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Robmoo

Robmoo ADN, BSN, RN

RN, ADN, BSN, CVRN-BC

I finally have a job where I get to stress other people!

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Robmoo has 25 years experience as a ADN, BSN, RN and specializes in RN, ADN, BSN, CVRN-BC.

Robmoo's Latest Activity

  1. Robmoo

    Anxiety Over Past Mistakes

    There are few different approaches to this one. Are you a Christian? If yes, have you prayed for forgiveness? If yes then God has forgiven you, why do you refuse his grace? Mya Angelou said that we do the best we can and when we know better we do better. Once you learned better you did better. Move on. I forget who said this one, but "you don't get clean by rolling in the mud. Do whatever you consider right to pay for your mistake and then move on. The move on part seems to be the area in which you are having trouble. I've seen far graver mistakes. What we considered a very bright young ICU nurse gave a paralytic to an unintubated patient for an MRI. Your mistake was small and if the water didn't burn you hands then it is unlikely that it caused that gentleman any harm. It is past time to move on. Many different cultures have purification rituals. Perhaps it is time that you found one that fits you background. Penitence and forgiveness are powerful words. You are already penitent. It is time for forgiveness.
  2. Robmoo

    Multiple doses in same syringe?

    Your manager he sounds like a wise experienced nurse. Most of the PACU environments that I've worked in have operated this way. That being said, what do your policies say? If a major mistake occurs the policies are the standard to which you will be held. A minor deviation such as multiple draws from the same vial for the same patient are less likely to cause patient harm if you aren't confident about giving multiple doses from the same syringe. Whenever faced with a problem always in this order ask, "What is in the patient's best interest? What does the policy say? What is the standard of practice?"
  3. Robmoo

    Vaccine Hesitancy

    Last Monday I vaccinated one of nurses who check marked "yes" to being pregnant. I asked if her OB had cleared her to receive the vaccine and she stated, "Oh yes! and my OB is pregnant and she has already received the vaccine!" Good enough for me. I enrolled in the Pfizer trial because my PCP was the lead investigator and I trust him. He was one of the first to get the Pfizer vaccine once it was approved. A lot of whether or not people feel that getting the COVID vaccine is prudent has to do with trust or the lack of trust. Who do you believe? What sources do you trust?
  4. Robmoo

    Took Ibuprofen for 2nd Vaccine

    I'd like to post a few words from the famous poet Danny Elfman. You worry too much You make yourself sad You can't change fate But don't feel so bad Enjoy it while you can It's just like the weather So quit complaining brother No one lives forever! You are worrying too much. The participants in the COVID vaccines have been documenting the medications that they took during the study. If there was a strong correlation between NSAID usage and a reduction in the efficacy of the vaccine then Pfizer and Moderna would have come out with recommendations against taking NSAIDs after receiving the vaccine. If you are losing sleep over this issue, why not speak to your physician about these worries?
  5. Robmoo

