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sistrmoon ASN, RN

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sistrmoon has 14 years experience as a ASN, RN and specializes in Oncology.

sistrmoon's Latest Activity

  1. sistrmoon

    Why are you an oncology nurse?

    I’ve been an Onc nurse for 13 years, the whole time I’ve been a nurse. I was lucky enough to have an Onc rotation as a student, and I knew that’s what I wanted to do. The patients are incredibly acute, and I agree with the previous poster, you have to be on your toes. These patients can turn on a dime, seem fine one minute, and then quickly take a turn for the worse. You need to be excellent at recognizing early signs of infection and really advocating for further diagnostics if you feel it’s warranted. Chemo can be overwhelming but you’re often doing the same few protocols and you become very familiar with the precautions/side effects for each drug. You usually don’t see the crazy adverse effects (like neurotoxicity) but a few times you do, and you never forget it. I personally love end of life care, but it can be emotionally exhausting helping patients and families who are struggling with when to stop treatment, stop invasive interventions, and accept death. But when you’ve seen a patient suffering for weeks and they are made comfort care, and you get them all sorted, the family looks relieved, their pain is eased, It is truly rewarding. Best wishes to you! It is not a boring specialty and you are constantly learning, but it can take a mental toll on you over time. When we have a series of young people with families die, I do ponder possibly pursuing something else. Emily
  2. sistrmoon

    Vocera Easter Eggs

    Try “I need a hug.” It May be the same response as I’m having a bad day. I haven’t tried that one.
  3. sistrmoon

    TB testing 2020, good riddance?

    We usually test annually but this year I was told there was a shortage of the tuberculin, so those not working in high risk areas were deferred. Very interesting that it’s not recommended anymore.
  4. sistrmoon

    Patient threat and HIPAA

    So I wondered if this counted as an actual crime(threatening to harm) and my attorney husband said probably not. I guess probably after the manager blew him/her off next step would be our security, maybe the manager's boss and/or HR? But the pt said someone would be waiting when the nurse got out of work so were it me, I wouldn't be wasting a bunch of time. And sorry to any hospital security folks out there but one escorting me out and maybe encountering a gang person wouldn't really make me feel protected.
  5. sistrmoon

    Patient threat and HIPAA

    "45 CFR § 164.512 Uses and disclosures for which an authorization or opportunity to agree or object is not required... (2) Permitted disclosures: Limited information for identification and location purposes. Except for disclosures required by law as permitted by paragraph (f)(1) of this section, a covered entity may disclose protected health information in response to a law enforcement official's request for such information for the purpose of identifying or locating a suspect, fugitive, material witness, or missing person, provided that: (i) The covered entity may disclose only the following information: (A) Name and address; (B) Date and place of birth; © Social security number; (D) ABO blood type and rh factor; (E) Type of injury; (F) Date and time of treatment; (G) Date and time of death, if applicable; and (H) A description of distinguishing physical characteristics, including height, weight, gender, race, hair and eye color, presence or absence of facial hair (beard or moustache), scars, and tattoos. (5) Permitted disclosure: Crime on premises. A covered entity may disclose to a law enforcement official protected health information that the covered entity believes in good faith constitutes evidence of criminal conduct that occurred on the premises of the covered entity."
  6. sistrmoon

    Patient threat and HIPAA

    "© Acknowledging the presence of patients: Responding to requests. (1) The presence of an identified patient in a facility or component of a facility which is publicly identified as a place where only alcohol or drug abuse diagnosis, treatment, or referral is provided may be acknowledged only if the patient's written consent is obtained in accordance with subpart C of these regulations or if an authorizing court order is entered in accordance with subpart E of these regulations. The regulations permit acknowledgement of the presence of an identified patient in a facility or part of a facility if the facility is not publicly identified as only an alcohol or drug abuse diagnosis, treatment or referral facility, and if the acknowledgement does not reveal that the patient is an alcohol or drug abuser."
  7. sistrmoon

    Patient threat and HIPAA

    Well, she shared the patient's name and that he was there. I've always been told any identifying information at all even without names was subject to it. I had the same reaction as you, but another person aware of the situation said she should be fired(wow.) and that if she had called the police directly, it wouldn't have violated it. I'll post the parts I found that were pertinent.
  8. sistrmoon

    Patient threat and HIPAA

    Based on a true story but I'll try to vague it up. Patient gets angry at a nurse, threatens his/her life(specific believable threat. Calls gang friend on phone and describes nurse.) Nurse is freaked out, talks to manager, manager says she/he doesn't think the patient is serious, does nothing. Nurse calls their(the nurse's) family member. Family member calls police. Police had warrants anyway for past violent crime, come and arrest him. Did the nurse violate HIPAA in this situation?
  9. sistrmoon

    Do you disconnect lipids from TPN when complete

    From cdc's recommendations: "Replace tubing used to administer blood, blood products, or fat emulsions (those combined with amino acids and glucose in a 3-in-1 admixture or infused separately) within 24 hours of initiating the infusion [182–185]. Category IB" That's from 2011, maybe I'm missing a more recent doc that addresses it. Same doc says no rec can be made regarding how often to change port needles, which is interesting.
  10. sistrmoon

    Do you disconnect lipids from TPN when complete

    The lipids are connected into the tpn tubing so it would all be discarded at the 24 hour mark anyway. The lipids are not connected with a normal leur lock connection that is easily disconnected. It often takes clamps and then you have to use a cap creatively on the tpn tubing to close the system. I'll see if I can find a picture. I guess my point is if the lipids do not grow bacteria faster, why remove them as you're opening the line up and it doesn't seem designed to be removed anyway.
  11. sistrmoon

    Patient to nurse ratios

    I work nights, we typically have 4-6 patients. I've never had more than 6 at this hospital but at my prior hospital we took up to 8 and it was awful.
  12. sistrmoon

    Nurses turn to pet therapy

    Kubla Khan: Tasha: Puddy: And in Memorium, my beautiful Sterling I had 14 years, who I lost in May to cancer:
  13. sistrmoon

    This week, I learned (7/18).....

    That we have a bed bug protocol and it involves some nifty looking suits.
  14. sistrmoon

    Do you disconnect lipids from TPN when complete

    Faster rate of bacterial growth than the TPN?
  15. When you have 24 hour TPN running with a 10 hour bag of lipids, do you disconnect the lipid bag/line or not when it's completed? Why or why not?
  16. sistrmoon

    Why did you come to allnurses? What made you stay?

    I've been a member since 2007 right before I took my NCLEX. I think I found it by searching on nursing topics. There are some things only other nurses will ever understand...that's what keeps me coming back: to vent, to use as a soundboard, to learn, to laugh. There are some great people on here.