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HomeBound

HomeBound

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Reputation Activity by HomeBound

Reactions Given

Like 256
Thanks 12
Haha 7
Disagree 15
Sad 1

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Like 306
Thanks 16
Haha 1
Disagree 9
Sad 1

  1. Like
    HomeBound got a reaction from brownbook in Write Up's and Potential Termination for Pain Reassessments   
    At a place I worked, we were dinged for not assessing the effectiveness of miralax.  You had 4 hours in order to do this. If the patient didn't defecate in those 4 hours, you must chart that the intervention was "ineffective".
    Well....what if my patient took a nice large constitutional at 4 hours and 1 minute?
    This is garbage that is most likely driven, IMHO, by risk management. Someone, somewhere, sued the hospital for being constipated. And that led to piles. Or a bright bloody stool. Or a tummy ache (because they refused to comply with bowel regimen while taking allllllll the narcotics)
    I think I've told this story before--that a Nurse Spy in my ER emailed me that I hadn't reassessed the effectiveness of that life saving tylenol on a patient I had for ....oh....45 minutes?  She wanted me to go back into EPIC 5-6 days later and chart something.
    I wrote back..."Don't recall the patient. Don't recall if I saved their life with tylenol. But if you want---I will go back and chart I did assess them...and I will also chart a blank progress note that I was notified by YOU to do this fraudulent thing."
    Crickets from that point on about my pain assessment skills. Or lack thereof.
    In the ICU, yes---we reassess pain much more frequently than the ER or pretty much any other unit. But we also are 1:1. I can do that. My monitor is tethered so I can stick my head around a corner and ask a quick "how's the pain?" or do a CPOT. Not hard.
    But having 8 pts? No way. No. WAY.
    This is the legal department issuing edicts in order to "save the hospital" from lawsuits.
     
  2. Like
    HomeBound reacted to RobbiRN, RN in Are all for-profit hospitals soul-sucking despots that truly only care about the bottom line   
    Yes, but they are only a small part of a lineup of "soul-sucking despots that truly only care about the bottom line." Some suck souls indirectly through the art of profiteering. I believe the correct order based on profit margins is: 1) pharma, 2) equipment makers, 3) health insurance companies, 4) for-profit hospitals, 5) bought and paid for legislators who enable the abuse, 6) lawyers who are having a good day, and 7) non-profit hospitals which rank last because their average CEO salary is only about $4 million.
    All profiteering at the cost of human lives is pathetic, immoral, and unsustainable at current levels. The beam will cry out from the woodwork. 
  3. Thanks
    HomeBound reacted to TriciaJ, RN in What Does #MeToo Really Mean?   
    Great post, HomeBound.  I think we've come to confuse self-respect with moralizing.  No one ever deserves to be drugged and assaulted, just like no one ever deserves to be run over with a car.  But if you don't look both ways before you cross the street, you increase your likelihood of being run over.
    Same goes for not being selective about the company you keep or the messages you send them.  By being open and trusting with people you don't know at all, you increase your risk of something bad happening.  Maintaining boundaries and behaving with a certain amount of decorum is not an issue of morality; it's an issue of safety.  Engaging in flirtation and trash talk in the workplace is unprofessional at best, dangerous at worst.
    When people aren't taught what it means to show respect for themselves it's a slippery slope to being treated with gross disrespect by others.  The internet and social media have enabled a huge uptick in victims and perps.
  4. Like
    HomeBound got a reaction from brownbook in Write Up's and Potential Termination for Pain Reassessments   
    At a place I worked, we were dinged for not assessing the effectiveness of miralax.  You had 4 hours in order to do this. If the patient didn't defecate in those 4 hours, you must chart that the intervention was "ineffective".
    Well....what if my patient took a nice large constitutional at 4 hours and 1 minute?
    This is garbage that is most likely driven, IMHO, by risk management. Someone, somewhere, sued the hospital for being constipated. And that led to piles. Or a bright bloody stool. Or a tummy ache (because they refused to comply with bowel regimen while taking allllllll the narcotics)
    I think I've told this story before--that a Nurse Spy in my ER emailed me that I hadn't reassessed the effectiveness of that life saving tylenol on a patient I had for ....oh....45 minutes?  She wanted me to go back into EPIC 5-6 days later and chart something.
    I wrote back..."Don't recall the patient. Don't recall if I saved their life with tylenol. But if you want---I will go back and chart I did assess them...and I will also chart a blank progress note that I was notified by YOU to do this fraudulent thing."
    Crickets from that point on about my pain assessment skills. Or lack thereof.
    In the ICU, yes---we reassess pain much more frequently than the ER or pretty much any other unit. But we also are 1:1. I can do that. My monitor is tethered so I can stick my head around a corner and ask a quick "how's the pain?" or do a CPOT. Not hard.
    But having 8 pts? No way. No. WAY.
    This is the legal department issuing edicts in order to "save the hospital" from lawsuits.
     
