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Critical care, tele, Medical-Surgical
Guide Guide Expert Nurse Retired
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herring_RN specializes in Critical care, tele, Medical-Surgical.

was a candy striper, nursing assistant, LVN, ASN, and finally BSN just before turning 50.

herring_RN's Latest Activity

  1. herring_RN

    Trump's 'religious conscience'

    It has been illegal since 1964 to require a nurse or other worker to participate in an abortion or sterilization procedure.
  2. herring_RN

    Trump's 'religious conscience'

    Trump’s ‘conscience rule’ for health providers blocked by federal judge U.S. District Judge Paul Engelmayer in Manhattan declared the rule unconstitutional in a 147-page decision that said it was “shot through with glaring legal defects.” The rule had been set to go into effect later this month. The judge said the administration’s central justification of a “significant increase” in complaints related to conscience violations “is flatly untrue. This alone makes the agency’s decision to promulgate the rule arbitrary and capricious.”... ... “The refusal of care rule was an unlawful attempt to allow health care providers to openly discriminate and refuse to provide necessary health care to patients based on providers’ ‘religious beliefs or moral objections,’ ” New York Attorney General Letitia James, who led the groups, said in a statement Wednesday. Many physician and health advocacy groups contended that the rule would have disproportionately harmed certain groups of patients, including LGBTQ patients... ... Proposed by department’s Office of Civil Rights more than a year ago, the rule was designed to protect “conscience rights” of health-care providers by boosting enforcement of at least two dozen laws already on the books that allow doctors, nurses, technicians and other providers to opt out of procedures such as abortions or sex-reassignment procedures to which they object. https://www.washingtonpost.com/health/trumps-conscience-rule-for-health-providers-voided-by-federal-judge/2019/11/06/39aa9b74-00b1-11ea-9518-1e76abc088b6_story.html
  3. herring_RN

    ICU Nurse Fired For Refusing 3rd Patient

    On vacation in another state I attended a CE class. Sevral nurses from a local Tenet hospital told the class about the night an emergency CABG was to be done on a patient from the ER. A nurse was told she would be assigned the patient whe he came from the OR and a PACU nurse would stay for an hour. The nurse told the charge nurse and shift supervisor who said they had nobody to call in. After arguing she was told to, "Put on your big girl panties and deal with it!" She still refused. She was terminated on the spot.Then two nurses were told they had to accept an unsafe assignment. One of them called the OR and asked for the surgeon, who was scrubbing his hands. After telling him she was to be assigned to two patients already an the fresh post op CABG would be her third AND another RN would be assigned three patients and one was going to Step-Down. That surgeon called the supervisor and ordered her to assigned his patient as 1:1. That nurse cared for two patients, and two for three patients until three critical care registry RNs arrived in less than an hour. The charge nurse already had two patients so the supervisor sat at the monitors until they arrived. When I got back to work I told my colleagues what I posted above. After that if our staffing would be unsafe we notified our Medical Director. From then until I retired I'm almost certain the worst was having the charge nurse take one or two ER admits.
  4. After many years as an LVN, I took the CCRN exam as soon as I had the required hours of experience about two years later. Most of our nurses were also certified. Our badges included "CCRN". I earned my BSN eight years later and that was on my next badge. I don't have "CCRN" on my allnurses info because I was certified from 1988 to 2003. For couple years I was "rare Per Diem" at a different hospital many nurses were also certified. Both hospitals had a plaque like on your link. Our names were on the plaque like in the photo. People who already knew or had asked felt confident knowing their nurse had the knowledge and experience required for certification. Some truly excellent critical care nurses were not certified.
  5. herring_RN

    Everyone is white?

    Living and working in Southern California at the hospital where I worked for decades, the ones where I worked registry, and the one where I was "rare per diem" (Only one weekend shift a month was required) staff has been ethnically and racially diverse. Now nursing is diverse regarding gender too as about half the new grads are men. At the per diem job a nurse answered a colleague's patient's call light and told the assigned nurse, "Your patient asked for "My nurse". I asked him who his nurse is and he said, "The White one." We six RNs and one secretary only then realized only one staff member on the unit, including two physicians, was White. Some days all but one would be white and the "not White" one was the only nurse born in the USA. Once I was the only one not in her or his twenties. Most of our young single nurses belonged to the Sierra Club and hiked together when they had the day off. They told me, "You are not grumpy like some of the older nurses. I think they are jealous of our youth and fitness." I never noticed this, but they did. These young attractive, slender nurses were of different races and from different countries, but had their nursing education at one of three local schools of nursing. Unfortunately that well staffed hospital with supportive management was sold to a for profit chain. Those who had only worked there had a reality shock. Most left for other jobs. (I quit before the new corporation took over) One hospital where I worked registry had a majority of RN staff from the Philippines. It is due to recruitment from there in the early 1980s. They also recommend to their school mates and younger alumni their hospital. In spite of the CEO and BOD not being supportive of safe staffing and sufficient supplies and working equipment they insist our state hospital regulations and Nursing Practice Act are followed so they provide the safe, effective, competent care with compassion all patients deserve. I don't really have advice. Believe me I've experienced and observed racism, but not from fellow nurses. Only once from a surgeon, but not against me. His answer when called to report a patient had less than 30cc urine output while on IVs he said, "Fat Blacks don't pee like normal people." Because he didn't seem to have truly listened I called our Medical Director, told him exactly what was said, and got an order for Lasix. He told me to document in the chart a direct quote. He came in early, asked me to fill out an incident report and he signed it. The medical director thanked my because he had been told about this surgeon before, but no one would document it. That surgeon apologized to our staff at a meeting and told us he apologized to OR and PACU staff too.
  6. The Anita Hill testimony taught me to speak up. Soon after I was orienting a new young attractive nurse to night shift. A physician teasingly laughed as he snapped her bra strap. She giggled as she turned away from him. I said, "That was inappropriate. He looked at me with surprise and said, "I was only teasing. I said, "As professional adults we know not to tease like that." Several nights later I saw him bending over the young attractive unit secretary reading aloud with his finger under the orders he'd just written. Then his hand squeezed her breast. I again said to him, "That was inappropriate." He responded, "W just wanted her to know what I wrote in case she can't read my handwriting". I said, "We all know better. I am filling out an incident report and hope you don't tough anyone like that again." Two weeks later he apologized and thanked my for only reporting one incident. Since then other similar actions happened where I saw it and I told them it was inappropriate. We discussed it at PPC and soon most of us began telling offenders not to do it again.
  7. herring_RN

