ecnav

the bon delves into the practice of those who's been egregious. could it be that your friend has been a bad actor? you should be fearful. the system is as such that anyone, anytime, anywhere can propose a complaint for any reason against you. welcome to public service. snide remark withheld...

Vent!! - Who's The Boss, Nursing or Management??? Who payes the bills? Management. In the end, someone connected to someone is watching over everyone who's paid to do a service. Nursing is NEVER in charge of anything.

Skip it. This staffing scenerio is a joke. Your gut instinct is correct...

moral relevance - ceteris paribus. when did it become so easy to excuse the misgivings of others as they tread upon us? when the world wasn't so crowded we might of permitted the luxury to excuse, but now... ? thank you for the catalyst gonzo!

if you message me i can send trauma team assignments. this should comprise all the key players in a trauma arrest - charge nurse or record keeper can play bouncer. don't forget to call on security if needed. triage according to competency. administration will likely want you to accept 'new cases' outside of current competencies in the learning/development initiative. all the rest gets routed to level i. coordinate this with that facility as they may expect overflow from failed cases. exciting times! very best to the whole team! :typing

Why care if it's unethical? Wow ... a coworker detects unethical behaviour/claims of another who seeks to gain a professional advantage. We should 'keep our nose out of it'? Why? Report her/hiss ass to the credentialing committee. What's fair is fair. If life is that competetive in your world, scrap it out to the end. Be a survivor.

Keep your license active. You have achieved valuable skills and knowledge. No one can discount this. Search and you will find.

NYS is notoriously slow at renewing. Did you submit evidence of infection control continuing education? Keep calling them. If you're current license is expired ... you'll need to apply for temporary permit while NYS processes you. Persistance! And get a 3 month jump on it next time around. Peace.

I will bet most physicians could very well ... "spike a drug, load a pump, and titrate a gtt, let alone running 20 drugs or more at once to strike an intricate balance that leads to a heart beat with perfusion, a blood pressure, cerebral perfusion, etc." If I had to choose between being stranded on a desert island with a physician or a nurse ... well, what can I say ... I've cornered myself ... LOL. Anyhoo, we are a team and let's not loose sight of our strengths and weaknesses. I just sensed a great deal of self-serving arrogance in your post. I've worked with many 'big-heads' in critical care; they continue to distress me. :bowingpur

In hard core critical care your chemistry/physiology knowledge will be an advantage. Medical & pharmacologic research often employs RNs with baccalaureate level studies in the sciences. If your good at the sciences, consider an advanced practice career... NP, MD, DO, DDS, DVM... rock on!

you have to change. seriously. i know this quick response may **** you off. they -the cna's- know they've got a sucker of an rn/lpn. advise the don that you are about to level the playing field and that pt care/safety is #1 rule. then, start you're next shift in 4 wheel drive! grow an index finger and point, 'you! do this and do it now!' get with the facility supervisor... they should have a vested interest. send someone home early... after their work to show you gots authority... next, send someone home right smack dab in the middle of the dinner hour to show you gots game. now, start parking your car in different spots that are well observed. be ready for reprisals even by management. refresh you're resume and begin job shopping. least common denominator rules... not you.

i agree with michael. i've seen them employed typically after the fact: whenever medical anticoagulation fails... try surgical. preference is obviously, toward less intervention moving toward more, as indicated. individuals present entirely uniquely. finally, we ask of the provider... their experience. i'm a fan of ivc filters.

icu 1:2 is standard. csu is 1:1. ccu is 1:2. intensivist staffing makes all the difference. i would ask: how many md/do intensivists per pt? what is the experience and certification level of nursing staff per pt: bsn, ccrn, msn...? ratio of hospital staff versus agency nursing per pt? (qualify: some agency is advantageous - too much agency indicates ... you know.) is there an md/do available 24/7? how many per pt durring the night shift? ratio of mid-level vs high-level providers... lower is better.and the such. there are so many aspects of icu performance. you can't rely on just one or two such as ... technology and floor space, for example. i'd rather be admitted to a unit flush with content, experienced providers operating a bivwac than a modern, expanded techno space staffed with... people. :typing

have not yet but, i certainly would if i witnessed or knew something, grievous. each of us has an obligation to society - not to management, not to coworkers, not to the legal system but, to the truth. coming to the aide of someone who is being injured or preventing someone from doing the injuring is a basic human instinct. we rely on -need- our intelligence and bravery to overcome the emotional obstacles to truth; presented throughout the social milieu, serving to short-circuit our moral instinct.

Good job. Move on

calcifications is the body's way to 'wall off' a potential problem. not something to get terribly excited about but absolutely get a second opinion from a separate practice that uses a different radiographic imaging system. in other words, new practice and better - if possible - mammogram, 3 months from today. in the meanwhile, educate yourself and network - communicate your concerns among trusted friends and associates.

i feel you. take a time out. i'm about to go see a career counselor myself. i need to understand how i can make this bizarre profession work within my self-concept and expectations. nursing has been like a really bad marriage for me. you stay for the children but, there is a breaking point. find some time for calm reflection. do something unusual... get back in touch with you... river rafting, horse back riding, motorcycles, small airplanes, cliff diving, scuba diving, sailing, boating, nude sun bathing, bungee jumping, sky diving, traveling - thailand?

Translocation? Absolutely. Enteral organisms will travel...

It's not on you. If the pt had acute distress you would have suspended the transfer pending further evaluation. Otherwise, transfer the twitching foot. Did you document your nursing diagnosis and supporting assessment? :heartbeat

She knows what's she's doing. People will resort to most anything to gain an 'edge'. That's nursing culture in a nutshell. She is dominating you. Simple. Anything goes.

ok, you've presented a typical case. atrial flutter. you see it on the ecg... flutter waves, now what? is the pt symptomatic? what's they're level of consciousness? impaired? then intervene per american heart association guidelines. start bls and report to your provider, that's it. forget the 'nursing diagnosis'. it's crap. save a life.

is she under the influence at work? is she endangering anyone - her child - herself - her patients - coworkers? is she in compliance with the governing policies of the facility and state nurse practice act? addiction is serious business too. maybe she is asking for help? you might speak with her - possibly an intervention by concerned coworkers? the cat's already out of the bag if you spoke with management. why would she choose to subject her fetus to abuse? so sad.

Nurses can be scary to work with. The nursing profession - where there are professionals - is an awesome vocation. Helping people in need... what a blessing! Helping 'needy people', well, that's another thing entirely.

Excellent. Must be a good program.

student nurses are not 'legally' responsible. they have no license or permit. students operate under premise that a licensed professional is guiding, assessing, and validating. the clinical instructor is ultimately responsible. if student charting is permitted, the clinical instructor should countersign, otherwise, whatever's being charted isn't valid. this is why i refuse student assignments. yet, i really enjoy working with students - it's a real pleasure. nevertheless, i'm compelled to reject the privilege of working with students for the sake of protecting my license. :typing