eakirlin

I had at first thought to not put in the comment about requests for the gender of a nurse. Often it is not as hard to accommodate, but on the other hand, I have seen my male counterparts sent home because of some useless allegation about misconduct... and of course it needs to be done, but all of us feel bad about it. So... sometimes a female nurse accompanies a male. However, I kept the gender reference, because you can be blindsided, and the public under our care needs the best from us... sometimes caregivers cannot be switched out, and I still believe they are getting the best care possible, ... so it is a harsh reality to be blindsided for matters of individual perception that are not under your control and have nothing to do with the care extended or received. I also say, well bless their heart, because they need the blessing.

I agree with how disagreeable it is to witness some of these racially motivated patients, but also equally disturbed by women who want only female nurses, although I understand if you were traumatized by a male. HOWEVER, as a white nurse, I am sometimes targeted by others in the nationality profiling, and quite frankly , if I know you already hate me... and some have made disturbing allegations which, if not directly witnessed by one or other nurses, could have ended my career... I would rather not be your nurse. When I find out that you are willing to make up incidents that never happened, I quickly request a change in assignment. That.... or if there are no other choices, put a camera on me at all times when I am in the room.

agree with too much baloney, and having been on some white/right supremacy threads lately (they came unsolited on my email), the tone of some of this crime documentation retorts has the same feel to it as white supremacists. ?‍? Let me say that without context, there are lies, damned lies, and statistics... Mark Twain did not make that up, but was able to use it when statistics have been used to support a weak argument. SPLC has found that when you break out crime statistics along the lines of single female headed households ( an unfortunate social context for some black females), crime rates break evenly among white and black persons.

I found the different posts on IT very helpful. Am also considering Diabetic Nurse specialist. Does anyone have that educational background and work experience? Thank you for your anticipated response.

more than racism, this country has a long history of social heirarchy common to most post colonial countries, and it applies heirarchically to races and the "majority" race , so called entitled, as well. Law enforcement has a goal of protecting property. I was reminded of this when I marched up the main avenue to the capitol building, where deputy sheriffs were holding their holsters to protect storefronts, but not the peaceful assembly who was being targeted by vigilante snipers from the rooftop. So, let's have a better day for the citizenry and police departments around the country. I would like them to earn the slogan "to protect and serve".

Just now getting the thread on catholic healthcare institutions encouraging futile care. Was the person encouraging an actual nun, priest, brother... because if so, they are going against very clear church teaching, which I am posting below: Catholic Medical Association April 19, 2007 A. General Principles First, the DOE explicitly affirms and explains the traditional Christian rejection of suicide and euthanasia. Even in difficult medical cases, no one is permitted to seek death as an end in itself or as a means to ending suffering. On the other hand, the DOE clearly teaches that the decision to forgo extraordinary treatment (see below) “is not the equivalent of suicide; on the contrary, it should be considered as an acceptance of the human condition, or a wish to avoid the application of a medical procedure disproportionate to the results that can be expected, or a desire not to impose excessive expense on the family or the community.” Second, the DOE briefly recalls and reaffirms the traditional teaching on ordinary and extraordinary means. People are ethically obligated to use ordinary means to conserve their lives (and the lives of those for whom they are responsible) since human life is a gift of God and a fundamental good. Ordinary means are medicines, treatments and operations that provide some benefit, and/or do not involve excessive burden, pain, or expense. Extraordinary means are medicines, treatments and operations that do not provide a benefit, and/or involve excessive burden, pain, or expense. While people may use extraordinary means, they are not morally obligated to do so since earthly life for humans is not an absolute good and because, at some point, medical interventions are no longer effective and/or because the costs and burdens of medical interventions are out of proportion to the good of earthly life that they are intended to serve. The DOE teaches that no one can impose on a patient a need to accept extraordinary means, or even ordinary means, when there is no efficacy.