    How Much was your First RN Paycheck?

    After nine years as an LVN at my hospital I was paid 10.41 an hour, whch was the top of the LVN range. In 1986 when I passed my RN boards I started at the bottom of the RN at 10.55 an hour. Six months later I got a raise.
  8. herring_RN

    Why wouldn't this cost of living hack work for California?

    I know a nurse who works three 12 hour night shifts in a row every week. She lives in Henderson, Nevada, a suburb of Los Vegas. She rents a room in a fellow day shift nurse's house to sleep for two days and somehow drives home after her third night shift. Sometimes she takes a flight instead.
  9. herring_RN

    Ratios Mom Baby Northern California

    I am a retired California nurse who was NOT a maternal-Child nurse. But maybe some information may help you. First from Title 22 regulations hospitals must follow as a condition of licensure: Staffing requirements for California hospitals: At my hospital the Maternal/Child nurses negotiated with their nurse manager and medical director that the ACOG and AWHONN guidelines would be used to add staff when needed. That is how they comply with the requirement to implement a patient classification system. The attached ACOG guidelines may still be in place OR may have been updated. ACOG Staffing Guidelines as of 2012_large print.pdf AWHONN has excellent guidelines too. I hope your unit has a copy. If not a hospital nursing, or medical library should.
  10. herring_RN

    Breaking the Rules to Save a Life

    I think the Illinois legislature did the right thing.
  11. herring_RN

    How do you handle touchy/feely coworkers?

    Our city councilman liked to hug. He would open his arms and give a smile. If the person didn't accept the hug he shook hands. The first time I met him I had attended a city council meeting. Sfter the meeting I shook his hand. After working with him on nursing issues we hugged "hello" and "good bye." He died of cancer a couple years ago. Here he was gugging a neighbor at the farmer's market:
  12. herring_RN

    CPR on a chicken?

    My sister sent me this. I laughed and laughed:
  13. herring_RN

    How do you handle touchy/feely coworkers?

    There are two men I've known more than forty years. One is a respiratory therapist and the other an EMT who often brought us admits from the ER. Both also liked to give shoulder massages. One did come behind me and began to massage, and I told him, "Please don't do that. I don't like it. The other first massaged the RN I was working with. I told him, "Please don't do that to me. I wouldn't like it." We are still friends.
  14. herring_RN

    Patients Say the Darnedest Things Nurses Week Contest

    Years ago I was working nights as an LVN. I answered the call light of a patient who said, "Sorry to wake you up, but I need help to the bathroom." When I told her I was on duty and not asleep she said, "Oh. I thought LVN meant "live in" and you lived in this hospital.
  15. herring_RN

    Nursing management necessary?

    I was blessed to work with nurses who mostly helped and supported each other much like OldDude did "In the night shifts of yore." from 1977 to 2014. The last couple decades I was often charge nurse. Beginning in 2004 charge nurses did not have an assignment. We could help others and did. We could go off the unit to transport patients when need be. We could take over the assignment so nurses could go on a break when there was no break relief nurse. For a couple years we were owned by a corporation that favored manager loyal to the corporation rather than patients. The best supervisors and managers quit or became direct care nurse and charge nurses. Once all top management, from CEO to unit nurse manager went on a weeks "working" conference at a Hawaiian resort. During nine days with no upper management we provided safe, effective, compassionate nursing care. Staffing was excellent because the clerk in the nursing office and staff nurse as temporary supervisor didn't hesitate to keep rather than send home a nurse after discharges or call a registry for sufficient staff. When the ER called with an admit we had enough staff. I don't think that could go on too long because of management responsibilities for hiring, ordering supplies, and personnel matters, BUT we did great with regard to patient care with no top management. After all the only reason a patient is admitted to the hospital is for NURSING CARE. All else can be done as an out patient.
  16. herring_RN

    Constant interruptions

    I know nurses who had that system years ago. It is silly and could be unsafe.