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dhenceroth's Latest Activity

  1. dhenceroth

    Quality Healthcare Week

    QNurse...sounds like you did a good job with such short notice. I'm Dir. of R.M./P.I. and I knew it was Healthcare Quality Week, however I was caught in the middle of a major "reduction in force"......no one felt like celebrating quality. Anyway, I've been in QA/QI/PI (whatever you want to call it) for 9 years....NAHQ is a good organization....also there is probably a state or regional chapter you could join. Also, work toward certification. I gained the CPHQ 4 years ago....now working on risk management cert. Good Luck.
  2. dhenceroth

    Are We Really a Profession?

    My only concern in calling nursing a "profession" is the prevalence of unprofessional behavior that I witness...not only in nursing, but in other so called professional groups, such as Physicians, Lawyers, etc. It almost seems to be an oxymoron to use the word "profession".....
  3. dhenceroth

    why did you become a nurse

    I never wanted to be a nurse....My girlfriend and I attended a "career day" presentation in high school. We both planned to go to college to be teachers. I had also had an interest in becoming an attorney. We heard an RN speak about the Nursing program at a local hospital (diploma program) and we decided that nursing was better pay than teaching (we didn't quite grasp the benefits of steady dayturn Mon-Fri and summers off!!! we just looked at the money at the time). Anyway, we both went to Nursing school and loved it. Later, in my career, I realized I had been "called" by God to be a nurse as I had several family members with long-term illnesses that I cared for. What is really neat about professional nursing is there are soooo many diverse areas of practice within nursing. Guess what...later in my career, I worked in IV Home Care and became a "teacher", educating patients on how to administer IV medications at home. In the past 2 years, I have become a Risk Manager, therefore fulfilling my interest in the legal field. Even after years of midnight shifts and weekends, I am glad God led me to be a nurse!
  4. Would any PI Coordinators share what indicators they are using for the Staffing Effectiveness standards that started July 1, 2002?
  5. dhenceroth

    QI/UR/Risk Management question

    I am a Dir. of Risk Management /PI in a hospital. I have a CPHQ certification and plan to take the CPHRM soon. Performance Improvement has evolved alot over the years and as Janis said...you need a sound knowledge of statistical process control (understanding control charts) and also statistical significance tests. For me it has been really challenging....besides loving my clinical years in ICU, I always was interested in math and thought about being a lawyer....so I satisfy those interests in my current job. It's not all fun though....can be long hours and Risk Managers even get woke up at night!!
  6. dhenceroth

    assulting my ears

    Some nurses can't seem to tolerate it being quiet. When I worked in ICU on night shift, it drove me crazy when some nurses would always turn the TV on (to MTV, etc.) in rooms w/ unresponsive patients. Due to the nature of the unit, there is not much difference between night and day, however whenever possible, I tried to make it quiet at night.
  7. dhenceroth

    Pediatric Procedural Sedations

    Our moderate sedation policy allows for dose limited amounts of morphine, versed, valium on peds pts.. Chloral hydrate is used for sleep EEGs. If your physician is doing alot of intubating, then he is NOT doing "moderate" sedation, but administering anesthesia. Is he credentialed to administer anesthesia? Someone in PI should be monitoring this outcome (intubations / use of reversal agents....JCAHO requirement) I have seen ketamine used in some peds sedation protocols, however not propofol. Our Med. staff chose not to allow those drugs (e.g. ketamine, propofol) in the policy because not all the physicians would be knowledgeable enough to use them safely.
  8. dhenceroth

    Discouraged and needing encouragement

    I echo the above sentiments. It bothers me when nurses in our own profession put it down. There are so many opportunities in nursing. I have been in a hospital for 27 years, however I have worked in ICU (10 years), evening/night supervisor, IV Home Care, Oncology and then went on to Performance Improvement and now Risk Management. There are not many other professions where there are so many different fields that you can explore. Hang in there....we need good nurses. Anyway, there are no perfect jobs out there in any profession!
  9. dhenceroth

    I think I have an ethical dilemma here...

    I agree w/ fed up nurse. I am an RN Risk Manager and I have had several clinicians come to me about unsafe practitioners. Please take accurate documentation of dates/times, factual first hand knowledge of specific incidents and documentation of the chain of command in which you have reported the individual. Usually the Risk Manager is able to do something if ther documentation is there.
  10. dhenceroth

    Patient Confidentiality

    Tell your friends and co-workers that President Bush just signed the final Privacy Regs under HIPAA. Breach of confidentiality can result in hefty fines and even jail time against individuals!!
  11. dhenceroth

    Alternatives to a traditional nursing carer

    I left bedside nursing 8 years ago.....have been working as Performance Improvement Coordinator and then 1 year ago, I became Director of Risk Management/PI. I have a PI Coordinator (a bedside nurse that came from ICU) that works with me. I love it....every day is a new challenge. Contact me if you want to know more.
  12. dhenceroth

    Walking Rounds/Report

    We do not have walking rounds at our hospital, however they do it at a SNF/LTC facility where I visit a family member frequently. I can often hear what they are saying and I think it is a definite confidentiality issue. I think the risks outweigh the benefits....besides, as you say, this may be the first time the nurse going off duty has gotten to sit down!! Good luck.
  13. dhenceroth

    Nurse addict?

    I agree with the others that your wife needs help. However, you mentioned that you found a dose of oral morphine. ...this may not have been "wastage".....as someone said, this is "diversion"....the patient that needed the morphine may have had it documented it was given, but in reality, it was not given. When nurses take drugs from patients, there is really a problem! I will keep you and your wife in my prayers.
  14. dhenceroth

    How much can a nurse do????

    At our hospital, nurses are given authority by the medical staff to do specific interventions (XRs, foley, IV access, etc) by developing protocols and/or critical pathways for specific diagnoses, or certain presenting symptoms in the ED (i.e. musculoskeletal pain). Just make sure you have documentation that these protocols have been officially approved by the physicians....reliance on a physician relationship is a gamble....I would want something in writing that backs you up. I'm an RN risk manager and I try to make sure we have good p/p in place to back up the nurses.