jodispamodi

Totally agree, what was the lockout dose on the PCA?

Thats not exactly true, I've done alot of training r/t and your patient should talk to an experienced elder law/estate planning lawyer. Also many people who go past the 100 days either self pay for additional services, or get services through the state. I'm not sure what your role in this is: nurse, aide, family member... BUT if your role is through a facility or agency then your facility/agency HAS to ensure a SAFE discharge plan happens whether she be in the facility or her own home-can't just walk away and say good luck. So if she's a facility patient you need to speak out and raise your concerns, and if she's in her own home you need to let your agency know she's not safe and needs to be evaluated for home safety, which may involve reporting her as an elder at risk to EPS. Once reported they can often bring in additional resources. There are many options, including AFC/SL. But the most important point of this is she cannot be dc'd without a SAFE discharge plan.

Good for you! Sometimes good things come from bad.

when I worked on geri-psych we took patients with dementia all the time, it seemed if someone with a medical dx had a comorbidity of dementia they ended up on our unit. But each geropysch unit has their own criteria about who is appropriate for that unit.

It would be interesting to know how many patients were referred to her by other doctors, and how many patients self-referred, I'm sure some who saw the videos probably considered her as a "down to earth" doctor who was "fun", but ignorance is bliss. Those with even a modicum of knowledge will see her videos and cringe with every fiber of their being.

Find another doctor... Has he had any exposure to ticks? may be worth testing for tick borne diseases

I trained and worked as a Surgical Tech, and very interesting that if the people who were gowned and gloved in the 10 seconds of video I saw were actually involved in the surgical procedure because they violated sterility up down and sideways. The only areas considered sterile when gowned and gloved are the hands up to the elbows, and the gown from the chest down to the (natural) waist, so hands on hips-not sterile, hands on butt-not sterile, hands above head-not sterile... I try to avoid watching this type of stuff as it inflames me.

And it also has to be factored in that patients ard much more acute than they were years ago. These days, and in the span of my career, unless you'rd a self paying plastics patient, you have to be pretty sick to get admitted to a floor

In my time on my current unit I can count on one hand the number of lunch breaks I've gotten.

I agree with Libby, checking her back and neck would have taken at most a couple of minutes, just lifting the shirt and hair, but that also would not have been a thorough check... The original tick was on her leg, why check just the back and neck those are two places ticks would be unlikely to be, as ticks tend to go into hair, behind ears, armpits, under breasts, skin folds, even near genitals, between toes, etc. Also weird the patient didn't remove the tick from her leg herself...but I digress. Perhaps in future a solution could be patients coming in with report of a tick bite have a thorough skin check from office nurse before provider sees them. jmpo

At my facility we wear gloves when giving meds, but one pair as the package is opened into the med cup. OP your hospitals policy is excessive and makes me think that either they have a pending lawsuit from an employee who was exposed to some med (oral chemotherapy???) and/or they were reported to OSHA- this goes beyond a CYA type of thing. (On a side note, it has always amazed me that oral chemotherapies are giving in a sort of cavalier way on med/surg units. When I have to give them I always call pharmacy and ask what precautions if any I should take). And I'm not saying an oral chemotherapy was the issue in your hospitals case, but it is one of the meds that has the potential to cause harm with unintended exposure.

Exactly... and my facilty has required staffing levels BUT I wouldn't call them SAFE staffing levels... BTW, the poster who wrote about nurses making gads of money. I've never broken over the mid-forties/yr as a nurse. I know some make who do make big bucks 80 or 90K/yr... But for what I make AND the amount of work I do, I could probably make just as much working a job that allows me time for lunch and breaks, and doesn't havd the "forced" liability nursing does- but I love being a nurse, and slowly, as I get farther, and farther into my career I realize certain things will never change because money is more important than quality care.

If I had the millions of dollars required to produce, make, and air a commercial? Sure.

I think the terminology I saw was "chronically understaffed hospital" and relates to the CoPs through medicare and medicaid. Just google medicare and chronic understaffing, it should bring links that mention it.

I'm not sure about links, I'll hunt around. What I have seen clearyly with my own two eyes were notices put up at several hospitals in the "legal info" area (where they put required labor notices from the state, etc) saying that if a hospital was "consistently understaffed, that medicare would be reducing payments", and I know as a direct result of this in the past 2.5 years I have gotten cold calls or emails from the HR of hospitals I had applied to years earlier asking me if I was still interested, my current job I got this way, because their medicare payments took a big hit. I seen it in writing and will see if I can find something to send you (I have no idea what the numbers look like as far as deciding short staffed)