  5. Like
    HomeBound got a reaction from TriciaJ, RN in What Does #MeToo Really Mean?   
    This is a great topic, SafetyNurse. I appreciate your thorough research and some light shed on how it effects us as nurses.
    However. (isn't there always a caveat?)
    I was discussing the decline of the attitudes in the "younger set"-and it includes younger nurses as well--that there seems to be this trend of "anything goes and nothing matters"---facebook posts of partying hard, bragging about being "wasted" and constant cleavage being shown. Instagram and Tumblr and all that.
    Another nurse walked by (she's not a "girly girl" so keep this in mind) and commented on a unit secretary in her former workplace---who had the misfortune of being involved in the case of a male nurse who has been convicted of sexually assaulting several patients and co-workers, after drugging them first.
    My co-worker rolled her eyes and said, regarding this unit secretary..."Well, I wouldn't go so far as to say she was a victim. She always was so flirty with him, always wearing revealing or "slutty" clothes to work, always joining in with the patting and touching with the group he was in. So no, I don't think I'd exactly call her a victim."
    I was stunned. This man drugged and sexually assaulted these women, but this woman (she's 36) felt that "being flirty" and "wearing revealing clothing" somehow was this clerk asking to be raped.
    This, unfortunately is the attitude not only of many men, but also of women. You deserve this, because of how you dress or if you flirt or even if you speak to men.
    It's ironic because of this woman's "off time" job--she works with mostly men, in a traditionally "more sexist than average" type of position. She's straight, by the way--and she is constantly sucking up and hanging out with the men on our unit---engaging in the lewd and trashy talk that sometimes evolves at 3 a.m. with a bunch of guys.
    It led me to start wondering about these sites like SugarDaddy.com and the like.
    What are men supposed to believe or feel---when women sell themselves (this isn't porn. these women are, essentially, prostitutes)---in order to get ahead in life? Yeah, yeah...I know....there are gold diggers throughout time.
    However---these young women (and men) post themselves online as "available for a price"---they're working their way through school (supposedly) or have a taste for the high life---and see absolutely nothing wrong with advertising themselves as open for anything---as long as they're being paid.
    This is the society in which we live now. This is the soup in which the young men and women of today are being steeped. It's being perpetuated by (usually) older, wealthy men who see young women (and men) as nothing but a commodity.  The sugarbabies aren't disputing this, but encouraging it.
    My coworker was just offensive---and I told her so. She was "do as I say, not as I do---I will judge you as slutty and promiscuous and deserving of sexual assault if you do the things that I do."  I had a family member say the same thing to me once---that I dared to walk into my own livingroom with pajamas on (while sick), lying on the couch watching tv---but a male family member was present in the house---so when he said something about my  boobs---it was my fault that he did this. I should have been fully dressed, possibly in a bourka?--in order to have prevented this *** from commenting on my body habitus.
    What's not a surprise?  There is a #muslimmetoo movement going on---where women who are oppressed in all ways, especially in the way they dress, how they conduct themselves (never walking with anyone but a male family member), their activity (can't drive, can't date, can't choose a mate)---where these women are covered from head to toe.
    Does it stop sexual assault? No.  It's the belief and the perpetuation of this belief, that women are objects. 
    And guess who isn't helping. WOMEN. 
    This is what's going on--what's on the ground, in the secret little circles and cliques---at high schools, in workplaces, in colleges--there are no boundaries and very little in the form of leadership.
