diosa78

I did the health informatics program at Univ. Of South Florida. I worked in clinical informatics for two hospital systems. I now work for a well-known health tech company. The health informatics education helped me because I learned other perspectives, not just nursing. I have found that non-clinicians think you know everything about everything - medicine, nursing, pharmacy, radiology, lab, blood bank, etc., so for me, the health informatics was the best route.

I have found that salaries vary depending on what industry you work in. Hospitals pay less and generally employ more nurse informaticists. Medical device companies and tech companies tend to pay more (starting salaries around 110K). They also tend to employ nurses with the health informatics or biomedical informatics degrees, one being more project focused and the other being more technical focused.

I did my MSHI through the University of South Florida. It is completely on-line, and I had the opportunity to learn a lot from other students in the program that came from different backgrounds (physicians, pharmacists, RTs, etc.).

I would walk away very fast and refuse it based on - 1. It is outside my scope of practice (I am not trained to handle Level 4 biosafety hazards) and 2. I do not have the adequate PPE to do the job thus putting my family and others at risk of me getting the disease and transferring it to someone else. However, if I get the training that those who work for NGOs in Africa and those that work with Level 4 biosafety hazards get than yes. I want a positive pressure suit, a respirator, the proper footwear, the proper gloves, disinfectant sprayed on me when I'm done, and ultraviolet lights. I also want a buddy and a hygiene team coming behind me to clean. That is how it's done in Africa - why aren't we, as a "more developed" nation doing the same. I think the teams in Africa are handling this much better than we are here as far as with healthcare workers. I encourage all of us to research how the Ebola teams put on and take off PPE in Africa as well as how the CDC handles Ebola in biocontainment units and then ask yourself if you have the same safeguards. These patients should be treated in the most appropriate facility - which is a biocontainment unit.

I just read this article and it's obvious the nurses working in Africa have had significant training on how to put on and remove PPE. The Australian nurse describes how it takes 5 minutes to remove PPE after being sprayed down. I don't think this was happening at Texas Presbyterian, but who knows. ‘A teenage girl bled to death over two days': Ebola nurses describe life and death on the frontline | World news | The Guardian

