grannyNan

One of my favorite evacuation procedures is the 5 H enema. High, Hot, Hellva lot, Hold it til it hurts!!! It really does wonders for those who can tolerate it.

Yes, I agree it is nicely written. However the nurse in me wonders if anyone ever really stood up for this patient? She had a living will which is a legal document that was ignored by the family, nursing and the medical staff. Does this facility not have an ethics committee or a risk management department? Were they not concerned about the legal issues the other family members could raise such as assault charges on the staff? The author only speaks of the one daugheter but clearly there are other family members involved. We as nurses must stand up for the patient especially when they cannot protect themselves from harm, and let's make no mistake that harm did occur here. Sometimes being a patient's advocate means you stand a hard fast line against those who would do harm to those whose care we have been entrusted to. I commend the author for her caretaking abilities as the life of this woman slipped away. The bigger problem is why do we fear death so? Why do we in the medical field feel we have failed when our patients die? We say things like we lost her or she expired, like we could have renewed her life if only we had sent the payment on time. The health care system is what ultimatelty failed this woman and the author. We have built up expectations that we can not live up to. Life and death is not really in our hands as much as we like to think it is, we are only instruments used by whatever higher being you belive in. Let's face it all of us have a limited time on this earth we should accept death as we except birth, a part of life.

What people really want, RNs, LPNs and CNAs alike, is for those who are performing below the standard to grow up and act responsible. No matter how much education you give a person it is ultimately their choice as to how they will act in any given situation. CNAs are a valuable member of the team but we all have to work as a team.

Salem Hospital with a "great reputation?" As a nurse and a former patient there I would seriously disagree with you! Salem Hospital is currently undergoing a mass exodus of staff due to management issues. The reason there pay is higher is because the cannot keep competent. I would look at Silverton Hosptial :yeah:or Santiam :yeah:if you choose the Salem area. As for Eugene if you are into the hippy drug culture that is the capital as far as I am concerned just one trip the the yearly "Country Fair" will explain what I mean. Gangs in Salem are no worse than anywhere else in the country. Meth is and always will be a problem anywhere you go but it is slowing down. Sacred Heart in Eugene is a nice facility and I have been impressed with their nurses. There is also McKenzie Willamette :yeah:in Springfield. If you want somewhere inbetween try Lebanon:yeah:, Albany :yeah:or Corvallis:yeah:. They are all owned by Samaratin Health services.

In Oregon CNA's are certified by the state most of them are trained in long term care. When they come to us in acute care we have to add to their training. The cool thing is Oregon has developed a program that allows CNA's to gain more education in effect creating a second level of certification. They have developed programs for restorative aides, acute care, and are developing programs in dememtia care and mental health. CNA's are a valuable asset to healthcare but they are not the same as a nurse nor do they have the same insights as nurses. The CNA's at our hospital are some of the best around but we have been very picky about who we choose. Just like anything else hospital life is not for everyone.

You are responsible for supervision of the CNA but, they can be held accountable for the care they give or don't give too. Every month our board of nursing posts discipline actions taken against both RN's and CNA's for not doing their jobs.

Maybe more so with IV's that needed to be checked and people staying longer and they have always wanted things NOW! Patients will always be demanding. It's the nature of the beast.

Often in our area the patient demands to be induced either because of social reasons(my mom came from over the hill, or my favorite Dad is scheduled to go to jail for 6 weeks) or they are tired of being pregnant. I understand being tired but the baby will do better and so will you if we don't rip them out before their time.

At the risk of sounding like a relic. In the days before IV pumps and vital sign monitors we did hourly rounds and without the benefits of a unit secretary or respiratory therapy or computers and if you worked nightshift or weekends no pharmacist. It can be done and done well you need to be organized and think ahead about what your patients may need. I do my meds and assessments on my most critical patients first then prioritize the rest of the group. I don't use a canned phrase but I always end with "is there anything I can get for you before I leave?", or something to that effect. I encourage the patient to call if they need something before I get back, otherwise I will see them soon. I also do my charting in the room with the portable computer. Hourly rounding is more critical thinking than task oriented and you don't have to disturb a patient with a long conversation each time you enter. Think about how you can make it work for you. I think you will be surprised.

You are correct in that it is a HIPPA violation and could be punished by a fine for the nurse and the hospital. You must have the patient's or in this case the parents written consent to photograph. Just because it was done in the past is no excuse. I would speak to your charge nurse and maybe even risk management.

Suezeekay What areas in nursing do you have experience in and what are you willing to learn? Our small (40 bed) not for profit community acute care hospital is always looking for hardworking, interesting people who are not afraid of challenges. We offer a competitive wage and benefits, plus the added bonus of living in the Willamette Valley. If you are still interested email me at [email protected] and I will tell you more. grannynan

Are you in Oregon? If so find a CNA-2 Acute care class and take it!! This is specialized training for acute care nursing. This is new so check with the board of nursing for approved classes. The neat part is this is recognized throughout the state.

Jules I don't know what state you are working in, but you had better check with the board of nursing before you discontinue IV's and catheters. As a general rule these are not part of the approved tasks CNA's are allowed to perform even if the hospital tells you it is. Very often CNA's are given tasks that they are not really supposed to be completing because not all nurses really know what the approved tasks are. If the board of nursing gives their blessing then go for it!! By the way I would just visit the web site of your board of nursing to see if you can find the answer.

I applaud your efforts but the decision to "press charges" is strictly up to the DA. Legislation will likey not change because the DA's will argue that they are already overwhelmed with crimminal cases and could not possibly prosicute and win. I agree you should always report it to the police and your facility. I wish I could give you a better answer.

Once years ago I saved a baby from the toilet! I was fairly new to L&D and was silly enought to let the mom go to the bathroom to poo with out checking to see how far she was dilated. I heard a scream and rushed into the bathroom to find mom squatting on the toilet with a head hanging out. The rest is shall we say history! Don't let moms go to the bathroom to poo unless I have checked them now. Learned that lesson well. Also I have delivered a baby in our hospital parking lot late at night and I got to deliver a nephew because the OB didn't believe me when I said "if you break my sister's water we will have a baby in a few minutes" He broke it and went to his office across the street and just got in the door when the nurse called him and said we were delivering!