    Take a look at snapchat and instagram and watch these young girls (and guys) showing every square inch of their private selves---and then ask....what are men (and women) supposed to believe---is this woman (or man) offering themselves up? Or are they just attention seekers? Who makes the determination?
    Look at the parents who purchased their kids' way into colleges--it's not different. They sold their kids to a college. The coaches and deans took this money in exchange for the arrogant and elitist parents to look good. If they wanted their kids to succeed---and the kid is capable---why have to PAY someone to take them?
    This is our society--and it's not men only that are perpetuating this idea that someone "deserves" trashy treatment because they dress a certain way.
    It's not okay. And I applaud the #metoo movement--it's a start. Sketchy behavior is never okay.  I let it out in a sideways manner that how I deal with people (coworkers) who act in an unprofessional manner?  I document. Document, document, document.  And then I don't confront these offensive people---I simply turn it in to HR and then on to the nursing board if necessary.
    I don't mess with these people. I don't even object. I just let them ramble and give them enough rope. Then I hand that rope over to the people who can hang the offenders with it.
    Consequences are the only thing that work with people who know no boundaries. Work is work. Just because I go to a bar for a beer after a hard day doesn't mean you get to approach me with a proposition to "go out back" (true story and has happened more than once. WHILE WEARING MY SCRUBS).  I get "dark humor" and that's a completely different animal than "trash talk" on the unit.
    Sorry. Long.
    Want people to have respect for you? Knock it off with the instagram cleavage shots. Knock it off with the snapchat suggestiveness. How about come to work and do your job--keep conversations professional.  We're not impressed. All it makes these people look like is cheap and easy.
    Do I think this will eliminate these episodes? No. But I definitely love the label I have when it comes to any man (or woman) who calls me a "***" or a "tattletale"---because it means I have boundaries. Anybody who doesn't respect that? Aren't worthy of my friendship in the first place.
  6. Like
    HomeBound got a reaction from brownbook in Write Up's and Potential Termination for Pain Reassessments   
    At a place I worked, we were dinged for not assessing the effectiveness of miralax.  You had 4 hours in order to do this. If the patient didn't defecate in those 4 hours, you must chart that the intervention was "ineffective".
    Well....what if my patient took a nice large constitutional at 4 hours and 1 minute?
    This is garbage that is most likely driven, IMHO, by risk management. Someone, somewhere, sued the hospital for being constipated. And that led to piles. Or a bright bloody stool. Or a tummy ache (because they refused to comply with bowel regimen while taking allllllll the narcotics)
    I think I've told this story before--that a Nurse Spy in my ER emailed me that I hadn't reassessed the effectiveness of that life saving tylenol on a patient I had for ....oh....45 minutes?  She wanted me to go back into EPIC 5-6 days later and chart something.
    I wrote back..."Don't recall the patient. Don't recall if I saved their life with tylenol. But if you want---I will go back and chart I did assess them...and I will also chart a blank progress note that I was notified by YOU to do this fraudulent thing."
    Crickets from that point on about my pain assessment skills. Or lack thereof.
    In the ICU, yes---we reassess pain much more frequently than the ER or pretty much any other unit. But we also are 1:1. I can do that. My monitor is tethered so I can stick my head around a corner and ask a quick "how's the pain?" or do a CPOT. Not hard.
    But having 8 pts? No way. No. WAY.
    This is the legal department issuing edicts in order to "save the hospital" from lawsuits.
     
