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  1. HomeBound

    Insulting pay raise

    Yep. At a "state magnet hospital" I worked for, "some" of the bedside ED RNs got $0.23 raises one year---while "some others", in full view of the recipients of the whopping $0.23 raise---were handed "bonus checks" varying between $1200 and $1900. These "others" were the ones that sat in the RN Mgrs office telling tales or disappearing--or just being "unavailable" for anyone by constantly claiming they are "doing work for management". They now have all been elevated to Clinical Nurse 3 or above, hide on a different floor of the hospital in a locked section that only can be accessed with "permissions" on your ID badge. The peasants are getting restive--and some managers are smart enough to know separating themselves from the great unwashed is the smartest thing they can do right now. Hand out those memos of how horrible we are while sitting in a locked tower. Unionize. It's the only way to deal with this favoritism and outright abuse of management authority. "giving them what they want" by jumping through every hoop they set forth is also not a recipe for any type of "merit raise" or "certification raise". My place of employment simply took those away---didn't matter what cert you had, you got nothing for it, but they also tried to make it a requirement for anybody to be hired in. (not a requirement OF the job, a requirement to be hired FOR the job) Unionize.
  2. HomeBound

    VA nursing salaries in Florida

    You can find the locality pay on the the OPM website here: https://www.va.gov/ohrm/pay/ You're asking a question that no one outside of the committee that decides your points can answer. "Years of experience" doesn't translate into pay grade without other factors such as certifications, publications, volunteerism, etc. The Nurse I, II, III categories are loosely defined and by no means does it ensure that just because you have a MSN, you begin at a NurseIII. When they ask you to put your years of experience on a resume and describe your work, that's what they mean. In detail. They cannot, and will not, assume that you work with cardiac patients unless you specifically say so. Any certification, no matter how small---list it. Join the ANA or whatever body that credentials your specialty. This isn't the time to be "concise" with your resume. They want hours of week worked, unit, what you did, how many did you supervise, population type, etc...if your resume is 12 pages long, then it's 12 pages long. As long as the information is relevant, it's usable to determine a pay grade. Also--read the instructions on the opening announcement. They ask for pieces of documentation such as OF-306, which needs to be renewed every 30 days. If you fill one out on Jan1 and apply for a job you see Feb 14, and use the same OF-306, you will not even be considered for employment--and they will never tell you. You won't even know.You just will not get referred after the job closes. The paperwork is very convoluted and complicated. The decision process is long and very detailed. It takes months. That's after you get referred and have an interview. You have to have all of your ducks in a row---and even then, it may not be good enough. Your experience sounds amazing--so showcase your talent and skills. Sell them on why you should be hired and at the highest rate of pay you can eek out. The other thing---look at the announcement. The ranges are there. You need to think, "If I were offered this position at the lowest pay range, I would be okay with that" (YOU WILL NOT BE. it's just a good place to get your head into how much effort getting into the VA is going to take, and what you may have to accept in order to be chosen) Good luck.
  3. HomeBound

    HIPAA violation and future employment opportunities

    Which is why I said, "so he claims". I didn't agree with it, because I knew the guy--and he was absolutely devastated. There were other factors in play, which had zippo to do with whether there was a "HIPAA" violation or not. The clinical instructor didn't like him--she had made accusations about other people in the past, that were unfounded and destructive. Her thing was to "divide and conquer". Set everyone against each other. She'd call one in, act the friend/concerned counselor...get information about maybe if that person was having difficulty--maybe being bullied, maybe seeing cheating, maybe being pressured to do projects for others (it happened all the time)--and then turn around and call the people who were alleged perpetrators of these things in---and start a war. She'd stir the pot, stand back---and watch the fur fly. The guy never recovered from it--he quit and he never returned to any nursing school. I know if I had understood that this instructor is one of many in "elevated positions" of power---I also would never have gone down this path. I've said it before and I stand by my assessment---nursing school is not to teach nurses to be nurses, it's to teach the how to pass one exam, the first time--so that the school can keep their accreditation. If they taught nursing, then there would be no need to have a "nurse residency" for a med-surg floor, for an entire year, or even six months. I agree "ORIENTATION" to a unit is necessary, but the idea that a nurse has to come in, take 8 weeks of classes in....oh.....BASIC NURSING....go thru "skills testing" for even the simplest of things like donning/doffing PPE or checking VS....it's absurd. This micromanaging and ruling by fear technique is very common in the hospital setting---I don't know how it is in outpatient or homecare or LTC---but it seems to me that administrators are pushing harder and harder on these ridiculous policies--while their own violations are going unchallenged---i.e. HIPAA violations and having to care for patients in the hallway for two days getting treatment.
  4. HomeBound