    Trying to get into the ICU but no luck as a new grad

    If you can't get into the ICU straight away which is not unusual then Telemetry is the best way to go. Skill with cardiac patients is a valuable step up into ICU. Since you don't have that choice PCU is best. MedSurg skills don't translate as well into the ICU unless it is a surgical ICU. Even then you will be behind the curve when it come to cardiac medication including potent drips and EKG interpretation. In the higher acuity PCU you will be gaining more skills that will give you a step up in the ICU. Two years may seem like a lot, but when you leave less time might make you seem like a potential job hopper. If your only misgiving about PCU is the two year commitment then go PCU. They are going to make a substantial invest in training you. I don't think that 2 years is unreasonable. Good luck in whichever you choose!
  6. It sounds like the person making your assignments does not much like you. Try to appear happy with COVD patients and quit asking for other assignments. If your assignments suddenly change you'll know. Or you could take the direct approach and ask the person making the assignments why they keep giving you COVID patient care. It might be as simple as them having the perception that you have more skills in this area. Good Luck!
  7. What is you facility policy and why has your manager not taken action? Our policy is coaching, verbal counseling, written counseling, final counseling and then dismissal. This process is usually done at the manager level. If your manager is refusing to take action then write him/her up yourself. You need to protect yourself in this situation. When something goes down if management can prove that you knew about the situation and did not follow the process, they will throw you under the bus. Make sure that you write him/her up and document every instance of reporting the situation to your superiors. If your manager refuses to take action then report each incident to the house supervisor accompanied by an official write up on your part. Unless this person if a buddy of your manager or you work at a union hospital I don't know why this person isn't gone already. I've heard that it is difficult to get rid off bad nurses in unionized hospitals, but there still has to be a process. To protect yourself and the patients, you have to follow the process.
  8. Frankly, I don't think that they should make the vaccine mandatory. Once we get to a point where anyone who wants the vaccine has had easy access for 3 months remove all restriction and let the chips fall where they may. Frankly, at times I think that we could use a little more Darwin. Just got word from our administration. We will be in line to get the vaccine first when it arrives and it is voluntary. There is no reason to make it mandatory if there aren't enough for everyone. The vaccine that would go to a disgruntled health care worker could go to a nursing home resident who needs it. I believe that health care workers should follow the evidence and not decline the vaccine as a knee jerk reaction or some emotional appeal. We should be leaders and examples for the community. We you find a credible scientific study that leads you to believe that the COVID vaccine's risks outweigh the benefits then so be it.
  9. Actually, Libertarian. Follow the evidence. The Autism Science Foundation page has links to many peer reviewed articles regarding autism and vaccination. Aluminum and autism? We are exposed to aluminum in food packaging and cook ware and the keloids in the brains of people with Alzheimer's contain aluminum. I wonder if anyone has done a study. https://www.CDC.gov/vaccinesafety/concerns/autism.html https://autismsciencefoundation.org/what-is-autism/autism-and-vaccines/
  10. Autism? Seriously? You do realize that the study that showed a link between vaccination and autism was pure junk science. The study cost the doctor who ran the study and several scientists their careers. They cooked the numbers and were caught, but not before the study got into the press and the rumor mill. What we need is evidence and science, not conspiracy theories. Does the autism thing come with a tin foil hat? I could use more tin foil.
  11. The technology has been used to develop biological response modifiers in cancer treatment. The applications are very similar. The RNA treatment causes the body to produce proteins, cancer cell vs COVID proteins. The body sees these as foreign and mounts and immune response hopefully destroying the cancer cells of forming antibodies to resist COVID infection. The RNA degrades and is gone within days. No, I haven't found an article regarding the safety record in cancer treatment. If you find one please post a link. I'd like to read it. Read the literature and decide for yourself if the benefits for you outweigh the risks. Don't reject it as a knee jerk reaction petulantly refuse because "they aren't the boss of me." As for basic rights, the Supreme Court of the United States already ruled that the federal government can mandate vaccines. I believe that they said something about promoting the general welfare. If your facility mandates getting the vaccine and don't won't get it, good luck in your job search. Perhaps if you are unionized you will have some sort of recourse.
  12. Robmoo

    Med error..... Could I lose my license?

    From the TXBON Looks like we would have reported both under current rules. Sec. 301.405. Duty of Person Employing Nurse to Report. (a) This section applies only to a person who employs, hires, or contracts for the services of a nurse,including: (1) a health care facility, including a hospital, health science center, nursing home, or home health agency; (2) a state agency; (3) a political subdivision; (4) a school of nursing; and (5) a temporary nursing service. (b) A person that terminates, suspends for more than seven days, or takes other substantive disciplinary action, as defined by the Board, against a nurse, or a substantially equivalent action against a nurse who is a staffing agency nurse, because the nurse engaged in conduct subject to reporting shall report in writing to the board: (1) the identity of the nurse; (2) the conduct subject to reporting that resulted in the termination, suspension, or other substantive disciplinary action or substantially equivalent action; and (3) any additional information the Board requires. (c) If a person who makes a report required under Subsection (b) is required under Section 303.0015 to establish a nursing peer review committee, the person shall submit a copy of the report to the nursing peer review committee. The nursing peer review committee shall review the conduct to determine if any deficiency in care by the reported nurse was the result of a factor beyond the nurse's control. A nursing peer review committee that determines that there is reason to believe that the nurse's deficiency in care was the result of a factor beyond the nurse's control shall report the conduct to the patient safety committee at the facility where the reported conduct occurred, or if the facility does not have a patient safety committee, to the chief nursing officer. (d) [Repealed by Acts 2007] (e) The requirement under Subsection (c) that a nursing peer review committee review the nurse and the incident does not subject a person's administrative decision to discipline a nurse to the peer review process. (f) [Repealed by Acts 2007] (g) [Repealed by Acts 2007] (h) [Repealed by Acts 2007] [Subsections (d), (f), (g), and (h) repealed by Acts 2007 (S.B. 993), 80th Leg., eff. Sept. 1, 2007]
  13. Robmoo

