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mcleanl

mcleanl

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mcleanl's Latest Activity

  1. mcleanl

    Oregon BON

    Hi All, I am not a traveler but I am thinking this might be the best place to pose this question. We recently moved to Oregon. I am originally from Canada, I completed a diploma program there and came to the US with reciprocity. I took my NCLEX exam once I got into the US so I could move around more freely within the states. I have been licensed in 7 different states and completed my BSN in the US. Oregon BON says I must get my Canadian schooling credentialed by CGFNS to the tune of 350$.....even though I have a BSN that was completed in the US.........I also have been a nurse here for 20 years. Sounds odd.......but if that is what they need, so be it. However, when I call CGFNS they say they have never heard of credentialing a diploma after someone has a BSN and completed NCLEX. I hate to through out $350 just because someone had some wrong information when I called to BON. Any ideas or thoughts?
  2. mcleanl

    Chart Audits....you have to be kidding me!!!!!

    Hello All, I have had a day to mull over everything. I still feel that it is completely ridiculous to call someone at home regarding an unchecked box. This in NO way impedes patient care. I also stand by what I said, if 100 percent compliance is the goal then someone should be doing a chart audit before I leave. It is interesting......the responses you get from nurses on here. Some people chose to jump on the not charted/not done band wagon, some were feeling I was lucky to have someone audit my charting to prevent a lawsuit and others jumped all over compliance. I think someone actually questioned whether or not I was telling the truth about the number of times this has occurred or if I actually left more boxes unchecked than I admitted to. Very interesting responses. I am a Registered Nurse in the ICU for 20 years, I take care of very sick patients and I forgot to check a box. I find it demeaning and irritating that someone would call my house to tell me that I forgot to check a box. I find it demeaning and irritating that someone would tell me, and the staff that I work with, that management will allow us to get away with 2 offenses but on the 3rd offense we must return to the hospital to correct out mistake. I dislike punitive management.....I find it very ineffective and offensive. We are Registered Nurses......we should be treated with respect, not like "naughty" school children. If the goal is 100% compliance, let's figure out a way to get there. So, there were some good responses. I plan to use some of the suggestions that were mentioned here, since I will be bringing this up at the next staff meeting. 1- self auditing..... If they can run an audit.....they can teach me how to run my own audit. When time permits, I'll run my own audit. 2- Leaving emails and giving x number of days to resolve the issue. Altra, I am not sure what to make of the quote below. Are you suggesting that I lack insight into the nature of my offense? If so.......is smacks of superiority. Just another issue some nurses have.
  3. mcleanl

    Chart Audits....you have to be kidding me!!!!!

    Thanks Monkeybug!!!!!
  4. mcleanl

    Chart Audits....you have to be kidding me!!!!!

    Actually Altra ..............what I am understanding is that we aren't documenting for better patient care but to satisfy TJC. As a nurse......I find that very satisfying (yes, I am being sarcastic). There are two camps of people........one camp that can admit how ridiculous this all is and the other that seems to believe that has some sort of deep level of importance. I promise you, my patient outcome will not change based on this one box. If reimbursement is the issue.....and I sense that it might be........someone should be auditing me before I leave........so I can leave and rest my weary bones at the end of my 12 and a half hour shift. Sure, If box checking is where it is at and what it is all about........no problem. I could actually reduce the amount of energy I spend on patient care and really focus my time on the box checking.
  5. mcleanl

    Chart Audits....you have to be kidding me!!!!!

    Thanks all, I plan to bring all this up in the next staff meeting. If the documentation is that important......I mean to the point where if one single box is not checked, then someone should come in starting at 6pm to audit, so it can be done before I leave. It is not as though all we do all day is sit around checking boxes. People having to return to work after 12hours to check a box.....I think this is all overkill. I hate the idea of someone calling my house with such trivial issues....and yes......it is a trivial issue. In the whole scheme of everything that I did yesterday.......checking the family notification box is on the very bottom my list. The other point that I would like to make to all the auditors out there........approach is everything. If you sound like your salivating because you found someone didn't check a box or if you sound like you enjoy calling people to tell them that their box checking skills aren't up to par...........you are going to get on peoples nerves!!!!!!!! If you absolutely have to call me, please say something like........"I can't believe I have to call you for this, I know you ran your butt off today BUT.........this box has to be filled out....."
  6. Ok......I just got a call from the night charge nurse. She audits the restraint charting somewhere around 2000hrs. She called to tell me that I didn't check the box (in EPIC) that states I notified the family regarding the restraints. Every other bleepin' box was checked except that one..........she called me to tell me that I had missed that one box. FYI.....this lady was maxed on pressors, rapid Afib, intubated and lined today and started in CRRT....wasn't like I was sitting on butt all day. She apparently will call you up to 2 times and on the 3rd time if your restraint documentation isn't perfect........you have to come back in to fix it. I work 12 and half hr shifts. Some staff members have been called as late as 2200hrs. Can this even be legal???? I feel totally harassed. I was always under the impression that my documentation was mine....done under my license. If I failed to complete everything, than it was my license at risk and that it would also show up on my evaluation. Can management really call you for such small infractions?
  7. mcleanl

