ErraticThinker

Willingness to work is rather irrelevant since it's a legal issue of being held to the standard of your education and license. The hospital wouldn't protect you, nor would they try and you would be opened up to all sorts of liability. Also, the idea that MD's RN's LVNs and CNAs are interchangeable is pretty unrealistic. Physicians deal with a very different philosophy and use much different ways of knowing. Their training is also drastically different. LVNs have a basic skill set that's a little bit higher than a CNA, though both lack any real education in the theory of what nursing is and can only approach problems based off of their previous experience as opposed to using critical thinking and being able to draw off of a theoretical body of knowledge. The labor market is artificially tight for RN's because of profit maximizing techniques used by hospitals (non-profits ironically enough), but working as a CNA isn't really a solution since in most cases you can be considered over qualified, and I'd be wary of an institution that's willing to look the other way and open you up to a heap of liability should there be an event. just saying.

usually if they're paralyzed they're pretty sick already and would already be a 1:1. but most of our post ops are 1:1 intially anyway. CRRT is definitely 1:1. Usually our 2:1 patients are either very stable or ready to be transferred to the floors.

strict contact precautions, if the nurse taking care of that patient goes into another room he/she should use reverse precautions with good hand hygiene. also see what policies your institution has in place for it. it spreads quickly so might need to start checking other patients for it as well. acinetobactor is found everywhere, but there are resistant strains of it that are pretty nasty.

The fenway community health center in Boston does a lot of research into the need for awareness of special needs when it comes to the gay community. You can google them, and they actually publish a guide thats pretty widely distributed for healthcare providers discussing special considerations when working with the glbt population. I personally prefer a gay doctor because its easier to discuss things that honestly a straight doctor just wouldn't get. But anyway, definitely look them up and check out their website it might prove useful.

There are a lot of things that are accepted by mainstream society that make little sense, so it's not exactly a valid argument to say that something isn't right simply because a majority of people disapprove for no just cause.

You'd probably be hard pressed to find a study of any quality supporting either claim. anecdotally, i've known male and female strippers who were functional and well adjusted who did find it empowering. Some lost themselves in the music and just liked the attention, while others like the expressiveness of feeling comfortable in their own skin. I think its something thats really difficult for people to understand unless they have been a performer of some kind whether its an actor or dancer. in this case most people can't get their prudish minds past the whole being naked part *shrug* :icon_roll

I'm not going to argue with you there. the lifestyle itself is pretty sketchy, and depending on where you work it can be dangerous. My point was that its possible to work and stay out of the darker aspects of that lifestyle. The problem here becomes societal views and how that shapes each persons perspective on it. You had a little exposure to it and those girls situations were all pretty sad. i've run into it as well, but my point was that it isn't all that way.I knew girls who stripped because they felt empowered and did not feel exploited in any way. and yes, these were pretty well adjusted girls with day jobs. Every job has a wide mix of people doing it for different reasons. and moral often becomes a cover for people attempting to impose religious beliefs. :) The whole take home of what i was trying to say that it's definitely an experience but the OP needs to be careful too. It's difficult not to judge people sometimes on their actions, and i can understand that. what eventually happens is people claim to pity rather judge which is just a more passive way of placing a value judgement. and i'm sorry but I wouldn't quote Dr Phil as an authority on any subject. He may have a PhD in clinical psychology, but he's not licensed to practice anywhere so when he says to seek professional help, I hope he means not from him. but thats a whole other topic.

one of the dancers i worked with was working on his PhD in physics. He told about his research grants, and how dancing gave him extra side money and a good work out. It's pretty easy to write someone off just because of the job they pick, but actually working in that environment definitely taught me that people tend to have pretty amazing stories to tell when you listen whether its another stripper or even the patrons.

I'm a guy and I was a dancer/ go go boy/ whatever you want to call it in college and a shot boy too at some local gay bars. It was awesome money, i had a blast and met some really great people in the process.. some places are pretty sketchy, but I think if you were able to get through nursing school and work as an RN, then you probably have the common sense to be able to steer clear of potential trouble in that kind of environment. I've seen people get swept in, and a few had tried to get me into it the drugs and the umm "questionable" activities. I was there to dance, have some fun, make some money and then go home. I think it takes a special kind of person to be able to do it and stay reasonably well adjusted. I ignored most of the people watching me, and focused on the feeling brought on by the dancing, the music and a good rush from the exercise. To the OP, I'd say if you have fun doing it, keep doing it regardless of how people can judge. They probably don't understand the weird rush from being a performer. Cover your bases, and check your nurse practice act because yeah some do have morality clauses, but technically you're not doing anything illegal. I never really bought into that puritanical florence nightingale thought process that somehow being a nurse means you have to live like a nun.... or a priest in my case.

Sounds more like they're trying to reduce their central line infection rate to improve their numbers. it's a big issue in ICU's, and I think some insurances and medicare are trying to not reimburse for icu stays related to central line infections. we dont place piccs all that often in our icu. we just have 3 and 4 lumen CVL's. if they're going to be going on long term antibiotics then yes, but otherwise it's just easier to have an SC or IJ

yeah that's definitely asking for **** poor morbidity and mortality rates. these patients need pulmonary toileting and they need to walk... a lot. in the step down here, the patients come up from pacu with a-lines and stuff.. but they're 2:1. they stay 2:1 generally for a few days because they need lots of teaching about fluid restrictions and stuff related to the procedure, and they need to get out of bed and walk usually post op day 1. no way can you have a fresh post op as one of four patients and expect them to do well. not even touching the part mentioned about vasoactive meds on the floor haha if they want to relieve pressure on the ICU's, hire more ICU nurses or stop doing so many surgeries. the joint commission would also love to hear about undertrained staff caring for critical patients

the BS gives you some extra theory and education that helps in professional practice. you learn how to look at the research and you get some more pharmacology and sciences but it depends on the program. It doesn't give you any more pay, if anything it gives you more options. It seems like larger hospitals won't hire you without a BsN. Getting a BS would be a good thing in my opinion regardless because it gives you that extra knowledge that helps in practice so if you have the oppurtunity to stick it out for the four years, I would recommend it.

The slow downs are probable more due to the holidays than anything but yeah the economy definitely plays a role. People are afraid to go in for any type of elective surgery that can wait because they don't want to miss work due to recovery times so if its not vital, it has to wait. The community hospitals are the ones being hit hardest i would think. The other issue is that people are losing their jobs, and losing their insurance because of it, so they're really not wanting to go to the hospital unless its absolutely necessary. One thing that always astounds me though is that during holidays and baseball games, the ERs in my area tend to be empty. But once the game ends, or the day after the holiday, everyone is there with aches and pains that have been going on for 6 weeks. And i had never taken an "economy class" but i've taken a course or two dealing with healthcare economics.

pretty sure the joint commission would have a few things to say about that...

I wonder what that CEO's background was. it always cracks me up when non medical types try to determine best practices at the bed side. I would argue that it could be a violation since granted the roommate probably hears this and that, but they shouldn't hear the gritty details that are discussed in rounds or report, and i doubt most patients would want total strangers knowing that. bedside report needs to be filed under "it seemed like a good idea at the time" because in practice it never works out. patients interrupt, they get mad when what the nurse says doesnt exactly match what the physicians say (like time of discharge), and ultimately, I don't feel like censoring myself when i report off. If the patients a pain, and needy and needs to have firm limits set, then I want to be able to say it. I'm all for both nurses going bedside and looking at IV's, dressings and all that so that they're both on the same page, but that should be a quick thing after the nurse has already gotten the history and everything else.