cjcerrn

I find it a little strange that you would receive a Post-Op patient. I do occassional Nursing Supervison for my hospital and I know it takes nothing short of an act of Congress to be put on diversion. Once we are in that status, ALL non-emergent surgeries must be cancelled and rescheduled. After all, if you can't take care of what you have, why voluntarily bring in more. This is part of the reason it takes approval from the CEO to go on diversion...loss of revenue from elective procedures.

In our hospital, ALL insulin is double-checked as a high alert medication. Both nurses are to visualize the order (to assure the right orders are followed), the insulin bottle (to assure the right type of insulin), and the amount drawn up. The double check ends when all of these are verified for Subcut meds. But for IV meds, the verifying nurse must accompany the delivery nurse to the bedisde to watch it given. Especially for IV drips, both nurses must be present to adjust the infusion device. This is the same mechanism for all of our high alert medications. And mistakes still happen. Don't beat yourself up. Learn by this.

Check your signed Consents for Treatment- the form all patients have to sign regardless of their inpatient/outpatient status. Ours includes consenting to the video-taping. This is a whole different ballgame than publishing the film.

As I tend to agree on many levels to your comments, I find it difficult to pin everyone's health and/or health problems on their behavior. Having recently been in a two car collision in which the other driver t-boned me, had nothing to do with my behavior. ($8002 for the Trauma Room, alone, not counting the cost of other testing!) As far as the chronic illnesses which can be directly attributed to a poor choice in personal behaviors, what is your solution? Most of the same people who cannot afford insurance are the ones who partake in these. Do we level more regressive "sin taxes"? And that person with COPD might very well have the problem from living next to a factory which emits toxic smoke. Do we penalize the industry or the person because of his residence? Which os more fair and equitable? My point in not being terribly happy with the proposed insurance plan is that I MUST, under penalty of extra taxation, pay for a servie I can guarantee I will never use. Taling about reducing the actual cost of healthcare is a totally different conversation.

"The new healthcare law will pack 32 million newly insured people into emergency rooms already crammed beyond capacity, according to experts on healthcare facilities. A chief aim of the new healthcare law was to take the pressure off emergency rooms by mandating that people have insurance coverage. The idea was that if people have insurance, they will go to a doctor rather than putting off care until they faced an emergency. From http://thehill.com/business-a-lobbying/98025-health-reform-threatens-to-overwhelm-already-crammed-emergency-rooms People who build hospitals, however, say newly insured people will still go to emergency rooms for primary care because they don’t have a doctor. “Everybody expected that one of the initial impacts of reform would be less pressure on emergency departments; it’s going to be exactly the opposite over the next four to eight years,” said Rich Dallam, a healthcare partner at the architectural firm NBBJ, which designs healthcare facilities." This is just the first list on the Google search of over 53 thousand articles that dispute the fact that ED visits will go down with Obamacare. Physicians, for a large part, have said they will not accept patients on Meicare and Medicaid, with good reason. The reimbursement for services by these agencies do not start to cover the cost of that service. Insurance coverage is truly a good step in the right direction for people seeking healthcare, but if this coverage is so good, why are so many companies being given waivers? If you want to fix insurance, start by offering carte-blanche services. After all, why should I be expected to pay for an insurance policy which covers pregnancy when I had a hysterecotmy 20 years ago. Let me pick and choose the services I want and charge based on the selections I have made. If a healthy individual wants to buy only catastrophic insurance, so be it. He is covered for that snowmobile accident but doesn't have to pay for anti-hypertensives he would have to under the mandates of a government sponsored insurance. Just my opinion.

UK_cats_rule... After reading this thread for days, I am not sure that anyone said that there were not drug-seekers in healthcare. The point is, how well do you know the patient's full history? Does the patient have an addictive personality? You know, this can lead to seeking behaviors of many sorts. What about his full medical history? Does he have chronic pain? This certainly can effect his tolerance of medications. As nurses, we tell the patient to know their bodies and their health. Who better to know what does work, and what doesn't? Are you willing to try to give Toradol to a patient that has an allergy to prove that they really do have that allergy? After having worked in the ED for years, I acknoledge that there are drug seekers...Just like there are stoic people who infarct and do not complain. Maybe that is why I try not to question what they are telling me. But I agree, that we ought to give the same respect to the nurse who works beside us...I try not to queestion her judgment either.

After attending a pain seminar a couple of years back, it was pointed out to me that chronic and acute pain are two totally separate entities. Chronic pain suffers undergo pathophysiologic changes that not only changes the type and perception of pain, but due to the changing of the pathways, areas of pain actually increase. But the saddest thing I learned was the fact that many of these chronic pain sufferers would not be in the shape they are in if effective management of pain had taken place at the acute phase. So when you think about chronic pain, take a good look at yourself in the mirror, and make sure you didn't contribute to that suffering by assuming that they really didn't need that pain med.

I just called the nurse on the IV team here that is certified to insert and work with PICC's. She states that it is not recommended, but not contraindicated if that is the last alternative. The fear is in fracturing the PICC line, but this is a moot point in case of emergency.

rags...... I have to agree with you on that. The entry level has not made a difference in my career, nor do I think it makes me a more proficient nurse. I have lots of letters after my name, and the thing that the patient cares about is the care that I give to them on a daily basis. It is rare that a patient even askes what they all mean. I have found that many of the nurses that have taught me things in regard to nursing care, are the ones that are on the frontline, handling patient issues and care with great success, and have the time invested in learning the art of nursing. As for Larry King.....If his favorite topic is the father of Anna Nicole's baby, are we sure that we want to be there?

If everyone is so concerned that they need an airway to educate the public regarding nursing issues, then why not merely buy a spot on the cable channels that are open to anyone? That way you can be assured that the things that you want said and heard are truly the ones that are broadcast. You can utilize the newest of the new nurses, as well as the veterans, to assure all points of view are heard. Why wait until an "Oprah" deems it an appropriate time? We are talking about everyday issues that seem to confound us all....not some sort of sensationalism that sells TV ads. CJ, RN BSN CEN CCRN Clinical Staff Educator

DOes anyone know if there is any testing of the use of Sucrose in colic? We are tying to see if it could be effective in treatment in the ED.