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purple1953reading

purple1953reading

ER OB NICU
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purple1953reading specializes in ER OB NICU.

purple1953reading's Latest Activity

  1. purple1953reading

    Med-error & down n the dumps

    Sounds like the familly saw BIG DOLLAR SIGNS. The hospital writing off a bill was , in reality, probably, ONLY the part that the family would have been responsible for, and if that patient had Medicare and a supplement, was NOTHING> I was charging ICU and we had a longtime nurse on Step down, who was throwing a big fit about me being in charge and she had been a nurse for 40 years, yadadada. I was on to charge, (as I almost always did) but took care of HER patients, just so as to keep them up to date. Administration stepped in when she said if she had to take the step down patients she was walking out, and said that was up to her, BUT I got moved back to charge in the unit, and her two patients. This is a person WHO always took only vent patients, or comatose patients, as she did NOTHING all day, but charted up a storm( another story) so when I got her patients, I went in with meds, and was told by the coherent patients "IT was nice to get her own meds for a change" Evidently this nurse had given the wrong meds twice to this patient, then went back and gave her her own on two previous days. The roommate had no clue what she took, and just took what was offered. IT IS AMAZING to me that patients have NO IDEA what meds they take, and would not question receiving a handful of different meds then they were accustomed to getting. That is why is it so important for us to give them the meds with the name of the med, and the reason they are taking it. I might do this a couple of times and then ask patients to tell me which is which and why, just a way of educating them. THEY NEED TO KNOW the names of the meds and WHY they are taking them. People who don't will take the wrong meds. Just as a source of support, I worked with a prnRN who went on to become a travel RN (Always wonder how) and she would come on at 7pm and go to the med room and MARK ALL meds for the shift on EVERY patient she had to pass off as given. (with the appropriate times) DID She give any ? WHO KNOWS, maybe if she wasn't asleep in the bathrrom, where she spent most nights, as she also worked fulltime as a home health and nursing home nurse. I did report her, and the DON said "WE don't know that for sure" and I told her I JUST TOLD YOU IT always amazes me that the people who own up to their mistakes, or report others for gross negligence, are the ones who seem to suffer. I would bet that you will be very diligent about checking now, and have learned from this. I don't even understand how you can get a final warning if there is no pre warnings, as it usually is a third deal type thing. This will blow over, and they should be proud of you for owning up to the mistake rather than covering it up
  2. purple1953reading

    your first....

    No scrubs here, just WHITE ONLY UNIFORMS
  3. purple1953reading

    I need CN advice!!!

    Perhaps,it IS the years of experience speaking, when others don't seem interested. Along with years of nursing experience, and skills, many look at other types of qualifications, including the personal, administrative, how you interact with those you are working with now, whether your co workers have lots of respect for you and trust you to make a splitsecond decision in a life or death situation. Even your personality, whether you handle things effectively in a calm manner, or become flustered as things go wrong. IF I were questioning my ability or whether or not I should apply, I definitely woud NOT do so. GIVE yourself time to be SURE you are the one for the job. There will always be another position opening up. CN wear out easily, and often with the administrative worries, long to go back to floor nursing.
  4. purple1953reading

    Rn or LPN Help

    At most associate or jr. colleges, the program is two years, in our state, and after the first year, you can take LPN boards, and then the second year, qualifies for the RN boards. GOOD LUCK
  5. purple1953reading

    Multiples for Media Attention and Community Help?

