shawng007

actually, it doesnt matter what the end result is, the patient has the right to refuse, and as i said, NO means NO.

i must also add that we must treat the patient, not the monitor. an oxygen sat in the 70's for me or you would definitly make us incoherent. a COPDer is accustomed to low sats and would be coherent. instead of looking at the readout, we should assess the patient, if they are sitting up talking to us and coherent, then we should never do what may harm that patient. if a person is on a heart monitor and the line goes flat, do we automatically start CPR or do we first check and find out the patient is talking to us, TREAT the Patient, not the monitor, is the first rule of thumb. monitors are great tools but only in context of the situation. a patient with a BP of 80/40 may raise concerns, but if we look at their history and find that this is their norm we would not normally do anything about it. we should stop thinking out of textbooks and start thinking.

again, the patient has the right to refuse, implied consent goes out the door when , on arrival, the patient says NO. ethically, morally, professionally this means one thing, when the patient says NO, this means NO. very simple. any judge or lawyer who disagrees with this is in the wrong field. nurses are there to take care of patients, whether we agree with them or not. if someone takes my car after asking me and i said NO, they would be in trouble for theft, period. if an ambulance comes to my door and i am a COPD'er and they put oxygen on me at 6lpm after i said NO, i guarantee they would one, lose their license, two lose the lawsuit. period. implied consent would apply if the patient said nothing, once the patient says no, that's that. the patient is my cutomer, and i am legally bound to respect their wishes, not to say ethically bound.

i am a well respected lpn, and one thing i always do is respect the patient, and/or the family. the fact that the patient did not want the oxygen increased is enough, add to this the family who is obviously close with their family member. for someone to go against patient wishes is wrong, and also illegal(unless it can be undeniably proven the patient is not able to make those decisions) when patient says NO, that means NO, period, end of story. to provide anything against patients wishes can land you in court. if a doctor orders a procedure on a patient and i go to give it and the patient says no, it doesnt get done regardless what the doctor says, if someone else wants to do it fine, let them get sued, i document pt refusal and let it be. i may try to persuade the patient otherwise but i respect their decision. the paramedic(assuming all the facts are correct in this case) was wrong, regardless of protocol you do not have the right to over rule the patient. period. if that were my family i would sue, and i guarantee i would win too.

I was thirty seven when i went to lpn program, and it was the best thing i ever did. you are only as old as you think you are, think young and go for it.

As an LPN at a hospital, primarily Med/Surg, when I started nursing over a year ago(I worked as an aide prior to that) I found that rn's had fewer patients and did less, LPN s got stuck with six patients, and there was very little teamwork because you had rns who had been there since the ice age and thought they were God(still do as a matter of fact), now we do primary and i get five patients (on a rare occasion when staffing is really poor i may get six), an rn covers me, and i get my work done, if i have problems the rn's know i will come to them and that i am capable. people today dont understand teamwork, and so unless you have a good team, it won't work.

i have done much study on gender issues, as i have come across them in my travels. people who are transgendered feel that they are the opposite sex, that they were born with the wrong parts. there have been studies showing that gender roles in mice may be genetically determined, and that neurons in the limbic system of transgender males actually approximate those found in genetic females. these individuals do not want to be the opposite sex, they need to be, and mentally, they are. there should be no discrimination of these people, for they are not in control of this. some may be able to stifle it for a while, but the reality will come about sooner or later. as an instructor, this is part of your teaching, to openly accept and teach this person.

I think this was wrong period no matter how you look at it. What did bother me was the story headline, "male" nurse. This makes all Male nurses look bad, tying males together with the action. It is almost like saying female nurses couldn't do such a thing. I think it is disrespectful of the male nurses out there who are caring, competent people who desire to help people live or at least die comfortably and with dignity.

Hello, I am an LPN in a local hospital, as a float, I work primarily in med/surg, occasionally pediatrics and mental health and physical rehab. The type of nursing depends day to day on which unit and who is working, whether we do primary or team. either way, I get an assignment, usually five pts, and I have an RN to cover me. Usually it's not too bad, unless there are a lot of PICC lines or TLC's, which we cannot access. we also cannot hang blood, although NY allows LPN's to become certified for blood, the hospital does not recognize it. according to written policy we can take telephone orders, but everyone there tells me we can't, so there is some discrepancy there, which i find out because many LPN's dont want the responsibility, and the RN's want to have the control apparently. We pass meds, except IV push and heparin drips, epidurals, and pca's. Other than that, it is usually just a madhouse and the stress level is out of this world. I usually dont even want to go to work, but once i am there and see my patients I wouldn't have it any other way, helping them is the most rewarding thing i could do. :roll

miss jkm, I am a nursing assistant with a local hospital in northern new york. before working as a NA, i worked as a sitter, mainly with elderly confused patients to prevent accidents and to keep them from pulling out catheters, saline locs and other equipment. i know that dealing with dementia is very frustrating and can be very challenging, and it takes a special person with a kind heart and a lot of patience to deal with. i feel also that it can be very rewarding as well. there is much literature on dementia, but experience dealing with patients takes time. maybe if you havent done so already, you could arrange to spend some time there to interact with the residents and get a feel of what is involved. put your heart into it and you can accomplish many things, and the rewards can be great. many people lack understanding of the elderly in general, and more so with dementia. take care and God bless. shawn galloway:roll