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ashagreyjoy's Latest Activity

  1. ashagreyjoy

    Everyone is white?

    I live within the privilege of an ethnic majority, and I cannot relate on a personal level for that reason. It sounds like a challenging and isolating situation. I guess my question to you is, does a gross ethnic disparity in employee diversity automatically equal discrimination? The disparity of employee ethnicity is a simple fact. It exists, in extremis at your place of employment apparently. Discrimination refers to how you are treated. Are you being treated differently or unfairly than your white co-workers?
  2. ashagreyjoy

    RN Recognition & Respect

    As an RN, I personally am not really interested in benefits or discounts. They dont really add up to all that much...are we talking in the ballpark of, cheaper car insurance? Points off on a mortgage loan? 25% off scrubs every Tuesday? As an RN, what I really want, is a National Nursing Association. One giant union across the entire US with every single RN and LPN allowed to join it. That would cause a lot of entities to Recognize us. And our big fat contract.
  3. ashagreyjoy

    Patient safety in nursing

    1. there are a lot of strange parts in this story, top one for me, sounds like its really about Nurse A being too freaked out about a patient's LOC change to be able to handle the situation. Why is it so important about how Nurse A was feeling. The appropriate professional focus of nurse A rather than wanting to "get out of there" would be "ensure the patient is as safe as possible". Claustrophobia is a serious psychiatric diagnosis and sounds like it would be very limiting for a nurse expected to care for any patient in enclosed spaces. I certainly wouldnt toss around the words "feeling claustrophobic" anywhere in front of management if it were me. If I were a manager, and my staff member said that word to me, as to why they made several seemingly poor decisions during a potential patient emergency, I would be watching that nurse's practice very closely in the future. .." At this point Nurse A is getting overwhelmed, all she wants is to get out there... another minute goes by, now we are getting closer to 4 minutes or more.... Nurse A, gets claustrophobic as " 2. Nurse A could have lowered patient to the floor. If patient is on the floor, they can't fall any further. Then go get a pillow, and some VS equipment and see what's going on. Yes the floor is dirty. Its also safe... 3. The tech did exactly as ordered to do by the nurse, as is the tech's job. The nurse should explain, why she didnt tell the tech to either get a gait belt and a wheelchair, or a pillow and a VS cart.
  4. ashagreyjoy

    right med, right dose, wrong route... ouchhhh

    Hell no dont pay the hospital bill Contact whatever hospital safety/patient safety/quality improvement etc etc teams or boards exist for the hospital and tell them, to make this right, you guys have a safety gap, you need to make sure this doesnt happen again to someone else(change the pyxis or something so it only spits out IM syringes of Epi or something) If the hospital dont want to do some process improvement/quality/safety review/etc, you can always say, fine I will write a nice article for local news agencies about how This Hospital Almost Killed Me Because They Are Too Cheap to Pay For Epi Auto Injectors
  5. ashagreyjoy

    Spouse of nurse

    Brutal honesty. Yes I have discord due to finances. Its not due to me making more money than my spouse now. I dont care if my spouse works a low paying job as long as they are happy. The discord is because of my personal goals. Im not tolerating his inability to budget, curtail useless spending and lack of long term goals. any more. Also I dont drink alcohol and that adds up and Im not paying for his drinking any more. And truth we have other $#!+ going on. So I got a separate bank account and everyone is now responsible for half the bills. If I choose to be more financially responsible and he doesnt its no longer my problem. When we have a fancy dinner once in a while, I always pick up the check, unless he chooses to order drinks.
  6. ashagreyjoy