    I think many of these families exploit their kids, and would NOT turn down any help as they WANT the attention, and the free stuff. The Iowa Septuplets, were born to nice parents, BUT they did get a new house, Provided by the city where they live from materials to construction all donated, the church family provided the in home help, WHICH we admit anybody would need help with that many babies around the clock. They also got free college educations at birth for all seven. NO qualifiying there, just given to them. A big 15 passenger van , that was for at least 3 years,I think.BUT the father quit his job, and then months later became a so called professional speaker, and talkes to groups about raising multiples. IN addition, the state picked up their medical bills from birth on. His work provided their insurance, but remember he quit as he was now a expert on something . Also, they have a contract with Journal magazine, where they do Christmas issues, and I don't know what else for so many more years yet to come. Read a big article in the Des Moines paper, where they were offered many contract with many companies for the pics, they picked the one they wanted. Also got free baby food, from Gerber for a couple of years, Diapers for two years, clothes from Carter for two years and the list goes on and on. IT makes me angry, that YES THEY almost all took fertility drugs, and chose this life for themselves, and then expect everybody to be amazed and wowed. I have 5 kids, never had anything free, esp. college educations they did not have to earn, and I LOVE them every bit as much as the parents of multiples, and wishe they could have had all the things provided to the parents of these MEDICAL WONDERS> IF they were natural, and truly extraordinary, that might be different. They did a documentary a few years back about which parents and what number of babies it took to get FREE RIDE. At that time, quads were no longer in demand, and there was one set of black quads, that had never been offered anything, used own health ins, from job, moved back to small apartment, had to apply for food stamps or something. It did not necesarrily inspire pity in me for them, as WHY , should people expect us to pick up the tab for their kids, but it did illustrate that the criteria stinks. Sorry pet peeve of mine. But it does not extend to just the parents of multiples, goes for the single moms, who never marry, yet have kid after kid, and milk the system for all the free stuff, Wick, Medicaid, FoOd stamps, HUD, etc. My niece fits here with three of her own, and told me recently that she would work a few more hours a week, but then they would take more of her money towards HUD and give her less Food stamps, etc, and I just looked at her and said WELCOME TO THE REAL WORLD As for Jon and KAte, makes you wonder how long this will last. MYfavorite, the time the wife of plastic surgeon, got her husband to donate free surgery, and then the make over. PLUS they are making a fortune on each episode, as they each get a salary for each of them for each episode. Wonder how much is being banked for each of the kids . I watched the one at the grocery where she spends $600 or so week.ly on ALL HEALTHY NATURAL food, no frozen, or processed for HER kids, and thought if you were not on TV then you sure would not have that choice, as his job does not provide that kind of money. There was another about the kids where Dad lost his job andhealth ins, andhad to rush to have surgery done on two of the kids the day before. And on the other hand, once they quit being a cute age, they seem to fall off the face of the earth and all the free stuff ends, so don't know if the kids are prepared for that psychologically or not. OH well, enough of my griping.
  6. purple1953reading

    Are we adequately treating pain?

    Not only are people undermedicated, they are not properly medicated. Years ago, almost every patient had orders written for fever, pain, and pain not controlled by the first choice of drugs , i.e., Tylenol #3 , two tabs q 3-4 hours, prn pain, If not controlled by T3, may give Demerol 50 mg IM q4hrs prn. In addition, EVERY patient needs to be medicated for that acute pain due to trauma, that is not part of their chronic pain. Also, many meds don't work for some patients like they do others. Morphine, for example,has no effect on me. I found this out after a TKR, and was told the PCA was all I HAD. Most patients prefer Percocet or a oxycodone based med, then Codeine, or hydrocodone. We all know it is now the most abused drug, but , in addition to controlling pain, that drug also has an UPPER effect, where the patient FEELS BETTER, in additon to pain control that does not come with Vicodin. I prefer Vicodin, as I don't like the out of control feeling. BUT NO MATTER we MUST not let our patients lay there and cry and scream in pain. IT IS RIDICULOUS, and why should they be in a hospital, if it is not to be helped. I believe that as the advocate, we do everyting we can for our patients, but unless medical staff cooperates, we are often at a loss. Too many drs. are now afraid to prescribe adequate pain meds. IT is funny how if a dr has experienced the same type pain he is treating, the difference in the amount of pain control he offers his patients.
  7. purple1953reading

    Can you be a Lactation Consultant but not RN?

    Here our lactation consu. is a young first time mom, just gave birth to second baby. She is not an RN> I know that many people get their pumps from county health dept. Why not contact yours, and see if they are interested. T
  8. purple1953reading

    Mary Jane Crocs

    Best crocs , at least till the sheeplined ones came out. T
  9. purple1953reading

    Needing to vent R/T attendance policy vs chronic illnesses

    Although it is correct , that your employer must still provide you with your benefits like health and life ins. it is also true that you have to pay for them. WE had to send a check every week for our part, that was normally taken out of the check before we get it. IF you use it intermittently, I wonder how that works, or if they don't bother to collect. I know we also had to pay for three weeks, before H. collected his shortterm disability payments. and even then we did not receive the payments until he had been off for 7 weeks, and the first was for weeks 4-7. SO you have to be prepared to pay for a few things to keep them up. We we told that they can CHOOSE to keep you on should you exceed twelve weeks, but don't have to do so. Also, be very careful not to use more than the twelve weeks, as then he had to wait a year to use them again. So, I don't see how that works if used intermittently. Perhaps it is different in each state. The FMLA rights should be posted in a common area, maybe by the tmeclock, or lockers, etc. Get the number and call if you have questions .
  10. purple1953reading

    Assertiveness, Important or not?