    HIPAA and "Hallway Patients"

    Nurses are being bombarded left and right with rules and regulations that, if broken, can mean the end of a career and perhaps potential financial ruin. My questions are simple, as the trends are seemingly "from the top down", and blame/responsibility lands squarely on the nurses. What about hallway beds? I've worked at three facilities so far that "hall" patients for their entire stay. No curtains, no privacy. I am required to care for them, discuss their care/diagnosis/prognosis/aftercare/appointments at discharge--in full view and hearing of every single other patient in that hallway. I'm required to (at times) perform embarrassing procedures like foley placement, by pulling a flimsy "screen" around their bed, because no rooms are available. I'm required to perform the 5 Rights, stating their name/DOB with other patients and their families in full view. Where is the hospital's responsibility for the "sacred" keeping of patient information? I've had patients and their families eavesdrop on my conversations with other patients---and comment to me...."Isn't that awful? That poor man. He's got cancer! What will you do for him?" I've even had a patient defend me against another patient who was threatening to turn me into the board for enforcing a doc's order to cut her off from her dilaudid. He volunteered to go to my RN Mgr on my behalf! The onus should not be solely on the nurses. The hospitals are placing us in this ambiguous "Do as I say, not as I do" position. If the hospital isn't responsible for affording patients privacy even at the lowest level (on a gurney in the ER), then how it is that nurses can be prosecuted for HIPAA violations that the hospital actually creates? What are your stories of privacy issues that were created by the environment in which you work--and what is your unit's policy on these issues?
  5. HomeBound

    Nurses Call the Governor of Tennessee

    It also doesn't help when a "Nurse Manager" doesn't have experience at bedside---maybe a year or so---because they're too busy pounding out papers for grad school, making sure they're going to be a chief and not an indian. I love this type---not. They hide in the office and zip off memos about how everyone is just so beneath contempt because the linen bill is too high or there are too many gluostrips being used. Not an iota of common sense or even real nursing experience to be had with some of them (**cough Jabba cough**)......but since they read a little bit of literature and once wrote a few papers...they're just the bomb. These are the ones who sit and spend their day on chart surveillance in order to "catch up" the nurses in the trenches---and all the safety and patient care goes right out the window---because hey---that irrelevant "BMAT score" on a vented, sedated patient wasn't done. There is no leadership---and the ones in those positions are driving the decent nurses to either seek employment elsewhere or quit altogether. Just because someone's got the paperwork that claims "expertise" doesn't mean they have the sense or temperament to be in that position. Bad managers give bad advice to upper administration. Sometimes---I wonder if it's not some of these "middle people" who are misrepresenting the facts on the ground. The safety issues. The patient care issues. The burnout issues. Everything's rosy because it looks bad on THEM if the unit is unhappy. Toxic environments encourage this type of sloppy nursing--whether it's because a NM doesn't have the backbone to enforce proper procedures, or they're too lazy to actually review an employees' actual performance (self reviews, anyone?), or they simply don't have the intelligence/experience (but boy do they write a mean grad paper!) to apply academic theory to actual practice. I suspect that the unit at Vandy is much like units all across nursing--sloppy management, focused on the wrong things, enabling sloppy nurses focused on the wrong things.
  6. HomeBound

    Nurses Call the Governor of Tennessee

    Thank you for the clarification. I saw it and was just...astounded that this just keeps on happening. Where a hospital settles with plaintiffs---right or wrong---and nobody is the wiser. Does it all have to rise to such shocking heights of incompetence before the public gets to know or that there is restitution, other than monetary?
  7. HomeBound

    Nurses Call the Governor of Tennessee

    {{{Wuzzie}}} no apologies necessary. You're one of the most experienced here---and I hope to God Almighty that if I ever get injured, you come pick me up in your flying machine. Hope you have a better one.
  8. HomeBound

    Nurses Call the Governor of Tennessee

    Holy Geezus. Can't come soon enough, IMO. Legal consequences, that is.
  9. HomeBound

    Nurses Call the Governor of Tennessee

    Possible settlement from this case? Nashville has a report that shows cases and settlements. Unfortunately, unless you have access to their version of LexusNexus, you cannot see the case filing. It's a curious timing--and the incident happened Christmas Eve 2017. This settlement, quite a large one, happened just two months later. The CMS report was complete in Nov 2018.
  10. HomeBound

    Nurses Call the Governor of Tennessee

    Jory, I am not assuming anything. I read the CMS interview of the Risk Management Director (not an attorney) who said: "In the end, there were so many things the nurse did - the 5 rights, basic nursing care. I had reached out to the family and they had already obtained an attorney - and the rest is confidential..." Confidential from CMS? The report goes into ridiculous detail on what happened, who said what, where they were, etc---there was nothing held back save the patient's name, and the nurses' names. What could be so confidential that it's redacted from an official government document? Oh. A legal agreement that binds the parties from allowing any information to be discussed where the public may have access. Like a confidentiality agreement. After a wrongful death settlement. Anon is simply speculating. As I said....We will Never Know. Because that information may be sealed.
  11. HomeBound