  7. Like
    HomeBound reacted to Luchador, CNA, EMT-B in Another Tragedy at Vanderbilt   
    When I had a knee operation the surgeon signed the correct knee with a big sharpie and then had a witness as I signed the correct knee.  Then they gave me ketamine and it was amazing. 
    "Never event" indeed.  Buy a damn sharpie. 
  8. Disagree
    HomeBound reacted to AbstracRN2B in Another Tragedy at Vanderbilt   
    I find discourse with you untenable, have a goodnight.
  9. Like
    HomeBound reacted to Wuzzie in Another Tragedy at Vanderbilt   
    I like the thumbs up if I agree because there isn’t any sense in re-stating something I agree with. 
    I’ve  given you thumbs up before. Shall I remove them?
  10. Disagree
    HomeBound reacted to AbstracRN2B in Another Tragedy at Vanderbilt   
    This isn't the only site with a rating system and you are taking something personally if you consider someone using a rating for its intended purpose as "childish". I rated it disagree because I disagree with your comment. 
  11. Like
    HomeBound reacted to Wuzzie in Another Tragedy at Vanderbilt   
    I don’t know you so you needn’t worry about me taking it personally. I tend  to refrain from “rating” people negatively, unless something posted is just awful, as it serves absolutely no purpose and I find it childish. I’d rather have an adult discussion about differences of opinion. 
  12. Disagree
    HomeBound reacted to AbstracRN2B in Another Tragedy at Vanderbilt   
    Thanks I'll remember that, have a goodnight. And it's a rating try not to be so thin skinned and take everything personally.
  13. Disagree
    HomeBound reacted to AbstracRN2B in Another Tragedy at Vanderbilt   
    She was negligent, in order for reckless homicide to be what occurred  she had to intentionally or knowingly give the wrong medicine. She did neither of those things. She did negligently override the necessary safe guard. And yes due to her negligent behavior a patient died. She was trying to pull Versed and put the name brand name instead of the generic, it was unintentionally done and fits more into negligence. 
  14. Like
    HomeBound reacted to Wuzzie in Another Tragedy at Vanderbilt   
    So AbstractRN2B I’m assuming that your “dislike” of my post is indicative that you didn’t actually read the CMS report. Since you aren’t actually a nurse yet you might want to have a look at it so you have a better grasp of what not to do if you want to be a prudent nurse. I would encourage you to try to identify every step that RV did wrong (there are at least 12) so you get a better understanding of the importance of diligence and attention to detail in your nursing practice. This will make you an excellent provider and your patients will benefit. 
  15. Like
    HomeBound reacted to Wuzzie in Another Tragedy at Vanderbilt   
    No it isn’t. Precedent was set years ago and the wildly exaggerated hordes of nurses being criminally charged for med errors simply has not happened. 
  16. Disagree
    HomeBound reacted to AbstracRN2B in Another Tragedy at Vanderbilt   
    I seriously cannot believe that people want that nurse to go to prison for manslaughter. What she did was negligent, definitely not manslaughter. And if she is convicted of manslaughter it's going set a dangerous precedent for nurses as far as case law goes. Regarding the Verconium incident she was honest from the beginning, Vanderbilt hid the truth from the family for months. Despite that fact some how that nurse is going to be a scapegoat for manslaughter instead of negligence. There's alot wrong with this situation.