These hospitals are not ready. Again Ebola is a Level 4 Biosafety hazard and those who deal with it have specific training before handling it. Why are government officials denying the virulence of the virus? I will refuse to handle any patient that might even have Ebola because it is out of my scope of practice (I am not an infectious disease or public health nurse trained in Level 4 Biohazards) and I have not been adequately trained and therefore am putting the general public at risk of spreading the disease. However, if I am properly trained and provided with the resources that government and military workers in Level 4 labs are provided, I will care for these patients. Details from the NIH are provided below. How many of our employers provide this?? [h=2]Elements of Training[/h]Formal training in preparation for work in a BSL-4 laboratory should consist of 3 elements: didactic or classroom-style theoretical preparation, one-on-one practical training in the facility, and mentored on-the-job training (Figure). Theoretical training helps laboratory workers develop an understanding of the underpinnings of biocontainment operations and the laboratory systems that support these operations. Hands-on practical training includes a comprehensive orientation to the specific facility in which the person will work to include a complete review and documented understanding of all standard operating procedures; orientation to engineering aspects of the facility; overview of all safety procedures, including alarms and emergency operations; and an introduction to the care and use of a protective suit or glove box. The institutional biosafety officer and building engineer typically assist in providing this orientation, some of which may be augmented by training videos. Figure Framework for maximum containment laboratory training. BSL-4 laboratory orientation training assumes that the person has already mastered all procedures for safe and secure handling of infectious agents at the BSL-2 and ideally BSL-3 levels. This training generally involves individualized orientation within the facility provided by an experienced staff member or dedicated training officer. It may begin while the laboratory is shut down for annual recertification and maintenance or while it is operational. Training would involve use of entrances simply designed to demonstrate how one enters and exits the suite, general orientation on the use of air hoses, working within biologic safety cabinets or glove boxes, storage and record keeping of pathogens, clean-up and decontamination following procedures or spills, solid and liquid waste management, use of autoclaves and other specialized equipment, communications with others inside and outside of the BSL-4 facility, and other general procedures. Finally, the person under consideration is assigned a dedicated mentor and is introduced to working with live pathogens in the BSL-4 laboratory under the mentor’s close supervision. This stage of training is basically open ended; the length of time and number of entries into the facility will vary greatly depending upon the skills of the person and his or her ability to master all procedures necessary for independent work. Final decision of when a person is allowed independent access is subjective and based on an assessment by the mentor and laboratory director; it is usually discussed only after the person has had extensive experience working in the facility. The time required to gain full independent access may also vary depending upon the kind of work that person will be undertaking. For example, persons not likely to be directly handling infectious material, such as safety officers, building engineers, or maintenance staff, may be offered limited independent access sooner than a person who will be handling live pathogens routinely. Partial or limited access may also be granted to a person for independent access only during normal duty hours. Laboratory procedures that involve animals or sharp instruments (e.g., needles, syringes, postmortem procedures) represent the greatest risk and consequently require special training and experience; these procedures should be mastered at lower containment levels before a person is permitted to undertake these activities under BSL-4 conditions. Most standard operating procedures for animal manipulation require that at least 2 persons be present, regardless of their experience level. Some laboratories require a final oral or written examination before granting a person independent access, which may be administered by the safety officer. However, the ultimate decision as to who is allowed independent access to the BSL-4 laboratory is made by the BSL-4 laboratory director. A typical mentor will be an experienced person who has earned full unrestricted access to the laboratory and has the clear confidence of the laboratory director. Although there are no set time or formal educational requirements to become a mentor, mentors should have extensive practical experience working under BSL-4 laboratory conditions. All laboratories should have developed a process for reevaluation of all persons working in the BSL-4 laboratory to ensure that their knowledge and skills remain current. This process may be an annual refresher course or periodic formal or informal review and training and may be augmented by orientation sessions as new equipment is introduced into the facility. Ensuring that senior program staff members are regularly present in the laboratory is important for maintaining consistent safety, security, and scientific standards. Go to: [h=2]Need for Certification of Training[/h]The need to document that a person has completed appropriate training has been discussed extensively. It is evident that a tacit internal certification exists in BSL-4 facilities currently operating and this takes the form of approval to work independently. This certification may be more formally captured in a specific document or may be a checklist signed by the approval authority. A more broadly applicable documentation system could provide evidence of consistency in training, demonstrate recognized capabilities with certain tasks such as for animal handlers, and provide a mechanism to gauge the number of persons working in the field. At present, those working in BSL-4 laboratories in the United States need security clearance and approval to handle select agents, must have completed the extensive training program described above, must have medical examinations, and must be known by the program director. Each BSL-4 laboratory is, however, unique and every program director should demand that all persons entering their facility be well prepared and knowledgeable of all safety and security procedures required of that facility. Although standardized documentation of training does not formally exist, there would be merit in developing an internationally agreed-upon facility-specific, time-limited document to recognize the specific skills and experiences of a person. Such documentation would have the added benefit of facilitating collaborations and personnel exchanges among BSL-4 laboratories.

My problem with the Ebola issue is that we are told to don contact/droplet PPE and place the patient in a negative pressure room. At least that is how it is where I work. So, we are talking about a level 4 biosafety hazard which is handled in a level 4 lab. According to wiki a Biohazard level 4 is handled as detailed below. How many of us work in a hospital that provides these types of safeguards? Biohazard Level 4: Viruses and bacteria that cause severe to fatal disease in humans, and for which vaccines or other treatments are not available, such as Bolivianand Argentine hemorrhagic fevers, Marburg virus, Ebola virus, hantaviruses, Lassa fever virus, Crimean–Congo hemorrhagic fever, and other hemorrhagic diseases.Variola virus (smallpox) is an agent that is worked with at BSL-4 despite the existence of a vaccine. When dealing with biological hazards at this level the use of apositive pressure personnel suit, with a segregated air supply, is mandatory. The entrance and exit of a Level Four biolab will contain multiple showers, a vacuum room, an ultraviolet light room, autonomous detection system, and other safety precautions designed to destroy all traces of the biohazard. Multiple airlocks are employed and are electronically secured to prevent both doors opening at the same time. All air and water service going to and coming from a Biosafety Level 4 (P4) lab will undergo similar decontamination procedures to eliminate the possibility of an accidental release.

I'm an ED nurse and we pretty much only hire our techs or EMTs/medics/respiratory therapists that we know. It seems to be easier for them to transition to the ED nurse role. Also, it's a risk to hire someone we don't know because alot of people aren't cut out to be ER nurses. I was hired on as an experienced nurse from a different specialty, and honestly I would never want to be a new grad in an ER. Some people are cut out to come straight out of school to work in an ER, but I'm glad that I had other experience. Get your ACLS and PALS. Seek out ED managers and ask to shadow and tell them about your interest in being an ED nurse. Good luck!

