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Kymmi

Kymmi

CVICU-ICU
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Kymmi has 20 years experience and specializes in CVICU-ICU.

Kymmi's Latest Activity

  1. Nurse156---first off I apoligize if I offended about the AA analogy..that wasnt my intention...I was just trying to come up with a way to express that someone might not know someone else is in the hospital but they see the name as they walk past the board....I do not know how the meetings are run but thanks for the info. Second ---I totally agree with all your points because I've asked the same thing about the non private rooms, ER and so forth and I have never gotten a good answer (from adminstration) about why those do not violate privacy acts but I did ask about the names on the board because a few years ago we ended up having to remove the boards from our ICU and it was explained to me by the powers that be just as I explained it here. So I dont totally get what makes one a violation and another thing not I was just answering based on what I was told by those in higher places. Once again I apoligize for anyone that I might have offended when I referred to AA...I was NOT attempting to offend and I guess it was a bad example to use.
  2. I understand why you'd think the way you do about anyone being able to call and ask if so and so is in the hospital but think about this situation. Mr X is here to visit Mrs X and as he is walking past the nurses desk and he notices the board says Mrs. XYPSOET is in room 404. Now the last name XYPSOET is not a common name and Mr X knows someone with that last name. He now knows that Mrs. XYPSOET is a patient where as before he did not know because he knows her from a AA meeting he attends but doesnt know her as a friend because they really arent friends....he just knows her....so yes....if its easily visible to people other than hospital personnel who have a right to know that info it is a violation.
  3. Kymmi

    Question regarding Humalog insulin

    My first comment is 555 is NOT normal for anyone. I understand that you are saying that 555 is what this patient usually runs but its apparent that her current insulin coverage isnt working. I would give the entire 6 units that is ordered before lunch as ordered. If it isnt given the way it is ordered then the MD needs to be aware and give a order to only adminster half and give it after lunch which I doubt he would do. If you have no orders to change the dose or the time then it must be given as ordered otherwise that is considered practicing medicine without a license which is a major violation and very risky to your nursing license. Now that I explained that part I would highly recommend someone contact the MD to let him know that the sugars are running very very dangerously high so that he can make adjustments to the insulin dosage. If the MD is not aware of the current trend of sugars and the insulin dosage isnt addressed I could see big time trouble heading for this patient...its only a matter of time until the patient goes into DKA. Also glucoses that high will effect the kidneys, cardiovascular system so even though your supervisior/instructor or whoever says that they are "normal" for that patient just remember they are NOT normal for anyone so they need to be addressed.
  4. Kymmi

    Vent about work

    Its been years and years since I've worked LTC so Im sure it has gotten alot worse since then but I do remember that there is a OMSBUDSMAN ?(spelling) number that you can call or anyone can call including family members to report unsafe or inadequately staffed facilities. Im also fairly sure it is annoymous. If you've gone to management and voiced your concerns and they do not seem to care and you truly feel it is unsafe I think that's what I'd do...make that phone call. Also if you are being asked to stay to finish work without getting paid for it then the Department of Labor would love to hear from you. Like I've said its been many years since I was in LTC and Im sure its not gotten better and Im also sure its gotten worse and will continue to get worse. I think the only hope is if nurses and CNA's begin to step up all over the country and start reporting unsafe practices but unfortunately that doesnt happen often enough...most are glad to have a job and do not want to risk losing it and others feel there is nothing they can do and they find another job and move on. I know our elderly are the ones suffering and I also know that if the time comes either of my parents need to be in LTC I will be one of those noisy family members that everyone complains about because that seems to be the only way to make sure that adminstration makes sure proper care is given. I know its not right but its a reality that in this day and age its all about who makes the most noise as to who gets the proper care. Management bends over backwards to make sure families think the facility is superb and the patients with no family or family that doesnt make themselves known are the ones left with minimal and/or inadequate care. I DO NOT blame the nursing staff for this because when there is only so much that can be done in a shift and most of the time management does not understand that because they have not attempted to do what they ask the staff to do so they are clueless as to just how much time and staff it takes to provide care to the patients.
  5. Kymmi

    Being Tired at work - How do you cope?

