rck213

Thanks for all the replys but the "device" doesn't contain any topical analgesic. It works by "pressure" which decreases pain perception. Supposedly, according to a recent study on Medscape, manual pressure with a finger can do the same thing. They mention "mechanical pressure devices" but give no names. The Shotblockers we use are from Bionix Medical Technologies, but every time we call them for more they say there is a two year backorder, something about the FDA reclassifying the device. It is a piece of plastic , not a medication so what the problem is with it isn't clear. They keep uping the number of shots we are required to give but won't help us obtain something that helps to administer those injections. Our Pediatrician does not want to use the topical agents in the office We do use them on the pediatric unit in the affiliated hospital, EMLA is the favorite at this time.:typing

Question relates to Pediatric Office setting but there is more traffic on this forum. We use a device called a "shot-blocker" when administering immunizations to toddlers and up. Our supplier no longer has them. I have done searches online and cannot find another source. It is a small plastic device with multiple small points on the underside and a hole in the middle. It does seem to help with the pain of the immunization administration. Any help appreciated, Thanks

A friend I graduated with recently retired after devoting 32 years to a local hospital in the OR. Her gift on her retirement: a small folding canvass chair also a year long fight to get 60% of the value of her ESLB. Any wonder there is no loyalty or longevity left in nursing? What a wonderful example for the new nurses, stick it out here and you get "a chair" to collapse in after all the years of bodily abuse!

I would expect more open minds from nurses. I see far more people out on disability for questionable "back pain" than I do for MCS, CFIDS, or fibro. I am a nurse, have had strange reactions to many medications tried for HTN control, ASA, NSAIDS and all antibiotics except the Levaquin family. I cannot stand to be around a heavily perfumed person, cannot use most scented products. This has all been since a flu like illness in 1988 that refused to go away. There is such a thing as toxic overload, we all have different thresholds of what we can take. I have had extensive testing for other disease processes over the years. I have good days and bad days, I managed to continue to work as a nurse from 1989 till present on a per diem basis, I raised two kids. I travel but bring my own pillow, water, air cleaner get a smoke free room. No alcohol, EVER. I don't live in a bubble but I avoid unnecessary chemical exposures. They think that I have a smoldering viral infection , EBV has been identified, last winter all my titers were positive meaning I had a reactivated infection. My immune system is out of whack. I get strange rashes for no reason. I fatigue much easier than most people and recover more slowly. Colds last at least two weeks usually going into the bronchi. None of this is a physcological problem. I do as much as I am able when I am able but have learned my limits. Depression becomes part of it all when no one has answers and the medical profession turns on the patient because they don't have any answers. It seems this group just did that. Are there malingerers out there? Sure. Do some money hungry practitioners try to make money off these people? You bet. But there are legitimate practitioners, many of whom suffered with the same ailments themselves who are looking for answers and methods of treatment. You don't know till you've been there.

You echoed my thoughts exactly. It is all about liability at this point, I would be on my own. I do not think the compensation and length of employment would be enough to offset the costs I would incur to set up my "business" and maintain my own malpractice insurance. Plus being expected to be on call every day without compensation just doesn't seem right. I wanted to be a per diem employee, covered by the homecare agency, no benefits, flexible schedule as needs dictate. For some reason they didn't want that. Just doesn't feel right to me.

I was recently approached by a local homecare agency to help them institute policy and procedure for homecare of the pediatric population which was previously provided by the county health dept. Their nurses have no pediatric experience. This agency is now affiliated with a healthcare network. The network hospital was a former employer of mine. I worked on their pediatric unit for over 20 years and helped develop policy and procedure for that unit. The Nurse Manager of Maternal Child Health at the hospital referred the homecare agency director to me as a resource Pediatric Nurse for them. I am currently(for the past two years) at a family practice office, I can no longer perform bedside nursing due to personal health issues. Originally I was going to be an employee of the healhcare agency,on an as needed basis,to help orient nurses to pediatric care, help write policy and procedure for the ped patients and help adapt their documentation to reflect age specific care. Suddenly the agency is telling me I will be employed as a "consultant" per a contract at a rate yet to be determined. I am now being told that I must get a business license from the county, I must submit my own taxes and social security BUT I must be available to the agency by phone during hours of operation for any questions the nurses in the field might have and I might have to actually go into the home with the nurse if it is a case she is not comfortable with. I am not a business person. I have worked per diem in many different areas of nursing but was always compensated as an employee. This seems like they want it both ways. :angryfire I have no idea how to be a "consultant" Does NY state have specific rules and regulations? If anyone can point me to any information that could be of help I would greatly appreciate it.