I'm pretty much in the same boat. I went to bag a patient 2 days ago with no gloves on and I'm allergic to what the mask is made of. I looked down and my hand was one big hive that went up to my upper arm. The doc yelled for someone else to bag and then told me "You need to take care of that." I have an appointment with an allergist next week but I've tried it all - benadryl, allegra, claritin, zyrtec, vistaril, clobetasol, hydrocortisone and my hands are still a mess. I have non-healing patches from where I've had hives. They've been there for months and I was told I have eczema, but the cracking, bleeding, redness, and itching are driving me crazy. I'm interested to hear what others have to say.

I've had 2 C/S. My OB placed the foley both times in the OR after I had a spinal. I didn't care who saw me, so privacy wasn't an issue. I just wanted baby out.

I do not understand why some nurses are so harsh and uncompassionate. Women get pregnant - it is temporary. They sometimes need temporary accomodations. Nursing is my 2nd career. I worked previously in a male-dominated field and I must say those men were so much more compassionate than what I have seen in my nursing career. Regardless, I must say that my fellow nurses were fabulous when I was pregnant. I had episodes of dizziness and faintness while standing while pregnant. They were so concerned that they wouldn't let me stand and after a work-up it was found that I had SVT. I tried my best to make it through shifts but I couldn't, so I was put on light duty at 34 weeks. Whenever I know a colleague is pregnant and/or suffering from an illness, I try to return all the favors given to me while I was pregnant. It's a matter of watching out for and taking care of our fellow nurses, many of whom we spend more time with than our own families. Go see your ob and see what his/her opinion is about standing/working for so long.

Yes, you run the blood in as fast as possible. I've had more than 1 unit of blood running in with pressure bags at the same time in patients that are bleeding out (AAAs, GI bleeds, ruptured ectopics, traumas, etc.) If the pt is coding or just at the point, it's more important to get some circulating volume and get them more stable than to worry about a reaction.

I find this the most annoying question when I'm working. I don't know, but it just bothers me. "So how do you like nursing?" If you think about it, I don't ask my accountant while he/she is filling out my tax return "So, how do you like accounting?" And I never hear patients ask docs "So how do you like being a gynecologist/neurologist/surgeon?" Go get an oil change ..."so how do you like being a mechanic?" Go to the grocery store... "so how do you like cashiering?" To me, nursing is my job just like all the other careers I just mentioned. It pays my bills, feeds my kids, and lets me enjoy my life. I just wish patients and their families would quit asking because it drives me crazy....ok rant over now :-)

I work in an ER and do not tolerate verbal abuse from anyone - staff, patient, patient's family. He's 18. His mother does not need to be there with him. If she's causing more problems, I would ask her to leave. He might have started to act more appropriate once she left. Just recently, I had a patient's husband scream at me and become verbally abuse. I explained to him and his wife that doctors see patients in order of acuity. I explain that vital signs are stable and I will observe for any changes, etc. When it continues, I excuse myself and then I tell my charge and the house supervisor that a patient and family member are being abusive. I then tell the family member that if they don't calm down and treat staff with respect then they will be asked to leave. I am there for the patient, not the family member and if they are causing more harm, it is my right to ask the family to leave per hospital policy where I work. I have always been supported because abuse is not tolerated where I work. I know it's hard to keep your cool sometimes. It's just something you can learn from for the next time.

I also have a stutter. When I have started new jobs, I will hear people talk about it or make stupid comments. I always make it a point to pull them aside and explain to them why I talk the way I do (I had birth trauma and was not expected to walk, talk, hear, or see). I did therapy but I have damage to my speech area which means it's there and it's not going away. In every single instance, after I have explained to someone, I get an "Oh, I'm so sorry...I didn't realize." The person usually feels terrible, and then they will speak up for me when I am not around if someone starts asking about it. I also work with a physician who stutters. He has done therapy and he has his good days and bad days. Patients love him because he is very down-to-earth, approachable, and kind. Nevertheless, despite the speech issues, we are both successful professionals. Have you seen a neurologist? It's odd that you would speak normally one day and begin to stutter the next. Stutters are developmental or caused by trauma/disease/brain damage.