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HarleyvQuinn BSN, RN

Military, ER/Trauma, Psych, Post-Partum, Med-Surg

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HarleyvQuinn has 12 years experience as a BSN, RN and specializes in Military, ER/Trauma, Psych, Post-Partum, Med-Surg.

Her Harleyness here!

 I've been an RN with my BSN since 2007. I've dabbled in specialties ranging from maternal-child health, military, emergency and trauma, pre-operative, medical-surgical, outpatient pediatric, and now inpatient psychiatric. I'm currently in school to obtain my MSN and become an FNP. I plan to specialize afterwards with a post-masters certificate in orthopedics. 

 I'm a disabled Army veteran and served in Operation Iraqi Freedom ( '09-'11) in Baghdad with the 28th CSH. All American, All the Way, Airborne. ;IGY6

HarleyvQuinn's Latest Activity

  1. HarleyvQuinn

    What's Happening at the VA Hospitals?

    A great example I have for you occurred after my subtalar joint fusion. The surgeon wanted to keep me for a week, but I had talked him down to only overnight so long as I was doing well. During that overnight, I started off well. It was painful, as expected, but manageable. Well, at some point the pain became unmanageable and began escalating out of control. They reached a point where they were giving me 2mg of IV Dilaudid at a time. Now, I had been taking 5mg/325mg Hydrocodone PRN no more than 30 tabs in a month (frequently filled less frequently than monthly) to manage the chronic pain from my unstable and degenerating ankle and subtalar joint and continue working. I was working in a level 1 trauma center at the time, or at least trying to. I was also trying to maintain regular, low-impact exercise. Obviously, the narcotic was not used prior to or during shifts, but it helped keep me from being unable to walk for days after them. Anyway, this sudden escalation of my pain and increasing need for much higher doses of narcotics resulted in the physician team rounding to see me no less than 2-3 times. Normal, right? They should be evaluating this. Well, during the times they came to evaluate me, they only asked one question. "Do you abuse substances?" They kept focusing on demanding to know about substance abuse. Not once did they do an actual physical assessment. Nor did they take down the dressing and actually look at the surgical incision. I did still push for discharge the next day, believing that fusion surgeries really are "just very painful" and to get away from being accused of substance abuse. I made it a day before I had to present to the ER because the pain had worsened to the point it was unbearable. They paged my actual surgeon who comes down and the first thing he does is remove the dressing to note the completely purple ankle. The drain had clotted off and a hematoma developed and residents from both hospitalist and podiatry missed it in their fervor to accuse me of substance abuse while ignoring physical assessment of a surgical site for potential complications. I almost had to go back into surgery. I wasn't screaming in pain or shaking or showing outward signs of pain, either. I had the stoic, quiet appearance. Even when I presented to the ER and even when the surgeon was manually squeezing the ankle to remove the clots. Without pain medication on board. Not a problem with the pain medications after that complication was cleared up.
  2. HarleyvQuinn

    Documentation

    Yep. Always a blast when my patients are banging on the nursing station windows demanding attention while I'm trying to complete the mountains of documentation about them. Take a worksheet for group out there since they refused to go to group, though, and they scatter into the wind. I have to document that too. Even if we move them from one unit to another because Supervisor wants to open up more beds to get more patients in. Gotta throw in a note: "Patient moved from appropriate unit to less acute unit due to acutely aggressive psychotic patient in the ER needing a bed per supervisor." I mean, come on.
  3. HarleyvQuinn

    When Police and Nurses Disagree Over Blood Draw Consent - Know What to Do

    Actually, refusal wasn't common at all. These blood draws are generally for patients brought in for allegations of DUI/DWI. For the patients I cared for, I never had one refuse the legal blood draw. They were calm and cooperative throughout the procedure. More often than not, it was the Officer/Trooper who was a ball of anxiety and convinced that the staff were going to "destroy my case" by "messing up the draw."
  4. HarleyvQuinn

    When Police and Nurses Disagree Over Blood Draw Consent - Know What to Do

    The ER I worked out informed us we were not permitted to refuse to draw for the police, that it was part of our duties as staff in the ER, unless the patient refused consent/was unable to consent and the officer/trooper did not have a warrant. This left us open to subpoena and we were forced to go to court on what was scheduled as a day off. That's if they didn't forget to tell you that you received a subpoena, as they came through the hospital. You'd get compensation if the patient didn't plea out as soon as they saw you walk in (happened to me), but that's not exactly how I wanted to spend a day off. It caused a bit of resentment. I'd rather the law enforcement offices have their own staff to perform the draws and show up to court to testify.
  5. HarleyvQuinn

    Legal obligation for disaster relief

    You'd think they would at least find a way to have arrangements for people to have their pets safely somewhere with them, even if crated. I would not leave my dog alone in a house knowing she was likely to die. I couldn't do it. I feel for you and hope that everyone is safe.
  6. HarleyvQuinn

    BON - Pending Case Review?

