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Multicollinearity BSN, RN

Acute Care Psych, DNP Student
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Multicollinearity has 4 years experience as a BSN, RN and specializes in Acute Care Psych, DNP Student.

Multicollinearity's Latest Activity

  1. Multicollinearity

    Unemployed New Nurses Would Be Wise To Remember These Equations

    I started as a new grad at a violent correctional facility. I learned more in that prison job than I have in my current hospital job.
  2. Multicollinearity

    A Plea to Nurses Everywhere

    In my (short) 3 years as an RN I have witnessed unprofessional behavior at 2 workplaces. I have witnessed an RN screaming, and I mean physically shouting an another RN. I have witnessed the DON screaming so loudly at a nursing supervisor that I cleared the area of patients. I have witnessed a nurse practitioner throw a chart at a CNA. That all was workplace number 1. At workplace number 2 I have witnessed an RN shouting at another RN in front of patients. I have witnessed yet another RN shouting at yet another RN and one quitting on the spot (abandonment) and the other being fired. I have witnessed "nurse wars' so bad that HR investigates for hostile work environment, and people get fired. And I have stayed out of all of it. I believe these sorts of behaviors and incidents happen in certain areas of the country more than others. I believe I have seen more of these behaviors than some nurses because I have worked in rural areas with a severe shortage of nurses - meaning "problem" nurses are attracted. Something tells me if I worked at, say, a big-city teaching hospital where they have their pick of applicants - I wouldn't have seen so much of this behavior.
  3. Multicollinearity

    My Reasons For Avoiding The Acute Care Hospital

    What's interesting to me is the variation of practice within different nursing environments. When I graduated from nursing school I consciously rejected acute care employment for many of the reasons you listed. I took a job at a correctional facility and found myself doing all of what you listed above - but without the backup a hospital provides. Many of our nurses at the prison went to the local hospital because they said the pace was too much at the prison. They liked med/surg at the local hospital because they said the pace of work was better. A couple joked they could "rest" in med/surg compared to our prison jobs. Now I work acute care psych and find this hospital job is nothing compared to my previous non-hospital job. I really don't care about uniformed nurses who think real nursing takes place inside a hospital - their narrow scopes and perceptions don't concern me.
  4. Multicollinearity

    Why In The Heck Should I Be A Loyal Nurse?

    I am loyal to my values & ethics and nothing else.
  5. Multicollinearity

    Lantus (Insulin Glargine): Scratching The Surface

    That's what happened. I held the lantus until I could get the on-call doc. I got an order to reduce the units of lantus. The nurse I was working with who had given lantus when the blood glucose was in the low 50s on the prior evenings said she didn't understand why it couldn't wait until the physician rounded in a few days because it's just lantus.
  6. Multicollinearity

    Lantus (Insulin Glargine): Scratching The Surface

    This reminds me of a discussion I got into with another nurse at work. I had a patient whose blood glucose numbers were dipping into the low 50s each evening. He was eating normally. He had recently been switched from 70/30 to lantus. I held his PM lantus and called the on-call doc to get an order. The 2-3 previous days the nurse gave the lantus even though the PM blood glucose was in the low 50s. She said it didn't matter because it's basal. I know it's a basal insulin. However, if the values are consistently low, wouldn't lantus just push it low...consistently?
  7. Multicollinearity

    Moral Distress In Nursing

    Moral distress weighs on you like nothing else in nursing. It hits up against the usual feeling that we are doing something good and makes us question if the opposite is occurring. I remember when my facility hired an agency MD who seemed odd. One day I was assisting him as he was doing an I & D on a GSW. That MD was digging around forever. Ok, maybe an hour. It's like he was lost in the tissue. I had assisted with similar procedures and never seen anything like this. Moral distress for me was that sinking feeling of working with a questionable practitioner and fearing the patient could be harmed. I voiced my concerns to an administrator, but nothing was done. There are so many issues in nursing that can cause us moral distress. It's tough to know what to press and what to let go.
  8. Multicollinearity