  17. Like
    HomeBound reacted to Wuzzie in Another Tragedy at Vanderbilt   
    This is very different than what happened in the RV case and I believe there is more to this story as some of the details don’t add up.  A simple stent placement in a normal kidney even if it’s the wrong kidney should not result in a patient needing dialysis for “life”. Regardless, the physician was not the only person tasked with assuring that the correct surgical site was chosen. The “time out” procedure involves the majority of the OR team. There is a system component to this as well as individual. Hopefully the licenses of all involved have been impacted and the surgeon, as the team leader, should have his pulled. The rest seems more suited for a civil action.  Now, if the surgeon refused to scrub, didn’t wear a mask or sterile gloves, wiped the instruments on his jeans before using them, sneezed into the incision, got the mesh tubing from Quality Farm and Fleet and closed the patient with stuff from his mom’s sewing kit then perhaps criminal charges would be appropriate. 
  18. Like
    HomeBound reacted to Wuzzie in Another Tragedy at Vanderbilt   
    That argument hasn’t really been proven true. Another poster did a search and found only 3 cases, including RV, since the late 90’s. None have resulted in jail time. 
  19. Like
    HomeBound reacted to DextersDisciple in Another Tragedy at Vanderbilt   
    @HomeBoundforcing the residents, fellows and other "still in school" (technically) to do the hard work. You know.....the time-outs and the site marking.
    IR nurse here- just wanted to point out that we cannot perform time out until the attending is present. However some pop in just for time out 🤷🏼‍♀️
  20. Like
    HomeBound got a reaction from brownbook in Write Up's and Potential Termination for Pain Reassessments   
    At a place I worked, we were dinged for not assessing the effectiveness of miralax.  You had 4 hours in order to do this. If the patient didn't defecate in those 4 hours, you must chart that the intervention was "ineffective".
    Well....what if my patient took a nice large constitutional at 4 hours and 1 minute?
    This is garbage that is most likely driven, IMHO, by risk management. Someone, somewhere, sued the hospital for being constipated. And that led to piles. Or a bright bloody stool. Or a tummy ache (because they refused to comply with bowel regimen while taking allllllll the narcotics)
    I think I've told this story before--that a Nurse Spy in my ER emailed me that I hadn't reassessed the effectiveness of that life saving tylenol on a patient I had for ....oh....45 minutes?  She wanted me to go back into EPIC 5-6 days later and chart something.
    I wrote back..."Don't recall the patient. Don't recall if I saved their life with tylenol. But if you want---I will go back and chart I did assess them...and I will also chart a blank progress note that I was notified by YOU to do this fraudulent thing."
    Crickets from that point on about my pain assessment skills. Or lack thereof.
    In the ICU, yes---we reassess pain much more frequently than the ER or pretty much any other unit. But we also are 1:1. I can do that. My monitor is tethered so I can stick my head around a corner and ask a quick "how's the pain?" or do a CPOT. Not hard.
    But having 8 pts? No way. No. WAY.
    This is the legal department issuing edicts in order to "save the hospital" from lawsuits.
     