    Did you still submit that documentation and check "yes"? They have access to expunged records in their background checks. The BON even has access to Article 15s from military service and counts that as a "legal history." They have held up granted a license to applicants in the past over this same issue until they were satisfied with the explanation regarding expunged/sealed legal histories.
  7. We did that in the ER, too. We changed everything out with each turnover of the room after the patient was admitted/transferred/discharged, though. I do admit it was wasteful if the suction wasn't used, though.
  8. HarleyvQuinn

    3 Ways Nurses Heal After Mass Casualties

    I'm not sure how well this will translate into the civilian sector, but we ran into this a fair amount in the deployed setting when I was serving as an Army RN. I always noticed after very difficult cases or mass casualty events, I ran into a lot of my peers at the gym after shift. It helped me to work off some of the tension, anger, and other bottled up emotions that come with handling this type of trauma to funnel it into something productive and physical like a workout. Physical activity is also beneficial for your body and your mind and it helps to tire you out, giving you a better chance of getting that much needed sleep afterwards. Some hit the weights, some cardio, some even would give a go at a punching bag. Debriefing, which I'm sure all emergency and critical care folks are quite familiar with, is also acutely necessary. It gives everyone involved a chance to review the situation, discuss, and even make some sense of what they experienced. It also helps to prepare for the next time you may have to intervene in these situations. Coming from a psych perspective, I can't say enough how important it is to have healthy coping skills. Whether that's music, art, making bird houses, or even taking pole dancer lessons. Something that you enjoy. People you can talk and vent to. In these type of situations, I strongly discourage using substances to cope. From both military and civilian backgrounds, I've seen many take this path and it always seems to end poorly. If you notice that you're struggling after an experience, please don't be afraid to reach out for assistance. It's far better to make an appointment, be seen and get treated, rather than let things spiral out of control and potentially threaten your career and life. Remember there are a lot of us who have been through the trenches with you. We're here to help if you need us.
  9. HarleyvQuinn

    Murder-Suicide of Elderly Couple Worried About Healthcare Bills

    This is becoming increasingly out of reach in our society. Even for those who spent their working lives at one company and were lucky to retire with a vested pension - all the company has to do is file for bankruptcy and only a small fraction of that pension is now delivered to the retiree. They're left with nothing. Wages that have been stagnant as the cost of living continues to increase. More and more of the manufacturing and other jobs that once supported lower and lower-middle class families up-rooted and moved overseas for cheaper labor. The high costs of education needed for the decreasing chances to obtain jobs in some fields. Healthcare expenses, even with insurance, that can wipe out your savings from one hospitalization. God help you if you're diagnosed with cancer or suffer a limiting or disabling injury. Our workplace and labor laws, especially in areas without unions, are heavily tipped in the employer's favor. Hell, the company I worked for recently gutted their retirement program making it harder for you to even get their "company match" percentage. Now you have to have worked a certain number of hours within the year, have to have been there since before the new year, and oh the company holds the money in their own account and only deposits the "match" amount at the end of the year. Any interest accrued? They keep that.
  10. HarleyvQuinn

    Scared RN 😱

    It's going to depend on your program, too. You need to be a disciplined student and able to proactively manage your studies so that you set yourself up for success. Keep on top of your reading assignments, your due dates, and searching for other resources to help you understand the material. What you learn is going to build on everything you're learning in your BSN program. Know your APA formatting inside and out. Establish a relationship with your peers. I'm in a part time program currently, but we're constantly reminded that "even though it's a part time program, it is a full time commitment." Research your school so that you are familiar with how their program is designed. Yes, there are programs that are entirely online. I selected a program that has on campus intensives, especially for health assessment, to help establish our procedural skills. Take a breath and remember that nothing worth doing is without challenges.
  11. HarleyvQuinn

    pre-employment

    Some hospitals in Virginia. It varies.
  12. Not shocked. Not the only HCA facility this is happening it. They'll retaliate in a heartbeat.
  13. HarleyvQuinn

    Help with Staffing Incentives?

    This. Even if it's for extra money, picking up extra time isn't always worth it if you know you're going to still be very short staffed and just end up feeling like you played chicken with an eighteen-wheeler and lost.
  14. HarleyvQuinn

    ICU Nurse Fired For Refusing 3rd Patient

    Haha. God bless Cali. On the opposite coast we aren't having luck with unions. Same situation with high turnover, though.
  15. HarleyvQuinn

    ICU Nurse Fired For Refusing 3rd Patient

    If your sneeze or fart so much as sound like the word union in an HCA facility, their alarms in HR go off and you will be terminated immediately. HCA describes their staffing as "FTE neutral," which means it's blind to whether the "FTE" filling is a tech or a nurse. They do this to have "flexibility" to provide coverage for shifts. They have a corporate staffing matrix, but each hospital department is allowed to rearrange this as they see fit. They set policies such as hospitals are not allowed to decline patients based on insufficient staffing to care for them. They have a history of being caught in medicare/Medicaid fraud cases. Profit is the most important factor here. Nurses are just an expense, especially those who are experienced, and will quickly be tossed under the bus in exchange for cheaper labor. Why is anyone surprised by this?
  16. HarleyvQuinn

    Did I do the right thing in this code situation?

    Not my first loss, as I'd worked ER/Trauma and Military prior. Just my first loss that young (<1 mo). I did speak to the NP and a couple others involved and provided updates about the outcome as we heard to try and do an informal bit of debriefing/information sharing. That's what was classified as "gossip" and we were accused of creating a liability problem and being disruptive. I was working out my two-week notice at the time. When we were interviewed by the Quality department, I mentioned the lack of debriefing and how important it is for staff involved in these situations. I'm not sure if they changed their practices. In psych, debriefing is an important part of the process after any hands-on intervention with patients. To the OP, I hope you're doing well. I've found journaling helpful in sorting out my thoughts so that I can organize them, reflect on the situation, and find closure. The first code situation is always hectic and scary, but as you build training and experience both yourself and as a team, it becomes a much more fluid and smooth experience. Nothing is ever exactly the same, but the preparation pays off. Find the time to care for yourself. Stop and acknowledge what you're feeling, know that it's valid, and build healthy strategies to cope. For example, since starting school for my MSN I needed a hobby that takes little time to enjoy, so I started trying to keep a Venus fly trap alive. Not an easy task! Doing well so far, though. So, little joys. Little triumphs. Find yours.
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