    Security Won’t Stop The Violence

    Your examples are inappropriate. If I startle a sleeping patient, I am rolling the dice. That was my choice not to wake the patient and therefore not allow them the opportunity to refuse care they possibly did not want. Active shooter events are something different. Want to stop that, then medical facilities need metal detectors at every entrance, just like courts and airports. In addition, we cannot "stop the violence" because ultimately we are unable to exercise control over the behavior of our patients and their family members. People control their own behaviors. A better example would have been, a nurse told a patient in the ED that the provider is not going to order Dilaudid. The patient then takes the call light and hits the nurse with it and says "I'll kill you". However, it is important to call out the fact that there is a small subset of patients whom we care for who choose to abuse and assault staff on a repeated basis. It is this specific portion of the patient population who need to be flagged, tagged, followed and ultimately charged. We can, via legislation, force employers and the general public to take notice that assaults against medical staff are not going to be tolerated by medical staff without repercussions for the institutions who employ us and the public we serve. I believe this would cause a shift nationally in the culture of violence against medical staff. Legislation doesnt work? OK so there are "Magnet" hospitals. How about hospitals that attract staff with the additional benefit of "Staff Safety" certification. This could be an independent certification organization (just like Magnet) requiring an institution to implement certain policies, teams, and protocols to earn a Staff Safety rating and designation. Throw the metal detectors in with this as a certification requirement. I know where I would choose to work! Independent nonprofit certification aside, nothing really has the permanence of legislation. The only way our employers are going to take this seriously is to have laws in place where the employer can be sued or fined when they dont follow the law. This is why employers are so afraid of OSHA. 1. FEDERAL LAW for specific criminal charges against individuals who assault on duty medical staff members of any kind. The state level is a mess, its different everywhere. 2. Outside and separate from criminal charges: enact federal laws that identify, track, flag and report individuals who perform or threaten assault against medical staff (just like the narcotics tracking systems). Once this individual is flagged, if they present for care in a medical facility, their flag displays and that medical facility is then under federal law required to provide a trained security officer escort for that patient as long as they are in the 4 walls of the facility. This could even roll up under OSHA. 3. Law for any facility giving short or long term admission to a patient including, dialysis centers, hospitals, SNF, LTACH, etc etc, where the patient is assigned a nurse who takes an admission of that patient, to have a Behavioral Safety Team (like Rapid Response meets Case Management, for behavioral safety issues). Patients who display behaviors that per the nurse's assessment make the patient a danger to the nurse or others, the nurse or physician can make a documented referral for that patient to Behavioral Safety Team. Example, patient who is yelling for ice water every 5 minutes but who is cooperative when redirected, no. Patient who throws ice water on a nurse, bites a CNA, or threatens to kill a physician can be submitted for admission to the Behavioral Safety Team. Then it is the responsibility of the facility to create a care plan for staff safety at the confluence of the patient's psychiatric, medical, purely behavioral, and criminal presentation. Nursing is removed from the inappropriate responsibility of having to diagnose behavioral disorders on the fly when the individual displays a history of dangerous behavior directed at staff. If the patient is discharged and later readmitted, and were admitted to Behavioral Safety service prior, Behavioral Safety automatically receives a consult and performs a new assessment each time the patient is readmitted. Behavioral Safety Team needs to contain a psych eval and is responsible for diagnosing whether the patient is competent to be accountable for their behaviors, or not, and Behavioral Safety must care plan accordingly. What mentally competent, abusive patient is going to show up to a Staff Safety-rated emergency room with metal detector, a federal law in place against assault, and a Behavioral Safety Team who at the first threat or assault, ready to slap a security escort on them and assess them to be forever flagged? Either they will behave appropriately, they will leave voluntarily when they realize they will not be allowed to abuse staff, Behavioral Safety will discharge them for safety reasons, or they will assault someone and suffer federal charges. And society will get the message.
  7. ashagreyjoy

    Is 35 yrs old too old to start nursing?

    I started my accelerated BSN program at age 35 and graduated at 38. I was in customer service and IT prior. I found intrinsic motivation and level of physical fitness were two very important factors. Mine are high (motivation) and low (physical fitness) but you can do anything if you really want to. You are very smart to do CMA first. My biggest pet peeves, everyone assumes I've been a nurse for 20 years, (although this is a huge bonus when reassuring patients) and work keeps trying to stuff me into a management position. Break a leg!!! You got this.
  8. ashagreyjoy