    If you are truly that exhausted all the time I'd be careful about chalking it all up to nightshift work. How are you on your days off? I know that for the past 2 years I've noticed I've been more and more tired even on my days off. There have been times that I'd literally sleep 24-36 hours straight only getting up one time or so to go to the bathroom. Times that I would sleep 10-14 hours and a hour after getting up I'd be needing a nap. I finally after several times of complaining to my primary MD went to a sleep specialist and had 2 sleep studies done which were abnormal. I did not have sleep apnea but I did have another sleep disorder which causes me to not go into the restoritive sleep stages no matter how long I slept and I also went into REM sleep very minimum. I started on Provigil and it has made such a huge difference in my life. I now feel refreshed when I am awake. If I do not take the medicine then I will sleep and sleep and not feel like I've slept at all. Its just a thought and Im not saying that that is what your problem is however it is worth looking into and getting a sleep study done to be sure there is not a underlying problem that is not related to nightshift.
  6. Kymmi

    Yelled at a patient

    SWS RN and Paul (I believe) I have to say dont worry about who's sitting there saying ***whatever about your witty remarks/comebacks to each other because I for one found comic relief in them and we can all use that. I must say Paul I did the same as SWS RN because I too was drinking iced tea and when I read the comment about continuing and Alzheimers I choked on my iced tea...I dont know why but I found that extremely funny. As far as handing out the AMA form I have no problems doing that to patients that are truly needing it. If I have a patient that is alert/oriented and able to make their own choices I do attempt to convince them to stay. I will remind them why they are here and what could happen if they leave and after that they are adults and can decide to do what they want to do. No one (other than the car salesman) ever begs me to stay so I can continue to annoy them. Sometimes I think that we as nurses attempt to feel responsible for everyone and everything and its those times that we have to remember we are not responsible and if someone choses to go AMA thats their choice just like the alcoholic or the drug addict that comes to us for treatment....we do our best to care for that patient and we hope that possibily we might be able to provide care and teach regarding the effects but if they choose to continue it is not our fault.
  7. Kymmi

    Yelled at a patient

    Ok Im agreeing along the same lines as SWS RN. Ive been in nursing for a long time so I would not have even done as much for this woman as you did. I would have explained to her once that the MD would be in to see her and at that time the MD would go over her test results. I would have informed her ONCE from a nursing standpoint what I was going to do as far as her plan of care was concerned. It is not within your scope to discuss test results with the patient...that is for the MD to explain and diagnosis with. If she continued to express that she doesnt understand why she has to be there or voice that no one will let her go I'd politely (of course) explain that she is not a prisoner and that no one is forcing her to be there. If she feels there is no reason to be there than she can sign the AMA papers and go on about her merry way. I'd of course ask her why she came to the hospital in the first place if she thought there was nothing wrong with her that required treatment. I would NOT give in to her attention seeking martry behavior. I wouldnt have called the insurance either. I would have told her to make the phone call...she apparently was capable of making phone calls and who knows that might have tied up her time with the insurance company and the doctors office would have gotten less phone calls from her. :) I know there are a lot of sick people that require our attention and care and I would never deprive anyone of that however I also will not force my care onto you. If you want to leave AMA or just cant understand why were "forcing" you to be here then leave but spare me the drama because I can better use my time to save someone's life. Just as there are very ill people there are also those people that seem to think they are dying constantly and really just like the drama and attention that goes along with being in the hospital.
  8. Kymmi

    Modifying tasks when pregnant. My boss says "no".

    I know I posted this info earlier in the thread but after reading the rest of the posts I want to restate what I said earlier. Light duty is given to employees that have had a on the job injury because it is better fiancinally for the hospital to have a employee sit at a desk and stare at a wall if necessary than be out on workers comp. Each time someone is out on workers comp that causes the employer's comp rates to go up so unless the employee is so injured on the job that they are unable to do anything other than lay in bed the employer will give light duty. This was explained to me by one of the MD's that we are required to see if injured on the job. If we are injured on the job we must see one of the hospital's workers comp MD not our own physician and that is because the workers comp MD will do what is best for the hospital so therefore unless the injury is so severe it requires complete bedrest the MD will write return to work on light duty. The case of injuries off the job or pregnancy is different because those reasons do not require the hospital to pay workers comp claims so therefore light duty is not offered to people injured off the job or for pregnancy. This policy is totally legal BUT if you are positive that people injured OFF the job have received light duty then you have a good case to inquire why they are given light duty yet you cannot. I'd say if you know and can prove it then I'd give your labor relations board a call and they will take it from there. If labor relations are called then they do investigate and they do it and get a answer back to you in a relatively short amount of time.
  9. Kymmi

    Modifying tasks when pregnant. My boss says "no".