  21. Like
    HomeBound reacted to Sour Lemon in I am close to graduating and do not want to do bedside nursing....help....   
    Any job that’s “easy” and available to someone with little or no experience is going to be low paying. 
     
  22. Like
    HomeBound reacted to Jedrnurse, BSN, RN in Write Up's and Potential Termination for Pain Reassessments   
    The Joint Commission needs to veer from cause du jour to cause du jour to perpetuate their own existence. If all the "high priority" problems were magically solved, they'd find new ones. Mind you, there's always room for improvement, I just don't see much improvement with new layers of paperwork/computer charting. Yeah, yeah "If it wasn't charted, it wasn't done."
    How about, "Just because it was charted, it doesn't necessarily mean it WAS done."
  23. Like
    HomeBound got a reaction from TriciaJ, RN in Another Tragedy at Vanderbilt   
    From The Tennessean: 
    "Both of those errors were deadly (*referencing the vecuronium incident vs. the kidney stent incident), but they still don't carry the notorious reputation of a "wrong-site surgery," which are among the rarest mistakes in modern medicine. The U.S. Department of Health and Human Services says these "vivid and terrifying errors" occur once in every 112,000 surgeries and at individual hospitals maybe once in every five or 10 years. Federal officials classify wrong-site surgeries as "never events" and say these errors are often signs of "serious underlying safety problems” at hospitals, according to a safety primer published by the federal agency earlier this year." (emphasis mine)
    This is apples and oranges in some ways, but it still comes down to Vanderbilt's (and most other enormous "teaching" hospitals) culture of laissez faire when it comes to basic safety.
    I just spoke to a former RN from Vandy, who actually gave money to RV's "pay my legal bills for me" fund.
    He doesn't believe in her. Not at all. He thinks she should lose her license and then be sued into next Tuesday civilly by the family.
    No, he gave because he doesn't want the supposed "backlash" of the outcome negatively effecting-----him and his practice.
    I am about done with everyone who is defending these mistakes---like ZDogg did--not because it's wrong, or patients won't benefit---but because it might effect the profession--meaning, people are going to have their feet held to the fire on their performance. Can't have that.
    This physician will have his feet held to the fire. Just as any other physician that has had this "never event" happen to them. What you don't understand is that physicians can't get malpractice insurance after an even like this--and that is actually worse than having their medical license revoked. They literally have the capacity to work, but cannot---because no one will hire them, and no one will insure them even if they get hired somewhere. Hospital risk management steps in on these cases. Then the families can go after the MD in civil court and ruin them financially.
    Yeah, crappy doctors work. The old joke goes again---what do you call the person who graduates last in their medical school class?  Doctor.
    What do you call a nurse who graduates last in their nursing class? Nurse.
    Which is why I don't comprehend this overarching support, without any logic, is being thrown behind RV---there are bad nurses and bad doctors and bad policemen and bad priests and bad school teachers and bad horse jockeys. 
    There is a percentage of the population that are sociopaths, psychopaths, borderline, functional alcoholics, functional drug addicts---and do they all live homeless under a bridge so we can all identify them?  No. They don't. They go to and graduate from prestigious schools and move forward to prestigious places.
    Vanderbilt has a serious problem with their culture. I was told point blank---the crew is green, because Vandy wants to pay the least for the most. You want our name? You do what we tell you to do. My friend told me that he was CHARGE NURSE on a step down unit within 6 months of graduating, while working at Vandy.
    Here's another point.
    I've worked for big, hulking "teaching" "magnet" "level 1" hospitals.
    I would not go to even one of them to have a surgical procedure. Not one. Because of this crap TEACHING thing. The hospitals allow attendings to prance in at the last moment, while everyone genuflects---to do 3 minutes' worth of whatever it is---then prance out---
    forcing the residents, fellows and other "still in school" (technically) to do the hard work. You know.....the time-outs and the site marking.
    Anesthesiologists send their residents to do consenting. Surgeons send their PAs or NPs to do the legwork. In surgery, I've seen 5th year residents doing practically the entire procedure---
    where is the attending??
    It's the culture of these big, ridiculous "magnet" "teaching" hospitals that provides the rich breeding ground for "doing whatever" because there is no oversight.
    But hey. They've got great sports teams! What a great name to have on your resume!
    I was told by another large southern system---you want our name on your resume? You will take what we give you. You say one negative thing? We will make sure you won't work in this state again.
    /rant over
    The question you posed, Beth, is insulting. I thought that the first time you posted the vec vs. versed thing was really to inform. Then it kept coming---trying to stir up sympathy for this nurse not because of the facts of her negligence, but to instill fear into nurses that "this might happen to you if you let this happen to her".
    Now this "us vs. them" thing. The physicians are held responsible. Did this doctor come in and literally say..."HEY! I have an idea! Let's forego the time out!!" (overriding the pyxis)  and then  "HEY! Even though that rad tech took the xray and it says LEFT and not RIGHT, let's just dig into the right kidney anyway!" (overriding the warning about paralytics, reading the label and ignoring it, reconstituting-showing inexperience/ignorance of her own job)
    There is a huggggggggggggggggggggggge difference between what RV did and what this MD did. 
    Where was the circulating nurse? Where was the resident? Where was the anesthesiologist? Where was the surgical technologist? Where was the surgical nurse?
    If the MD is held responsible, so should everyone else in that room. Including the nurses.
    Again.....there are bad nurses and bad doctors. Vandy's culture is such that they will hire anyone that is willing to do exactly what these other enormous teaching hospitals demand of their hires----you work cheap and you shut your mouth or else. It's our way or the highway with a big black mark on you for daring to criticize.
     