I would like to make two observations, and then thank the respondents for some real gut issues, and the courage to take it where it leads. 1) I almost stopped leaving notes in my personal life, because there is no way to control the "tone" in a note. Even if you are choosing your words carefully. The tone is self issued, based on the narrative and individual history. All I need to hear is "the boss wants to talk to you", and I cringe, no matter how many good boss sessions I have had. 2) Quoting Mark Twain, in the categories of untruthful argument; there are lies, damned lies, and statistics. It is popularized because of how statistics have sometimes been deployed to support a weak argument. I think there is a role to play in societal and employment opportunities, that govern choices in a way that eludes a tidy assessment of race, even IQ, gender, sexuality. When you have whole stretches of society where the family structure is shaky, where employment and education is restricted and ends early due to financial pressures, it may appear as one of the FBI statistics, with no other narrative support offered. It is too limited, in other words. I am thinking of Australia's birth , a penal colony for the upper classes of Great Britain. And you should see what the brits had to say about the lower classes! The works of Charles Dickens treats the "criminals" in a more sympathetic light than many of that era... and... I rather like Australians, don't you??? You could get shipped over for stealing a lady's handkerchief. You could definitely do worse in life than being accused of being Australian. Have a nice day?

One person, maybe more, wondered if I reported the policeman-nurse. Yes, and nothing became of it. Not at my facility, who buried the complaint, and the police force would not even do forensics on the nails. I saved them. I asked my charge nurse to save hers. The nurse giving me the heads up was out on disability,but said she would testify. So I am convinced that my near death experience with my car going over the side of a 20 foot overpass into downtown traffic, was a successful crime. Probably reinforced the behavior. I am not forgetting my stories, however, date, time.... and writing my senators and house of rep person. Like the police, some of those lawmakers will do something, but many will not. We'll see. So since I am white, I know it has been easier for me to get heard, because now I live in a mixed race neighborhood where a black person was recently stopped because the police, two of them, thought he "looked like someone they were seeking"... and he got his jaw broken twice, and then, oops, he maybe didn't look enough like someone. This person was sitting in a car after a minor purchase at a stop n go. Then, there are the wonderful police stories, like the ones that followed me off a highway when my car was clearly failing, and drove me to my place of work. I am just saying, the negative stories SHOULD NEVER HAPPEN. It would be as if nurses tolerated lethal injections in someone who doesn't do them very often. And yes, I worked opposite Jeanine Jones back in the day, and have much more to say about that also. we ought to be zero tolerance society for police and nurse mischief. I really don't encounter nurse mischief since old Jeanine. Her case keeps coming up for parole, and so far, she is still in Huntsville.

Excuse me.... but it takes much more than a police force to maintain civic order. Where there is no justice, there is no peace. Have any of you used your first ammendment rights to meet in a peaceful assembly to petition the Government? The first time I did, was in 1969 when I marched against the Vietnam War. We just celebrated the 50th year anniversary of the students killed and injured at Kent State. America knew of the Fulf of Tonkin incident. The war had had protests for years, no end in sight, and was extremely unpopular. I was not at Kent State, however. On this day, my medium sized metropolis of maybe 1/2 million, had streets along the main route of the protest, that were lined with deputies, hands on holsters, lining the boulevard. We were told via loudspeaker that the police were not there to protect the peaceful marchers. They were there to protect the storefronts along the boulevard. Then it was pointed out that the buildings carried vigilantes with sniper rifles, shooting at us, and those of us in peaceful assembly were on our own. Mind you, several hundred students , no weapons, a few carrying signs, many of us with relatives being drafted into the war, and some of us with relatives who had fled to Canada to escape the draft, no fisticuffs, no bricks, and thankfully no tear gas or horses to break us up. But we were told essentially that the storefronts were of primary importance. There were no looters among us. The view of law enforcement with its chief role as "protector of property", and by deduction, there to protect only those with a stake in property, has a long historical context of how we got to this pass. Then... and this is really amazing, I got visited by the FBI for weeks afterwards. I do not have a criminal record. I did not yet have the vote. I belonged to no groups. I was working on my Chemistry degree, and that is about all I had time for. Your tax dollars at work. The FBI had followed , targeted, and visited dozens of students over a period of weeks and months. Was this an attempt to intimidate, I believe, but only the FBI know for sure. Anyway, until you have taken your first ammendment rights for a test drive around the block, realize you may not be aware of how this rolls out.