    Confused about IV Infusion that should not be stopped

    "Never" is an awful big word. It would be better to say that these drips should never be stopped without an excellent rationale that is centered in the patient's best interest. Unless parameters for titrating or stopping the drip are in the physician orders including standing delegated orders or hospital policy, you'd better call the ordering physician or you could be practicing medicine without a license. What this really comes down to is knowledge of the patient's disease processes and knowledge about the medications. Add Octreotide to the list. In octreotide drips for the control of GI bleeding once the drip has been off for more than a minute or two you lose the effect and have to re-bolus. Yes, that means you can't turn it off to take the patient to the bathroom.
  14. Robmoo

    Med error..... Could I lose my license?

    I was on the peer review committee at my last hospital and can tell you that little gets reported to the board. Most issues even a lot of very serious issues are handled in house. We had a blood administration error. The nurses were given remedial education and tasked with presenting to the entire hospital staff 1 unit at a time and putting together a binder of education on the topic. The staff nurse complied with all of the requirements and was not reported to the board. The other nurse was a traveler who did not turn in their binder and comply with the requirements and was reported. A patient CRF patient in the ICU develop hyperkalemia and died. We were prepared to handle this in house in a similar manner, but the nurse refused to knowledge that they did anything wrong. We reported it to the board. You can see that only serious incidents get reported to the BON and frequently if the nurse admits their mistake, shows contrition, and complies with stipulations from the peer review committee, that even serious incidents sometimes do not get report to the BON. I believe that the Texas BON has since passed some mandatory reporting standards, but giving a dose of Dilaudid 2 hours early isn't going to the board. You made a mistake as all humans do. Just be more careful in the future. Frankly, I'm surprised that the computer system didn't throw up a big red flag. If it did and you over-rode the big red flag then that is a more serious issue. These systems are in place for the sake of patient safety. you over-ride them at the peril of your patient and your license. Don't over-ride the safety systems without careful consideration. If you over-ride and don't have a sound rationale for doing so, you could end up explaining yourself to the peer-review committee.
  15. They can't force you to resign, but they can fire you if you won't make the move. Yes, nurses can qualify for unemployment, but I'm not certain if you will be able to in this situation. They will be required to reorient you to the bedside. If they push you out of orientation before you believe that you are ready and give you an assignment that is not compatible with your skills you can follow the Texas rules regarding "Safe harbor." Alternatively you send your resume out today and see if there are any hospitals where you would like to work who are hiring people with your skills.
  16. Robmoo

    What is your minimum base pay on Covid-19 unit???

    If you hired on as a new RN and now have 3 years of experience you are likely worth a lot more in your market than you are currently being paid. Apply for a couple of positions in your area and see what they offer. If the offers are better then accept and put in your 2 weeks notice. After 4 years I went from $13.44/hr to $16.38/hr plus a $1.50 ICU differential. Another facility in the area offered $23 and had an annual retention bonus. After that move my pay bypassed a lot of nurses with more experience who weren't willing to take a chance. That was about 20 years ago. Lessons to learn: Nurses with a few years experience are worth a lot more than new graduates. Don't be afraid to make a change if you believe that you are not valued in your current position especially early in you career were loss of seniority is not very painful. If you are not married with kids, you might even consider a contract to travel and work In one of the areas hard hit by COVID. They need help and are offering a lot of money. You might even find that you like that part of the country better and want to stay. You might find that you enjoy traveling nursing. There is a lot out there. Don't be afraid to take a chance and try something different if you are unhappy.