    Escaped Mental Patient

    I work in a secure setting. Today I took an unexpected phone call. Today I answered the phone and noticed the caller ID was a local hospital. The caller, (Maureen, not her real name) was asking to speak with "Juan" whom she thought was in our building because he "used to be a police officer". Maureen then became very tangential with her story, telling me a long life history and exhibiting pressured speech, flight of ideas, and ending her sentences by calling me Mom. I was immediately concerned about this person. Me: Maureen, are you in the hospital right now? Maureen: Yes, Im supposed to be in the behavioral health unit. Me: Maureen can you go get your nurse and put her on the phone with me because I really want to help you. She agrees and sets the phone down. And doesnt come back for 4 whole minutes. So, I ended the call, figuring, her nurse tracked her down and she's fine. She's obviously INSIDE the hospital, right? Phone rings again, its Maureen again... Rather distressed, wasnt able to find the nurse. Me: ok dont worry, is there any staff member you see walking by I can talk to? And by the way what floor are you on? Maureen: well Im supposed to be in room 334 and there isnt anybody around but...thats probably because Im DOWN IN THE BASEMENT. Me: Maureen, Im really worried about you. Will you promise me that you will go back up to your room? Maureen: yes I know where the elevator is, I promise I will go back over to the elevator. Maureen then recited a prayer to me and said "thanks mom" So, I called hospital security and told them, hey if you are missing a patient named Maureen who is admitted to room 334, she's in the basement. They promised to go look ASAP. Maureen, take care, I hope you are safe.
  9. ashagreyjoy

    How do you handle touchy/feely coworkers?

    So this is going to sound weird....to me it depends on the co-worker! I am not a hug-giver myself by nature but. We have some nurses where I work, who have been nurses longer than I have been alive, who are the hardest working and most amazing nurses, and they have already forgotten more about nursing than I will probably ever know, they have backbones of steel and The Voice like Bene Gesserit (Dune...) and if one of them is glad to see me and hugs me, its because Im special..it makes my day. Everyone else, dont touch me. LOL.
  10. ashagreyjoy

    Stupid hurts.

    Shoot heroin, nod out, while wearing a polyester jacket vs. campfire = 3rd degree Burgler vs. drug dealers bored pit bull = hamburger leg Fugitive hopping fences vs. cops are tired of chasing you and they boost the Belgian Malinois over every fence = hamburger arm
  11. ashagreyjoy

    So I called the police on a patient

    Jail nurse here. My 2 cents. Threats of harm from a patient or attempts to harm self or others by a patient need to be dealt with as 100% serious. Staff safety is just as important as patient safety. If your hospital is going to require nurses to be security guards (by not having in-house security or psych techs available to intervene on strong and aggressive patients) I would use 2 steps: 1. hospital chain of command 2. then call the police. Obviously you are working and paying taxes, and there is some hospital CEO raking it in off the difficult, hazardous, and underpaid work you perform as a nurse. Your personal safety is on the line. The reality is, only you were assigned to that patient. I have experienced all kind of second guessing from others after an incident. It means nothing: I kept myself and the patient safe. If you really think my ADPIE was professionally incorrect, then ask management for a debriefing. We can pull my charting and the security video (this is jail) and walk through the incident and we can all learn from it. Still havent had a debriefing yet!! I will use every available resource to keep myself, my staff, and the patient safe if they cannot keep themselves safe or their aggression is escalating. There is no wrong when calling for backup. If you think you need it, you call. Chain of command (charge/nurse mgr/house sup) can either back you up, or your chain of command is broken and you need to back yourself up. These things are not black or white. Like most of nursing they are a judgement call. In acute care the reality is a lot of detox patients need a sitter, and "there isnt one available". The patient your hospital admitted to the floor. Whom the hospital will bill Medicaid/Medicare and get paid for. The hospital apparently failed to provide sufficient resources to manage that patients medically induced behavioral problem. Patient detoxing and making threats, displaying aggression? Yeah we get that in jail. And the patients learn to control their behavior really quick, even with an altered mental status, for a lot of the time, because I have a deputy with a taser standing behind me and 15 more a radio call away. The acute psych term is Show Of Force. Do altered patients get tased? No. Is the altered patient's behavior less aggressive because they see that deputy in the doorway? You bet. It registers even in an altered mind. I think this is applicable to every field of nursing: I nurse with the understanding I may experience aggression from a patient at any time. This does not obligate me to continue to experience it once a particular patient displays it. And I will be a nurse leader by demanding a culture of safety. If patient had a dangerous medical condition, I would get it treated. If they display a dangerous security condition, I will get that "treated". It is my role as a nurse to intervene to keep myself, my patient, and my staff safe. I am a nurse, not a provider. I am obliged to consult for medical AND security orders. It sounds to me like you had to make your own chain of command for security orders because your hospital leadership failed you when consulted. Good for you! Stay safe!

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