There is a culture in some police stations and in some locales, and it amazes me that the police are roll-modeling assaultive behavior for the camera... like the young women thrown on the curb, later hospitalized.... or the 75 year old man pushed back until he fell on the concrete and started bleeding from the head. I once worked with a police man, who decided to become a nurse. One day, all 4 of my tires exploded while on a 20 foot overpass in our downtown area, and each tire had a nail pushed through it. I almost died, because my car was set to careen over the side of the overpass. I was later told that this policeman-nurse liked to carry around a box of nails, and push them into the tires of someone with whom they had disagreed. Same day, my charge nurse's car lost all 4 tires. and another coworker had police show up at her door to arrest her for an as yet unpaid parking ticket... all of us had had an incident with this nurse. It betrays a level of permission that many police think they have. While that is needlessly mean spirited, it is far from some really serious allegations of police brutality. Would agree that it needs to stop, and it may mean to imbed peaceful population in with the police. Also, did I say they need to turn on their body cams?

Believe that in many locales, police violence is a problem, and I have my own stories to tell on that subject, and the stories of many friends and neighbors. I think many nurses look to law enforcement for help, and in some cases, that trust has been abused. And yes, examine your own prejudices. Would recommend getting involved with your local government, to see if their is a rule governing lethal force, and even nonlethal force. Would also wish that many Americans understood more about health insurance, so that they can make a good choice come the next election.

thank you hppy for having a positive reference for nurses. I am rather aghast at the responses that are so judgmentally placed as to remind me that while nursing ought to be a compassionate enterprise, many of us are not kind and not compassionate. Lots of horizontal violence still goes on. Let it end here, on the covid fields. Annie

More to the point, might we consider some thoughtful criteria by which we might screen caregivers in their roles as potentially being in the middle of a covid ward? my facility just gave a nod to remove pregnant women from this scenario.... whereas for the past 5 weeks many have worked without N95's. The "what if everyone did this argument" reminds me that this line of logic ignores other problem solving dialogues. Quite a few years ago, when equal numbers of males and females were considered to be the criteria for managing disparity in gender, a choir famously did not move forward when they could not find enough female bass singers. There also might be some consideration for hazard pay.

Have been fascinated by the thread of narratives following the statement of the ED nurse under "discipline" for illness related to covid19 exposure, however one processes whether this actually occurred or not (the exposure/ illness resulting). Therefore, it seems worthwhile to consider that there are many reasons this should spur an industrial surge toward nursing power and organization. If we do continue to organize, will need to drop comments that exhibit vivid levels of disapproval and nastiness. "Tone".... counts for a lot, and it is difficult to control your tone in print. Now.... we hear from a manager who has compassion for nurses, an employee caught on social media evidently manipulating a situation. The manipulator will wash out... without anyone doing a thing about it. The compassion will last. Legal assistance is nearly always worthwhile, because that is one of the few remaining avenues to take a stand, and its main value may be anecdotal and educational, if not directly employed. You do not pay $400, or any price at all, for seeking a legal consult... and there are many kinds of legal, from medical/malpractice to administrative law and beyond. Once an administration commits a thing to paper, it has a life of its own. Not everything is worth fighting, for sure, but it is worth examining the many ways your fellow nurses are serially disempowered by this trickle of threats, and then, the trickle of unsupportive responses to a situation that should have been reformed by our ordinarily compassionate culture. I assume, we have been well trained to attack each other, because horizontal violence is the common ground for suppressed societies. (You know that you are a second hand citizen when you are encouraged to not use the dominant medical language of physician diagnoses, and then come up with other language which can be used by nurses, defining these medical diagnoses without using the primary language.) But this is not even about the second hand citizen argument..... ladies and gentlemen, we cannot continue to be set against each other this way. The difference between being sent into battle without appropriate armaments, and being sent into this covid battle without proper armaments, is because IT MAY CAUSE US TO HARM, IF NOT DECIMATE OUR OWN NUMBERS, AND ALSO THE PATIENTS WHOM THIS BATTLE IS ABOUT. The charge of the light brigade was written in the time of EMPIRE, and the empire has broken up.

