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.

So, who is going to be liable if a mother can't afford to have a baby in the nursery and something happens to that baby? When I had my 2nd baby, I was told to send my baby to the nursery if I was tired. I am a nurse at the same hospital I delivered. I got inside information that they liked babies to go to the nursery (even though we do rooming in) because several exhausted mothers dropped their babies onto the floor when she feel asleep breastfeeding. I stayed alone, had a C/S in the early afternoon, had no one stay with me, and I was not mobile at all. I couldn't feel my legs or move around, so how is that type of patient expected to take care of a baby without help. In addition, my baby had apneic spells. I was specifically told by the neonatologist that I was not to keep the baby in my room if I was sleeping, showering, or not able to keep an eye on her. So, I would send her to the nursery where they would observe her apneic spells (which she had there as well). So, what are they going to do? Mom can't afford a nursery stay, but baby may need it as was in my case. Are they going to go to the NICU which, in effect, is even worse for bonding?

I had C/S with both my kids. I breastfed them both. I took Percocet 1-2 tabs q4h with both CS along with Motrin 600mg q6h and weaned myself off of them over about 10 days. Percocet is used in postpartum breastfeeding mothers alot.

I am referring to wages, not total salary. I don't know a single person that gives their total salary when asked how much they make. And looking it as $6.75/hr/patient is just another way to look at $27 an hour when breaking the wage down on a different level. I used to do wage and salary analysis in my previous career and we would break down wages and salaries many different ways to come up with a fair compensation package. Most other companies do tuition reimbursement, health insurance, paid time off, etc. The difference is in the wages. I have a BSN and my husband has a high school education, and he makes significantly more than me. Is that fair? No, but life isn't fair. I am just bringing it up so we have something to think about when we look at nursing wages.

So, I am tired of the student nurses that come through our unit saying "Well, nurses make alot of money." I like to gently explain to them that we don't in the following way: I make $27 an hour. I have 4 or 5 patients with varying acuities (I work in an ER). So, if I have 4 patients, I am making $6.75/hr per patient (with 5 it's $5.40 an hour). I am responsible for assessing, verifying orders, medicating, etc etc. The last time I was in the hospital I asked for an invoice, and if I remember correctly, they charged me around $200/hr for nursing care. (Now this was on a floor, but I am just using it for general comparison). I have to also take into consideration that hospitals have overhead (housekeeping, techs, etc.), but still that mark-up is huge. In my previous career, I was making considerably more money for less responsibility and less stress and the mark-up on the products was around 13%. I know I am comparing apples to oranges, but it's just something else to think about. Most students gasp at this when looking at our wages like this, but it's just something I think we should consider. I sometimes think our wages would be better if they were based on acuity and ratios (for hospital nursing). What do you guys think? Am I looking at this all wrong?

So, I went to a new doctor today based on some excellent reviews I read on him. I glanced at the tag of the young lady that roomed me and I thought it said RN. Then I met the doctor and he explained that he does not use MAs in his office due to their inability to triage, assess, educate, etc. that he sees as a requirement in the office, not just in a hospital. He said that he worked at a practice that used MAs and left because he did not believe they were qualified to work based on the lack of education/knowledge. So he opened his own practice, only hires RNs and feels much more confident and feels his money in well spent. Wow...I was very impressed. Anyone else been or heard of a practice like this one? I'm just so accustomed to only seeing UAPs in the office setting that it shocked me.

I am pregnant with my 2nd and currently working in a busy ER. I plan to breastfeed/pump and return to work when baby is around 8 weeks. I am nervous about not being able to pump (I have only worked about a year in this ER and from other nurses, I have been told that there is not much support to express milk). I would really like to pump until I can get through respiratory season to reduce my baby's chances of getting sick. I know federal law mandates that I get breaks whenever I need to express milk (which I would like to do every 4 hours and I understand that they don't have to pay me for these breaks which I am ok with). Basically, I would need two 15 minute breaks and I would use my lunch time to pump as well. So, any advice on how I should approach my manager to make sure I get these breaks? The last hospital I worked at was very supportive and I was able to pump about every 4 hours, so I am nervous that I am not going to have the same support. Any advice/tips is appreciated.

We have a dedicated security team including a K9 team. They will restraint combative patients with an order. Most of them are ex-military and alot of time the combative ones will calm down just by having them presence. The dogs are a great deterrent too. They are very calm and friendly, but can sense someone that is about to explode and they will cry, whine, and bark whenever we have an unruly patient. The hospital has this team due to the large number of staff being assaulted. Even with them on staff, we still have staff occasionally assaulted, spit on, etc.

Try Capital University. They have a school of nursing and it's just outside of Columbus.

Love, love, love our medics. If they are trained and competent in a skill, they are allowed to do it in our ER - thus they can do EJs, chest tube insertion, and intubate if it becomes necessary. They are a valuable resource. They cannot triage, discharge or do pt education. They are actually allowed to do more skills than us RNs in our ED.

I used to work on a 30 bed trach floor....all trachs all the time :-) Clean technique is used in the home setting and caregivers will use clean technique in the hospital setting as well (it is not reasonable to expect a caregiver to use a new suction catheter every time as you might go through 100+ suction catheters a day...) Nurses should use sterile technique in the hospital setting. If you have a patient with tracheitis that is spewing secretions, it is acceptable to put a yankeur up to the outside of the trach to suction out thick secretions and then use sterile technique with a suction catheter to suction out the rest of the trach.