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DallasRN

DallasRN

ICU/ER/Med-Surg/Case Management/Manageme
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DallasRN specializes in ICU/ER/Med-Surg/Case Management/Manageme.

RN for 34 years

DallasRN's Latest Activity

  1. DallasRN

    Another Quitter

    Nothing wrong with making decisions that are in the best interest of you and your entire family. Someone else said something about how the working situation looks different to those with kids vs. those that have to kids or other family members to consider. So true. Another thing...if you became sick with this virus and infected your kids and husband they might inadvertently infect someone else before realizing they, too, were infected (food delivery person, grocery person, etc.) and on and on it goes. Also, if any one or two of you ended up in the hospital you would only be putting additional strain on hospital resources. That's kind of a stretch, but it isn't entirely far-fetched. Whatever...your highest priority is yourself, your family. After that, you consider your profession, patients, etc. Take care! Be safe!!
  2. DallasRN

    Refusing Care of a COVID-19 Patient Due to Inappropriate PPE

    I greatly resent these types of comments. I'm one of the oldest nurses here. Me and several of my "older nurse" friends have volunteered for the Texas Disaster Volunteer Registry. I received notification yesterday of a potential assignment in South Texas needing staffing for a 30+ bed Covid-19 med surg unit. I'm not accepting that assignment due to the distance; however, an "older" friend of mine has accepted. I can assure you if my services are requested closer to home, I will go. And like the other poster said, we older nurses have experience it's going to take some of you many years to get. When I was a younger nurse, I relied on the older nurses for information, guidance, wisdom. Be careful with your ageist comments. It's not a good look.
  3. DallasRN

    Refusing Care of a COVID-19 Patient Due to Inappropriate PPE

    Amen! Personally, I appreciate a provider - nurse, doctor, RT, PT - with a pleasant and courteous bedside manner, but I rely on them for their clinical expertise and efficiency. If I want a back rub, I have family and friends to perform that activity. On the other hand, some people, and especially older people, do appreciate a back rub or having someone spend a few minutes talking with them, holding their hand. It's individual and the "best" nurse will do what she/he does best...assess and prioritize the needs of the patient and perform accordingly.
  4. What don't you get? (admit it is early, just now having coffee so maybe I'm confused?)
  5. DallasRN

    Refusing Care of a COVID-19 Patient Due to Inappropriate PPE

    My comment has little to do with title of this thread but I want to say one thing. I am sick to my core of hearing/seeing these mega-rich stars, politicians, and others on TV - those living in their 15,000 SF homes (or more) with their personal swimming pools, tennis courts, 9-hole golf courses, etc, etc, etc - parroting this "we're all in this together" thing. I sometimes feel like screaming at the TV - No! Until you are living in your 1000 SF apartment or wondering how you're going to protect yourself and your own family members - your own children and elders - because you are having to go off to work without appropriate PPE (talking about all doctors, nurses, first providers)...knowing every patient you encounter could be the one that ultimately leads to your demise...No. Sorry. We're not "all in this together." You, Mr and Ms mega-rich, living in the safety of your compounds with nannies and manicured grounds on which to entertain your children, have no idea what the average person - and especially the healthcare providers - are living through. Thanks for listening to my probably inappropriate rant! PS: Maybe someone needs to start an "inappropriate rant" thread!
  6. Unless you are in one of the states with just 1-2 cases (thus far), I would suspect you would be a welcome volunteer in many different areas. I've got almost 40 years of experience and just recently signed up on some Texas.gov site for nursing volunteers. Frankly, even with my many years of experience, I haven't worked acute care in a long time and would not feel safe doing so. However, I know there are a million and one things I could do to ease the load of the active nurses in the ICU/ED/Med Surg floors...helping to give baths, feed, vitals, provide child care for those on the front lines. If you really want to find something, you can.
  7. DallasRN

    What is it like in your hospital right now?

    This is a terribly stressful time for everyone. c_etude, like many of us, is having her income cut due to the call-offs, probably somewhat worried about her risks and the risks to her friends/family...I know I am. First and foremost, I think we all need to support each other without slinging insults. It seems some people are seeing things quite different in their areas from what we're seeing/ hearing on the news and from what others might be seeing. Look at the sick maps - 1-2 cases in Montana, North Dakota vs the cases in Texas, New York. And finally, she's isn't incorrect - per NIH https://www.nih.gov/news-events/news-releases/new-coronavirus-stable-hours-surfaces
  8. DallasRN

    What is it like in your hospital right now?

    I no longer work in a hospital and in fact, my little clinic has been closed entirely. However, if I WAS a hospital nurse and was handed that kind of BS, I'd write letters to the Surgeon General, Anthony Fauci, the President and Vice-President, the Govenor of your State, your State Board of Nursing, ANA. And anyone else I could think of. Get everyone possible to sign off on the letters. Mail copies to hospital admin and the corporate entities. I understand the need to safe-guard/ration for the potential influx of positives, but to prevent you from wearing your own mask? So often I'm so happy I'm no longer in the hospital environment!
  9. And they might say you ask too may questions because they don't know the answers. Moving on, thought about this after my first reply. When I first started nursing, several of us carried small binders in our pockets with information pertinent to us. For example, things needed to set-up for certain procedures, certain lab values...all sorts of things. I updated, adding and deleting, over the years. Carried it with me for years, too. Like my "security blanket". Not long back, I came across that little well-worn binder. It brought back warm memories. It was like this one on Amason: https://www.amazon.com/All-Pro-Software-Small-Binder-inches/dp/B009RTWNN2?ref_=fsclp_pl_dp_6
  10. DallasRN

    Shoulds I Consider Transferring?