    My dad was a 'throw-away'

    Flare, Nurses are human beings as well, it is never satisfying to code a 93yr old-even if they are healthy. It is reasonable to discuss these things with families and often times I don't think that people really understand what "do everything" means. Truth be told most nurses outside of the ICU rarely understand the nature of what is done to these patients. Lines and tubes in every possible place....poking, proding, shocking, chest compressions. It is not a matter of not wanting to be busy........it really is a matter of compassion and there is an element of frustration, why are we so fixated on keeping people alive?
  8. mcleanl

    My dad was a 'throw-away'

    Alaur.....This post has come at an interesting time for me. As an ICU nurse for almost 20 years I have had a couple of recent cases that have kept me up at night. Cases where family members have elected to continue on with care despite a poor/unfavorable prognosis. In each of these cases the patients were of advanced age and ended up with a trach/peg and have low GCS scores with no quailty of life. People often pray and desire that their family members live, they want them to beat the odds. Where my conflict lays is that we have the ability to keep many people alive......and we often do (at families requests) but what have we really achieved......and how do the familes really feel after the reality sinks in....the reality that the neurological state their loved one is in, will never really change. I whole heartedly believe the nurses you were dealing with had these thoughts cross their mind as well. I understand that your father is in a different catagory than the examples that I have described above but I wanted to share what it can be like on the nursing side. It can be emotionally challenging and these situations are very delicate. There are many times as a nurse I have felt that in the name of healing we are actually torturing people (this is especially true in the ICU). I found your post interesting, it really speaks to what families really want and should you really just tell them what they want to hear. I am very, very conflicted by this..... The other thought I wanted to share, and I try and talk to families about this as much as I can. Extended stays in the ICU are rollercoasters. There can be good days and bad days. There are many doctors, nurses, respiratory therapists etc but the one constant is the family. As a family member, you are part of the team. Since most families are at the bedside daily (and the other team members come and go) you may pick up on things that we may miss......that doesn't make us stupid or incompentant.......it just makes you a valuable member of the team.
  9. mcleanl

    calculations

    I am really trying to understand this question .....if they want you to run something in mcg/kg/min than that means that you are giving that amount of drug multiplied by that weight over a minute.......you cannot give something in mcg/kg/min over 4 minutes.
  10. mcleanl

    Ortho nurse or transplant nurse?

    Transplant!!! I agree that the learning experience will be incredible. Just as an aside......ortho floors are very heavy...and the work is physically difficult.
  11. mcleanl

    Medication Error

    I suspect the OP is referring to the "college of nurses." It is a equivalent to the US's BON.
  12. mcleanl

    Ketamine for adults while intubated?

    I've seen it used for bedside procedures (in adults) along with versed but never in drip form. I was taught to minimize stimulation and talking near the patient while ketamine is in use to prevent flashbacks/psychosis.
  13. mcleanl

    Vented Patient PEA

    This is a good question. I actually had a vascular pt, several years ago that occluded his graft and needed to go to the OR stat. He was intubated, SR on the monitor. We packed him up to go the OR, placed him on the portable monitor/vent and started out the door when I happened to notice that his rhythm looked slightly different......it was PEA. Our monitor didn't pick it up and the pt didn't have an A-line. He potentially could have made it to the OR without any of us noticing!
  14. mcleanl

    Cyclical vomiting syndrome

    Not sure about the diagnosis, but in my world cyclical vomiting gets an NGT.....
  15. mcleanl

    leaving the community... but where

    Trish....hugs to you. Your post did make me giggle when you wrote "Hamilton (not a fan). I grew up there and it was often referred to as "the mistake by the lake." Good luck with your search, TO and the burbs......that is where my heart longs to be!
  16. mcleanl

    Offensive or not??

    "Manchildren"....................:lol2::lol2::lol2::lol2:.........I never knew there was a name for this, but I know exactly what you are talking about!!!!