you are correct.... at this point nothing.... I generally keep a lawyer on retainer, because once you go down the occurence report menu, things come up that are often not resolvable... and often lead to damage ....but that is a backstory. If the occurence does not meet regional standards, then you have a point for a grievance, and then you might chat up the safety officer and standards officer to see what the big picture is. I just keep an attorney around, because when you need one, the filing time is too short to get a good counsellor for yourself.

Appreciate your response. Since I do not know which specific items you are responding to, would offer the following: Objection to unsafe standards should not qualify as a glass half empty. I believe Florence did plenty of this in Crimea, and Queen Victoria wanted to name her as the head of her War Department. Perspective is everything. You may not have been responding to the unsafe standards argument, but that appears to be at the heart of most responses. It is perhaps the choice of whether to work/not to work in these conditions. That is a personal choice, and while I might applaud the the sheer brio of someone who is forging ahead, it would not be wise to avoid taking on the environment of care which affects all of us, including the patients. Hopefully, nurses will unite over this and other conditions which keep us from being the public helth resource we are.

I am so sorry about your situation. Get your employment lawyer now. It takes a few weeks to find one who will do more than take your money. Yes I have sued my employer before, over a safety and staffing issue, and was able to countersue for slander and defamation of character. If you are encouraging others to speak up at your facility, and taking safety concerns forward, then you are a labor organizer, just make sure you get noticed if you do this. The labor board called me at the time, and offered their legal support when I sued. I am in Texas, not known for any labor support. I actually got fired for calling OSHA and the state health board... who came in with cameras. Definitely a primo move.... but it seems that OSHA may be politicized since they do not appear to stand firm on issues these days Annie RN of 40 years, specialty certification x 2, Masters prepared.... endangered species and still working.

ohhhh my heart goes out to you. Does your doctor at least have a new protocol with how to deal with patient's with coughs, or coughs with fevers.... my personal physician won't see any of those people and is sending them to ED. Don't touch anything with bare fingers... for starts. Wipe down surfaces/pens/clipsboards/phones/ desktops with each use with chlorhexidine. If chlorhexidine not available, check and see (CDC) if chlorox wipes and alcohol 70% are sufficient. Do you have an N95 mask, or can you get access? Might consider placing a thin line of bactroban in nares, like they do for immunocompromised patients, but ask your own doctor for that, because I do not have prescriptive authority. Those surgical masks are better than nothing. ARE ANY OF HIS PATIENTS ASKING SERIOUS QUESTIONS? Once again, my PCP office is all but closed, and there is one person stationed lateral to the building, social distance line, and you go into office only if no fever no cough. What does your mayor or your metropolitan health district say to do? I will think about this some more and get back with you, but this gives you a start. (Annie... RN 40 years, mostly ICU... currently an endangered species)

hmmmm! my BS meter is chirping. Try sending this to the CDC and a national news agency, and see what is said about that from official sources. See if you can do it anonymously, if to a news agency. This is a yellow surgical mask, not even an N95 respirator. It is kleenex with strings. RN with 40 years of experience, most in ICU, two credentials, lots of scars from weird fights with administration.

could you send your protocol to Gov. Cuomo of NY and the other state governors?