    I disagree with the comment about staying and giving the hostility and gossip time to die down. You mentioned your self-confidence. If you stay, it's going to take a beating and it might take a very long time to get it back. Also, working under that type of stress will make you more likely to make a mistake. Those two things, combined or individually, might hamper your long term goals more than not having an ICU experience. I want to add...for years, I worked ICU/ER/Trauma in some top-notch centers in several states. Great experience. However, the very best experience and the toughest job was working a couple of years on med-surg floors (surgical and tele). Incredible what I learned in those 2-3 years even after many years in specialty areas. I personally think jobs on pedi floors/pedi ICU's will definitely assist in meeting your LTG's. Take care.
  11. I love this response (as well as others) because many years ago, I felt the same...adjusting slower than some of my peers. We all have varying degrees of confidence, we learn differently, we adjust differently. I would much rather you ask questions for the safety of your patients and your own rather than NOT questioning things. Another thing - maybe the person that said that was just making an off-hand comment that may have had no negative connotations at all. You, due to a bit of insecurity as a new nurse, took it differently. And for what it's worth, I've been around in nursing longer than many have been on earth and I still run things by other nurses occasionally...things I think I know the answer to but not 100% certain.
  12. Perhaps you (and your hands) might be more suited to an office job - insurance/case management/workers comp, health coaching. I loved telephonic health coaching! You can use all your nursing knowledge/expertise in those areas while eliminating patient care and constant need to scrub. Best of luck to you.
  13. DallasRN

    Need Your Advice ASAP

    Hello, All. I started to post this in Ambulatory Care/Clinic forum but seems there is very little traffic there and I need advice quickly - and especially from experienced/seasoned nurses. And if any RN, JD's want to chime in - please do! I work part time (15-18 hours/week) in a clinic (of sorts) with one other RN. No physician, no physician oversight, no policies. Clients schedule appointments and we stay busy. It's a 501-c for seniors. Essentially, all we do is ear cleaning (warm water flush), toenail trims/files, and low cost lab work. We do not require physician order to draw labs. We also do the usual b/p checks, FSBS's. Now for my concern: Aside from continuously making my thoughts known on needing a physician medical advisor to at least be available for questions/review policies we might write, I have issues with blood draws especially. I consider it to be an invasive procedure. When we get results back from lab, the clerk mails them to the client and nurse doesn't always see them. I'm of the very strong opinion these results need to come to the nurse for review and if labs are abnormal, the nurse needs to contact the client and review/recommend client discuss with their PCP, make referral to a free clinic, etc. Obviously, nurse can't dx. However, if liver enzymes are elevated, I might discuss potential causes (alcohol intake), determine if client using acetaminophen excessively, etc., and again, recommend f/u with PCP. This contact/discussion needs to be documented in client chart. After 38 years of nursing, I can make fairly decent judgement calls. Again, aside from the fact I constantly worry about my license, I also feel like I have an obligation to the clients. Please, please, please send your advice ASAP. I have a meeting Tuesday and as you might guess, I've met huge resistance. Then, too, maybe I'm wrong. Tell me that, too. Thanks!!
  14. DallasRN

    Dry, Cracked Hands

    Well, it's been a few years since I've had to wash my hands as often as hospital based nurses, but years back while working in a trauma ICU, most of us started using Neutrogena Norwegian Formula® Hand Cream. I still use it. When first applying, it feels almost a little tacky on your hands but after a few minutes it seems to soak in and form a bit of a barrier. And just a dab will do the trick when used on a regular basis. Also, it comes in a fragrance free formula. And some unsolicited advice from an oldie-goldie...aside from raw, red, cracked hands, keep your hands moisturized 24/7. After so many years of washing and NOT moisturizing, my hands are my oldest looking body part.
  15. DallasRN

    A few questions

    I can tether my chromebook to my phone. I have unlimited data/phone/text/etc. with my carrier. Check on that. Also, I'm not so certain your company is so wonderful based on your pay rates (I'm in a metro area so probably much higher), no mileage, running around here and there. $55 for a SOC? That is low IMO. Look at the time involved in a SOC. Figure out the number of hours a day you spend total - visits, driving, charting, add in gas/wear and tear on vehicle cost - what does your true hourly rate come to? Beyond that.... As for buying your own supplies, I had an "experienced" nurse con me into doing that at one time. Huge expense! Don't get caught up in that. When the company gets the order for home health/wound care, they should be obtaining the supplies. And you should always have basic supplies in your "go box". What if you're in a patients home to check cardiac status and they fall in front of you. You need to be able to provide basic wound care/stop the bleeding, etc. Ask some of the more highly experienced HH nurses for a list of supplies for your "go box". Totally agree with chrisjk. If they are that inflexible they are not homebound and makes me wonder why they are on service. Just like they are going to accept appointment availability at at doctors office, they should accept your availability, too, as long as you're being a bit flexible. However, you will burn yourself out in a hurry if you're having to double back, run around helter-skelter. Nope. Don't do it. I didn't do LVN sup visits, either. Just CNA's. Have your agency look at the policy. Money. Square your shoulders up and march into the office with a friendly but confident smile and tell them you need to talk about the raise previously discussed and you were counting on. I would also mention an increase in the SOC rate. You have great value as an experienced nurse but also now as an experience HH nurse who really seems to enjoy the job and eager to learn more. Good luck!!
  16. DallasRN

    I can’t stop crying over a bad death

    I'm sorry this happened to you. Many years back I had an experience that never left me but in the end, it made me a far better nurse for that exact reason...it never left me. You can't see it right now, but I do. You are the exact type of person that DOES deserve to be a nurse. You are the nurse that many of us would want at our bedside because of what your recent experience taught you. One thing I would suggest...don't let your feelings of guilt get ahead of you. You may find you need a bit of counseling to deal with all that happened and how you've internalized things. I did. You may want to check into your employer's EAP. Cut yourself some well deserved slack.
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