    I am very assertive , but am also very respectful, of people's feelings, space, etc. I have always worked as a supervisor, and it comes with the territory. As said previously, to not be mildly assertive lets everyone else take advantage of your good nature, inability to say no, etc. I rarely raise my voice, but have been told the look in my eyes says it all. I can only remember once in the past 5 years, I was aggravated enough to raise my voice, (as aggravation comes with the territory) and I had listened to the same old sob story by the same aide, who worked herself to death to pay for and feed a 100 year old horse she had had as a child, and a worthless drug addicted, alcoholic, non working 38 year old son, who never said THANKS MOM
  11. purple1953reading

    Needing to vent R/T attendance policy vs chronic illnesses

    Last year, my husband broke his titia and had a rod put in. He was paid short term disablity after 2 weeks. His FMLA , however, had to be started the first day, the day he had surgery. He was released to go back to work in a boot, about 3 weeks before the last day of his FMLA. BUT when he got to work, they told him that he could NOT work in the boot, and refused to put him on light duty. ALTHOUGH Anyway , had the brace made, this was two days before christas and there was a weekend, and then he had to be back by Jan 2. SO my GP called a trauma OS surgeon at the university hosp got him an appt on 12-30-06, and HE signed off for him to go to work, on Jan 2. WHen the dept of labor called the plant they kept saying the dr. had rescinded but when she talked to us and found out they called the dr. which is illegal for them to do, she asked HR WHY and they said they had a new note, she asked that they fax it and waited and waited but they never did, so she said if they kept him from going back to work, we could sue and they would help. IN additon husb was 60 so it was senior discriination. ANYWAY plant dropped their no return (and we found out they had already prevented over 12 of the longer employed guys returning to work) and when he went back the plant manager came to him and said " Glad to see you made it back. Congratulations" The lines gave me a standing ovation as nobody that they had taken FMLA had got to come back. JUst a story to show that you may have to go farther than so far. This plant has a no abscence policy. BUT they have a built in earned bank hours, where they earn so many based on how many hours they work (about 50-60 a year) and if they need a day off they take bank hours and get no demirits or whatever, but they do not get paid for those hours, they just don't get punished. BUT if they don't use them , they can carry them forward or add to christmas bonus. I would think that hospitals would know that people get sick, they are seen in the ER of the place they work, they use drs. that work there, and any time I was ill, I always had a doctors note. Usually, I would call somebody who was off, and try to change days, as they make it so unpleasant if you are ill. EXCEPT for those who have babies. They also do not have to guarantee you the same job, just a similar while on FMLA, and if they do decide to let you come back and you took prolonged FMLA, then they can give you what ever job. Use all the dept. at your disposal. I keep copies of my excuses from drs. and I would present them all together. \If you don't stick up for yourself, nobody else will. Search the topics, look up your policy, look through the sites offered, and remember there are other dept to help also. Follow the rules exactly, so nobody can come back on you. Be careful. Thousands of people call in everyday. Why they pick a few to pound on is beyond me. Good luck, I know what it is to have to have the job to have family insurance.
  12. purple1953reading

    Call me crazy... but..

    I would never apologize, for being ahead of the game, sure of myself, and prepared. I , too, am like that. I went through school at the top of my class, and was the one that everybody said "You don't have to get straight As to be a good nurse" about, because, in their own security, they wanted to say something to imply I was wrong, but in reality, I wasn't. THey posted our grades by SS and after the first 3 weeks, I changed mine, because somebody was so insecure, they would see my number at the top for each post, and always say:" Of course, that must be T", the first time I picked a number that turned out to be the same as somebody else, and I got 100 and she got 80, but she saw her number at the top of the list and thought she got a 100, so I had to look for a new number. Every one will make remarks about you, like SHE must spend all her time studying. SHE doesn't have a life. ETC Best of luck, and enjoy learning.
  13. purple1953reading

    What can we do to change this to prevent errors?

