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travelingrn2001

travelingrn2001 ASN, BSN

ICU
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travelingrn2001 has 23 years experience as a ASN, BSN and specializes in ICU.

travelingrn2001's Latest Activity

  1. travelingrn2001

    Why are so many nurses against unions?

    Unions have the most effect over pay and benefits. Unsafe working conditions fall under AHCA or OSHA. Unsafe patient care falls under TJC or AHCA. Administration encourages the belief that unions are ineffective and expensive regarding things that are beyond their realm. Until recently TJC inspectors pre-scheduled their inspections and were housed and dined at the hospital’s expense. There is no need for a union when there is an attentive administration, unfortunately the attention for the past 20 years has been the quarterly profit report.
  2. travelingrn2001

    Why are so many nurses against unions?

    I think that one of the common reasons nurses are against unions is that hospitals do a very good job painting a picture of how ineffective and expensive a union for nurses has been. Generally, unions do not have any ability to effect working conditions, that is usually done by state law, and government oversight and other agencies like TJC. Unions do have the ability to give the employees a voice when it comes to benefits and pay. When was the last time you actually were aware of what your benefits are (IE, is hospice care paid for, likely yes but not universal) much less had any input in deciding what benefits are available to you? I have not been a strong advocate for unions in the past. I feel that the threat of a union can be much better. The current pandemic is making me reconsider this as my life and the life family has become more at risk. I am beginning to feel that a union will be helpful to create a contract to protect my family from the loss of my income as the workplace becomes increasingly dangerous and businesses are fighting to limit liability for my future damage to my family if I am disabled or unable to earn a living because of my work environment.
  3. travelingrn2001

    Doctors not assessing COVID patients?

    In Broward county Florida, I believe that the standard is that the physician must "see" the patient in order to bill. This is my understanding of the drive to have nurses carry an ipad/camera etc into room for remote exam. I do not understand how this reduces the use of PPE, physical exposure or any of the additional reasons to justify a nurse entering the room instead of a physical visit by a physician. The PPE is used by the person carrying the equipment, exposure to a contagious patient is not minimized and entry/exit by physician is swapped for entry exit by nurse.
  4. travelingrn2001

    Covid and Hospitals: How are things now?

    Ft Lauderdale, FL after simmering around 4-7 cases in hospital since before labor day, cases now consistently over 12, for over a week, with more critical care patients that will remain for weeks.
  5. travelingrn2001

    Temperature checks for Employees

    Does your hospital check temperatures for employees to work? Are they consistent or only sporadic? Some days, only at high volume times one or two people are assigned to check employees' temperature, besides these rare times, people pass through unchecked at my facility.
  6. travelingrn2001

    Conservation of Resources not Lives

    I work in a south Florida hospital and like many others my access to PPE is limited. Administration has created policy/guidelines to limit the number of people requiring PPE by limiting access to high risk areas ie designated COVID units etc. Environmental, nutrition, IT, and even MD's are requesting, at administration's direction and support, that nursing enter into patient rooms to perform their duties such as mop floors, hold devices for zoom interviews and evaluations. I have always felt that nurses are generally not well respected by non-nurse administrators. Now to see that it is encouraged to risk a nurses life with additional non-nursing related visits into room to with the thought process "conserve PPE" makes me feel that we are not part of the team, only a tool.
  7. travelingrn2001

    Condescension from Critical Care Nurses Towards Med-Surg Nurses

    I have seen rapid responses called by floor nurses because the situation was not receiving proper attention from an aloof physician. Patient needing simple lasix order to prevent escalation in intensity of care. I have seen rapid responses called because the nurse was worried and likely not needed but the concern for a patient should never be discouraged. As a critical care nurse my head spins after seeing my fourth patient in a day, where a med/surg nurse often sees over ten patients during their shift. I clearly understand I not a better med/surg, ortho etc nurse than the nurses that regularly staff these areas. Unfortunately an increasing number of nurses begin and spend an entire career in ICU and never learn the challenges of working outside their protected walls.
  8. travelingrn2001

    Interdisciplinary Lack of Respect

    This may be a rage tweet but after three incidents in one week I can't hold it in. A resident interrupted me mid-sentence during my admission interview of a new patient by speaking with the patient without even addressing me. A resident laughed at me because I could did not see any mention of newly placed IABP mentioned in the cxr report to confirm placement and I thought it was in the wrong place and patient had hematuria. It was 6cm low. I was interrupted during a patient care to answer a call on my phone from the dietician from two floors away so I could catch them up on why a patient transferred to ICU two days before. Was the patient vomiting. diarrhea, etc. Rapid response team documentation from day of transfer stated gastric distention, emesis, respiratory distress likely aspiration and diarrhea from likely ileus as complicating condition. I know, I read it, that's how I know what happened. Are you also feeling like your hard work is not respected or appreciated? Sorry for the rant but seems to me like this is becoming more pervasive int he industry.
  9. travelingrn2001

