frankie

Hi ageless and telepathic - frankie here - I work in an out patient infusion center. I have been asked to declot hemodialysis catheters, as they have been being sent to ONE DAY SURGERY - can you believe that - the ED nor inpatient IV team will declot the catheters. I am well versed in the venous side, but I have only flushed the arterial side - never declotted it. So, I know with the correct inservice, competency , etc... It is within my scope of practice, but I wanted input from other RNs who do this daily. thanks a bunch - frankie

Question for RNs - If it is within the scope of nursing practice in your state, do RNs declot hemodialysis catheters (permacaths)? and If yes, where could I find procedure for declotting the arterial side? Many Thanks - frankie

Konni - frankie here - USL- huh! Is that still the party school it used to be? Well into the 80s it was known as "go to party" by college students. Maybe the name change helped. frankie

NRSKarenRN - I guess by now you have read the award settlement. The jury stated their opinion loud and clear. I still find it difficult to understand how a licensed professional would/could do this to patients, just for money. Why not rob a bank or something. frankie

Of course I am proud to be a nurse. If I was not proud of my profession, I would find another one. frankie

never never never nursing has been short staffed for the over 25 years i have been nursing! you guys need to get real. you are people, you get sick. a hangover is not sick. sick is sick. you don't work sick. staffing has absolutely nothing to do with your being sick. if you are sick, you would not care a hoot about the staffing, because you would be sick. frankie

not many of you posting here - what do you think?

Terri, I have a chemistry degree - got that before I realized I had to earn a living wage - so...when I studied in college, physics was not the most difficult course, but I will say it was the most difficult to grasp. I remember making the highest grade in the class on my first college physics test, and I had no clue about the stuff. I could not have taught anyone else how to solve/answer the problem. I ended up with a B+ in that class. I still do not know much about physics. It is a mystery. I think the hardest class was physical chemistry. I absoultly love love love physiology - try WilsonPatho page at : http://www.loyno.edu/~bwilson/ good luck - frankie

Hi Tigger, I am frankie - your questions are interesting - Confidentiality is quite a concern for patients and nurses and hospitals and just about any medical facility. I do not explain confidentiality to patients, that is, unless a question is posed. This is a patient right. A patient should NEVER have to ask for confidentiality. There are limits to confidentiality, in a sense, like reporting suicidal ideation to a physicial, informing a radiology technician of a persons know pregnancy, things like that - but I do not view this as breaking confidentiality. A reasonable individual would know these things are required to be shared on a need to know basis. In caring for a patient, I require the pertinent info R/T care I am delivering. I cannot address the holistic patient if I do not know pertinent facts. It depends on what I am doing - venipuncture probably would not require much info, where as a hospice care plan would be indepth patient and family info. If nursing records and charts are required for legal proceedings, I would have to comply with the law. Same for deposition. Minor rights are not different from any other patient right. Legalities r/e consent, authorization, informed consent, etc...require a legal guardian, however, only pertinent info need be relayed. Everyday ethical delimas are everywhere. The most common are being asked/required to do something you feel is not in the best interest of the patient. It may not be in the worst patient interest, and it may not really harm the patient, but you have to do such and so - usually to not make waves. It becomes a pick your battles carefully. I think most nurses weigh this issue early on in their carrer. The other ethical problem that irks me is physicians who are not OK MDs. Especially when the patient is compromised. This is always a tricky issue. We all work through it. I have left jobs before due to ethical issues, like being told what my charting should say, despite what is really the case. This happens alot in homecare. This is an issue we could all wax on about for a long time; I guess the important thing is I see myself as a patient advocate - always have/always will. frankie

eieiyo, i can sympathize with you. i think we have all been in your shoes at some point. you are correct in asking who is the patient advocate - you are. doesn't this charge nurse have a supervisor? i see this kind of stuff with the elderly crowd too. MDs send a 92 yr old who is contracted, bedbound, confused, tugging at the diaper - for a PICC line !!!!!! he pulled his other out and put it in his diaper. not a good candidate - infection wise. so yeah we called the doc and said no veins - send for port/SVC. hang in there - it almost always passes, but sometimes it gets a little worse, berfore it gets better. pardon the typing - im tired. take care of yourself frankie

The nursing shortage problem will not be solved with importing nurses. The nursing shortage problem will not be solved until nurses are compensated as other professionals are compensated. Why pay a hiring bonus/pay shcool loans for "new" nurses/ import nurses when seasoned, high quality, smart, experienced bedside nurses get a 50 cent raise for the 25 years contributed to patient care? I vote no to foreign nurses.

Cover your unit - Pay nurses more - Pay for retention of nurses - Treat staff as people - Treat staff as professionals - Stop paying hiring bonus - Do not burn your nurses out, especially until they call in sick - Do not make your nurses feel guilty, sometimes nurses get sick - I have been on both sides of management, from staff RN to Director of Cardiac Services - Treat the nurses as you would be treated.