     
     
  24. Like
    HomeBound got a reaction from TriciaJ, RN in Another Tragedy at Vanderbilt   
    From The Tennessean: 
    "Both of those errors were deadly (*referencing the vecuronium incident vs. the kidney stent incident), but they still don't carry the notorious reputation of a "wrong-site surgery," which are among the rarest mistakes in modern medicine. The U.S. Department of Health and Human Services says these "vivid and terrifying errors" occur once in every 112,000 surgeries and at individual hospitals maybe once in every five or 10 years. Federal officials classify wrong-site surgeries as "never events" and say these errors are often signs of "serious underlying safety problems” at hospitals, according to a safety primer published by the federal agency earlier this year." (emphasis mine)
    This is apples and oranges in some ways, but it still comes down to Vanderbilt's (and most other enormous "teaching" hospitals) culture of laissez faire when it comes to basic safety.
    I just spoke to a former RN from Vandy, who actually gave money to RV's "pay my legal bills for me" fund.
    He doesn't believe in her. Not at all. He thinks she should lose her license and then be sued into next Tuesday civilly by the family.
    No, he gave because he doesn't want the supposed "backlash" of the outcome negatively effecting-----him and his practice.
    I am about done with everyone who is defending these mistakes---like ZDogg did--not because it's wrong, or patients won't benefit---but because it might effect the profession--meaning, people are going to have their feet held to the fire on their performance. Can't have that.
    This physician will have his feet held to the fire. Just as any other physician that has had this "never event" happen to them. What you don't understand is that physicians can't get malpractice insurance after an even like this--and that is actually worse than having their medical license revoked. They literally have the capacity to work, but cannot---because no one will hire them, and no one will insure them even if they get hired somewhere. Hospital risk management steps in on these cases. Then the families can go after the MD in civil court and ruin them financially.
    Yeah, crappy doctors work. The old joke goes again---what do you call the person who graduates last in their medical school class?  Doctor.
    What do you call a nurse who graduates last in their nursing class? Nurse.
    Which is why I don't comprehend this overarching support, without any logic, is being thrown behind RV---there are bad nurses and bad doctors and bad policemen and bad priests and bad school teachers and bad horse jockeys. 
    There is a percentage of the population that are sociopaths, psychopaths, borderline, functional alcoholics, functional drug addicts---and do they all live homeless under a bridge so we can all identify them?  No. They don't. They go to and graduate from prestigious schools and move forward to prestigious places.
    Vanderbilt has a serious problem with their culture. I was told point blank---the crew is green, because Vandy wants to pay the least for the most. You want our name? You do what we tell you to do. My friend told me that he was CHARGE NURSE on a step down unit within 6 months of graduating, while working at Vandy.
    Here's another point.
    I've worked for big, hulking "teaching" "magnet" "level 1" hospitals.
    I would not go to even one of them to have a surgical procedure. Not one. Because of this crap TEACHING thing. The hospitals allow attendings to prance in at the last moment, while everyone genuflects---to do 3 minutes' worth of whatever it is---then prance out---
    forcing the residents, fellows and other "still in school" (technically) to do the hard work. You know.....the time-outs and the site marking.
    Anesthesiologists send their residents to do consenting. Surgeons send their PAs or NPs to do the legwork. In surgery, I've seen 5th year residents doing practically the entire procedure---
    where is the attending??
    It's the culture of these big, ridiculous "magnet" "teaching" hospitals that provides the rich breeding ground for "doing whatever" because there is no oversight.
    But hey. They've got great sports teams! What a great name to have on your resume!
    I was told by another large southern system---you want our name on your resume? You will take what we give you. You say one negative thing? We will make sure you won't work in this state again.
    /rant over
    The question you posed, Beth, is insulting. I thought that the first time you posted the vec vs. versed thing was really to inform. Then it kept coming---trying to stir up sympathy for this nurse not because of the facts of her negligence, but to instill fear into nurses that "this might happen to you if you let this happen to her".
    Now this "us vs. them" thing. The physicians are held responsible. Did this doctor come in and literally say..."HEY! I have an idea! Let's forego the time out!!" (overriding the pyxis)  and then  "HEY! Even though that rad tech took the xray and it says LEFT and not RIGHT, let's just dig into the right kidney anyway!" (overriding the warning about paralytics, reading the label and ignoring it, reconstituting-showing inexperience/ignorance of her own job)
    There is a huggggggggggggggggggggggge difference between what RV did and what this MD did. 
    Where was the circulating nurse? Where was the resident? Where was the anesthesiologist? Where was the surgical technologist? Where was the surgical nurse?
    If the MD is held responsible, so should everyone else in that room. Including the nurses.
    Again.....there are bad nurses and bad doctors. Vandy's culture is such that they will hire anyone that is willing to do exactly what these other enormous teaching hospitals demand of their hires----you work cheap and you shut your mouth or else. It's our way or the highway with a big black mark on you for daring to criticize.
     
     
     
  25. Haha
    HomeBound reacted to Wuzzie in Another Tragedy at Vanderbilt   
    I’ll keep that in mind. 
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