    I can answer your question of why others are allowed light duty and you are told there is no light duty because I went thru this myself, was given a explanation and checked to be sure the explanation was legal. IF you are injured on the job and collecting workers comp. then the employer can assign light duty. They'd rather have someone sitting in a chair the entire shift doing nothing as to being at home collecting workers comp. because for each day paid out from workers comp. the hospital's workers comp. rates raise. It saves them more money on their workers comp. fees the less workers comp. they have to have paid out. IF you are NOT injured on the job then they are allowed to say there is no such thing as light duty and therefore you either need to be allowed to work per your job description or else take a LOA. Im not sure if your hospital would agree but I had my MD write I could perform all duties per my job description but could not work more than 2 days in a row. My employer allowed me to do that. Also I've seen others who's MD wrote they could only do 8 hour shifts and the hospital worked with that employee also.
  10. Kymmi

    Dr revoked DNR

    In the 4 days between when the MD revoked the DNR and the patient required intubation did anyone tell the patient that the MD revoked the DNR? If so did the patient agree with the MD decision to revoke it? Did the patient and the MD speak about the DNR issue and the patient possibily changed his mind? If the patient was alert/oriented and no one addressed the DNR status with the patient then thats where the first mistake lies. If the patient wished to remain a DNR after the MD revoked it then you would have had 4 days between then and the time of intubation to involve the ethics committee which is what I would have done. Sometimes these issues come up quickly however it seems there was a 4 day window to clear this up unless no one bothered to inform the patient that the MD revoked his DNR against patients wishes. If that is the case then I'd say someone missed the boat on the chance to do what the patient desired.
  11. Kymmi

    How visible are your patients in your ICU?

    Let me see if I understand this right....are you saying you are the ONLY person working in a 3 bed ICU? If thats what I understand then I think you have bigger concerns than if you can see your patients. To answer your question I work in a 8 bed CVICU and we cannot see all of our patient rooms from the main desk but we have pods between every two rooms where we sit and we can view both rooms from one pod.
  12. Kymmi

    Hospital changes attendance policy

    I do believe most hospitals count it as one absence for each call in. So if you are sick and need to be out 2+ days that is only one absence and one point..NOT one point for each day missed. If you break it down and lets say you can be off 7 absences in a rolling year. That works out to one absence every 2 months with 1 left over. You work 24 shifts every 2 months therefore if you call in more than once every 24 shifts there is a problem....if it is due to a chronic illness than whoever talked about FMLA has a great point because FMLA does cover you however I feel if you do not have a chronic illness which prevents you from going to work if you are consistently unreliable less than 23 days out of 60 days then it should be a issue. Lorelei, Why was she terminated if she took a pain pill on one of her days off?
  13. Med-Surg or any floor nursing. I also could not work burn unit. I'd love to do psych nursing but have NO psych experience. I've been ICU/CVICU for so long that I do not know if any psych unit would train me but I've thought about looking into it.
  14. Kymmi

    RN stealing from my facility

    I can't understand why management would talk badly about and accuse employees of any wrong doing to other employees. That is just bad management and I could see where that could set the facility up for a slander lawsuit. I can understand why management doesn't terminate employees based on what the management thinks is happening but can't prove it. The management/facility must be able to provide proof of stealing or wrong doing before terminating otherwise once again they would be setting themselves up for a law suit.
  15. Kymmi

    H1N1 will you be giving the vaccine?

    I will get the H1N1 vaccine but only because I pretty much HAVE to take it or else wear a mask the entire 12 hour shift (as soon as we enter the unit until the time we leave) from Oct 15th to March 31st.
  16. Out of curosity why do you not want to interview?
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