Utica College of Syracuse University in Utica NY has a BSN program which looks at prior credits to work toward a degree as does SUNY Tech of Utica Rome in Marcy, NY However I am not sure if you can enter as a junior with no prior nursing courses. You would have to check with them

Did not go on for BSN because even though graduated from a NY State Hospital School of Nursing the nursing courses didn't count as college credit. Found I would have to pay over 10,000 to get the degree. Wasn't worth it, the hospital I worked at didn't offer any money to obtain the degree, made it difficult to get time off for classes, and then you would get only about 200 more a year if you had the degree. Didn't stop me from being in a charge position, some managers in the facility didn't have the BSN either. Out of the hospital now, couldn't hack it anymore due to safety concerns, both for my patients and for my poor aching body! Work in an office, and am respected for the amount of knowledge I bring through experience. Feel there should have been some grandfathering in of diploma nurses if they could stay active in hospital nursing for over 20 years and show proof of continuing education. I attended many seminars which counted for nothing!

I worked for Maxim Healthcare and they provided the written doctors orders, but I am pretty sure the docs were in state. New York is very regulated, not sure how an order from an out of state doctor would work. Too many rules and regs and way too much paperwork for me, I did the clinic for one season only. I now work in a hospital based clinic and give the shots only to our patients.

There are no mandated ratios for NY except for critical care If there were I would still be working in a hospital

It depends on what state you are in. I am in NY and there are specific rules written in the nurse practice act. I also did flu shot clinics for a home care company and they were required to give us a full day of inservice on policy/procedure, infection control etc before we could work for them. There has to be a standing order from a physician for both the immunization and for the treatment of anaphylaxis. In NY no one under 18 may be given the shots. Need to check your states rules and regulations.

Check your state Dept of Health regulations In New York State you cannot have any patient with cancer or any infection, any diagnosis of "itis", on a Maternity floor. If the hospital has a dedicated Pediatric unit no patient under 14 can be put in the room with a patient older than 18 unless there is permission from both the patient's pediatrician and the patient's parents.

Thank you for the honest discussion. My fear also is that this is a blind exercise to show that administration is encouraging "nursing" involvement but all along the course has already been set by administration and they are trying to make us think it is our idea. Add to that the fact that the current "acting" VP of nursing services who was one of the "Service Line Managers" who stabbed every bedside nurse in the back every chance she had so she could collect her year end bonuses. :angryfire ....This person is sitting in on the meetings. There are promises to hire a new Nurse Executive, someone with power equal to the CEO, which this facility has never had before. But if they fail does this acting VP get the position? Also there is only ONE actual bedside nurse at the table, the rest are charge nurses, managers, and clinicians. Looks like there is much to be done and I am still skeptical. I would still like to know which model, Primary or team is preferred

I am asking because at the first meeting no one had any idea of what the possibilities mean. Too many years under a dictatorship and many newer RNs had never experienced anything else! A consultant was running the meeting. She mentioned magnet, primary and team. In team nursing she stated that the unlicensed personnel had their own patient assignment which meant the RN on the team could care for more patients....example, if ratio usually 6 pt to 1 RN it could become 10 patients if using an aid to assist. Doesn't sound quite right to me! The consultant did say the committee members would have to contact or visit facilities using various models to get an idea of how they work. When this will occur is unknown. Hard to trust after so many years of abuse.

Recent nursing satisfaction surveys have finally prompted our facility to look into a different way of administration of nursing care. For the past 15 years it has been an undefined mess of whatever some "Service Line Manager" felt would work at the time with the minimal nursing staff the facility budgeted for. There was NO input allowed from the staff nurses and for many years no director of or vice president of nursing services. A nurse practice committee has been set up to decide what care delivery model should be used and also to completely redo the mess made of the policy and procedures for the facility. Looking for ideas of what does and doesn't work and why.