FlorentineRN

Call the Dean.

If you were treated for pulmonary tuberculosis in the past you should be prepared to provide medical records to establish the drugs used and your completion of treatment. DO NOT TAKE any more TB skin tests. You are going to be repeatedly positive for a PPD test. Explain your previous history of TB and your completion of treatment. A yearly X-ray of the lungs is not necessary. Your Employee Health program should send you an annual symptom survey to ask if you have any TB symptoms such as cough, fever, weight loss. Obviously, you should report those symptoms sooner than annually when present. You should have no problems as long as you can provide the documentation of your previous treatment.

I'm sorry for your trouble. Also don't know what continental refers to here. The best advice is to get an attorney with experience in Board of Nursing issues. The attorney can then advise you about next steps such as a hearing . These laws also seem to vary from state to state jurisdiction. You may be able to get licensed in a neighboring state but not in your own. Best of luck to you.

How could it possibly happen that you are being treated in this horrible manner. I know it is expensive, but I think an attorney familiar with these manners is really needed to get some sanity in he door. I’m sad this happened to you.

I would tread very carefully. These are the questions I would be asking: Do all patients receive an examination by a medical provider and is this documented? What are the diagnoses? Who mixes the IV infusions? If it doesn’t come from a pharmacy I would be worried. IV therapy always carries the risk of infection which may lead to sepsis. What are the policies about this? Also, ask your State Board of Nursing about any regulations for this industry.

If I may add to my own comments….. The device should not have been in the sink with the emesis basin. If it is a disposable instrument it should have been discarded in a sharps container at the point of use. If it is reprocessed after use, you should have a protocol for transporting those items to the pick up area for sterile processing staff.

It is a blood borne pathogen exposure for sure if the fluids come in contact with the skin. If the “sharp” punctured the skin it could be considered a needle stick. More important is for each blood borne pathogen exposure to be assessed individually. Occupational Health can review the medical records of the source patient for history of hepatitis, HIV and high risk behaviors. This is the true key in deciding if post exposure prophylaxis is indicated. Of course, used hollow bore needles are the most dangerous.

I think you are in a great position to put your education to good use. So many possibilities including: quality improvement, patient safety, patient advocate, infection prevention. See if you could be on one of those committees at your current facility. A lot of that work is really interesting. By serving on some of those committees, it will increase your visibility when positions become available. And, of course, you could be a nurse manager.

A patient in a wheelchair came into my office and asked about my family photos of little girls on my bulletin board. He placed his wheelchair between me and the door and proceeded to masturbate while looking at the photos of the girls. When I tried to push past his wheelchair to leave, he STOOD up to block my egress. The wheelchair was just a ruse, a prop. I filed a report with my facility police. I was working at a federal agency. They did nothing. So being a good sleuth, I read his medical records from recent years. He was a pedophile who had come to our state without registering as a sex offender. In our facility in a neighboring state, he had prevented a female physician from leaving by parking his truck diagonally at the parking garage exit. He was also wanted for questioning in another state for intentionally running over a woman. I was counseled by my facility that I did not have a need to know this patient’s history and that my review of his chart was inappropriate. I would face disciplinary action if accessed the record again. So, you can certainly get in trouble accessing a patient chart.

Nurse Navigator (NN)is definitely care management. The VA has these positions and they pay well. Monday-Fri schedule. For my interest, NN would be more fulfilling because you follow a patient population for their entire journey, not just inpatient. I would worry that the inpatient care management position is going to involve lots of begging facilities to take hard-to-place patients. Either way, congratulations!

I am at about retirement age so I have had time to reflect on my career. Nursing has been good to me and I think no other profession offers such diverse experiences. I absolutely hated being a nurse in an inpatient setting and I thought I had made a terrible career choice. After I completed my BSN, I became involved in public health and it was truly my calling. Surprisingly, my salaries have been good as well. Don’t give up. You will find your niche in nursing.

Completely agree. I’ve seen too many NPs choose friends to be their preceptors. I think a one year internship or residency should be required for entry to practice.

I’m leaning toward a respiratory infection given his respiratory rate and breath sounds. There is no consolidation which points away from pneumonia. Lesions in mouth and cachexia could be thrush and general immunocompromise May be anemia of chronic disease. Negative COVID test suggests that previous COVID infection may have caused long term pulmonary damage Differentials interstitial lung disease of unknown origin (COVID associated, asbestosis? Silicosis?) R/O TB though lack of cavitary lesions makes this unlikely Admit to inpatient care. Isolate on airborne precautions for now. Continuous O2 monitoring.

NP education is a huge problem. Entry to a NP Program should be limited to RNs with previous clinical experience. No open book exams and choosing your own clinical preceptors. It may be too late though because a lot of people are upset about the end product of these schools. Should NP programs close? No, but entry requirements should be stringent. The education should involve enough clinical hours to make graduates able to succeed.

My time with my father is not tarnished. I am lucky to have him. We did an advanced directive and POA together after the events in the ED.