have considered working for plastic surgery myself, except that it is potentially so high risk. Everyone gets sued if the patient doesn't like the result. Do not believe you can create a note for anyone but yourself, but contact the ANA or your state's nursing association, or state board. (as an example, is the intention to use you to duplicate physician services and commit fraud through documentation? Physician services are sometimes paid by the note.) And if you are to be involved in finding surgical codes to charge for services provided, make sure you are well trained, or once again, another fraud charge could follow if the diagnosis / service had expanded the service to a higher charge than merited. The new nurse / new attitude idea has been used a lot to signify that the employer does not wish a nurse who is grounded in their practice, and savvy to the wiles of employers. How long in practice.... less than a year? Is it dressing changes, or do you do some of the cosmetic work itself, to include injections? Is there a procedural book for your work, which you can copy (take a copy home, because if there is trouble, it will disappear) and use to justify your services? My sister got fillers once for her smile lines, and the fillers wound up drifting so that it enhanced the frown/smile lines, and otherwise the job was perfect. She could have sued. Just went to another practitioner. Anne,RN in Texas

being 70+ years and with two comorbid conditions that would likely cause me to die if covid 19 were contracted, I have had to consider that this might be the hill I die on... and in particular when N95 masks are not made available to me. I have one lung, I have diabetes, and I have a progressive lung disease that puts me on steroids. What say you.... is my choice really to only surrender my license or die?

An N95 .... my kingdom for an N95" might loosely echo the Shakespearian cry from Richard III and that he was in need of a horse or his kingdom would be lost.. and in point of fact all of our tiny kingdoms could be lost because we do not have regularly issued N95 masks. Perhaps I could have visited nieces and nephews the last days off, but I could not verify I had not had a covid19 contact. Not only am I not regularly supplied with PPE, we are not doing testing on staff or patients..... until the first test came back positive a few days ago. That is a long time without testing for an ICU handling primarily respiratory patients. So I am not visiting friends or neighbors, except to drop off some fresh eggs and vegetables to those without access. Still, everything goes out double bagged. Am working on my garden. Eating as many antioxidants as I can get. I am relying on a relative to get me the PPE that should be supplied by my place of work.

I am an RN of 40+ years experience, certified for ICU with 35 years as CCRN. Name is Eleanor A Kirlin,RN,CCRN, MBA Graduate of University of Texas/Austin 1978 December I am working at Baptist Medical Center in San Antonio, TX

Title: "is it just me.. or...? Is there a significant downturn in the use of cough etiquette in this country??? For me, the answer is yes. I have had to up the ante on the cough information on my ICU patients since flu season started in September. I boldly display the use of the crook of the elbow, clothing, less opportune is hand with wad of tissue... to demonstrate cough etiquette. I figure I am at high risk for covid 19 if only because of the fact that I get coughed on multiple times, in my face, during shift, by both patients and their visitors, and there is this stunned hurt bovine look in some cases, like "what?" This despite the fact that we actually WISH many of our patients to cough. Post-surgical patients, for instance. Patients with thick secretions, as another example. Fortunately, I have a handy-dandy icon for education on my screen, with a subconcept entitled "cough"... which could mean, "turn, cough, deep breathe", or "cough because I am about to pull out your ET tube''... or "suctioning your upper airway is going to make you.... cough". It seems like yesterday, but was in fact the second week of February, where I had a group of non-vaccinated pre-teens, wishing to go in the room of their Mom, who narrowly missed being placed on a ventilator for flu A. I told them,"consider this early education for Coronavirus, which is just around the corner". They looked dazed. I drew large air circles around the head/bed of their relative, describing the cloud of viral agents, then indicated that with air flow and currents in the room, it would likely go outside of the "safe" 6 foot environmental caution (although my facility was then teaching "3 feet" as safe) area following wind eddies, until it dropped on surfaces. They had recently come to the city and not been exposed already to the virus. It was their choice whether to go into room or not, and they all chose to stay out of the room, even while Mom was still not covering her cough. I believe my health is directly compromised by the behavior of patients and visitors, and can only offer point of contact information, which might be largely ignored. Wouldn't it be prudent to have a public service announcement to remedy the loss of this important point of health and etiquette?