we). The Board of nursing will generally provide due-process to the nurse. Unfortunately, some people on this blog apparently don't believe in due process. I believe in accountability. If you look at my first post you would have seen that I wrote the nurse is at fault as is the system, the pharmacist, the doctor, etc. all at fault and all contributed to varying degrees. All should be held accountable- policies and processes need to be changed and all involved parties including the nurse should get remediation. The nurse should be suspended by the BON, required to take classes in patient safety, medication safety, and the nurse practice again and also complete a probationary period with restrictions on IV-push medications.
  9. pseudonym87

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    I agree. Absolutely gross negligence. The entire person needs to be assessed- her work performance evaluations, previous incidents, etc. Using The Whole Person method, she can be appropriately disciplined and absent any evidence pointing to a PATTERN of gross negligence or misconduct, remediate and reintegrate the nurse.
  10. pseudonym87

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    Texas law further explains violations of the NPA as Providing information which was false, deceptive, or misleading in connection with the practice of nursing; By adjudicating action against a nurse without having all of the information a Board of Nursinf would request, you are being deceptive and are therefore in violation of the NPA. Other states has vague statutes that provide broad powers to regulate every aspect of a nurses life. With that said, it's still a violation. Now, just to clarify, I have no connection to any of the involved parties at vanderbilt. The solution of firing someone and revoking a license should occur after it has been proven that a pattern of behaviors have led the board to believe, that it is in the best interest of the public for someone to no longer be allowed to practice. This one incident, although a horrible outcome, is not a pattern. Why can the hospital provide a corrective plan and be allowed to stay in business but the nurse can't be placed on a PIP? The reason why I am even concerned with the nurse is because I care about our profession. Yes we must keep the public safe. We also must hold ourselves accountable but in a way that doesn't create a blame culture and promotes a just culture. We're professionals. And just to address your rude assumptions- I'm lucky to have never been put in a situation where one of my patients were harmed because of my actions. We're all human. I, however, as a supporter of nurses, supporter of unions, and former union delegate would fight for this nurse because I promise you she didn't walk into work saying, "I want to hurt someone today." She's not a criminal- she made a series of stupid mistakes and she should be held accountable and placed on a PIP.
  11. pseudonym87

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    Right- but let's say she did the right thing and stayed with the patient, she would have most likely saved the patients life.
  12. pseudonym87

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    Of course I was ICU trained. I was going to take the post-code patient on the unit but the sup called up to start caring for the patient on the floor until patient was able to be given a room (pretty sure I mentioned this in my initial post). I recalled the policy from my previous hospital that you should not transport a patient after a fresh intubation until placement is confirmed with CXR. After this situation, I investigated, and the same policy was in place at this facility as well. The portable x-ray team had not arrived yet, co2 capnography was not used during intubation and I sure as heck wasn't moving that patient unless I was certain that I had a secure airway. Sorry, breath sounds don't cut it and I would say airway trumps cooling measures (I continued caring for this patient finally in the ICU until the end of my shift and cooling was not indicated. Just a few vasoactives, fluids, a-line, central line. There were no delays in care. Your red flags seem to ignore the potential for an unconfirmed airway to lead to respiratory arrest en route. My point is that you have to stand your ground. Maybe this nurse was summoned to the ER urgently and made the stupid decision to save time rather than to be safe. Instead, she should have properly administered the versed and stayed with the patient. She should have stood her ground and not be rushed to the next task. I'd like to know if a supervisor was aware that she was going to administer versed and then rush to the ER. There's something missing in this story.
  13. pseudonym87

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    It's unprofessionalism which also violates the nurse practice act. You have not seen everything the board of nursing will weigh in their determination to take action against her. To think that you can adjudicate on someone's professional licensure based solely on a review of content released to the public without taking account other evidence is unprofessional and this violates the Nurse Practice Act in all states. Of course I take issue with the errors made by the nurse, the physician, the charge nurse, the pharmacy, etc. She ignored basic checks but we need to determine if this is a pattern of behavior or an isolated incident before we revoke her license in the court of public opinion.
  14. pseudonym87

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    How dare you even say that a nurse should lose her license without knowing her, her work ethic, the quality of her work throughout her tenure, and without knowing all of the facts. The CMS report does not address the nurses experience level, whether or not she had received the training and competence to be a Resource Nurse, and does not address other patient situations that may have led to her being rushed. With that said, I've heard of resource nurses providing coverage for a specific unit. I've never heard of a resource nurse for the hospital. Typically, when an RN is providing coverage for a hospital it's usually as a SWAT nurse, IV nurse, etc and the requirement always remains to not move on to the next patient unless you've made sure as a RN you're leaving the patient in a safe situation. The nurse who administered the vec immediately went to the ED to care for another patient. I'm sure someone told her, "after you give the versed, head to the ED, we need you there." So while the nurse is the one who injected the medication, many people and departments dropped the ball here. I'll tell you a story of my own. I was called in to go to work- there was a call out. When I arrived, I was told there was a code and I would be taking care of the post-code patient. The nursing supervisor called and asked me to come to the floor to care for the patient during transport, imaging, etc etc. I had no other patients and even though my charge nurse didn't want me to go to a unit I wasn't trained on, I still went. Essentially, I used the nurses and aides as my gofers while I cared for the now intubated patient in a non-ICU. We were ready for transport- portable vent, monitoring, code meds, ambu bag, everything was ready. But, a CXR to confirm placement was still pending. The doctors, and the nurse supervisor, were pressuring me to go straight to the ICU and we can confirm placement there. Although I was newer to this hospital, I remember from my previous hospital to never transport post intubation until we have a CXR conforming placement. Well, it was my patient so I told the sup and the MD that I'm not going anywhere until we get the CXR and if they want to move the patient, then I need to endorse the patient to another nurse. We waited for the CXR. I guess the point of my relatively uneventful story is that many times, supervisors and docs will pressure us to do things that are not safe- that go against best practice and we always 100% of the time have to stand our ground and respectfully tell them to F off or bring another nurse. To say a nurse should lose her license without even conducting an investigation is unprofessional and quite frankly, goes against the Nurse Practice Act of every state and territory of the USA.
  15. pseudonym87

    Bare bones staffing

    Generally speaking 2 nurses. The only time it was acceptable as 1 nurse 1 aide is a pre-op unit that hadn't been opened yet. But that's a no brained, lol. In the event of a code, 2 RN's for sure at minimum.
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