    I would much rather spend my time taking care of my patients , giving the right meds, expected and ordered cares and treatments, than looking for other people's mistakes. BUT I do check my meds, and in fact , the protocol to prevent med errors is in place for this to happen. The chart check s for 24 hours against the new mars and 24 hours orders help prevent many errors. Those of us who have been in nursing , or worked in small rural hospitals where WE basically are the pharmacist who mixes the meds, know how far we have come with just unit dosing. We used to get a 3 day total dose of a med in bottle, if it were dc'd prior to that time we threw it in the box for pharmacy. This led to much borrowing, if a patient came in that needed the same med, and it would not come from pharmacy for awhile or was not allowed in the "stock"meds that we were allowed to care, Also led to lots of mistakes, patients were charged for the 3 days worth, and then what was used(or just gone) from the bottle was still charged to the patient when returned to the pharmacy. If there were any left, appropriate credits were made. (many times to the wrong patient. All of us develop our own system of checking our meds, to organinzing our days, to prioritizing(within guidelines) and yes I have taken care of 12 patients.In addition, I have learned through the years, just because it is charted or initialed, it is not necessarily done. Like others, I too have seen too many just signe their names, and not really look, whether it be hang blood, checking pcas, etc. Not to be cliche, but the panic diminishes, the mistakes lessen, and your sense of confidence increases, and with this everything starts to fall into place, and although the days are still too short and the duties too long, we become accomplished nurses, who tend to our patients with educated skill, knowledge, and security. Along with all this comes the ability to recognize when we are in over our heads, and when to compromise to refuse assignments that are beyond our scope of practice, I wil continue to check my meds, wash my hands, and wear gloves. I will continue my detailed notes, keeping up on all that is going on on my pts, and those I supervise. IT is who I am, and the way I see myself as a nurse. I manage 5 kids at home, 3 who are 14, 16 and 17, and find that much more difficult and mentally tiring.
  14. purple1953reading

    Study Habits

    I am one of those you don't want to like, but everybody wants for a partner in class. I graduated at the top of my class, made the first As on essay tests, for those missed while in the hospital,and really did not ever open a book. I listened, asked questons if I did not understand, and if I reviewed for tests, I went through the material, eliminating all I already knew, concetrating on a much reduced size notes to learn what I did not know. I also think comprehension not memorization is the key, esp when psych, and some of the specialities come into play. One of my instructors once asked me"Why are you here, you coud be the next famous dr." Did not want to ,wanted to simply be the best nurse I could be. I do think that getting this basis and understanding carries forward through the year of school, and when it come to NCLEX, it is automatic. Took 75 questions in less than20 minutes, walked out, never looked back. BUT IT WAS EASY for me, and it is not always, MY niece, studied hours on hours, for her BSN, and took all 265 questions, but did pass,almost ran out of time though. 2 people,2 different ways, same outcome.
  15. purple1953reading

    Silliest thing you ever did after a long shift...

    A night supervisor, fell asleep in the middle of giving me report. SHe had a 40 minute drive home.You have to wonder.
  16. purple1953reading

    What can we do to change this to prevent errors?

    I think at this point, we have to realize, that WE ARE responsible for giving the right med, at the right dose, at the right time. That is one of the responsibilities of being a nurse, and though time constraints are felt by all of us, we simply have to take the time to check them and to it right. Several years ago, I got called in to a busy L&D unit, where they had floated a RN from med surg, who had previously only worked oncology, and when I got there, she had just mixed enough MAG Sulfate to KILL the mom and baby, and was one step from hanging it!!! PLUS I would never give a med mixed or obtained by another nurse, not because I do not trust my fellow workers, but BECAUSE I AM RESPONSIBLE for giving the med, and checking it. As house supervisor,I was making rounds, and walked in on Morphine Drip, that had been mixed by the pharmacist, by adding ms to a reg. bag of IV fluids, "because he thought it was going to cost too much to use an enclosed, premixed system" like the PCA and it was hanging through a reg. IVAC pump. OF course, I immediately pulled that drip, though no nurse had made note of it from the present or previous shifts. THEN spend too much of my time, having to write up that incident report, try to count and account for the amount still missing, and wasting the rest of the 1000 cc bag of MS. Relying on somebody else or some other entity I don't think will help. We have all the charts, books , checks in place, we just have to do it. Granted, we are thrown every obstacle that exists from too short on staffing,to pharmacists making mistakes before we get the meds. I always check new meds against the new orders, when I receive them, I even have been the one to point out to the nurse who brought me meds as a patient that she was giving the wrong meds to me. This is just a priority for me, and I hope for all nurses.