    Travel Nurses - Share your stories

    Just my 2cents. It's been a long time since I have travelled but thought I may add from my experience. I incorrectly assumed that a high completion bonus meant a difficult assignment, wrong. Ask your agency to for the names of nurses that have completed assignments at a facility you are considering, some are very unfriendly to travel nurses, constant floats, assignment changes within the day, etc. I loved the 2 yrs I spent as a travel nurse. Some facilities appreciate your help, some hate you for your expense.
  10. Kind of strange, I just finished my RN to BSN program and not a single hour counted towards my continuing education requirement for my license. I thought this was an interesting side note.
  11. travelingrn2001

    Continuous ST segment monitoring

    Although I understand some of the benefits of continuous ST segment monitoring and QTc, I feel that our facility continues to struggle with alarm fatigue. Until the reliability of these alarms increases so that the alarms do not add to the already high number of false alarms, I feel that these automatic systems should not be implemented.
  12. travelingrn2001

    Discovery of Falsified Documentation

    Thank you for the replies to my situation. I have come to the conclusion that I will not be fired for this incident but it is likely that progressive discipline for other unrelated infractions will lead to my end of tenure at this facility. I am very surprised about the distrust of patients in a hospital. The patient's goal is almost always to get better. It has been said here that raw information is not required for informed consent. What is needed then? If a doctor says suspicious of malignancy, it will worry a patient. Almost every patient in the hospital thinks they might be dying of cancer. All the notes and internal documents related to a patient's stay are discover-able. I have read my policy regarding patient's ability to review chart after searching over thirty minutes to find it. The policy was very different than explained by a director. For all the people that are quoting your policy, have you actually found it to read? how long did it take to find? Was the policy you read the same as your supervisor or person who was responsible for orientation explained it was? For those that have insinuated otherwise, I merely reported the patient/family complaint to my supervisor to investigate. It was my responsibility to report patient concerns regarding care to the appropriate person, that is my facility policy and my accountability.
  13. travelingrn2001

    IV in an artery

    I only have personal experience to add. I once received a patient shortly after cardiac arrest. Sepsis was the original diagnosis. The intensivist placed an emergent femoral central line, blood return was dark and appeared routine. Usual medications and treatment continued (levo, neo, abx, propofol , crystalloids etc) throughout the day. Later in the day when rechecking labs the patient had stabilized more and I noticed the blood in the tubing was pulsatile. Hooked it up to a transducer and obtained an arterial tracing. I called the intensivist, lines changed, femoral arterial line removed, incident report filed. A few days later the patient left ICU and I lost track of the patient. I don't know of any terrible complications but it has made me more alert to a central line placed on a hypotensive, hypoxic patient emergently.
  14. travelingrn2001

    You are NOT allergic to...

    I understand the frustration that you may have when untrained people use technical terms incorrectly. The proper documentation of allergies, who verifies the information and how incorrect information is removed is an important topic in healthcare. How does a nurse document heparin induced thrombocytopenia (HIT)? It is clearly not an allergy since it is IgG mediated, not IgE like a true allergy. If the heparin is not documented as an allergy then the patient's life and limbs are at risk. Give the patients and the professionals who have to fit them into rigid checkboxes a little patience, people may benefit from your understanding.
  15. travelingrn2001

    Discovery of Falsified Documentation

    Recently a patient and family member questioned me what their physician was saying about the case, we reviewed the notes together with the permission of the patient. Both the patient and the family member who intentionally stayed at the patient's side to act as an advocate denied that the physician had been in to the patient's room that day even though there was a complete head to toe assessment with problem list and plan. The patient now stated that since I am aware that there is documentation that they say is fraudulent I am being held accountable by them to report the incident, which after confer with the house supervisor on a weekend I reported to the unit manager. I have been questioned multiple times regarding this incident and the issue continues to be the discussion with the family not the fraudulent documentation of the MD. I feel like my job is in jeopardy now even after a conversation with my manager. Will human resources or any other pathway be helpful in preserving my position. I will be completing my BSN in December and will have more flexibility after completion of my degree to change facilities. Any suggestions will be greatly appreciated.