    Nursing Leadership Styles (Part I): Authoritarian Leaders

    Under authoritarian leadership the strong nurses will leave. They will not feel respected and will not feel they can contribute their knowledge and expertise. Collaboration is nil. It will downwardly push staffing towards newer, less experienced nurses who question less and feel more vulnerable due to their newness. At my former place of employment, under an authoritarian DON, the nurse with the most seniority had 9 months (after I left).
  9. Multicollinearity

    Prejudice Against Overweight Patients: An Issue To Ponder

    Leo, I deleted my prior post as it was rambling and long. I described a scenario where a physician claimed many overweight people will be overweight no matter what they do. I agree there is prejudice and bias. I'm afraid, though, that fear of claims of bias will tie healthcare providers' hands when it comes to addressing the issue honestly and kindly.
  10. Multicollinearity

    Prejudice Against Overweight Patients: An Issue To Ponder

    i think we have shifted from a culture of doctors orders, and patients' compliance. that reflected prior generations' vested authority in physicians that no longer exists. now physicians and other healthcare providers are partners in creating and maintaining health. truly. i prefer educating and coaching from healthcare providers and patients' adherence or non-adherence, which is their choice.
  11. Multicollinearity

    Prejudice Against Overweight Patients: An Issue To Ponder

    Overweight patients need to be addressed with respect, and healthcare providers DO need to be aware of their prejudices and bias. That said, I fear we are getting to a point of overly-politically correct enabling approaches where the issue will not be able to be addressed with overweight patients without "bias!" and "over-weight prejudice" being called.
  12. I graduated from an ADN program. I am about to graduate from an RN-BSN program. The ADN program was more challenging than the RN-BSN. ADNs are rarely 2 year programs even though they are 2 year degrees. It's unfair to ADN grads. That said, I do support the BSN as the entry level to RN practice.
  13. I believe we are sloooowly shifting towards ADNs being employed in LTC and rural settings with RN shortages.
  14. Multicollinearity

    My PhD Journey - Part 1

    So exciting. I'm excited for you. Imagine how all this hard work will pay off when you wear the regalia and become a PhD. Your contribution towards nursing research will be signficant - I'm sure of it.
  15. We cannot put all of the blame on nursing education, though. Rates of anxiety and depression among the general population, including nurses, has increased in the last few decades. People are more anxious and less secure. I had extreme anxiety as a nursing student. It impeded my learning in nursing school. It had nothing to do with my nursing school or my education; it was me. Now, as a practicing nurse almost one-year into RN practice, I run codes on my own and I feel less anxiety each time it happens. My point? Levels of anxiety and psychological disorders have increased in the last few decades and new grad nurses are effected by this, too.
  16. I may be taking this back further than you intended, but this makes me think of a conversation I had with a relative who is a retired nurse. This relative practiced as a nurse in the 1950s thru '80s. She described the following to me. She said she made a single entry on the patient's chart in a shift. She did not have to deal with all the defensive practice we deal with now. She did not have to check medications out with things like we have now, pyxis. She just went and got their medication. There was no counting. She mentioned they didn't have all the equipment requiring complex technical skills. She also said she always got a lunch break, and if one of the nurses had a headache, they'd just take a narcotic from the bottle of narcs at the nurses' station. Things were more simple. Nursing has become complex, but the education has not lengthened to match the increased complexity. Now add to that the student loans many students are taking out, and it's a recipe for high-stress. My relative? Her hospital sponsored her and even paid for her housing in a nurses' dorm. Today's students...most of them are working other jobs while in nursing school. Most graduate with student loan debt that burdens them and adds to their stress. Most do not start with a firm foundation from nursing school and a clean financial slate. I think part of the issue has to do with moving nursing education from hospital-based training to academic education. The move to academic education was needed for nursing to be a true profession, but it compressed the much needed clinical experience. So what's the answer? Lengthening nursing education. I don't see that happening.
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