    Nurses Call the Governor of Tennessee

    I guess we will never know, because if there is a confidentiality agreement, the family is effectively silenced from talking of anything they know or feel about the subject.
  12. HomeBound

    Nurses Call the Governor of Tennessee

    I think his Anon's point was that the family retained an attorney and the "rest is confidential". If you read the CMS report, there is a portion that is redacted. You have to read it carefully, I almost missed it. When HIPAA is in play, that simply is PMI--the patient's name wasn't used, RV's wasn't used, etc. The report contained detailed information on what was said and done, just not identities. The fact that the family had already retained an ATTORNEY at the stage of the CMS investigation--speaks volumes. I've known doctors who were sued for negligence or malpractice or whatever the family's attorney could dream up--and it usually was the death of a patient, but there was no direct causation--i.e. not responding quickly enough to examine a patient in the ER for a PE, and the patient later died. Hospitals settle with a confidentiality agreement and no admission of guilt. Malpractice insurance takes care of the payout. I know this much because I have a close family member that this happened to. (he was the one being sued.) I also have been involved personally with a large hospital system where they were sued by a co-worker and I was deposed. The co-worker was winning hands down--and the hospital knew it--so they made a deal with her for money and a gag order. She has a nice retirement, but she can't say a word to anyone, and nothing changes at the hospital, because technically, with the confidentiality agreement and no admission of guilt...the incident effectively never happened.
  13. HomeBound

    Nurses Call the Governor of Tennessee

  14. HomeBound

    Nurses Call the Governor of Tennessee

    Absolutely agreed 100%. It has to happen. I was reading up on "nurses who kill"--yes, they are serial killer psychopath types---but the fact still remains that these people were either shuttled off by quietly firing them, or they drift from job to job---and there is suspicion. If everything is "handled from within"---because the BON has absolutely no authority to really penalize someone who has criminality in mind--people died in these cases because of "nursing shorages" or they "don't want to alarm the public about healthcare workers". Those aren't good reasons. Having the most trustworthy image and perception in the world comes with a responsibility. Transparency and the willingness to accept what society would find "negligent" or "reckless"---particularly in the death of a human, be they elderly or infant---is important. The minute we believe we are to be "exclusive" and "closeted" ---only judged by other nurses, held only to "our own law"---the situation is ripe for abuse.
  15. HomeBound

    Nurses Call the Governor of Tennessee

    Why would a nurse be exempt from the rules that society has put in place? What makes us special cases? Doctors have the AMA--and they are sanctioned all the time for their behavior, some losing licenses and such---however, when there are the three elements of criminal act in place, Mens rea: Others may require proof the act was committed with such mental elements such as "knowingly" or "willfulness" or "recklessness". This is not to be confused with "motive". The law does not take into account "motive" when the basic elements of a criminal act is being deliberated. In general, guilt can be attributed to an individual who acts "purposely," "knowingly," "recklessly," or "negligently." Together or in combination, these four attributes seem basically effective in dealing with most of the common mens rea issues. actus reus: All crimes require actus reus. That is, a criminal act or an unlawful omission of an act, must have occurred. A person cannot be punished for thinking criminal thoughts. This element is based on the problem of standards of proof. How can another person's thoughts be determined and how can criminal thoughts be differentiated from idle thoughts? Further, the law's purview is not to punish criminal ideas but to punish those who act upon those ideas voluntarily. [5] Unlike thoughts, words can be considered acts in criminal law. For example, threats, perjury, conspiracy, and solicitation are offenses in which words can constitute the element of actus reus. The omission of an act can also constitute the basis for criminal liability. concurrence: the act and the mental state must occur at the same time causation: A causal relationship between conduct and result is demonstrated if the act would not have happened without direct participation of the offender.[5] Causation is complex to prove. The act may be a "necessary but not sufficient" cause of the criminal harm. Intervening events may have occurred in between the act and the result. Therefore, the cause of the act and the forbidden result must be "proximate", or near in time. These are the rules that civil society has agreed upon that constitute the basis for a criminal act. Extenuating circumstances occur--which is why there are levels of charges, such as "involuntary homicide" or "Aggravated assault". The law is not black and white, as some here are proposing it is---ergo, RV CANNOT and SHOULD NOT be charged. She meets the criteria for the standard of behavior for citizens of this country. She is a nurse. The two are not mutually exclusive.